Monday, January 11, 2010

E for Emergency Room

It started Friday afternoon at work. My head suddenly felt very heavy, and I got dizzy and nauseated. At around 3:30, I really began to think I was going to vomit. My boss came over to work on a project, and I kept thinking, “OHMYGOD! I’m going to vomit right here at my desk!” It was horrible. When he finally left, I went to take a break in the ladies’ room. I thought I’d sit down, rest my eyes, and take some deep breaths, and then I’d be good as new. I had barely locked the stall door when the puking started.

I hate puking. (Really, who doesn’t, right?!?!) Even in my own, immaculately cleaned bathroom, I don’t like curling up to the toilet and sticking my head in the bowl.  I found out that the whole bad experience is made far worse when it takes place in a public bathroom; it’s something I’ve never experienced before (Well, not sober at least; there was one time in a bar when I was in my 20’s and drank too much.) and hope to never experience again. I had to figure out a way to throw up in a public bathroom that didn’t involve sticking my face in, let alone very near, the toilet. This was hard to do considering that I was dizzy. Needless to say, it was messy, and I was glad that the restroom remained empty the whole time I was unwillingly emptying my stomach. When I was finally finished, I started to clean up the toilet and walls of the stall the best I could with toilet paper. I was surprised and pleased that I managed to keep myself clean. The whole restroom smelled like vomit; it was awful, and I felt really bad, but it’s not like I had much of a choice. Even though I cleaned up the best I could, I didn’t bend down to get the walls or the floor, so I hope no one had the unfortunate experience of trying to use that stall later in the afternoon.

I rinsed my mouth out with water, went back to my desk, shut down my computer, popped a piece of peppermint gum, and walked to my boss’ office. As I stepped into the doorway, I said, “I’m heading home a little early today. I don’t know if I ate something bad for lunch or what, but I just threw up in the ladies’ room.” My boss made a face that was mixed with shock, horror, and sympathy, and said, “Okay…no problem.” He had asked earlier if we could meet at quarter to five to discuss some things, I referenced that by saying, “Sorry…we’ll talk Monday?” He cut me off and said, “Yes. Definitely. Don’t worry about it. Just go.” It was only as I was walking away that I realized he had been indulging in an afternoon snack.  OOOPS!  Hope I didn’t ruin that!

As I road the elevator down to the lobby of the building, I texted Music Man: “Heading home. Just puked @ work.” Short, sweet, to the point. About ten minutes later he called me. He asked if I was okay and what had happened, so I told him. He told me to drive very carefully and that he’d see me at home—he was just leaving work for the day.  Once I got home, a headache hit. I took some ibuprofen, and it didn’t work, so I then took a migraine pill, which sadly also didn’t work. By about nine o’clock, I was beyond miserable, so I said goodnight to Music Man and the dogs and headed to bed. As I lay down, I hoped and wished that I would be good as new the next morning.

I woke up Saturday to the very same headache I’d gone to bed with. This was not good. I cursed my head, and my life, and just about everything else as I got out of bed. I spent the majority of the morning on the couch, dozing off and hoping for relief that just wouldn’t come. I took a really hot shower later in the afternoon, hoping that it would help. It didn’t, so I got back into bed and slept for a couple hours. When I woke up, I was still suffering. I cried. It was all I could do.

Finally, at around six o’clock, I asked Music Man to take me to urgent care. I just couldn’t handle this headache on my own any longer. After getting the dogs pottied and settled, we were off. We arrived at the clinic at around 6:30; my wonderful husband made me take a seat while he got me all checked in. The wait seemed to take forever. The nurse finally brought me back into a room, and we started talking about my symptoms: I’ve had the headache for over 24 hours now. Yes, I had vomited. Yes, I still felt nauseated. Yes, I have a history of migraines. No, this wasn’t like any headache I’d ever had before. On a scale of 1-10, 10 being worst, it’s most definitely a 10.

I cried again. I was just in soooooooo much pain and felt so miserable, helpless, and hopeless. The nurse assured me that they would fixe me up and left the room to get the doctor. After having the same discussion with the doctor, followed by a quick exam, she told me they would give me morphine for the pain and an anti-nausea drug. Then, she told me we’d need to go to the local Emergency Room for a CT scan. She stressed that this was a conservative measure, but with headaches as serious as this, they wanted to rule out tumors, aneurysm, or any other kind of brain bleeding. I received a shot of anti nausea medication in my upper arm and a shot of morphine in my right hip. Then, I met music man in the lobby and told him we needed to go to the emergency room for a CT scan.

