This story is not packed with gritty drama, nor does it recount brave stories of heroism from the Emergency Room floor. It is a story unadorned in pretty symbolism. It is simply a story of my little health problem, which began quite suddenly at approximately
I am presently a regular patient in my local hospital emergency room. Which, until a week or so ago, was a title I thought reserved for hypochondriacs and the insane. After all, who would voluntarily choose to visit the emergency room on a regular basis? But let’s start at the beginning.
Several months back, my lovely wife Maddy asked me if I would be willing to take over her Tuesday evening slot with her personal trainer. While most regard the personal trainer to be an affectation of the rich and famous, her ‘Personal Trainer’ Trevor, is in fact a good friend of ours, who happens to run a professional gym from his home. Trevor’s son Marcus is the same age as our son Zachary, and my wife Maddy met Trevor through his lovely wife Julie, who was in her ‘mommies group’ (the typical consortium of bleary-eyed bewildered new-moms, joining together for a sessions of joyless camaraderie). Ironically, this little story begins back at the
So, now that Maddy had lost over 20 pounds and magically sculpted her body back to her ‘pre-Zack’ form - with the help of Trevor and his fancy exercise equipment - she was hoping that I would take one of her two weekly exercise slots. She was hoping that I might put down my rye and coke long enough to at least consider losing some of my personal spare tire, and focus some energy on my health. I had given up smoking a few years back, and logically, I suppose it was indeed time.
I gave it some thought (for about a month) and reluctantly decided to join Trevor for the sweat-fest on Tuesday nights. The first three sessions were in actuality, a whole lot more yakkin’, than sweatin’, as Trevor is an engaging fellow, with an infectious charm that makes conversation flow like Gatorade in the sun. In truth, while I was in reality ‘working out’ I began to look forward to just hanging out with Trevor….which is (come to think of it) probably why he is so successful at what he does.
I drove home that cool summer evening, feeling great after my workout, and (truth be told) just a little proud of myself. I had dropped about 10 pounds, and was actually beginning to think there was hope in turning around my sedentary lifestyle.
Maddy was up watching TV, after winning the struggle to put our 4 year old down for the night (lately he tends to go about 8 rounds with the sandman). I slipped down to the basement to check our e-mail and flip Trevor some detail on a DVD recorder he was interested in buying. I noticed it was pushing
A short time later I was sitting up in bed, gasping for air, the weight of an elephant bearing down on my chest. I glanced at the clock and it was just after
For the next five hours or so, I sat bolt upright in the basement, and watched a half-dozen episodes of one of my favourite television programs “Dead Like Me’ on the PVR, blissfully unaware (at the time) of the irony of my viewing choice. For those not familiar with this particular show, it’s about a group of the undead, who essentially act as grim reapers among the living, while they slot their ghastly duties in between their mundane regular day-jobs. There is all manner of gallows humour and a fair bit of ‘man meets violent end’ macabre to entertain the viewer. Just my cup of tea.
In hindsight, it is difficult to describe what goes through ones head when they feel their life is in peril. But truthfully, at this juncture in my little health drama, I wasn’t really sure if my life was in peril. Your brain ping-pongs back and forth between ‘I’ll be just fine’ and ‘holy shit I’m going to expire’. I suppose in my case, because I was having such trouble breathing, I wasn’t thinking all that rationally. I was sure however, that I had a heck of a lot better chance of not dieing in my sleep, if I simply didn’t go to sleep. I was feeling a bit encouraged though, for as the sun was creeping into the basement, and the clock pushed
The enormous weight upon my chest seemed to have also been lifted a tad, but I was indeed still gasping, and even walking around the room was making me wheezy and light-headed. I did entertain the notion of calling 911, but (I know, I know) I didn’t want to worry everyone, and really didn’t want to freak little Zack out. I decided I would ride it out a bit longer. Zack would be off to school, Maddy to work, and I would make an appointment to see my family physician.
Believe it or not, even after gasping for hours, I was pretty convinced this whole thing would pass. I figured I’d just check in with the office for a bit from home, and then I’d call my doctor.
The only strenuous activity I participated in was my daily work regimen of:
20 reps of Furrowed Brow
10 reps of Hand Wringing,
10 reps of Plaintive Yells to the Sky
And my favourite, and most common exercise..
25 reps of Running Hands Through Hair, till I sport a Buckwheat hairdo.
By the end of my workout, I was thoroughly exhausted, having dealt with 3 customer complaints, (two minor, one serious) two employees who have all manner of family emergencies a minimum of 4000 miles from their place of employ, some scheduling problems linked with ‘pet’ emergencies and car trouble, and a host of other nagging annoyances.
We’re rascals, scoundrels, villains, and knaves
Yo ho, yo ho, a Manager’s life for me.”
(Although lately, I have noticed I don’t seem to be ‘managing’ much, certainly not any people, anyway.)
Finally, after a particularly scary coughing fit that dropped me to the ground, I called my docs office.
And here, at this very point in my little story, the hands of fate intervened, and things took a different path than I expected.
Mary, the terribly uncooperative ‘Gatekeeper of the Physician’s Office’ was adamant that I present at our local Emergency Department. Apparently, ‘having trouble breathing’ is not a symptom usually remedied by a visit to the doctor.
Who knew!?
I was too tired to argue, and in fact, was just beginning to notice that when human beings speak, they are incapable of breathing at the same time. While that may seem fairly obvious when you think about it, I really hadn’t had any reason to think about it at all, until now. As I spoke, I became more and more breathless, as I had to gasp deeper and more often, to make up for all my tongue waggin’. I conceded defeat, thanked Mary anyway, got dressed, and drove myself to the emergency room.
Day One
Wed July 11
Triaged
I was pretty nervous about the standard of care I was about to receive. I know how under funded hospital emergency rooms are, and how difficult the patients can be. All manner of aches and pains, both serious and minor present themselves to hard working staff that cant possibly move fast enough, or efficiently enough to please the masses. I was bracing myself for the unpleasantness. I was wholly unprepared for how my experiences would surprise and enlighten.
After being greeted by a friendly face and a warm smile, I was asked to sit down, and explain what brought me to the emergency room. I was processed quickly, my blood pressure and temperature taken, and asked to proceed with the paperwork they generated for me, to the next stop – the Lady Behind the Glass Window.
Another friendly face, more efficiency, and I was given a snazzy wrist-band emblazoned with my very own name and OHIP number. Soon I was waiting with the masses, about 12 or so of humanities groaning, broken and sore.
