Tuesday, December 22, 2009

Reports of my demise have been greatly exagerated (a close run thing)

You will note that my recent postings have had family very much in mind.

I will now relate what ultimately happened to my Dad as a preamble to what has just happened to me.

In August 1985 at the age of 58 my dad was at his ladyfriends house hanging a picture when he experienced chest pains. He thought nothing of it at the time, but the pains continued throughout the afternoon. In the end it was so severe that he called an ambulance and was rushed into hospital. He had experienced a heart attack out of the blue, a week later he was dead of a second massive heart attack.

Well Sunday Evening I was sitting in my chair over the computer and I experienced the combination of chest pains and my heart beating very rapidly and hard against my chest, as if I had just run up a flight of stairs.

Now I am not actually unused to heart problems, I have been twice to emergency before, first time with an irregular pulse and the second time with the combination of an irregular pulse and chest pains. In each case I was inspite of the discomfort able to walk to emergency, and although I did have an irregular rhythm it was diagnosed as 'benign' and a subsequent referall to a cardiologist assured me of that.

What I felt on Sunday was different, it didn't feel irregular it was too rapid. Normally if you have a rapid heart beat that is just part of the bodies flight or fight response, brought on by some anxiety, if you fly with it, that is to say get up and go for a walk, it will settle down. Well this did not, I could not even walk about the flat without it getting worse, and there was the chest pain too and it was not going away any time soon, so I decided it was time to call an ambulance.

By the time I got into emergency (and it is nothing like you see on television,if you are brought up on a diet of casualty, ER, and House it is mostly boredom and nothing happening at all) my heartrate had slowed down somewhat and by the time I was hooked up to the monitor there wasn't anything unusual or scary to see, which was reassuring. However the pain still needed investigation and I was for a chest X ray, In addition the Dr wanted to keep me in, because the only way to establish beyond doubt if I had just sufered from a heart attack would be to carry out a blood test which they have to wait a certain number of hours for whatever is supposed to happen to happen before they test for it.

I then had a 3 hour wait on my own in the cubicle while they found an empty bed. (the usual situation at this time of year, with the cold snap there are a lot of falls and a lot of respiratory diseases.

Well the arrangement of the wards is into 4 bed bays and at 54 I was by far the youngest in my bay. What was rather traumatic for me, apart from worring about myself was the flashbacks that the guy next to me was causing. From listening to what the Dr's and his relatives were saying, and the fact that he was on oxygen and clearly having breathing difficulties, he was a man of 71 with chronic emphysema, complicated by pneumonia, and he was not well at all. It reminded me all too much of my mum's last hours in hospital in very similar circumstances, it also showed me in retrospect how little chance of survival my mum had, when they brought her in, the dr's suspicion was probably right she was in the terminal stages, because she was in a lot worse condition than this unfortunate gentleman, who during my stay was showing signs of improvement and stabilisation.

Unfortunately for me, quite apart from the poignant reminder of less happier times for me, the noise of his oxygen was keeping me awake for the two nights I was in.

I could complain that an autistic with sensitive hearing should not be in that situation, but the truth is, in an emergency you need a bed, wherever it is and if your life is at stake (as it might have been) you have to go with it.

Well in truth this wasn't the worst at all, the worst was being brought in unprepared late in the evening by the time you have a bed, and missed all the meals and usual hospital rounds. Then there are the bright lights, and other sundry beeps and noises, and above all not knowing what happens next.

I would have appreciated knowing at what times I would be disturbed for monitoring temperature and blood pressure, what times the dr's come round, what time the meals were. I was left to figure out for myself how the adjustable bed worked, and where the emergency call button was, in fact I didn't find that until the middle of the next day.

Another annoying thing was the cold. I was just left on this bed initially in a hospital gown and single sheet, there wasn't even a pillow, I had to ask several times before I was brought one, and is little wonder every time a nurse asked "have you any pain" I could say "Yes my shoulder" For the first night I was freezing. Only the next day when I was up and wandering around in my gown did the nurses find me a pair of pajamas and then some extra blankets.

The hospital didn't get it right, they did not take the blood test at 7 am in the morning as they were supposed to, and of course it didn't come to light till after the Dr's ward round. I had to wait till 4 o clock, which was some 3 hours after I had been assured that they were coming soon. Worse that that I had been told that if the test was Ok I could leave that evening. (I wasn't really keen on staying as I was getting extremely worried about my flat being left in a hurry)

Anyway I had been told that the test results should take a couple of hours, so I duly started counting the minutes. Needless to say well over two hours later the results were not available. Indeed I was eventually told that even if the results did come in that evening I would still have to stay in overnight, because the Dr's had gone and would not be back till the morning to officially discharge me (if all was fine)

Fortunately I had some extra blankets by this time, and had been fed at the proper mealtimes, having had nothing but sandwiches to eat the day before as I hadn't yet eaten at home when I called the ambulance)

Well I couldn't sleep and spent a lot of time pacing up and down the corridor outside. I was feeling physically better by that time, normal heart rate and B P so at least I could get up and wander about so long as I did not wander off the ward altogether.