It didn’t take us long to get to the hospital, which is pretty much right around the corner from our house. The anti nausea med didn’t seem to be working, but thankfully I didn’t throw up in the car on the way. Once again, I took a seat while Music Man got me checked in. A woman came over and put one of those lovely hospital bracelets on me, and we waited for the triage nurse. We eventually met with a triage nurse, and I went through the same conversation as I’d had with the nurse at the urgent care clinic. After putting another bracelet on me (this one indicating that I was allergic to codeine), she put Music Man and me in a quiet, empty, dark family consultation room to wait for the doctor, which was pretty neat not only because they were being so sensitive to the fact that I had an excruciating headache, but also because we weren’t exposed to the rest of the people in the waiting room.

The morphine had started to kick in at this point. It wasn’t making even the slightest dent in the headache pain, but it did make me feel very “out of it.” It seemed like we waited forever in that small dark room. I think I dozed off with my head on Music Man’s shoulder a couple times. I had visions of having to drop my Psychology class, because there was no way I was going to be better by Wednesday, which of course meant my degree would be delayed by half a semester. I wasn’t pleased.

Eventually a nurse came to lead us back to an ER room. I had the headache conversation for the third (or fourth or hundredth—I lost count) time. Despite that second fancy bracelet that was put on my wrist by the triage nurse, I had to tell the nurse that I was allergic to codeine. (I’d also have to tell the doctor this a few times when I finally saw her.)

The nurse gave me one of those stylish hospital gowns to put on and told me I had to undress down to my waist. I handed my clothes to Music Man and put the gown on; he came over to tie it up in the back so that I could try to retain a small amount of dignity, which didn’t much matter since I looked like hell and had dressed like complete white trash (a la People of Walmart)—rockin’ my light gray sweatpants and a bright pink long sleeve t-shirt—in fact I think the gown might have improved my appearance some; it at least gave me a reason to look like hell. In my defense, I was in too much pain to give a shit about how I looked for what I thought was gonna be a quick trip to urgent care. I was just thankful I had remembered to put a bra on, because otherwise I might have looked far too similar to Ms WalMart.

The doctor came in to talk to me. After the conversation that I could do on autopilot at this point, she told me they were going to put in an IV in order to give me some headache medication and saline. She said she wanted to do a CT scan as well. The doctor said CT scans typically only find 90-95% of problems they’re looking for, so if the scan came out clean, they would need to do a spinal tap just to be sure the scan didn’t miss anything. Lovely. I obviously didn’t want them to find anything on the scan, but I didn’t want a spinal tap either. It was not a fun position to be in.

A medical assistant came in to take down all of my insurance information. They don’t take the info before you see a doctor, because they want to make sure doctors treat patients fairly despite the patient’s insurance (or lack thereof) and financial situation, so they wait until after diagnosis has started and treatment plans have been decided on. I thought this was very interesting, but probably a good policy. After I indicated that I was in fact married to Music Man, they quit ignoring him and started involving him in the conversations about my care, which was a good thing, because I got progressively more useless at making decisions and answering questions after they started giving me meds.

It really made me think about people who don’t have the right to get married (like our best friends, “the boys”) and how frustrating these situations must be for them to deal with. Music Man was allowed to check me in when he indicated he was checking his wife in, but after that they pretty much ignored him. Once I told them he was my husband, everything changed. Even in my pain induced daze, I realized this and saw the difference. It made me pretty upset.

A nurse came in to put in the IV and to give me the first round of meds. I was thinking they were going to put in an actual IV, complete with the large hanging bag of saline, but they didn’t. Instead, I got a pick line (not sure if I’m saying/spelling that right), which was just a large needle inserted in the crook of my arm (bend of elbow) with a little tube running out of it. The nurse shot a syringe of saline in to clear the line. Then, she gave me a headache medication, more saline, and finally some Benadryl that was supposed to help with the nausea, I think. (I had told them the previous nausea medication was pretty much worthless.) As each medicine was injected, a warm wave passed over my head, and my face and chest felt “weird.” Within minutes, I felt some sweet relief. The headache wasn’t gone, but it was certainly less painful. Within a few more minutes, I was knocked the fuck out. I barely knew, let alone cared, that I was in any type of pain. They had told me the Benadryl might make me a “little drowsy,” but that was apparently a ginormous understatement.