I felt woefully inadequate sitting in the waiting room. Sure I couldn’t breathe too well, but there was ‘busted-hands-fell-off-a-painting-ladder’ guy, grimacing off to my left, and ‘looks-like-she’s-dieing-clutching-her-stomach’ girl to my right. A whole host of other maladies around me, I didn’t really feel like I deserved this fate – or the incredibly long wait time I would undoubtedly have to endure. I figured I would be triaged behind all the other, more serious cases.
Much to my surprise, my name was called out quite quickly, and I was asked to step into a curtained off area, just next to where I was originally sitting when I first presented in the ER. A lovely woman who I recognized immediately as a phlebotomist (by the trolley and her supplies) introduced herself as Evelyn, and after closely examining my wrist-band, proceeded to take my blood. She asked my how I felt, and small talk led to my vocation, and the irony of my interaction with yet another member of the venipuncture trade. She seemed very busy, with a gigantic stack of requisitions to process, yet she had an air of purposeful competence that set me at ease.
I was soon sitting back in the waiting room, and noticed clutching-stomach-girl was nowhere to be seen.
Now at this point it’s probably appropriate to introduce you to the greater irony at play here. I work in the healthcare Industry, specifically for a private lab company that provides OHIP and non-OHIP diagnostic test results to physicians. I am responsible for about 20 local patient service centres, where the community at large presents to get their bloodwork performed. So yes, my staff are predominantly phlebotomists. Lab results, bloodwork, and the
Just then a young man smelling distinctly of old curry chicken walked into the hallway past the entrance doors. Without any hesitation, he dropped a scuffed beige suitcase adorned with a Grateful Dead sticker next to the admitting nurse, took a seat, and explained politely “ I need to be admitted to the psych ward”.
Wow” I thought.
“Now that’s self-aware.”
When he was asked why he was in the emergency room today, he calmly replied..
“I am a paranoid schizophrenic”.
At which point he was processed, and asked to proceed to the Lady Behind the Glass Window.
Soon he was sitting next to me, with his trusty bulging suitcase (wow, self aware, and prepared!) all the while rubbing and patting his arms as if trying to put out a small fire. He didn’t remain with us in the waiting room long. Soon a pleasant young girl called his name, and he was walked down the hall. He strolled behind her like a fellow who knew his way around the place.
My name was called again (so soon?) and I was asked to follow another technician down the hall to what seemed to be a holding room, complete with these really comfy nifty reclining chairs with handy folding drink trays attached. The chairs had a cool sort of ‘operating theatre’ look to them, and I found myself thinking that if they were outfitted in leather (instead of hospital grade vinyl) they’d double as great home-theater chairs.
OK, so I wont try and mislead you, I was scared shitless by this point in my little story. I started doing the typical frail-human things…regrets, lost opportunities, reflections upon the cleanliness of my underwear, but all through this, I was trying to figure out a way to make sure I didn’t needlessly worry anyone. (From what I hear this is a typical male trait..at least typical of the stupid male.) I mean, nobody told me I was dieing, so there was no burning need to call Maddy and tell her they were planning on pumping me full of some kind of dye so they could shove me through a CT Scanner – right? And they also had some run-of-the-mill chest X-rays scheduled, and that’s pretty routine for any respiratory ailments, and I have had a few of those before anyway…so nothing to be too worried about yet.
Yet all the while, that scary ‘C’ word kept creeping to the head of the panic-line forming in my sleep deprived head. Surely I didn’t have lung cancer – I was working out now for damn sakes! I have a personal trainer goddammit! I even gave up my dear sweet friend nicotine! Maybe its just pneumonia, yeah, pneumonia would be friggin’ awesome.
By this point I really couldn’t help but notice that as I lay in my ER Home Theatre Recliner, there seemed to be a lot of grim faces peering down at me. Oxygen tubes were quickly stuffed up my nose, blood pressure and temperature recorded again, and I was asked to lie quietly and wait. No problem, I could use the rest. The oxygen was strangely soothing, but the tubes were not all that comfy in the nose. They have all sorts of disposable ear inserts for headphones, and I wondered if anyone thought of approaching the manufacturer to suggest they re-think the design of this contraption. I also felt compelled to crank up the O2 from 3 to somewhere in the neighborhood of 5 on the dial.
Soon a physician I hadn’t seen yet appeared in the door. He peered intently at my chart scribbled a quick notation (patient fiddles with equipment in the absence of supervision…watch him carefully.)
“Did you drive yourself here?”
Was the physician’s odd query
"Yes, why?”
I responded, a little puzzled.
“Huh. Interesting.”
Was all he said, as examined the readings on the beeping monitor.
I’m alone again in the Home Theatre Chair Lounge, just me and the incessant beep of the blood pressure monitor. I eye the tiny switch with the universal symbol for audio,
I’ve braved the better part of the day, but eventually I did call Maddy at work, and let it slip that my trip to emerg was soon to involve a bunch of other testing, and it wasn’t too surprising that she grabbed Zack from school, whisked him out to Trevor and Julie’s, and with a very brief summary of my situation “he cant breathe well, in emerg, gotta go, will call soon, thanks’ was off to the hospital.
“What did you do to Mark Trevor!?”
Julie exclaimed.
“Why would you say that Jules, why would you say that!?
Trevor replied with not just a little bit of shocked outrage, the worry evident on his face as he watched Maddy’s car speed out of the driveway.
So with Zack pleasantly surprised by the unscheduled trip to his friend Marcus’s house, and Maddy breaking land-speed records between
Pleasantly Scanned
A short time later, I note Pit-Stop Phlebotomist and Doc of few Words having a short conference in the hall. After peering at the clipboard handed to him, he glanced up at me, smiled, and walked away, as the phlebotomist came back into the room.
A dye was apparently now going to be pumped into my veins, so that they could easily see my innards when they perform a CT Scan, which stands for computed tomography. A CT uses x-rays to take detailed pictures of structures inside my body. The CT scanner sends X-ray pulses through whatever they want to look at.. Each pulse lasts less than a second and takes a picture of a thin slice of the interesting site. The pictures are saved on a computer, which is cool, as I wonder if I can get the CD Rom as a souvenir.