The Ward sister told me before she went off duty for the night sister that the results had come back and she could look on the computer for me. I was a bit nervous in case they were not what I wanted to hear, but fortunately they were clear, so at least I could spend the rest of the night in some certainly that I would be able to go home the next morning.

And so I was pretty eager to get the silly needle out of my arm (put there as a matter of routine in case I needed anything intervenous, but made life rather uncomfortable) and to get dressed.

WEll early in the morning I left, they informed me they had emailed my GP, so I did not need to wait for a letter to take down to the surgery.

So I went home, called in the surgery on the way and booked an emergency appointment for later on.

By the time of the appointment they hadn't got the email yet.... but I was able to explain what had happened, because I was concerned that this might happen again, and what was I supposed to do. He prescribed me beta blockers (which I have had before, for occasional use, though not having felt the need for some time, my prescription had lapsed and was out of date.

What should I do if the same symptoms re-occured, I asked. Call an Ambulance he said, that is what he would do in the same circumstances, the fact that it may have been a false alarm this time does not mean it will be the next, and far from being worried about calling an ambulance uneccesarily I should be concerned that it always is always better to haved called one and the symptoms turn out not to have been a heart attack in retrospect, than to have had misgivings about calling one and died as a result.


Michael G. Dixon said...

As someone who has spent his life in the administration of Academic Health Centers in Boston and Cincinnati, I am glad you shared your report of your experiences. They resonate with great to fidelity with what I have heard from other patients and observed myself. I am not sanguine about the likelihood of change in the short run because hospitals function irreducibly as businesses and there are powerful incentives to put all available resources into cultivating doctors who admit lots of patients. The nature of both the doctro patient relationship and the incidence of illness to not create finanical incemtives for creating a "good patient experience." It makes you story all the more important at a humane level to others who have had the same experience and to the possibility of change through not collaborating in a silence on the issue.

Socrates said...

Glad to here you're back home. We were all rather worried.

Does this mean Lake Unpronounceable to Englishers is off for this Xmas?

Jannalou said...

I am very glad that you are home safe and sound, Larry; I was worried about you. I hope you have many years coming to you.

Merry Christmas!

Jane said...

Very glad to have you still among us, Larry. And I concur with your doctor's advice: Call an ambulance when/if there's another event of this kind. Every time!

abfh said...

Glad you're back home safe and sound!

Selina said...

Am relieved to know you are home again, and basically okay for now.

I had a similar run-in a few years ago (also a "false alarm" as it turned out) and sympathise deeply with you over all the stresses involved in the experience. Noisy, bright, uncommunicative staff, inefficient arrangements, lack of privacy - a veritable smörgåsbord of all the things that are the antithesis of what is needed for wellness. :(

The worst bit of all for me was being forced to watch Casualty on the ward TV - I am phobic about any television, but there was something particularly vile about being subjected to a gory medical soap opera. What is it with NTs?

Best wishes for the forthcoming "festive" season.

Casdok said...

Lets hope there isnt a next time. Glad you are home.

KWombles said...

Glad you are safely home.

kabie said...

Happy to hear that you're back home. Hope you still get the christmas you were planning.

jEAn said...

Your story so resonated with me, Larry. I'm glad you told it. Glad also you're holding your own but wish for you a more definitive treatment plan to quell the anxiety. I got an ICD--implanted cardioverter defibrillator--which along with a couple of additional hospitalizations & medication re-combinations (see "Winter Breaks" at for my merry tale)I appear to be living uneventfully. I feel your fear. All the best. Larry.

Anne said...

Yes, call an ambulance, maybe take an aspirin. Ignoring tachycardia is a bad idea, I can tell you from experience. Glad you're home again!

Martijn said...

I too am relieved it was a false alarm this time. Best wishes from Kalen and me.

Kent Adams said...

Larry, I had a heart attack in the spring (I was 41). My brother, 10 years my senior has has 4 and currently is awaiting to have a defibulator placed in his heart. What I felt was an extreme amount of weakness and light headedness, no pain, no rushing heart rate, just exhaustion from doing very little. My brother though, in his first heart attack felt an extreme amount of pain in his arm.

If you are not already, get on some statins and ask these be given to you. Considering your father's history and your age, there is no excuse for you not to be on a statin.

Astrid said...

Since I am horrible with checking E-mail lists, I only found out today that you'd been hospitalized. I'm glad to read that nothing serious was going on and that you're back home.

Adele said...

Glad to hear it was a false alarm, but never hesitate to call an ambulance if you think you need one, as a friend of a paramedic I can assure you that it doesn't once occur to people NOT to call one when they damn well know they don't need one.

Perhaps you should pen a letter to the hospital caring for you outlining some of the basic things that could have been done to make your stay more comfortable. Things like ensuring a patient has enough blankets to stay warm and knows how to work the bed and emergency buzzer are basic and take minutes. Admittedly, in a busy understaffed ward minutes can be hard to come by, but that is their problem & should not be the patients. As a healthcare professional I wish that everyone who experienced substandard care would complain about it, it would get us more staff and less stress for patients and staff alike.