Chest pain.
I had experienced chest pain at bedtime but decided it was stress induced so took a propanolol and ibuprofen, watched a movie with my husband and then went to bed.
2 am.
Sharp squeezing pain in the area of the Left chest woke me up. I tried to sleep but the discomfort kept sleep from me. After an hour trying to get comfortable, I slipped downstairs, and wriggled around in the easy chair - mulling over what to do next.
It wasn't typical chest pain that you hear patients talk about when they are describing cardiac MI type pain. No shortness of breath. No cold perspiration or nausea. No epigastric or back pain. I did have pain that went down the left arm, though.
Having a history of shoulder injury with arm pain, I could be forgiven for thinking perhaps it came from sleeping awkwardly on that arm.
And then there was the neck pain that went up to my jaw. Hmm. I palpated my neck thinking that perhaps I had done something to that also.
Denial, denial, denial.
Finally at 6 am my husband comes downstairs. Told him he should probably take me to Emergency this am. I must have sounded really calm and nonchalant because the next thing I knew, he was going out the door to sit in the hot tub for a while.
Ok.
So, I get dressed, put on makeup, make the bed and am ready to go just as my husband gets out of the hot tub.
At this point I was thinking to myself...."If this were one of my patients, I would be giving them supreme hell at this point for not calling an ambulance...." I couldn't blame my husband for the lack of action. I didn't give him any indication that this might be an emergency. What would he know about chest pain?
He drives me to the hospital and lets me off at the door.
I kiss him good bye, tell him I will call when discharged and he continues on to work while I go up to the triage desk.
"Sit down over there" the clerk told me as I approached the window. She's busy talking on the phone about that night's statistics. Didn't even look up from the computer screen in front of her. From the last trip in with my girlfriend's mom, I knew how this would play out.
I sat in the chair, obediently waiting. Deja vu.
Serves me right for wandering in at shift change. I should know better.
Finally, 10 minutes later, the clerk crooks her finger at me. I sit down on the chair outside her mouse hole opening in the bullet proof glass and I pass her my information, my care card and my drivers license and tell her I am having chest pain. She's unimpressed.
I walk over to the chairs and sit down. I am the only one - except for a cop sitting with a young man - in the entire waiting area. A security guy ambles past. I'm wondering if he knows CPR.
Five minutes later the Triage nurse calls me over, takes my blood pressure, pulse,temperature and asks a few questions about my chest pain. She's unimpressed.
I guess I don't look like I am in pain, and not wanting to overdo it I tell her I am 6/10.....(here I am thinking it would definitely be a lot worse pain if my leg were hanging half off) She then tells me to move over 2 cubicle spaces and give more information to a second clerk and get my ID/Allergy bracelets.
The clerk insists on putting my girlfriend down as contact person (her name was still in the system from my gall bladder incident a couple years ago) - which, at this point, I can see would probably be a smarter choice, however, my husband would probably object. I tell her my husband would expect to be listed as my primary contact. She says - so I will put your friend down as first contact - to which I reply - no, you had better put my husband as contact person.
At this point I am wondering if I am speaking in an unintelligible language.... because no one seems to be hearing me.
Having sorted out who would be making my end-of-life choices for me, the nurse tells me to go through the double doors. There are two sets - one to the left and one to the right. She doesn't indicate which one, and since she has already departed and no one is at the windows - I enter through the set that swings open and stand there waiting for her.
And wait.
And wait.
There are a couple of gals talking and joking by the desk - ignoring me - and I am thinking at this point I must be invisible. If I knew what bay I would be put in, I could probably walk there myself.
I am re-thinking my decision to come to this Emerg...after the last visit here, I swore I would have my husband drive me all the way to Running Wildly's place of employ, especially since she had saved my friend just the day before when she arrested in her ED.
Along comes the Triage nurse - around the corner. "Where did you go????" - she gives me heck as if I were a little kid sneaking around where I am not supposed to be.
One of the other gals laughs and goes "Oops - I guess I opened up the wrong set of doors"......
I follow the nurse to what turns out to be the furthest bay in the Emergency Department. As we are walking along, she hands me 4 tiny pills. "Chew these". I know what they are without her saying. ASA.