An iodine dye simply makes the organs easier to see on the CT pictures. The dye is used to check blood flow, find tumors, and look for a host of other problems. The catheter is inserted quickly, the oxygen is cranked up a tad, and I am told to lie back and relax. Why not? I aint going anywhere.
As soon as I am all dyed-up, a lovely young nurse transfers me from my Home Theater Lounger, into a pretty primitive wheelchair. I’m taken to a stark white room with that giant machine from that TV show “House”. Once again, I am referencing yet another of my favourite TV shows that depict the frailty of human life, and our struggle to make sense of it all. Every time the ornery ‘Doctor House’ was presented with a medical conundrum of some kind, some inexplicable symptom with the patient’s life hanging in the balance, he always orders the patient to be whisked through one of these huge donut-shaped scanners. Will the technicians speak about me behind the glass wall in the darkened control room, as they do in the TV show? But more importantly, should my family jewels not be covered with some kind of lead apron?
While we waited for the CT Scan Technician, the bubbly nurse reassured me everything was fine, and all quite routine. I didn’t feel too fine, and while I know it’s a hospital cliché, I really don’t understand why the gowns have to open at the back. Unless the majority of people are required to expose their butt when ill, I cant see the harm in having these garments designed more like bathrobes. If they were more like bathrobes, in combination with the requisite mix of medication, it could feel sort of like you were on vacation.
Soon the CT Tech arrives, and once again, I found myself in the presence of yet another monstrously enthusiastic and pleasant hospital employee. Doesn’t anyone here have a crappy attitude? Nobody having a bad day, willing to take it out on a hapless patient? The nurse and the CT Tech launch into some friendly banter that was not only engaging, but quite funny too. It was all beginning to seem really weird.
“You may feel like you are peeing your underwear, but I can assure you are not.”
That warning, was without a doubt, one of the strangest preambles to a procedure I have ever heard.
“I’m not clear” I said.
“Do you mean I should be prepared to pee my underpants, and if so, am I really wearing the right outfit?
“No” he said with a smile. The pretty nurse giggled.
“It’ll just feel like you are peeing your underpants”
I wanted to ask why it would feel like I pissed myself, but figured after being fitted with the catheter , and having been recently pumped with iodine dye, perhaps I should just cut the chit-chat, and let the professionals do their jobs. Besides, as I listened to the odd hum of the donut scanner revving up, I was pretty sure this machine was contributing to global warming. Lets save a tree or two, and get this over with already.
Before the fun however, I was asked if I had carefully read the waiver, which naturally worried me.
“No, not really.” I replied.
And then my stand-up-comic CT Tech proceeded to rattle off what could only be described as ultra-fine-print medical legalese. He recited the details like R.E.M. performs “It’s the End of The World As You Know It”..at a breakneck staccato, leaving the words perfectly audible. I could catch most of it, and lets face it, they need to know what’s going on inside me, so until they devise the medical zipper, or the chest cavity trap-door, the Whirring Radiation Donut was my best bet. I found his shtick pretty humorous actually.
As it turned out, I needn’t have worried about the family jewels, for they didn’t send me into the Donut past my waist. Before I knew it, I was done, back in my wheelchair, and being whisked back to my comfy ER home theatre chair.
A little while later, Maddy arrived, looking none too calm. Actually, she looked like she was doing her stoic ‘brave-face’ thing. If I veered down the wrong topic-path, we could be getting some water-works.
‘Hey, I’m getting the best of care, and feel a lot better’ I said with lots of enthusiasm.
‘lets keep it light. We’ll be on our way home soon enough.’
And sure enough, we were.
Thank Gawd for Bacterial Infections
A happy, young doctor who looked like he would be more at home on a surf beach in
Pneumonia – I friggin KNEW it. I’ll be right as rain in a week.
The Hang-Ten Doctor then asked the nurse removing the catheter from my arm if she’d like to buy a sofa and an end-table, then quickly turned to me and asked if I would be interested. He had some kind of moving emergency, and was working the ward to unload the stuff. I believed him when he said it was a real nice sofa, and he only wanted $100.
I didn’t really need furniture, I needed something to eat. But first, I would have to coax a parking chit out of the automated chit-dispenser machine. All I had was a twenty, and it was creased. It took sixteen tries, but eventually it begrudgingly accepted my crumpled bill, and spat out twelve loonies, and a parking chit. Swell. I’ve got loads of change now.
It was now at least 10 hours since I had ingested anything, and when I stepped out of the truck at an Ajax Pharmacy to pickup my prescription, I was seduced by the smell emanating from the A&W across the parking lot. Last time I was at an A&W was during a road trip with the family, and I was real disappointed because they didn’t serve me my root beer in a frosty mug. Now the mug isn’t all that big a deal, except that they had posters everywhere, not only expounding upon the virtues of “the mug” but their stoic adherence to the policy that ONLY the frosty mug would be used in dispensing the famous A&W Root Beer. It’s a small thing, but I really felt they had failed the customer that day.
Well, I needn’t have worried, because this A&W had the frosty mugs, and all manner of artery clogging confection. I ordered just a Junior Burger and the highly anticipated frosty Mug o Beer (paid with loonies). The cashier/order-taker was the cutest dang fast-food girl I had ever seen, and I don’t think I have ever seen anyone slinging burgers that looked any happier to be doing it. I exaggerate not. When I walked in, I glanced behind me, because the look on her face was as if she had spotted her best friend in the whole dang world. Surely that person was coming in the door behind me.
Nope, no long lost friend sighting, just a minimum wage employee slinging fast-food, happy as all get-out to give me my dang frosty mug. I found myself looking around for a comment card I could fill out.
One bite though, and I started to cough. And this was no ordinary cough. This was a get-the-hell-out-of-the-restaurant-you’re-gonna-freak-people-out kind of cough. I went outside, sad to leave my frosty mug for even a moment, and leaned on the side of the building. The more I coughed, the worse I felt. The more I coughed, the shorter of breathe I became. I started thinking that I actually might have to take tomorrow off work. Bummer. I had a lot of crap to get done.
After about 10 minutes of sitting on my ass in the parking lot, I’m feeling a bit better, but now I really didn’t want my burger. I went back into the restaurant, and was met with a worried look from my favorite root beer girl. I quickly downed my beverage, threw most of the burger away, and slowly walked across the way to the drug store to get my penicillin.
Now I hate to sound like an ungrateful SOB, but ya know, at 10 PM, why does it still take 20 minutes to put pills in a dang plastic bottle? There’s no friggin back-log, no log-jam of pills waiting to be stuffed into bottles, no rocket science involved.