I don’t now how much time passed, but eventually a nurse came in to tell me they were ready to do the CT scan. She grabbed my bed and started wheeling me out of the room. The meds had me off my rocker messed up at this point. I stared at my feet, which were sticking up in front of me, and followed them through the hallways. I couldn’t decide if I wanted to throw up or not. I didn’t really like that my body was moving without any work on my part; I felt too disconnected, which made me feel sick. It was kinda like in the movies when there’s a tracking shot and you’re seeing the scene through the eyes of a child, or from the point of view of the character except I was seeing everything through the frame of my feet. I kept thinking that it was weird that I had my shoes on when I was basically naked from the waist up—the barely there, and not in a sexy way, hospital gown the only thing standing between my nakedness and the viewing public. It was like I wasn’t in my body, and I kept thinking, “Wow! This chick needs to shave her legs. How gross! I can’t believe she’s not embarrassed for people to see her like that.” Then I realized the chick was me, and despite what seemed to be large amounts of effort, I couldn’t reach down to pull my pant legs down to cover my embarrassing stubble.

The nurse left me in the CT room, telling me the tech would be with me in a minute. I didn’t know what she was talking about, nor did I really care. I was so out of it, and I was really just getting pissed that, instead of letting me stay passed out, people kept annoying me with their stupid questions and talking. My eyelids were too heavy for me to try to keep my eyes open or pay attention in any way, and yet these people were acting as though I was totally lucid. I was frustrated, and at the same time, I didn’t give a damn.

The tech came in, lowered the bars on one side of the bed, and told me to move over to the CT scan table. I nearly laughed when I realized that she seriously thought I was going to be able to move myself anywhere. Somehow I managed it, but I’m glad there wasn’t any way for me to see it happen, because I know it was far less than graceful. I felt, and I’m sure looked, like some large sea creature rolling itself up on a rock.

The tech told me to lay flat on my back with my head between the guides. This did not make me happy, because on a good day lying with my head flat—at the same level as the rest of my body—can make me dizzy, and I was already dizzy enough. I had visions of sitting up when the scan was finished and vomiting all over the scan table and the floor.  NOT GOOD! I was told to lie perfectly still, which was absolutely no problem being that I barely had the energy to even open my eyes at that point. The scan only lasted a couple minutes and was pretty uneventful. I felt the table sliding up to the scan area, and then I heard a loud whirring noise for a minute or so. The table moved me back to the starting position, and the tech came in and started talking. I couldn’t really hear what she said, because the foam blocks holding my head in place were right over my ears. I got the impression that I was supposed to sit up and transfer back to the bed, which was just as ungraceful as before.  She wheeled me back to the room; this time I kept my eyes closed the whole time, because I was suddenly feeling almost overwhelmingly nauseated.

When I returned to the room, Music Man was sitting in the same chair in the corner of the room. The tech wheeled the bed next to him, locked the brakes into place, and left. Shortly after, a nurse came in to give me different medicine—this one was a combination of headache and anti nausea all in one and was, by far, the best medication I’d received all night. Again, I got the warm sensation all over my body as medication was injected into the IV line. The nurse asked if I’d like some blankets, and suddenly realizing that I was nearly freezing to death, I accepted her offer. She brought in two blankets that felt as though they’d just come out of a hot dryer—it was heavenly!  I sat there rolling in and out of consciousness until the doctor came in. She said the CT scan looked good; they had found a little bit of fluid in my left sinus, but nothing to be concerned about. I was happy for a moment until the doctor finished her thought with, “So now we need to do the spinal tap to assure that there’s no blood in your spinal fluid, because if there is, that indicates possible bleeding in the brain.” I would have cried if I’d had the energy.

The doctor assured me that the procedure wasn’t too bad, and that the risks were (1) infection because they are going through skin, but they minimize that risk by being super sterile, and (2) a bad reaction that would give me the worst headache of my life and would require them to do a “blood patch” to fix it (apparently the injection site scabs over internally, causing a bit of a “gap” in the spine, in which case they inject some of your own blood to fill that gap). My sister had had the second side effect after her epidural when she had my niece. Even today, nearly four years later, when she talks about it, she nearly breaks down because it was such a horrific experience. I was terrified that this meant that I was assured to have the same experience. Then I realized that I was already having the worst headache of my life, so it probably wouldn’t make a difference. The doctor left the room to have the nurse setup the supplies for the procedure.