She waves me in the direction of Bay Number Nine. "Go on in there - someone will be with you shortly".
I sit down. Again.
And wait.
I am realizing that five minutes is a long time to wait when you don't know what's going to happen to you. I think back to my many patients that had to wait....
The RN assigned to me approaches - a Filipina gal, very serious. "Here" is all she says as she passes me a gown - and leaves me to it. My brain is telling me it's all good, while my panic mode is struggling with what's going on. She closes the drapes behind her, and shuffles through my paperwork at the desk.
I change into the gown and sit down on the bed. The RN returns to take my blood pressure and applies the heart monitor electrode patches to my chest. No sooner does she have me decked out with stickers, but a ECG Tech comes and does a 12 lead ECG on me.
I laid back on the bed and the Tech jokes about my allergy to latex, clearly marked on my armband: " You are allergic to lattes hmmm?" I smile at her attempt at a joke but, lost in the distraction of the moment, I don't quite get it right away. Confused, I check my allergy band to see what is actually printed on there.
I am hoping they don't think I am disoriented as well.
It's been 3/4 hr since I walked through the door. The ER doc comes in and I recognize him as the doc that misdiagnosed me with pancreatitis on my last visit a couple years ago. He auscultates my chest and heart. Asks a few questions. Asks about my chest pain.... orders blood work. I suggest that if he wanted to order cholesterol and lipids that I haven't eaten or drank anything in more than 10 hours.
The RN comes back in and decides she should probably put on a little oxygen.
In all my years of nursing, I have never had a nasal cannula sticking in my nostrils and decide that plastic prongs in the nose really aren't very comfortable. Small thing though, in the big picture.
My RN pulls a roll of tape out of the drawer.... "You can't use this, right?" she comments - and walks away - I guess not really caring whether I answered her or not.
Bringing back a roll of paper tape, and without explanation or comment - not that I need one - she places a saline lock with a #20 cathlon in my hand.
No gloves.
Blood leaks all over. She asks another passing nurse to help her pull the cap off the line...ignoring my offer to help. With the lock in place, she secures it in situ with an opsite square and applies a couple strips of tape. She doesn't seem too upset that she has my blood all over her hands as well.
Before I realize what I am saying, I am apologizing for the blood.....
The lab comes in and draws a few tubes. I make a comment that it probably would have been easier to pull them with the IV insert, as I have always been used to doing. Smiling, the lab gal agrees. In most hospitals in this province, it's the lab only that does the draws.
I spot the nitrospray in the RN's hand and I know what's coming. She doesn't ask me to open my mouth, but I know what to do automatically. Without explanation, she sprays a shot under my tongue.
Ten minutes later, another shot of nitrospray - only she misses and hits my cheek. Next shot hits my chin. Third time hits my upper lip and the top of my mouth. Fourth shot misfires. Fifth time lucky. At this point, I am not sure how much of the nitrospray I actually got. She walks away unapologetic.
Ten minutes later a young man - whom I will assume is the porter - comes in and wheels me out to the xray department for a couple of chest photos - standing - despite my light-headedness from the nitrospray. It's a quick trip and I am returned to my cubicle.
The internist arrives. She checks me out and asks more questions. Tells me all the blood tests are normal and I should see my MD and states that they aren't sure what's going on, and that perhaps - she guesses - my cardiac "arteries are spasming" and I might benefit from adalat to stop it.
She suggests that I make an appointment with my own MD and that I get him to give me an RX. She asks if I would want to do a stress test before I leave. I say sure, why not. She disappears to make arrangements.
The RN comes back and while she is adjusting the BP cuff, I ask her name, trying to work the social etiquette. "Oh...it's a difficult one" she replies and mumbles it incoherently. "Pardon?" I ask and she repeats it - the same mumbling. "It's a name you people have difficulty with" she says, shrugging.
I am thinking that if it was said a little slower and clearer that I could possibly try....but at this point I don't bother.
