Tuesday, January 28, 2014

ER "trip report"...

So, as I already said on FB and via emails, yesterday morning  I hobbled off to work.  People asked why I’d come in and honestly, my only response was, “well, I come in if I have a headache--this is just pain somewhere else. I’m here because that’s what I do on Monday mornings -- come here!!”  It was strongly suggested I go to the doctor before any powers that be decided to =send= me.  There’s a clinic associated with Columbia Presbyterian a half block away on 51st St, but they couldn’t see me until the next day, so I got in a cab and went over to St. Luke’s-Roosevelt Hospital near Columbus Circle.

I filled out a little card and told the triage nurse what was going on.  I was really nervous and didn’t want to be there and was trying not to cry.  I had in the back of my head how my temping-friend Cathy went to the doctor for a cough in November and turned out to have stage 4 breast cancer and was dead before Christmas.  I haven’t seen a doctor in ages (haven’t really needed to!) and this was the first I’ve had to be in the ER for myself in almost 19 years.  I was considerably nervous and my blood pressure showed it, but she didn’t say anything and later when they took it again, it was well within normal.   She asked me how bad the pain was and I said, “what, on a scale of 1-10?” Yes. “14.”  She started to put her hands on the computer keyboard to enter my response, then =looked= at me and laughed.  I said, “honestly—It’s way off the charts of any other pain I’ve felt before” and was trying not to cry.  She nodded, said they’d fix me up and gave me some papers and my wristbands and told me to follow the yellow line on the floor to another nurse’s station. I said, “wait—don’t you need my insurance card??”  “No, not yet.”  (Me… damn!!  My memory of ERs is that this is the first thing they usually want!)  So I stood up and this was the only time of the entire day that I thought, “I can barely walk…why don’t they put me in a wheelchair?!” but I hobbled off.  (And when I say that, I mean I was really limping and sort of lurching to the left…)

I got almost all the way there and had to stop and lean against a desk—several times throughout the day the pain was blinding-and-making-me-dizzy-bad (an episode of this while I was still at work is what made me decide that perhaps everyone else was right and maybe I =ought= see a dr.) and a nice man in scrubs saw me and had me sit and took my papers to the nurse I was to give them to, and then they put me in a room.  I have to say right up front, everyone I encountered yesterday was really =nice= and friendly. Or at least they acted that way in front of me.

I sat there, and then decided that lying down was preferable (there was no comfortable position), and then a young woman came in.  She introduced herself and told me she was a 4th year medical student.  She asked me a bunch of questions and I told her about the grapefruit-sized ovarian cyst I had in 1994 and that I thought I’d pulled a groin muscle while gardening in 2009, but had never seen anyone for it—just laid low for a couple of days, and those were the only things I had ever felt comparable pain to.  She had me walk for her and I showed her what I could do (hobble) and couldn’t do (turn around or walk backwards), and she went off to tell her attending dr. all this.  I lay there a bit, then pulled out my iPod to play Bejeweled butterflies to try to distract myself.  It was only then that someone came for my insurance info.  (Which at this point was on the other side of the room, LOL, so I had to get up and get it…)

After a bit, the 4th year came back, looking a tiny bit embarrassed and told me that she’d forgotten to actually =look= at the site of the pain or otherwise physically look at me.  I laughed and said, “Oops!”  Some of my memory of yesterday is a skootch fuzzy, but at some point she told me I have a great sense of humour and it might have been this point.  Shortly after, Nurse “K” came in to help me get out of my pants and top and get into a gown and to take all my vitals, and the doctor came in and I told him everything all over again and tried to explain the pain, that it was mostly in the front and sometimes in the back and when I first lay down on the gurney, it felt like someone had driven a lance through me. He nodded, examined me, asked me more questions, and told me about the various tests they were going to do and all the things it =could= be.  He said they were going to give me a Percocet and a Tylenol and first they were going to do a sonogram.  (Somewhere along in here, I decided I better let my family know, so called them, and then posted on FB.)