“that’ll be about 20 minutes sir” was the sittin-on-high white-coat response as he glanced at the illegible scrawl on the prescription I handed him.
So you head to the magazine rack, because any household item you may actually need is marked-up by 700% at the drug store, so you dare not shop. They peer at you reading their precious magazines as if you might be too poor to purchase it. But there are no TV’s, no video games, no distractions to help you kill the 20 minutes…so you read House and Garden’s Fabulous Kitchen Makeovers. Ten minutes of that and you actually want to be dead, so I strolled over to the “You Too Can Be Your Own Doctor” kiosk, better known as the Automatic Blood Pressure Machine. I stick my arm in the constricting sleeve thingy, snickering (because c’mon, how many times do I really need to do this in one day?) and start worrying that the readings don’t look anything like the ‘normal values’ printed on the machine..for my self-diagnosing pleasure. I dismiss it as a cheap carnival game, and check my watch – 13 minutes.
And do you know what happens if you come back in say, 13 minutes? That’s right - they aint done yet. As my favourite character from the Coen Brothers movie ‘Oh Brother Where Art Thou’ exclaimed, “Isn’t this store just a geographical oddity!…no matter what friggin pills you need, you’re always 20 minutes away from getting them.” True enough.
Its 22 minutes now, so I’m pretty sure the white-coats have cracked the riddle of the bottle & pills by now. And they have, so I’m on my way. I glumly note that they charged me a higher dispensing fee than my neighborhood drugstore. I suppose they gotta pay for the enormo-store’s operating costs somehow. Those white-coats gotta be shaking down at least 50K a piece for the groundbreaking work in the field of pill-management.
Another crappy nights sleep awaited me, but I was comforted by the knowledge that the horse-pills I had just dry-swallowed, were already speeding their way to my abused lungs. I would be hanging out in the backyard, listening to 1970 Rolling Stones with my pal Pete, sucking on a cigar.. in no time at all.
Day Two
Thurs July 12
No Cigars for You Sir
I wish I could say I heeded all the doctor’s stern warnings, slept in, and relaxed all day, but I was at the damn laptop ‘just checking in’ at the office from sun-up to about 1 PM
Maddy and Zack weren’t due home for hours yet, and I figured I’d take my chances at work and get some shut-eye. So with a short coughing fit, and some scary sounding wheezing, its time for a nap, and 2 seconds after I become horizontal, I’m sound.
I forget to turn off my cellphone, and two (very short) hours later, I am dragged from the pit of sleep by its incessant ring. When I got the fancy phone, I programmed the Ramones ‘I Wanna be Sedated’ as my ring tone. I thought it was a harmless blend of funny and cynical, but lately its just damn annoying, as every time the cellular rings, the ring tone now seems depressingly prophetic, not funny.
I don’t pickup the call, but the ringing wakes me anyway, and I sit up and squint at the alarm clock. Was I really out for that long? I note the winking red eye on the cordless, and see that I also missed a few calls to our home voicemail. I figure its probably Maddy, as she has a completely unintentional sixth sense – If her hubby is in REM sleep, she will call.
Well surprise, surprise, it wasn’t Maddy, it was the Emergency Room calling. They would like me to come back to see them, as apparently I haven’t quite yet spent enough time with the broken down segments of our community.
I brace myself for the conversation I’m about to have, because I know it will be rife with vague references designed specifically to scare the crap out of you, all the while providing you with no real information at all. I recall getting one of these calls from my physician once, when I had a bad bout of the flu. While I don’t recall exactly why I had to return, it was about as medically important as a notification that I had left my fly down.
“Hi, this is Mark Klein, I visited your emergen….”
“Oh Hello Mark, can we have you come back right away?”
OK, so now I’m sufficiently freaked out. Not only did she sound insistent, I wasn’t put on hold for 20 minutes while people shuffled through charts and reports to figure out who this Mark Klein guy was. They had the name, and situation details right smack at the top of their to-do list. And lets remember people, their to-do list involves some pretty grim shit. Aneurisms, broken ribs, heart attacks and the like.
I don’t suppose you could tell me on the phone what this is about – right?”
(I asked with little hope)
“Well Mark, we took another look at your CT Scan..”
(why would they feel compelled to look again!?)
“..and we found something we’d like to take another, closer look at.
“Something?”
Like what? Lego I ingested in my youth?
The large obstructive mass of old bubble gum my mom told me to quit swallowing?
Or was it the ‘C’ word, undoubtedly caused by the lack of respect I’ve shown for my body since I was 14?
I was fast thinking it was door number three.
"I can be there in 20”
I said in a cheery voice that surprised even myself.
“Excellent, we’ll be waiting for you”.
I called Maddy, tried to downplay the ominous nature of all this latest development, and assured her all would be just fine, that I’d call her from the Hospital, once I had a bit more information.
Forty five minutes later I strolled into emergency, and true to Triage Nurse’s word, they were indeed waiting for me. My vitals were taken again, more grim looks, and I was off to station two – the Lady Behind the Glass. I handed her my file folder, and was politely told to never remove the wrist-band with my name and OHIP number, as it makes repeat visits faster (repeat? meaning more than twice?). She made me up another wrist band for me, and snapped it on my wrist.
Given the speed at which I was re-processed, it would have been entirely appropriate to have a ‘Welcome Back Mark’ banner strung over the waiting room entrance, complete with a polite smattering of applause from the miserable throngs. It seemed just that orchestrated.
Another nurse rushes in, and with the speed of an Indy pit-crew, quickly disinfected by wrist, pulls a needle off her little wheeled cart, and drew some more blood form my wrist. With the deft hand of a magician, she removed the tube from the needle, places it on the cart, grabs some gauze, and then looks me strait in the eye, and asks that I pay careful attention.
“This is drawn from the artery, and the blood is under pressure, so be sure you really keep the gauze tight, or it could start to spurt on you.”
Spurt? I ask myself. Spurting blood? Then shouldn’t you perhaps stick around? I find myself wondering.
I look to the Doctor of Few Words, but he has somehow slipped out of the room without me noticing. And if leaving me alone with the potential spurting artery wasn’t unsettling enough, the nurse abandons her little rolling cart of healthcare implements, and runs, no, sprints down the hall with my little vial of blood clenched in her hand. The squeak of her green crocs on the linoleum fading fast as she disappears into the depth of the hospital’s innards.