The nurse came in and told me I’d need to undress from the waist down now, because the procedure is done really low on the spine. I removed the last of the clothing I was wearing (except for my socks, which didn’t help make me feel any less naked), and handed them to Music Man. The nurse injected yet another different pain medication into the IV and set about getting the tools for the procedure ready. I was wheeled to the opposite side of the room; my bed positioned under two very bright, adjustable overhead lights. Soon, the doctor came back. She had me sign paperwork indicating that the procedure and its risks had been discussed with me, which scared me a bit, but I signed it. I was so out of it that I’d started signing my maiden name, which thankfully begins with the same letter as my married last name, so I just finished by signing with the rest of my married name.  Oops!

The doctor lowered the back of the bed, and she and the nurse instructed me to curl up in the fetal position, sticking my lower back out as far as I could. I was less than thrilled to once again have to lay flat, but at least this time I was on my side. They pushed my shoulders and knees around to help position me. I was thankful that I was pretty out of it at this point, because I felt very exposed. I wasn’t really lucid enough to care, except that Music Man was getting a less than appealing view of my naked ass, which I hoped wouldn’t turn our marriage into a sexless one. (I don’t think it will—he told me later that he was fascinated watching the whole procedure and felt bad that he hadn’t thought to come hold my hand.)

The doctor washed my back with some kind of cleaning solution. Twice. It was very cold. Then, she stuck a paper covering over my back. The covering had a hole in it—this was to protect the surface of the now clean skin from germs and gave her a small opening to work through. She told me I’d feel a slight pinch as she inserted the needle with the numbing medication into my spine. It hurt, but it wasn’t excruciating—it was like any other shot you’d get, except it was in my lower back.

Within a few minutes, she started the procedure, which apparently involved sticking a couple giant needles deep into the spine to harvest the spinal fluid. (Thankfully Music Man refrained from illustrating the size of the needle with his hands until the next day.) She was having trouble getting the fluid to flow. She told me there was only a small little space that the needle had to hit exactly right in order to collect fluid. She instructed the nurse to go get another needle, because she was going to have to “give it another try.” I was not pleased. However, the numbing mediation was working well, so I felt nothing except a little pressure in my back.

When the nurse returned, more numbing medication was injected, and the doctor started over. After a couple minutes, I heard her asking the nurse about other doctors who were available; she told the nurse to go get another doctor to give it a try. Soon after the nurse returned, the doctor triumphantly reported that she “got it!” and that she had apparently just needed to call for someone else in order to make my spine cooperate. Shortly thereafter, an older gentleman peeked his head through the curtain; even though he’d heard that the doctor had gotten it to work, he just wanted to check in.  Nice.  I mean it’s not like I already felt totally on display or anything. He and the doctor joked about how she’d just needed to call someone else to get it to work, and he finally left, which was good because I was getting ready to tell them how not entertaining this all was.

The doctor told me they were collecting a couple samples of the fluid, because the first one was too cloudy from the blood that had collected as a result of the multiple tries. (Music Man told me the next day that the fluid dripped out very slowly—drop by drop—and that the first vial was very very cloudy, and the next two were as clear as water.) Shortly after, the procedure was done. The doctor told us it would take about an hour for the lab to analyze the samples, and she left the room. The nurse cleaned up my back and covered me again with the blankets. I asked her to raise up the back of the bed, because I didn’t want to lie flat any longer, but she said I had to lie flat and still for a while.  Not wanting to risk the bad reaction to the procedure, I relented, resting my head on my arm to try to raise it up just a bit. I don’t know how much time passed, because I kept dozing off. The nurse had given me yet another dose of medication, and it seemed to be working well. My headache was now down to about a 5 or a 6 instead of a 10.

The doctor came in to tell us that the lab was going to take longer than an hour, because they had received a couple other samples they had to test as well. I had started wanting to go home hours and hours before this, so I wasn’t happy at this news, but it wasn’t like I had much of a say in the matter. She asked if I wanted more headache meds, and I said yes, because I was feeling very nauseated again. She asked if I needed anything else, and I asked if I could sit up in the bed, which she said would be fine as she raised the back of the bed up. I also asked for some water—I had been desperately thirsty for hours now, and they hadn’t allowed me anything to drink. A different nurse came in to give me some headache meds and the anti nausea medication that, of course, totally didn’t work. I was really surprised that I hadn’t thrown up yet, and I realized that feeling like you’re going to throw up is so much worse than actually doing it. Once you actually throw up, it’s at least over, and most of the time you feel a little better.

