Tuesday, June 7, 2011

the day the nurse stood still

October 22, 2010 at 1:17am
First, I want to say that with only 1 exception, the nursing and tech staff at Lake Shore were, to my experience, fantastic, kind, considerate, helpful and gentle people.  There is one tech that I'd like to subject to the same things to which she subjected me, but that's neither here nor there.

That said, shortly past midnight (Thursday morning) I signed the paper refusing hospitalization, packed my things and had Peter drive me home.

To understand my reasoning for this decision, you would have to know some of the ickier details of my past and I'm not going to subject you to that.  Goodness knows I've subjected unsuspecting people to enough ickiness in these notes.

The morning started off with ultrasound time... externals and internals, girly bits and heart.
The results - nothing new.  Same old problem with the girly bits, heart is just fine only beats faster than it should.  The muscle itself is healthy and normal, the valves work fine except for the occasional, tiny murmur.

Back up - during the internal ultrasound, I freaked out and started crying.  I had a horrible flashback to prior abuse and it was not good.  So I was on emotionally unstable ground from the start of the day.

X-ray of lungs - everything is fine, clean and clear, working as well as asthmatic lungs can work - and even the asthma isn't as bad as everyone (including me) thought it was.

Blood cultures came back clean.  No specificity for the infection source.  Blood tests came back clean, no sign of a source for a viral infection.  White count still slightly elevated, apparently randomly dropping and rising.  Fever also apparently random, though I can almost tell time by the spikes - one between 9 and 10 pm, one between 3 and 4 am, one between noon and 1pm.  The fever isn't high, only ~99, 100 at the most, and does not last long... usually 15-20 minutes.

I'd blown an IV placement the day before, and had another put in the crook of my elbow.  The nurse tried to flush that one and it blew.  Then began the procedure I like to call "let's turn Anna into a pincushion."  3 sticks, no hits. Next nurse.  3 sticks, no hits. New nurse.  Two sticks in the arm. Nurse: "How do you feel about hand IV's?"  Me (flinching) "If we have to, we have to, but can it be my left hand since I'm right-handed?"  Nurse: "Ok, let's see."  Sticks left hand, no hit.  Nurse: "Let me try one more, ok?"  Me: (in tears) "ok"  Sticks WRIST, digs for it, no hit.  Nurse: "Ok, that's it, I'm done." Shift change.  Next nurse.  3 sticks, no hits.  (to be continued)

Now, in between these stabbing attempts, the gyn came in to talk about the ultrasound results.  There is one procedure that I am absolutely terrified of when it comes to gyn things.  I had already talked to him about this, and explained the reasons why which stem from past abuse.  He was all sorts of comforting and assured me that he would keep that in mind and that it was very important to him and that he was very understanding about the situation.  All well and good, right?  Not exactly.  His first words were "I know you had expressed concern about <procedure> but in your case I think this is the way we need to proceed."  And then he goes on with the associated risks and such, and how it is so much better to do <procedure> rather than to run the risks of a surgery where they would have to actually cut... and ends with, "and if it doesn't fix the problem, we can go ahead and do the surgical solution later."

Wait. What? I mean, yeah, it fixes the problem in 80% of women.  But the surgical solution is 100% effective, and it's a solution for which I'm willing to accept the risks.  AND I wouldn't have to contend with the mental anguish of dealing with past abuse issues.  But no, he was absolutely certain that this procedure is what is necessary... oh, but we don't have to do it during this admission, it could wait one or two weeks, but it would be simpler to just go ahead and do it while I was there.

I said I had to talk to Peter before deciding.  He agreed and left, to return around 5pm the next day, wanting to schedule the procedure for Friday.

I am understandably upset.  I post an internet shoutout on facebook begging someone to get in touch with Peter to let him know that I needed to talk to him urgently, either by phone or in person.  (My only outgoing communication during my stay in the hospital was facebook/email via my iPod.  Blessings to Apple and that little machine!) A few minutes after I posted, Steph called me saying Peter would be at the hospital as soon as he got out of work.  Breathe, breathe, breathe, ok.  Good.  Had to hang up on Steph because my doctor walked in.

