Saturday, May 30, 2009

In The Hospital - Again!

Last year at about this same time I was in the hospital due to my heart going into Atrial Fibrulation. This past week was once again a repeat of 2008.

I hope this is not going to turn into an annual event.

Monday was Memorial Day and the end of a 3 day weekend. I had planned to do 3 things. The yard needed mowing, I needed to fix the toilet and finally put the mesh around the chicken coop and make a door for it. I just was out of strength. All I wanted to do was lay in bed, read and sleep. When I made an effort to get up and do one of the projects, my body said, "No. Go lie down."

I woke up at about 8:30 PM and my wife commented that I didn't look well. She got out her stethoscope and listened to my heart. It was beating around 140 beats per minute. No wonder I was tired. A call was made to our family doctor who directed me to go to the nearest emergency room. When a choice was suggested, the doctor said, "The nearest ER." So we hastily got ready to go to Saint Lukes Hospital. It is five minutes away by car.

I spent about 5 hours in the emergency room. An IV was inserted and I was given Cardizem, a drug that slowed my heart rate. Xrays were taken. I was put on a heart monitor. I then waited for minds to decide the next step. At around 2:30 AM I was transported to a room. More Cardizem administered along with Heparin, to prevent blood clotting. I was fitted with a portable monitor that could be read at the nurses station. They seemed to take blood from me every 4 hours. I also had my finger pricked at about the same rate to measure my blood glucose.

Sleep is out of the question in a hospital. The room was hot. The air conditioning was not working properly. Any time I dosed off, I awoke to find a nurse standing over me wanting to know my level of pain. I never had any pain! In fact the only symptom was severe fatigue and the inability to perform routine tasks.

No medicine was ordered until a doctor came to see me. I couldn't even take my own medicine that I had brought with me. I wasn't allowed to eat or drink. Linny and I went out to lunch at around 3 pm on Monday. I didn't get fed again until almost 4 pm on Tuesday. They were afraid the doctor was going to perform some invasive tests.

I asked several times for a box of tissue, but apparently due to cost cutting measures, tissues are scarce. I used my dirty gown as a handkerchief.

A nurse practitioner came to see my at around noon on Tuesday. She questioned and examined me. She asked me about stress in my life. I explained the job could be somewhat stressful and that we just experienced a large layoff. When I told her that I relaxed by playing guitar, that struck a chord with her. What a pun! She plays guitar too and was quick to tell me about a guitar that was recently built for her. We went on for a few minutes discussing the ins and outs of guitars. She said she didn't think any procedure would be scheduled and I could eat.

The doctor came in that evening at around 7 pm. He was a small, swarthy fellow with a pronounced accent. He kept changing his mind about my condition. First he would say, "Well we are going to keep you here on the IV meds until tomorrow and see how you do. I have an echo-cardiogram scheduled in the morning for you." A few minutes later he would say, "What we need to do is run a stress test. Then possibly an angiography." Then he would say, "No-no-no. We may need to do electro cardioversion." I believe he was just thinking aloud.

When he finally left the nurse came in and asked what the doctor said. I explained I was having an echocardiogram in the morning. Depending on the results I was going home or having a stress test. The nurse said that was not what he told her.

Wednesday morning I was up at 6 AM and about a half hour later greeted by a young lady who said, "Transport. Transport." To which I replied, "Well Transport to you." So I was wheeled down the hall, then downstairs to meet Colleen the electrocardiogram lady. This is a mostly non-painful procedure, but it is somewhat unnerving. You can see your heart beating on the screen. You can see the valves open and close. You can see colored lights that probably indicate electrical current. But you don't know what any of this means and Colleen sure ain't telling.

After about 15 minutes I was finished and set out in the hall to await Ms. Transport to retreive me. I could overhear the phone conversation coming from the echocardiogram office. Colleen was telling someone I was about 40 or 50%. But I don't know what that meant. Ms. Transport finally collected me and wheeled me back to my room just in time for a clear liquid breakfast of chicken broth, orange and apple juice and jello.

The doctor came in at around 2 pm and asked if I could walk on a treadmill. I said sure. Ten minutes later an orderly came and took me to the nuclear medicine room. This is a large room with a couple of big cannisters to slip folks in and out of. There are intimidating warning signs posted all over the hall regarding the radioactive nuclear material and to keep out if you are pregnant. A nice young fellow that had nothing to say came out and gave me a couple of injections in my arm. I asked if this was radiopague dye. He said it was something to that effect, but didn't go into detail. Patients are far to ignorant to understand anything. I had to wait 15 minutes and then walked over to the cannister. After situating me just so, I slid me into the easy-bake-oven. I lay there for a long time while a couple of large metal boxes slowly moved around me. I fell asleep. I then was pulled out and put back in the wheel chair to await the transport orderly.