So they wheeled me to another room to do a sonogram, and the doctor and the 4th year came in.  I had a little trouble getting my feet in the stirrups (they wanted to view my ovaries from the inside as well as from the outside), because it hurt SO much to move my leg to the side like that and the doctor said, "They didn’t give you the pain meds yet?"  “Um, no… “  He frowned, but we went ahead with the exam. I couldn’t see the screen, but he was pointing things out to the 4th year, and was frankly sort of jabbing the sonogram’s probe sideways to my left side.  I winced and inhaled sharply, especially when I thought he was trying to reach my hip bones with it (and was trying to quell thoughts that I had a cyst or cancer or something awful), and he apologized if it was hurting me, but they were trying to get a good look.  I opened my mouth to start to say, “Well, things aren’t supposed to be going SIDEWAYS in there…”  and then I thought, “Omg, I can’t say that to him!!!” so said, “Mmm-hmm….” and started laughing.  I put my hands over my face and was trying not to shake with laughter because by this point it all seemed so completely absurd.  (I can’t help but wonder what they went home and told their loved ones about the weird lady who was shaking with laughter and pain during a vaginal ultrasound…)

They finished and left and the nurse came back in to draw some blood and put in an iv line (the dr. had changed his mind about the Percocet/Tylenol combo and wanted to give me some morphine).  I sort of lost my laughter at this point—fear of needles, etc.  I vaguely remember saying that I probably would have worn plain socks instead of my kissing polar bear socks if I’d thought it was the only thing of mine that I’d end up keeping on all day!!  She was swabbing my arm and I was trying to remain chatty but was aware that I wasn’t actually saying anything and I vaguely remember thinking I should probably say that I felt like I was going to hyperventilate, but then I was really =hot=, and said so.  She said, “oh, that’s the vaso-vago—that often happens when you pass out.”  That didn’t really register as I was trying to get my hair off my sweaty neck, and then I had a, “wait…I wasn’t lying down…” moment and what she said registered and I said, “Wait—what?!?  I passed out?!?!”  I started laughing and apologized.  She said not to worry—she had caught me and laid me back and finished the blood draw and I was only out a moment or two, and then I had snored a couple of times.  I started really laughing at that point and she said, “See? I knew you’d be ok…”

She took me back to my little ER room, and they wanted to send me up to the official sonogram dept. as the ER doctor wasn’t getting great views of anything, apparently.  And I had to start drinking this yucky stuff that tasted like plastic (o-something), because if the sonogram didn’t show anything, they wanted to do a catscan, and this stuff would help various parts of my body glow on a catscan. (I =really= wanted to see that, but they didn’t share the pix with me…dammit—I think if they’re going to make my body parts glow then I should get to see it…)  She gave me the morphine iv and FINALLY the pain stopped for a bit.  (Honestly? I don’t understand any fuss anyone makes about this drug…Yes, it stopped the pain and that was wonderful, but it only lasts about an hour and a half!!!  I was sort of wanting whatever they put in darts to tranquilize elephants…)  (also, somewhere along in here, I joked to Nurse K that it was probably useless telling her the catscan (with a cat) joke, as I was sure she and everyone else had heard it.  She chuckled and nodded...)

Anyway, they eventually took me upstairs for the other sonogram.  I wouldn’t want to play poker with the young woman doing it—she had the same look in her eyes as she was viewing everything!!  She did have a mask on, so maybe she doesn’t have as great a poker face as I was thinking at that point, but it sure seemed it!   At one point the machine started making a weird noise and I turned my head to look at it, and she told me not to worry—it was the sound of my blood.  She had to go get her supervisor, as she couldn’t find my left ovary.  (Ah-HAH.  This is why the ER doc was jabbing me sideways like he did—he probably couldn’t find it, either…)  I joked that it was tired of the cold and probably went on vacation without me. (This is when I learned that they just sort of float around in there…) Her supervisor found it and at this point I thought they got a good picture of it. (It was “anterior” and “ant-something else.”)  (No, not “-eater”!!)  When I finally looked today at the copy of the labs report that they let me take, I saw that they never really did get a good, =good= look at it, but they got its size and it didn’t have a cyst.  (The right one actually -does- have a little cyst on it… could have fooled me!!)  (At home I was still amused about this whole situation and imagined my shy, little left ovary wearing a chiffon headscarf, saying, “no…no paparazzi, please!!!”  Again… I suspect this was the pain meds, LOL…)

They took me back down to the ER and as nothing bad showed up on the sonogram, I had to finish drinking this awful stuff for the catscan.   I asked the nurse if she’d put down the side on the gurney so I could go to the bathroom and said, “you know, should this hurt??” (pointing to the iv line).  No, it wasn’t supposed to-- I’d blown the vein in moving and doing the sonogram, so they had to take it out…

