14 Hours in the ER

February 5, 2018: I knew the drill: the arrival of two trucks and four EMT’s who bring in the stretcher. They’d look me over, do what they could and then make the decision. Off to the hospital.

One EMT I remembered from another time because of his tattoos. Both arms from wrist to elbow were completely covered with a solid tattoo. I’d find out later these are sleeve tattoos. Both arms were covered in what looked like a nature scene. Why would such a clean cut nice looking young man do that to himself. It’s funny what oddball details are  remembered while what seems, at the time,  to be a life-threatening emergency.

This was about 11:00pm on a Monday night. I’d awakened from sleep with an asthma attack. After taking two puffs of albuterol, things began to get better. And then they didn’t. Albuterol doses can only be taken four hours apart. And I was suddenly developing strange symptoms I’d never had before. I was unable to stand, felt weak and anxious, couldn’t breathe and could only see outlines of the EMT’s along with black dots in my field of vision. I was about to faint and felt safe once I was on the stretcher.

As soon as I’m in the ambulance a flurry of activity begins including oxygen, IV’s and blood pressure. Tattoo man was worried when he was unable to get a blood pressure on me. He said at check in that he thought I was having a heart attack. But not so.

Each time I have to take the ambulance to the ER I learn more about the health care system. This time I saw more parts of the ER’s inner workings than ever before. I got wheeled around from the regular rooms to triage. I’d never been in triage before and didn’t even know it existed.

It was scary because I didn’t think I was in that bad of shape for triage. The nurse would explain that it’s a section used for short term cases. Like those Saturday night bar fight incidents where patients are cleared and out quickly. Like cleared medically before going to jail. He said it’s used more on weekends. I was there because the ER was packed and they had no other place for me. I would spend several hours in triage.

While I’m stabilizing the nurse noticed pink spots on both of my calves. As we observed the changes and movement of what looks like bruises, the nurse commented that it looked like the sisterhood of the traveling hives. It’s good to have a laugh in the midst of all this.

Later, a nurse or doctor would tell me I had symptoms of anaphylaxis. Right then I had no idea what that was. I’d learn later about the allergy attack, the different symptoms involved and the new vocabulary I’d have to learn.  And of course, the epi-pen.  But that’s another story.

The ER’s hurried pace and the noise felt like a war zone in a third world country. Or a mash unit. The hospital was at full capacity due to the flu season and many of the doctors and nurses were wearing face masks. So, began the usual round of staff who quickly entered and left after completing their small task.

First the nurse, then the resident and then the attending. Each time they asked the same: what’s going on. I got it that they needed to hear the story directly from me to figure out what’s wrong. I tried not to become annoyed with having to repeat the whole scenario over and over.

Once I was stable with the oxygen and IV’s going it was time to wait. About 3:30am the attending returned to say he didn’t feel right sending me home; they’d poured lots of meds into me, he explained, and if this came back after the meds wore off, I’d be back.   Better for me to stay a while. That’s good because how would I manage a ride home at 3:30 in the morning?

He also explained since the hospital was full, they’d move me to what they called a boarding room, ER rooms that were now mini hospital rooms. He explained that I’m an admitted inpatient and they would move me to a real hospital room as soon as one was available.

The nurse from triage moved me to the boarding room which was very small with no amenities; the bathroom was across the hall. My door had a small window so I passed the time watching the steady stream of stretchers pass through.

Police and security guards were everywhere. My nurse stepped out into the hall for a moment. I heard her talking to a policeman about having something thrown at her. At one point there was a line of stretchers outside my door at a full stop waiting to get checked in down the hall. A stretcher with a man surrounded by four police officers was stopped for several minutes outside my door. All this on a Monday night.

Around 6:00am a nurse showed up and told me she was my nurse until 7:00 and was there anything I needed. She gave me permission to eat so I was happy. Then after 7:00 a new round began. New nurse.  New resident. New attending. I told my story to each once again.

Next, it’s the hospitalist with their Intern in tow. Hospitalists are doctors who cover all inpatients until discharge. In the meantime, I ordered breakfast between having ex-rays and a CAT scan. When I asked, why a cat scan, the nurse said they wanted to be sure I didn’t have a blood clot. That’s why I love teaching hospitals. They look at everything. It would take several hours for my blood pressure to get near normal. The pink spots were lessening. I was starting to feel better.

The hospitalist said I was ready for discharge but had to see one more doctor. That began another process. More waiting. Meantime, I saw a pharmacist to discuss my medications. Then I waited. Another doctor and her intern appeared to reaffirm I’m ready to go home.

My niece came to pick me up and was surprised when a police officer instead of a clerk checked her in and sent her to my room. It had been a challenge to tell her when to come so she didn’t show up before all was done and then waste a lot of time sitting around. The best laid plans didn’t work too well. We waited forever for the final paperwork and the nurse to give his instructions. Finally, I was wheeled to the door and into the car.

Each doctor had responded to my off-hand comment about their busyness saying that I should never think I shouldn’t come in if I need to and that they don’t discharge until they’re sure the patient was ready. And that’s why I love teaching hospitals. When the attending said he was keeping me at 3:30am I was glad. Now at 1:00 pm when they said I could go home, I’m also glad.

 

 

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