I am dutifully keeping that steady pressure upon the artery puncture site, and then it then dawns on me why the Pit-Stop Phlebotomist was in such a hurry. She wasn’t sprinting because my case appeared grave or required Herculean bursts of speed, but rather because she was rushing to perform an arterial blood gas test. All of the other blood tests I’d had were performed on a sample of blood taken from a vein, after the blood has already passed through the body's tissues where the oxygen is used up and carbon dioxide is produced.
An arterial blood gas teat (ABG) measures the acidity and the levels of oxygen and carbon dioxide in the blood. This test is used to check how well your lungs are able to move oxygen into the blood and remove carbon dioxide from the blood. As blood passes through my lungs, oxygen is supposed to move into the blood while carbon dioxide moves out of the blood into my lungs. An ABG test uses blood drawn from an artery, where the oxygen and carbon dioxide levels can be measured before they enter body tissues.
My blood cells in the tube would have continued to consume oxygen and nutrients and produce acids and carbon dioxide at room temperature. If my blood remained at room temperature for more then 5 to 10 minutes, the pH, blood gases, and glucose values would all change. While cooling it to between 1ºC to 5ºC would slow the metabolism and help stabilize the specimen, given that the hospital has fancy equip to test on-site, Pit Stop Phlebotomist was hustling because she knew that testing the specimen as soon as possible after collection would ensure the most accurate results.
I was immediately whisked right back to my friend, the Medical Home Theatre Reclining Chair, and soon I was speaking with another doctor I hadn’t seen before. He met my eyes with a curious blend of ‘stern’ and ‘its gonna be alright’ and commenced to explain what was so worrisome. He did his best, but it’s true what they say – patients hear 20% of what is told to them when they are stressed out. It’s a good thing everybody else I came across over the next few hours had the script with them, for it was only after becoming ‘repetitive question man’, that I finally gained an understanding of my predicament.
I remember thinking it was pretty funny that when the doc first mentioned “PE” my brain translated the acronym as “Physical Education”, not “Pulmonary Embolism”. And especially ironic given the fact that had I experienced more physical education in my life, I probably wouldn’t be in the pickle I was in. Life’s fucking funny.
Thinner is Better
One if my favourite Nurses, Paula, made a surprise reappearance, and as with all things since my sudden return to the ER, she blew into the room with a real sense of purpose. A tiny paper cup with water is handed to me, which I down immediately. Paula laughs, and produces another, much tinier paper cup with some pills, and informs me the water was supposed to help me ‘wash down the Warfarin’.
Now undoubtedly, I was probably told earlier why I would be ingesting rat-poison, but I really had no recall. While I also couldn’t recall where or when I would have been introduced to the word ‘Warfarin’, I was pretty sure that’s what we used to feed the mice at the farmhouse when I was a kid. My brother and I would carefully line up the stricken mice like dead soldiers on the kitchen window-sill. An ominous warning indeed, to all the other cowering mice – stay away! – we have Warfarin, and we aint afraid to use it.
Warfarin is indeed a rat poison. And it is also an effective anticoagulant, or blood thinner. The medical equivalent is known as Cumadin, and is designed to reduce the formation of blood clots in veins and arteries. I imagine as they were doing the post-mortem on the original rat, at the great rat-poison laboratory, they noticed that not only were the rats very dead, their blood was also real thin. Eureka!
Its now also used to prevent heart attacks and strokes…all things I’d prefer to avoid. Given its wide-range of uses, I was pretty pleased I was being asked to take the little pills.
And naturally, as with most drugs, there are side-effects (I Googled it) …and the side effects fall suspisiously under the heading of ‘Cure Sometimes Worse Than Disease”
Consult your doctor if you think Cumadin is right for you…Cumadin may cause birth defects in unborn babies..if you need a spinal tap, temporarily stop using warfarin….don’t use asprin or any anti-inflammatory drugs while on the rat poison, as these other medicines can affect blood clotting and may cause serious bleeding in your stomach or intestines….
OK, so I’m at no risk for the birth defects thing, and if I really needed a spinal tap, I’ve got bigger problems, but wait! …there’s more..
Speak to your doctor if you feel Cumadin is the answer to your prayers, as Vitamin K decreases the effects of Warfarin, and large amounts of vitamin K are found in foods such as liver, broccoli, brussels sprouts, spinach, swiss chard, coriander, collards, cabbage, and a host of green leafy vegetable, so speak with your doctor, and please avoid these foods, and stay away from cranberries too...
OK, so I shouldn’t rescue the large broccolli at the back of my fridge and convert it into soup, as I was planning. Maddy will be thrilled, as she hates broccolli, and I do believe even its mere presence in the house is unsettling for her. Done. No broccoli.
Ya know, all these weird restrictions seem really arbirary and unconnected. Why the hell should something like broccoli place me in peril?! What about bacon? Can I eat a vat of bacon? Pork rinds?
Enter nurse Number Two, again with that ominous sense of purpose. Needle in hand, with the syringe pulled back, ready to administer some sort of a shot. The shot I was told (but later had to Google because I forgot the details immediately), was Tinzaparin, designed to bust up My Clot. Lovely Nurse #2 would inject the Tinzaparin directly (by what else?) a needle, into my stomach.
Tinzaparin is also a blood thinner, that is supposed to prevent blood clots from forming in my body. I was guessing it was the Roto-Rooter of thinners, capable of zero-ing in on all your unwanted clogs. It is used to treat a type of blood clot called deep vein thrombosis, or DVT. This condition sometimes occurs with a blood clot in lungs, or pulmonary embolism. Tinzaparin is used together with warfarin (Coumadin) pills, to treat clots. Which I already popped just moments before. It seems the closer the clot is to vital organs, the more aggressive the thinner therapy.
….speak to your doctor if you think Tinzaparin might save your miserable life, as Tinzaparin may cause severe or life-threatening side effects if you use it while while you experience active hemorrhaging, such as a bleeding ulcer, nosebleeds, and do speak with your doctor if you experience unusual bruising, blood in your urine or stools, unusual vaginal bleeding, or begin coughing up blood….
OK, so, I’m safe in respect to the vaginal thing, but the other stuff sounded a tad ominous.
The kind faced doctor with a soft spoken manner, instructed me to return to emergency if I have any signs of these symptoms, which also included feeling light-headed, fainting, uncontrolled nosebleeds, pale skin, unusual weakness, easy bruising or bleeding, or purple or red pinpoint spots under my skin, and again, coughing up blood.