After IV attempt 13, my doctor showed up.  He talked about how none of the blood tests were showing why my white count was up, that I had been given so many antibiotics that even a resistant infection would be destroyed, and yet they really don't know what's going on.  That's when I found out that nothing had grown from the cultures.  And when I found out that my white count was high, yes, but not nearly as high as I'd been led to believe... at least not anymore.  And that the white count seemed to be going up and down, but within a fixed range, and that it probably wasn't anything to be worried about.  The doctor advised me to let them put in a pic line - a deep vein type of IV that goes in somewhere in the arm and terminates around the entrance to the heart.  I hesitated to agree, considering that while everyone tells me I "shouldn't" feel the IV tubes in my veins once they are in place - I do.  When I tell people I can feel them (they hurt for the length of the tube that is in my vein) they tell me it's just the pulling of the tape, or soreness from the stick.  No, sorry, I know what I'm feeling and it's the darned little tube inside that vein, thank you very much.  I know what soreness from sticks feels like.  I know what tape pulling feels like.  And I know what that little tube feels like as it ebbs and flows within my vein... they are different feelings... and the little tube freaking hurts - but I endure it because I have to.  Now, what I'm concerned about with the pic line - am I going to feel this thing ALL THE WAY from the entry to the opening of my heart?  Because that would most painfully SUCK. The doctor assures me that if I will just agree to have this done, the nurses will stop trying to start IV lines.  "No one will stick you again" he says.

Resume.  Doctor demands to know why I've started crying.  I can't tell him because I'm freakin' crying.  And this is not just little cries, this is outright nose-running sobs.  Kudos to me, I managed to keep my breathing under control throughout so I did not get short of breath.  Yeah, well, this goes on for a few minutes... Doctor finally asks me if I'm Christian.
Are you?
Why not?
What are you then?
Well, the closest thing to what I am is Wiccan.
What is that?
Excuse me?
I know what it is, but I want you to tell me what it is to you.

Thus ensued a "discussion" which involved him telling me what I should believe.  And how it was "all the same anyway" and how I should make decisions with my "heart" or "soul" or whatever I wanted to call it if I didn't believe I had a soul. He said that everyone makes decisions based on what is the best. He asked if he put $1, $10, $100, $1000 and $1,000,000 in piles on the table, which would I pick.  I said, probably the $10 because it would be sufficient to meet my current needs.  He looked shocked for a second, then said "See, that is the 'best' for you" and told me I needed to make the decision.  That he picked the best option for me, and that I came to him for his help so I should take it.  I told him I needed to talk to Peter before I made any decision about putting in the pic line or getting the gyn procedure done.  He tells me that I need to let go of the past (abuse) and live for the future.  He tells me that I need to make the decision, myself, based on my heart/soul, not based on any discussion I had with my husband.

No, I really don't think so, thank you. That's not how I operate.  When it's something big, something risky, something scary - my husband and I talk it out. I didn't say this to him because at that moment the doctor gets a call, excuses himself to take it and tells me he'll be back in a few minutes for my decision.

I try to calm down, and make a list of pros and cons for the pic line and the gyn procedure.  The pros are all the arguments the doctors have been making.  The cons I really don't write down because I keep second guessing myself, telling myself I'm being too emotional and irrational and silly.

Thank goodness at that point Peter showed up.  I calmly outlined what the doctors wanted to do.  I used my little list of arguments - which were all pro-procedures, and essentially convinced us both that it was best if I said yes to all of it.

Doctor came back - well Peter had to go out and tell him I was ready.  I said yes to the procedures.  He said "good" and left.

(I promised a continuation)
Shortly after he left, the nurse entered holding IV sets.  Multiple IV sets.

The nurse told Peter that I was getting a roommate so he would have to leave. I asked when the pic line would be done, because I wanted Peter to be nearby when it was.  The nurse responded "oh, that won't be done until 'sometime' tomorrow"  ... and started unwrapping IV placement stuff.

I was confused.  Before I could say anything, the nurse had the tourniquet on my arm.