Next I went to the stress test department. The orderly forgot to bring my chart and my portible EKG monitor. So we had to wait for him to retreive those items. I was then asked what I knew about a stress test. Not much I replied. I knew you started walking on a treadmill and built up speed. I was fitted with more electric leads. The nurse/tech was very informative. I had to get up to 138 beats per minute and hold that for a few seconds. If I didn't the test was a failure. The doctor then arrived along with about 4 other techs/nurses and the test began. At first I had to be taught to try to stay to the front and take long strides. Things were OK until the mill started revolving faster and the incline was elevated. I wasn't getting out of breath, but my legs were giving out. I had to stop for a second by straddling the sides. I then got back on and made it to 136 beats per minute. The doctor kept yelling, "This is not good. It is a failure." But the nurse kept saying, "He's hit 136 and still going. Can't we inject?" The doctor finally said, "OK. Inject." I had to walk another minute to make sure the new radioactive material went through. After thanking everyone, I went back to the nuclear medicine room and had another go at the cannister. I was more alert and didn't fall asleep this time. An outpatient had done this just prior to me. He asked when the doctor would read his results and get in touch with him. The tech said it would be a few days. After he left I asked the tech when the doctor would read my results. She said as soon as I email him and that she was going to do that immediately. I was left out in the hall with my chart next to me. Should I read it? Should I not read it? I read it. It was boring and didn't say anything I didn't know already. The nurses notes were illegible. At least the doctors were typed from dication.

I was back in my room within 20 minutes. No one told me, but I was certain I passed the stress test. Some poor fellow sitting next to me did not. He was being talked down to by his wife and the doctor was scheduling an angiogram. I figure I would of heard a similar story if I didn't pass.

Although I passed those tests, I was still in atrial fibrulation. However my heart rate was down to 70 beats per minute instead of 140. I was stuck in the hospital for another night.

That morning after a visit by the dietician and letting her know I was on a diabetic diet, I was once again provided with a clear liquid breakfast. I was somewhat upset. Wednesday I only got breakfast and dinner and was looking forward to something more substantial than chicken broth. I had an IV placed in my arm on Monday night. The site had become infiltrated and blood leaked out on my arm. The nurse was able to save the IV, but didn't clean my arm up. It was just taped over. No food = bad mood. So I mentioned I was being neglected because I had been so quiet and complient, but I wanted a solid breakfast and I wanted someone to clean up this IV site. The nurse hedged about the IV and said, "We run the risk of pulling it out." I said, "Fine, me wife will take care of it if you can't, but I trust your professionalism enough to beleive you will do a fine job. In the meantime, this blood is escoriating my skin and breeding infection."

I guess hospital staff at this facility are not used to being treated like folks are treated in other industries. This nurse clammed up and didn't speak to me much the rest of the day.

My doctor came in before noon and told me the stress test revealed no heart disease. He was thinking about sending me home. He asked if I could administer shots to myself. I said no worries, my wife is a nurse. The nurses were not told that I could possibly go home.

So my wife visited and went on to her mother's house since I was going to be here for another night. At around 6 pm I was then told Dr. Banks would be in to see me. I asked if this was David Banks? The nurse did not know. Sure enough it was David Banks who formerly was in the group of my family doctors. I introduced myself. He asked if I wanted to go home. He inquired, "Has anyone discussed options with you?" I didn't know I had options. We could send you home with some anticoagulation meds and a shot you would receive every 12 hours. You will need to come to the coumiden clinic and see your cardiologist as soon as possible. Or you could stay here (and rack up a larger bill). I told him I would like to leave.

Shortly after that, the cardiologist came in and pretty much told me the same news only he would be drawing up the discharge papers.

I called my wife and told her to come up to pick my up. However we had to wait for around 3 hours. A different nurse came in to sign me out. Apparently I had pissed my nurse of the day off sufficiently by mentioning my wife could do her job, she was afraid of a confrontation with my wife. So the monitor was removed and the IV was untaped and removed. A bandage was put upon it. The nurse said, "Oh I have to get some more forms. I'll be right back." She apparently forgot I have been on coumiden and heparin for the past 3 day. Linny looked at the floor at the puddle of blood that was collecting at my feet and all over my pants. She gave me a wash cloth and held it on my arm real tightly. I then held my forearm up and applied pressure to the wash cloth.

The nurse attempted to inject some humor into a bad situation by saying, "Oh I see your donating blood." We were not amused. After about 5 minutes the bleeding subsided, but a pressure dressing was applied. This should have been done initially.

After signing the discharge forms, I asked if I could have a garbage bag or something plastic to not get blood on my car seat. The nurse said sure and wandered off. We waited and waited. I poked my head out the door and the nurse was looking in on other patients. I am still in atrial fibrulation. The blood on the floor would be cleaned by housekeeping. I was no longer her problem.

I left.