At this point Lovely Nurse#1 pinches a small amount of skin on my stomach, and injects the Tinzaparin. I didn’t even feel the needle.
Now I could see why they would need to warn me (again) of the dizziness, and the nosebleeds, but honestly, do people really need to be told to come to emerg when they cough up blood? I mean that guy in that horor movie coughed up blood right before the alien jumped out of his chest. Spewing blood is always a harbinger of bad things.
So I have my orders; I am to report back to the Emergency Room daily, for my stomach shot of Tinzaparin, and I am to chow-down on the little Cumadin pills they give me. They will monitor my INR levels (my Internal Normalized Ratio) which is just a fancy acronym for the thinness of my blood). They aim to have my INR stabilize between 2 and 2.5. And apparently its tough to say just how long this is gonna take. I’m only at .87.
That little voice in the back of my head (that was telling me to panic) was getting louder by the minute.
Super.
Day Three
Friday July 13
The Monotony Begins
So now my dual-life begins in earnest. By night I am a normal person, meeting all manner of family obligations including dinner (no broccoli though!) playtime with the boy, and generally fairly restful sleeps. By day though, I am Clot Boy! fiercely determined to fight The Evil Blockage, whilst never inconveniencing friends, clients, customers, or my employer.
Apart from saddling Maddy with the task of now taking Zack to school in the morning, everything was pretty normal. I would wake each day at
Before leaving the house this morning, I take all the stuff out of my laptop-bag and cram it with a few dozen magazines for the waiting room. I have lots to give away, as for some stupid reason I have felt compelled to keep all of Maddy’s “Home & Garden” magazines when she was a subscriber. They’re a few years out, but hey, overpriced chic for the home is always in style, and it beats the heck out of reading the medical pamphlets scattered around the waiting room. If you read enough of them over extended periods of time, you become fairly convinced you have whatever malady they are warning you about.
Given my job, I am painfully aware that keeping any manner of interesting reading in a waiting room is a fools game. I also know that when people steal magazines (which is pretty well all the time) they very rarely ever complain about the wait-times. Please people, feel free to jam the magazines down yer pants, into your purses and briefcases. We just don’t mind.
So day three of emergency acquaints me with all manner of human oddities, and it starts even before I enter through the large smoked safety-glass doors, at
As I make my way up the steps from the parking lot, with my stash of out of date decorating magazines and my huge coffee, I suddenly become aware that the short climb seems like a long hike. I have to sit down and catch my breath for a moment or two. While I sit, I notice a woman in hospital scrubs throwing something to an excited black Labrador retriever. Oddly enough, the object of the dogs interest is not a ball at all, but what seems to be a semi-round rock about three inches in diameter. I find myself wondering when tennis balls got to be so damn expensive. Funding cuts even hurting the hospital mascot?
As I make my way up the path along the edge of the building, past the automatic doors designed for the gurneys and the ambulance crew, I come upon two women, well actually, one girl about 16, and a woman about 40 ish. They are both sitting on the bench just outside of the ER front doors. Swearing up a storm, they recount the mundane details of their latest boy-troubles. What strikes me as odd, (and sadly, something I cant seem to just let go) is that they both are sitting there, directly under a huge sign that reads: ‘This is NOT a smoking area, do NOT smoke here’. Naturally they are both smoking, the cloud produced, I walk through on my way past them both. I recall an elderly woman sitting on the same bench the day before, with the portable oxygen tank, but she however, wasn’t smoking.
Without slowing my gait, I point to the sign above their heads, and ask them what part of the sign they find particularly confusing. And immediately, as if waiting in anticipation of my commentary, with the butt securely fastened and bobbing in the corner of her mouth, the 40-ish woman pauses mid-stream in her profanity riddled discussion, and screams: “fuck-off asshole, shut-thefuckup whydontchya mutherfucker!”
I smile nervously, and keep on walking without retort (I honestly was a bit taken aback by the fury). I feel smug in the knowledge that given her forty-ish going-on-sixty pallor, she’s likely visiting the cardiac ward, and that eventually our OHIP dollars will be permanently reassigned from this idiot, to another.
And so begins my day in the ER.
By now I have picked up a few time saving tricks that I learned from the many hours already logged:
1) As soon as you enter, if there isn’t anyone in front of you, quickly sit down at the triage chair, so your vitals can be taken pronto. Let the Triage Nurse know you are a repeat customer, so your file can be quickly retrieved.
2) At the Glass Window, quickly shove your hand forward, so as to expose your wrist band (for gawd sakes, don’t remove it at night! Shower, eat, whatever, but keep the bracelet on!)
3) Say No-No-No, and then No, in rapid succession. This saves Lady Behind the Window the time consuming task of having to ask you if you have diarrhea, a fever, have stayed overnight in the hospital lately, or if you’ve traveled out of the country in the last six months.
4) Before sitting down to wait, proceed immediately to the Automatic Parking Chit Dispenser, and insert either a CRISP bill, or insert the exact change you were smart enough to bring with you. This will allow you to leave immediately when you are discharged, and save you the uncomfortable experience of having to watch another poor wretch beat the shit out of the parking chit dispenser for refusing to take crumpled bills.
Adhering to the above rules can shave anywhere from two to three minutes off your total ER wait time.
I’ve flown past steps one through four, performed a sort and discard on the torn and crappy waiting room magazines, replaced them with my stack-o-mags, and read one in its entirety (a special edition on shelving and storage solutions) and then, my name is called. There is one other lonely person in the waiting room, and he appears to have no apparent malady.
I know by now I am not actually seeing a doctor this quickly, but I am being taken to the curtained off room next to Triage Nurse to have my blood drawn. The results of the bloodwork will determine my INR levels, so as to ascertain the proper Cumadin dosage, prior to my gut-shot.
I am reacquainted with the same phlebotomist I met on day one, when I first presented in the ER. Linda is what I’d categorize as a ‘career phlebotomist’. Sunny, efficient, a tad world-weary, as she has likely seen it all. She greets me with a warm smile, and exclaims her surprise at seeing me.
“They told me you were discharged on Tuesday night, and we were all a little surprised they let you go home. How are you feeling?”
Now this greeting was worrisome, and somewhat confusing. Should I have been admitted? Was there some sort of odd sowing circle of nurses that perused the day’s cases, second-guessing the physician’s directives? Should the Hang-Ten Doc on Day One have kept me overnight?