Somewhere along in here they gave me more morphine. It might have been before that—my experience with each of the 2 doses was that an hour and a half later, I felt it wear off and suddenly had to pee!!!  (Yes. It is very hard suddenly having to pee when you can’t walk well, but I managed, LOL…)  Then a diff’t nurse (“Nurse E”) came in to replace the IV line.  Damn, that was a significant tourniquet she put on me (SNAP!) and she started tapping all my veins and I was being chatty.  Nervous-chatty.  I warned her that I’d passed out earlier and she said, “I =heard=!!” And proceeded to tell me about some guy she once had who was so nervous that he worked himself into a seizure.  And we continued to chat—she was funny and down to earth and reminded me a bit of my friend Roben, who’s also a nurse.

She didn’t like any veins on that same arm. (“Nurse K used the only good vein over here!!”) So, she tried my right.  She said that my veins were all “short.”  (not enough room in them for iv line—we had a huge discussion about veins at this point…)  I laughed and told her that I’m the shortest of my siblings and my brother teased me when I was little about being short, and I couldn’t WAIT to tell him my veins were short, too!  She got a kick out of that… I said what about these big ones in my hands?  (I’ve had ivs in there before…)  She said the catscan guys don’t like it when you use those.  (ok, whatever…) She thought a vein near my right wrist looked promising, so she put it in and I was looking away (needles, etc.) and she said, “Well, look at that.  Nope, that’s not going to work…” and I looked and saw a huge lump growing (she’d injected some saline to test the line)… Aaaand, Commence freakout.  She said, “no, no, it’s ok, It’s ok!!!  It’s just saline and we take it out and it’s fine!!!”  I calmed down as she went back to the left arm to try to find something there again.

She was tapping away trying to find something, and that’s when the 4th year came back in.  They also wanted to do a dye contrast for the catscan and I had to listen to all the potential perils and sign a consent.  After the first potential issue, I turned to Nurse E on my left side and said, “I was much preferring our vein discussion to all of this stuff she’s telling me.”  After the 2nd potential effect (allergy and anaphylactic shock), I was considerably frightened and said, “we =really= have to do this?!?!? All that yucky stuff I had to drink wasn’t =enough=!?!”  Nurse E assured me they do these every day and not to worry.  Somewhere in all of this while the 4th year was talking and distracting (aka terrifying) me, she got the new line in me and I didn’t even =notice= it happening!   She’s good.  I do have a little bruise where the first one blew and I have a tiny red mark where the 2nd one blew, but I cannot even =find= where she put this 3rd one in me (closer to my hand on my left arm. I am significantly impressed!!!)… I signed the consent and a bit later, Nurse K came back in and I told her that the dye thing sounded really scary, and she told me that in all the time she’d been there, she’d never seen anyone have a reaction and that made me feel sort of better.  (It didn’t occur to me until just now that I have no idea how long she’s been there, LOL!)

I had to wait a bit after drinking the yucky stuff before they could do the catscan and my phone had run out of charge so I couldn’t call anyone, and I was almost out of iPod charge, and I thought, OH, I have my knitting with me, but was afraid that the movement of my hands would dislodge the iv again, so pretty much just lay there and tried to rest and not think about dire things.  I briefly thought about calling someone to see if they wanted to come down and keep me company, but didn’t think I wanted anyone seeing me crying every time I moved and it hurt and besides, no phone charge, LOL.   I think this is the first day in months I’ve gone off in the morning with no music and I lay there wishing I had some to work on memorizing.  They finally wheeled me over to the catscan rooms. BRRR.  After a while, I heard them wheel another guy over to wait, and he said rather loudly, “God DAMN it is cold over here…Fuck!!!”  I couldn’t see him, but said, “I =know=, right?!?!”  He laughed.  When I finally got into the room (I had to wait and wait and wait…) I asked the guy if it was because of the machines that it had to be so cold and he said yes.  Just about the minute I got on the table I had to pee again. Ugh.  Oh, LOL, also, he was helping me get on the table and was reaching for my left hand and I said, “No!!  We have to be careful—I’ve already blown 2 iv lines! If I come back with this one messed up, those nurses are gonna kill me!”  He thought that was very funny.  He was also very nice and was amused when I was asking him something and interrupted myself with, “wait…is that a =fly= on the ceiling?!”  It actually was!!  I have no idea where it came from.  He said, “Did you feel like someone was watching you??” Heh…The actual test didn’t last long at all.  I was thinking it would be really funny if the fly flew down and got in one of the pictures.  I think that was the morphine…So, I was trying to be all still, but was wanting to shiver from the cold and shake from the laughter and was trying not to pee.  Then he put in the dye and it didn’t take long for it to go in and I had no adverse reaction, except it makes you feel warm all over.  (ALL over…I said I feel warm, and he said, “that’s ok—and you might feel like you’re urinating on yourself.” I lay there thinking about how badly I had to go and was worried it was more than the dye’s reaction and then he ran me through the machine once more after that. I said to him, “that’s =it=?!”  He said, “see? You were nervous for absolutely nothing…”  I said, “yeah, that’s usually the way it is, isn’t it…”  Then I told him I =really= needed the bathroom and he opened the door and I did a lurch-sprint and the guy who’d sworn about the cold had just opened the restroom door to go himself, but saw me and let me go first and I thanked him.  “whew…”