Stick one, dig dig dig, no hit.  And then the tech mentioned at the beginning of this note came in -- while the nurse was looking for a vein to stick in one arm, the tech starts to wrap the other in a blood pressure cuff.  She's wrapping the arm that had the blown IV at the elbow and the other lower down that blew the day before was still swollen and red.  I told her the elbow was VERY sore still and asked that she try not to overlap it with the cuff.  She never spoke to me, just asked the nurse if it would be ok if she took it ON THE LOWER PART of the arm.  I said that one had blown there as well.  She ignored me, continued wrapping the cuff.  The nurse told her to take it on the upper arm and to try not to cover the elbow.  Meanwhile, he's still thumping my arm all over looking for a vein... with the tourniquet wrapped on my upper arm.  She starts the blood pressure reading just as he finds a vein.  Nurse stabs as the cuff inflates.  Dig dig dig... push in... pull back some... blood pressure machine beeps... nurse says "aha!" as blood starts to back into the IV tube, but before the nurse can thread it, the tech rips the cuff off my other arm, jerking the needle away from the vein.  Nurse "damn. it's gone." Tech (to nurse) "The pressure is 198/99, should I read it again?" Nurse (to Tech) "Maybe you should come back and take it when I'm not stabbing her with needles." Tech (still oblivious that she's screwed up the 15th attempt at placing an IV) "oh, ok then"  Tech walks out.  Nurse says nothing, just starts smacking my arm, looking for another vein.  3rd attempt, no hit.  New nurse.  "Ok, I hear your veins are being shy... I'm here to stick you."  Me "Maybe"  Nurse "Yes, I'm here to stick you."  Me "Maybe you're going to stick me, maybe not, right now, however, you're not.  I need some time first."  Nurse "Ok, no problem, you call me when you're ready."

Peter is still in the room.  I am sobbing somewhat hysterically.  I beg him to get me the heck out of there.  He wants to know if I mean for him to smuggle me out.  I said no, that I just wanted to check myself out and leave.  That I couldn't take one more stick in my arms... 15 IV attempts since noon, 7 IV attempts the day before, arterial blood gas (required 2 sticks in the wrist), repetitive blood draws (9 sticks, right arm, 2 sticks left arm), and 1 stick at the doctor's office before going to the hospital.  36 sticks.  In 3 days. I have photos of my arms.  They are mottled with bruises and swollen red patches and lots and lots of stab wounds.  I can barely lift anything with my left hand because my arm is so sore.

A tech stops by to remind us that a roommate is coming and Peter needs to leave.

I ask if we can go down the hall to the waiting room to talk.  We do.

I try to calm down.  (Holding Squishy, the stuffed turtle Gaia gave me, helped, though I'm not sure he liked the excessive squeezing.)

I start outlining a plan - not of how to get out of the hospital, because the nurse told me that it was only a matter of signing a paper saying I was declining hospitalization, but a plan of what would happen -after- we got out of there.  Could I get caught up in my classes?  Could I even finish out the semester?  Would I have to do some sort of medical or mental withdraw procedure.  Maybe take incompletes (if possible) and finish up the work next Spring.  Or just do my best and most likely fail one or two of the classes - then take independent study type things over Spring with understanding professors... writing some sort of research papers, primarily from home.  Or, if it ended up that I couldn't finish, how I could get a retail job and still be content... because the goal was to have a job that allowed me time to write.  I could do that just as well with retail as I could with teaching.  And maybe Peter and I could get back some of the things we've been missing in our lives... like the joy of living them.

So, the decision was made... and yes, doctor, I did indeed follow my heart and make the decision that was best for me, although I'm sure you won't see it that way.  And perhaps my friends and family won't see it that way.  To those who do not, I can only say... it is my body.  I will continue to do the best I can with it in order to stay living among all those kind enough to share their love and their lives with me.  I cannot continue to see a doctor who has lost my respect and who has lied to me and misled me.  I will not lie quietly while people decide my fate and use my mental agitation to coerce me into agreeing with them - when calm, rational thought would never make me agree to the same decisions.

We came home.  I slept, for the first time in days, and slept deeply and well.  What tomorrow brings is up to us.

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