I say I’m feeling much better, and am looking forward to not having to return daily for shots and bloodwork. Linda then launches into an apology. She is concerned that when we first met, she looked just awful, and assures me that she really doesn’t look that bad all the time. Seems her father had just died, and last Tuesday was her first day back at work after the funeral.
I’m a little taken aback by this candor, and soon we are discussing the details of her father’s demise. As the story unfolds, I am beginning to feel quite embarrassed, and not just a little bit humbled. Here I am, living my new life as Clot Boy, experiencing the healthcare world efficiently revolve around me. Less than a week after her father is wheeled to the basement morgue (right in the very hospital she works in) here is this woman, back at work, helping me. She displays no bitterness, just some muted sadness over the loss.
My competent phlebotomist releases the tourniquet on my upper arm, deftly switches each full blood tube for new empty ones, and explains that while her father wasn’t doing all that well lately, nobody expected him to go that fast. She had made space in both her life and her home to care for her elderly father, and had rushed him into emergency when he was having trouble walking. It was all over within 24 hours of admittance. She didn’t volunteer the details surrounding his particular ailment, and I secretly hoped that the reason for withholding the information wasn’t because her father had a blood clot, and then stroked-out.
The needle puncture was taking a fair bit of time to clot, and I had soaked through the first cotton ball wad. There seemed to be a commotion outside in the waiting room, and I could hear people in the hallway filing into the waiting area. Linda reminded me that the blood thinners were simply doing their job, re-applied a new cotton ball, and reassured me a bit more constant pressure should do the trick. She had a pretty big stack of bloodwork requisitions to process, apologized for not being able to stay longer, and was on her way. Back to the waiting room I go.
Today’s motley crew of physically damaged visitors is composed of:
A gang of six east Indian kids, I’ll refer to as ‘the Car Accident Posse’.
An elderly woman in a wheelchair and her husband, I’ll refer to as “Dysfunctional Couple”
A pretty young lady with a huge shiner under her left eye.
A young girl, who cant stop vomiting.
And two burly hospital security guards, their presence mainly linked with the Car Accident Posse.
I take my seat in the corner closest to the coffee table opposite the TV screen. The 20 inch unit hung high up in the corner is blaring a really bad children’s program, which nobody seems to be watching. This has got to be the fourth time I’ve noted the channel tuned to something insipid, with nobody making any effort to change the channel. Discounting the physically challenged patients, you’d figure that at least those capable of movement, (currently staring at the wall) would want to change the channel.
On my way back to the my super-large coffee I have left on the magazine table when I arrived, I swing by the TV and change it to CNN, and lower the volume. I am especially restless today, and find myself pacing the room and the adjoining hallways. I can hear one of the two burly security guards practically yelling at the Car Accident Posse,
“If you don’t quiet down, we will throw every one of you out of the ER.”
Two girls, three boys, and the alleged accident victim make up The Car Accident Posse. When the security guard shouts his warnings (clad in some over-the top Mad Max outfit, complete with what looks like body armor), the girl is the most defiant, rolling her eyes, actively looking for the boys to show the same amount of disdain. The boys look suitably intimidated, and shut up, until the nightstick-men leave. For the next 40 minutes or so, I listen to them recount their little tale of misfortune to at least three people in the waiting room, and to each other about twenty times. It seems that ‘a fucking cabbie’ cut them off, and they crashed the car they were driving. The accident victim held a wad if paper towel in his mouth, soaked with blood. Oddly, this didn’t seem to slow his yapping any.
“I’ll beb you anybing that the fucking cabbie gets off, and nubbing happens boo him.” He blubbers through the paper towel
The mother of vomiting girl asks;
“was he charged at the scene?”
No man, that basbard jus took off!” Bloody Mouth Kid replies.
“And it happened so fast, we didn’t even get the fucker’s plate number either!” Defiant Girl blurts out.
“Were the police involved?” Asked the pretty girl with the shiner.
“No, we had to get our friend to the hospital right away!”
As the rest of the Posse expounds (yet again) upon the grave injustice at play here, and as Defiant Girl cradles her injured mans head with a ‘there-there, it’ll be alright’ gesture, I come to the fairly obvious conclusion that the Posse is full of shit.
They crashed the car because they are teenagers, and six teenagers in a car is a big driver distraction, and the driver looks like an idiot. His friends and girlfriend aren’t in the Mensa Club either, and everyone is just a tad too riled up about ‘the fucking cabbie”. I think its safe to say that the cabbie doesn’t actually exist, as (conveniently) neither do witnesses, a police report, or anyone’s parents. And I am just so glad this group of idiots will be adding to my wait time.
Vomiting girls mother is extremely composed. She holds the waste-basket in front of her kid, and seems fairly unconcerned about the retching. Vomiting Girl, who looks no more than about 11 years old, seems pretty sullen, which is to be expected.
Someone gets up to change the channel on the TV (shocker!) and we are now listening to the insipid banter of the local morning show hosts. While the woman is pleasant enough, the fellow is really annoying. I cringe as someone turns up the volume so we can all hear and see his amateurish camcorder footage of yet another accident he has witnessed on his commute into work. I wonder if he is aware that every time they air one of his little ‘human interest pieces without context’ the station owners just saved a few bucks, by NOT having to send out a professional camera/news crew. And I wonder if the guy is wondering why those savings aren’t translating into a heftier xmas bonus for him.
The Dysfunctional elderly couple are by far the most depressing slice of humanity I’ve had to share a room with. The old lady looks like she’s in real pain, and is squirming to be able to lie down. She’s pretty sure if she sends her (shockingly disinterested) husband to speak with the Lady Behind The Glass, someone will rustle up a gurney for her.
“Why don’t you just shut up and be patient, like everyone else here?!” The old man snorts, barely taking his eyes off the camcorder-carnage on TV.
“Why do you think you are more important than anyone else here?”
So at this point, the interaction is making me terribly sad, and angry. For gawd sakes, if you hate her that much, ya old fart, just shove off and tend to the rest of your life alone. How the hell does one stay married and be so full of hate, when they have so little time left on the planet?
++++++++++++++++++++++++++++++++++++++++++++++++
OK, so it occured to me that I really should share some correspondence I have on file. I had come across a local newspaper, and there was an article slagging the health care institution that saved my life.
Dear __________.