She hasn't smiled at me once, and up until now has said little and avoids eye contact. I am thinking how difficult it would be when a language you have to use entirely isn't your 1st language - and then try to work in an environment in which you have to not only speak only in English, but also think and then quickly communicate. I think one might try to avoid all unnecessary contact in that case.... I suppose it might be less intimidating to sit at the desk, back to patient with the eyes glued on the computer screen.
She offers me a Tylenol. I asked "what for?" She says "for your headache". I tell her I don't have a headache.....she tells me I told her I did. I tell her no, she had asked how my pain was and I told her I still had a little chest pain still......but thanks anyway. Maybe she didn't comprehend the entire conversation?
At this point, I have told no one (save the Lab Tech) that I am an RN. From my past experience in this place, I could see that it would put me at a disadvantage.
It's a fine line for an RN to walk - you want to get the best care that you know you should get, yet you don't want to step on toes or appear to be "demanding"..... besides, this couldn't be cardiac anyway, right?
I have to say now, that I have worked (and been in Emerg) in three smaller community/rural hospitals in this province, and 3 of the largest hospitals in this province, and know that this whole scenario is not typical for most hospital EDs.
I am just glad I am going to get to do the stress test - and then go home. The RN wheels me over to the ECG lab. I offered to walk over but that didn't go over too well. I did get a laugh out of her though.
The ECG tech welcomes me to her area - after her initial surprise at my unannounced arrival. I guess I made it there before notification did. I heard that my space was made available due to two cancellations. I am just thankful I can get it done.
Curtains are pulled and the Tech plasters on more electrode patches and attaches the parts to my waist. My gown is open and in wanders a little old lady from the next booth over. She has lost her way. The Tech redirects her and pulls the curtains shut.
Turns back to me. "Sorry about that" she apologizes. " I really like a little more privacy than this...." I reassure her that I am grateful it was only a little old lady. We laugh about it.
The Internist is present for most of the test and she gives the OK at the end. The Tech hands me my results, signed by the internist.
All goes well and I pass with flying colors. Once again I offer to walk back to Emergency.
Instead, I am wheeled back to my Cubicle number 9.
My RN is nowhere to be seen. Must be break time. I am thinking at this point that color coded scrubs might be the way to go, because honestly, I'm and RN and I can't tell the difference between the MDs and the nurses and the techs. They are all dressed the same - in street type clothes.
I can eliminate the ones with the mops and the garbage cans.... but all the rest? It's confusing. I don't know who I am supposed to ask to help free me from my IV.
A happy looking gal walks by and I ask if she knows if there is anything else that needs doing - besides IV removal - before I go?
The RN says that she will be with me in a minute to help me - and I start taking the IV apart myself....and have all the tape and opsite loose, ready for a square of gauze and tape when she comes over to help. She looks at me quizzically. "Are you a nurse, by any chance?"
I laughed. "Ya - who else would be taking out her own IV neatly - without ripping it out and blood all over?" She joins in with the laughter. "Ya, really" she replies.
I change out of my gown and gather up the sheets and dirty laundry in a neat pile in the middle of the stretcher. Old habits die hard.
I spot my paperwork feathered out across the counter. The RN looks through it and I ask if I can take a peek at the blood work. "Sure" she says and takes the lab results printout and hands them to me. "Here you go - you might want these - it's a good idea to keep your records...".....I smile and thank her.
I only get lost once trying to find my way out. In and out in 3 hours and 15 minutes.
Not bad.
It's been 48 hours since my Emergency visit.....still having slight chest pain - not as bad as before. Good news is - I have been slotted in to see my MD (Dr. Johnny Depp) today and will see what transpires.
I hate being a patient.
I also discovered I have developed another allergy.
Adhesive. I can tell by the 10 round red itchy circles all over my chest.....
************
Just got back from Dr. Johnny Depp's office.
He just laughed at me and told me I didn't "fit the profile" of a cardiac patient and told me it was probably "anxiety". Hmm. Which I would believe if I were actually anxious about something. And if the pain didn't wake me up out of a dead sleep at 2 am....
Who knows.
He gave me an Rx for adalat anyway, and I suppose I will try it out......
What's the worst that could happen?
I'll do anything to stay out of Emergency.
I would probably even prefer to die first - before I go back there.
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