These new meds made me feel worse than I had in hours. I wished they’d given me the good stuff I’d had earlier—the combination med that knocked the headache down to about a 3 and actually did something about the nausea. I never did get the water I asked for, but I hoped it was coming soon. (It never did.) I apologized profusely to Music Man for at least the tenth time that night for ruining his weekend. He, of course, told me I had nothing to apologize for or to worry about; he just hoped I’d feel better soon. The doctor finally came in to tell us that the spinal fluid was normal, which was very good. She asked how I was feeling, and I told her the nausea was about the worst it had been all night but that the headache had definitely diminished. She asked if I wanted more of the anti nausea med, and I told her I didn’t think it worked. She responded by telling me that it sometimes didn’t work for people. Lovely.

She said she didn’t know exactly why I’d gotten the headache, but she was chalking it up to a bad migraine and recommended that I return to my normal doctor to discuss different migraine treatment options. She said she’d give me a prescription for Percocet, a very strong pain reliever, to help me through the weekend in case the headache got worse again or didn’t go away completely. I was just glad to finally be going home. It was around 1:30 a.m., which meant my “short ugent care visit” had lasted about seven hours.

I got dressed with Music Man’s help and waited for the nurse to arrive with discharge papers and the prescription from the doctor. It seemed to take forever. Thankfully driving home meant going less than half a mile, and we arrived home at 2 a.m. I finally had something to drink, which did nothing good for my nausea, so I went to bed. Music Man stayed up to eat (we hadn’t eaten since lunch Saturday afternoon) and to let the dogs run around and get some energy out.

I woke up Sunday feeling like a pincushion; my hip and the IV site were bruised quite badly, and the site of the spinal tap hurt like a mo-fo. I removed band-aids from where the IV had been, from the location on my back where they’d done the spinal tap, and from my arm and hip where the urgent care clinic had given injections. I also felt relieved—the headache was finally almost gone! I took some ibuprofen for the lingering “phantom” pain, and lazed around the house for the day. My cuddly caregivers by my side, making sure I didn’t do anything to exert myself.

(That's "Wiggly" on the left and "Bug" on the right.)

By the afternoon, the headache was gone, but I was exhausted from the battle with the headache and the night in the ER. I decided to take Monday off of work to rest and relax a bit more to make sure the headache stayed away for good.

I feel tired today, and the site of the spinal tap still hurts like a mo-fo, but I’m glad to say that the headache seems to be completely gone. When I go to the doctor for my physical in a couple months, I will talk to her about switching migraine medications. In the mean time, I hope my health will finally start to turn around.

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  1. Dropping in from SITS!

    You poor thing! What a horrible way to spend your weekend. I'm so glad you are feeling sooo much better though!

  2. What a crappy weekend!
    I'm glad you're feeling better. And man ... what a guy Music Man gets some huge props. :)

    The whole "dignity while naked" thing, yeah, nothing you can do about it but you survived ... congrats!

  3. holy weekend batman!! Music Man sounds like an awesome guy, and dude who poked his head in during the spinal tap..not cool. I'd be less than happy too.

    I'm so glad you're doing better, that's just awful :(

  4. Wow, that's some post, girl! I have so much to comment on now, so bare with me...

    First, I hate puking too; but when my head is in the bowl and I notice its dirty, I will clean it, even if I feel like I'm on death's doorstep. I am *that* OCD.

    Second, I have given birth, and I have had migraines. I can honestly say that in the midst of a brutal migraine, it can be just as bad as labor (labor WITH an epidural, not without, though!).

    Third, look at you, so clear of mind to realize the wrongness of our health care system and its biases even in the midst of your pain. You are stronger than you think!

    OK, I will stop there... but thanks for an entertaining read!

    Confessions From A Working Mom

  5. omgoodness, i hope you are starting to feel better. hang in there!!!!!!!

  6. Wow. If you weren't planning on kids, I'd have said right off that you were expecting. lol.

    I see the illness didn't affect your writing ability! ;)

    I'm glad you aren't sick. Not SICK sick. :) Thanks for visiting my blog and your encouraging instructions about SITS. I appreciate it!



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