When Your health Fails, Mom aint the answer....
I stumbled across an old News Advertiser the other day, and happened upon your sanctimonious 'review' of the Rouge Valley Ajax and Pickering Hospital’s Emergency Room. Normally I wouldn’t have paid much attention one way or another, and your opinion-piece would have seemed like nothing more than the whiny diatribe of a woman who has absolutely no comprehension of the complexities of managing an ER dept.
However, as luck would have it, I recently had the opportunity to meet and interact with the very healthcare staff you seemed so quick to dismiss as 'revolving door' nurses…and I didn’t have just fleeting interaction, but was a regular visitor for over a week. During my stay, I met caring thoughtful nurses, shockingly accommodating administrative personnel, physicians with a bedside manner that made me feel at ease and well cared for, as well as a sea of friendly faces.
So, in odd juxtaposition with my personal experience, is yours. An experience apparently rife with rude employees, poor medical treatment, cramped and even unsanitary conditions. I was at first puzzled by the incongruence of our two experiences, but then I re-read your piece.
In your snide article, you mention you have had 16 operations in your lifetime, and are no stranger to surgery, or long hospital stays. Your most recent trip to ER was for Intussusception, which as far as I understand it, is a rare but serious disorder which reeks havoc upon the intestines. Given your familiarity with all things medical, you likely know that the condition is often fatal without proper medical care so as to prevent dehydration, shock and infection. While Intussusception cuts off blood to the intestine, in your case it must also have cut off blood-flow to the part of the brain responsible for rational thought and compassion.
I hate to be the one to point this out to you, but thanks to the medical intervention you received in a busy emergency room, you are able to write future snide articles, and you free to continue to denigrate our under-funded, overworked, and underappreciated healthcare workers. Despite your (undeniably) poor attitude, the very people you see fit to insult, probably saved your very life.
Are you really so naive that you would sparingly dole out thanks to just the surgeon? You note that she was the 'shining star' of your story, after which point ‘things went downhill’. Is it possible that you can be so self-absorbed in your personal plight that you would not recognize that the surgeon was just a small piece of the healthcare puzzle? All those dedicated individuals you were so quick to dismiss - the diagnostic technicians, the phlebotomist, the nurses, the admin staff, they all played a part in providing the surgeon with the clues to your condition. Without them, the surgeon would not have even picked up the scalpel. Without everyone working together, you would have perished. Let me repeat that for emphasis – you would be dead.
I suppose I can understand the moral outrage that can colour ones judgment when they encounter what they categorize as substandard service. What I cannot understand however, is why a sentient emissary of our local press establishment would feel it reasonable to simply air an opinion, without even attempting to affect positive change. Did you feel slinging arrows would do anything more than denigrate and insult? Did you not feel it was important enough to contact the hospital directly to express your concerns?
You sit at home now, smug in your comfortable opinions, and since you left the ER, perhaps hundreds of nameless, faceless people have relied on the Ajax Pickering ER Room to restore their health. I walk upon our green earth today, thanks in large measure to the entire team of that hospital unit. Caring, professional healthcare workers, the entire lot of them.
You should know your cheap shots undoubtedly hurt many people who do a tremendous service to our community. Shame on you for not caring enough to turn your experience into an opportunity to provide constructive feedback.
The next time you get sick, I offer you this bit of advice: Please do not call your mother in New Brunswick. While you may not wish to head back to the ER, mothers are great for support and chicken soup, but generally pretty lousy when it comes to emergency medical intervention for the treatment of rare intestinal disorders.
================================================================================
and the moron's response.....
Dear MK,
Thank you for taking the time to respond to my column. I always appreciate hearing from readers.
I am truly glad that you received such wonderful treatment at the Ajax Hospital. Hopefully most people do and my experience was the exception.
I am aware of the serious nature of the condition that I had and, as I state in my column, I am happy and thankful to be alive. However as a journalist I feel I have a moral obligation to speak out when I see a publicly funded institution that isn’t up to snuff. Contrary to what you state in your response, my column was an attempt to affect positive change.
I enjoyed your letter and hearing your comments. If you would like it to be considered as a letter to the editor please forward your telephone number as my editors confirm all letters by phone.
Again, thank you for writing.
================================================================================
and my response....
thank you for the reply, most appreciated.
I considered the option of writing to the editor, but felt it couteous to correspond w/ you first.
There are total word-count restrictions on letters to the editor, However, if the paper would agree to consider publishing my letter in its entirety, I would be most willing to provide my name and number. Otherwise, the only further action I had planned, was to provide the Hospital Management Team with a copy of the letter I penned to you.
Let me know, when you have a moment.
Mk
===================================================================================
and pretty much what I figured she’s say....
Hi MK,
Unfortunately the word limit is a firm rule. We don't publish letters that are over 300 words. If you would like to re-submit it at some point I welcome you to do that.
===================================================================================
…and my final correspondence with this idiot...
I will attempt to whittle it down, but it stands at over 700 words in its current form. I doubt the distilled version would accurately convey my thoughts.
I trust you noted a recent article penned by your colleague, ______, on the recently approved (and badly-needed) funding for the hospital's expansion. I read with interest that the emergency room that you considered so sub-par was designed for 20,000 visits per year, but currently handles 46,000 patients.
Again, thx for the prompt response.
Mk
================================================================================
...and then I forwarded it all off to the Hospital's Patient Relations Director, who brought it to the CEO, who adressed the ER Team in person and read the letter, then had it framed and posted in the staff lounge.
Now THATS a smart boss.
And my health? I have an appointment w my doc next month, to discuss the side effects of the rat poison, which are (at times) pretty crappy, and tough to take. Unfortunately there is only one way to halt the blood thinner therapy - I need to endure massive amounts of radiation, if they are ever going to locate the source of the original clot...and wouldnt it be one of lifes ironic twists...man dies of cancer, because of the radiation absorbed, trying to keep him from having a stroke!
So, as they say, there Are Always Choices...and I have a few.
1) Stop taking the thinners, risk another blood clot that has me dead before I hit the ground.
2) Continue on the thinners forever, bloodwork/tests every Monday for the rest of my life, and develop arms with junkie trackmarks.
3) Get a bunch of x-rays that (might) find the source, or perhaps not...and stroke out anyway.
swell.
PS: if all my Facebook postings suddenly stop - call Maddy ASAP to find out the details about the wake - There will be an open bar for sure!
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