They wheeled me back to the ER and then I had to wait and wait for the results, so I sat and watched people come and go and watched the doctor and nurses at their station.  I went to the bathroom again (a longer walk, as they’d put someone else in the other room while I was getting the catscan), and the doctor watched me walk and asked me some more about the pain and sort of frowned and came over and poked at me again.  He went away and I lay there thinking what I =thought= were really deep thoughts but I suspect the pain killers were influencing that.  However, I did think that the most impt. piece of technology, to use the word loosely, in the entire ER is the =wheel=.  Gurneys, wheelchairs, the chairs at the nurse’s station, carts with  bedsheets, carts with other equipment—I saw a portable x-ray machine being wheeled around, and the first sonogram I had was from a little machine on a wheeled cart.  The cleaning guy who I’d seen several times and who was doing his best to make me smile every time he passed had a garbage can with wheels at one point.  That whole place would be VERY different if wheels didn’t exist!!!

Finally the doctor came over to tell me that my catscan showed everything (bowels, uterus, kidneys, lower bits of lungs, heart) was fine, too (I have a tiny bit of diverticulosis, which is the little pouching through which the diverticulitis can happen, so I need to be sure to eat a lot of fiber…), and that it looked like what was wrong is a really strained groin muscle.  I thanked him for everything he did and told him that while I’m really glad that nothing’s seriously wrong with me, it was sort of embarrassing after all those tests to find out it really is a pulled muscle. He said he was glad it wasn’t anything more serious. Nurse E to me when I said this to her, “What?!  Pain is pain—you have nothing to be embarrassed about!”  I said that I had no idea how I was going to get home and she started to tell me where the subway was and I laughed and said, no, I knew that but I was probably going to take a cab.  She gave me my prescriptions and discharge papers and a copy of my labs (figured would be useful), and told me there was a Duane Reade drugstore at the corner.  I said, “Oh, good, I can get a cane.”  She said, “a Cane?!”  And I said, “did you =see= me only barely making it to the bathroom over there?!  I’m =really= not walking very well…”  She understood finally what I meant when I said I had no idea how I could get home and she said, “oh we have lots of those!” and went and got me one.  Oh, it was slow going, but so much nicer and a bit less painful to remain upright using that than lurching to the left and worrying about falling over!!!!!

The pharmacy at the Duane Reade was closed--oh, the poor counter girl…I had sort of “had it” by that point and as I said, “oh the nurse at the hospital said it was 24 hours!!” and just started crying of fatigue, hunger and frustration… she apologized and said the store was 24 hours, but the pharmacy closes at 9.  I apologized for crying and she said her mom recently went through something and she hoped I got home safely and got what I needed.  I had a brief moment of, omg, I’m so not old enough to be compared to your mom! Instead I thanked her and paid for my water and gatorade (I’m supposed to drink a lot today) and as I was leaving, she called, “YOU CAN DO IT!!”  I laughed and said, “Thanks!”  I then hailed a cab and had him drop me at the Walgreen’s up near me, which I thought had a 24 hour pharmacy.  I was right and I got my Rx’s and a sandwich from the deli across the street (had had nothing to eat since 10am when I had 3 slices of bacon and a can of coke—I hadn’t eaten my 2 hard boiled eggs (the rest of my breakfast) and had them with me all day, but they didn’t want me to have them at the ER in case something was wrong and they needed to rush me to surgery. They weren’t enough though, hence the sandwich…) and then I took another cab for the short ride to the apt. (ZOMG, I =know=--3 cabs in one day!! Oy.) and, well… that’s that.