Thursday, July 29, 2010

I Think I Set A World Record For Almost-Dying: Part Two: What's A Blood Pressure SUPPOSED To Be?

I almost died twice in one week. Part one of this story is here.

Almost dying can be kind of relaxing, provided you don't know what's going on.

That's the kind of wisdom that I, as a guy who almost-died twice in just 7 days, can pass on to you. That's a quoteable quote, right there. It'll probably appear, in mispelled Korean, on the arms of young actresses within a week or two. From there, eventually, it'll appear on a postcard under the picture of a giant Ratalope in a gift shop in Oklahoma, and after that my words will be forgotten. (That, my friends, is the lifestyle of an inspirational quote these days. Unless you're lucky enough to appear as a chapter heading in a Chicken Soup book, in which case you're immortal. I'm working on my own Chicken Soup book, by the way. It's going to be called Chicken Soup for the Chicken Who In Short Order Will Be The Soup. Look for it in bookstores shortly after I finish writing Aeneid, Missisippi.)

The treatment for bee stings is surprisingly easy -- provided that you'd like it to be ineffective, as well. First, it involves a conversation that invariably goes like this (once you get past the religion question):

Caregiver/person in scrubs/person holding stethoscope: So, you got stung by a bee?
Me: I got stung by
sixteen bees.

Caregiver: Are you allergic?

Me: I don't think so.

Caregiver: You are now.

I had that conversation, more or less, with the triage nurse, the nurse who met me in the ER room, the guy who was a paramedic in training who was in the ER room, the doctor who came in, and, ultimately, Sweetie, when she got inside after dispatching Oldest and Middle off home with the Babies!

Beyond that, the treatment for bee stings -- the ineffective one -- is to give the person a dose of Benadryl, and a dose of steroids, the latter (a) making me ineligible for the NFL this season, and (b) tasting absolutely disgusting. I'm no pup, as I've mentioned, so when I say something tastes disgusting, you can either be pretty sure I'm describing a vegetable, or something equally gross tasting. The steroid pill left a trail of slime down my throat and then began to rot in my stomach, making me feel a little queasy.

"That's normal," they'll tell you in the ER, while not apologizing at all for the medical establishment's complete inability to make medicine taste like something other than rotten mold. It's like the compost those pills. Health insurance companies are probably behind that; we'll seek less treatment if we know that taking medicine is basically the equivalent of licking the bottom of a 3-year-old's shoe.

The other thing I found disconcerting, beyond the amazingly rancid flavor of steroids, is that some of the medicines they gave me were things I already had in my medicine cabinet at home -- things that I'd already known to take, in fact. That's not what I go to the ER for. If I wanted to get a treatment I could give myself at home, I'd simply stay at home and Google my symptoms (Googling symptoms is now considered front-line treatment under Obamacare, you know, so you can get reimbursed by the federal goverment for doing just that whenever you, like me, have the sniffles and like me Google them and self-diagnose a possible brain tumor), as I actually tried to do until one of those symptoms became "pain in the chest" and I was forced to consider that Sweetie might be right on with that go-to-the-ER idea she'd floated.

So at the ER, it seems like they should do something I couldn't do for myself. They should hook me up to machines. They should take my blood. They should monitor things that need monitoring. And they should not say "Here's a Benadryl." Imagine if other professions did that. You'd go to a lawyer and he'd say "Oh, if you want to sue someone and get a million bucks, just cut-and-paste the names in this document and have it handed to them. That's what we do." Or your mechanic would admit "All those things under the hood don't even do anything. Your SUV runs on black magic. You're going to Hell." (That latter only applies to people who drive Escalades.)

They did have me hooked up to two things. The first was that little "Pulse Ox" monitor, the clip that goes on your fingertip and claims to be monitoring your oxygen when clearly it's doing nothing. There's no way to monitor oxygen levels in the blood without getting at the blood, especially through a fingertip. I tested one of those things once by holding my breath for a really long time (about 15 seconds, maybe?) and noted no change in the blood oxygen levels' readings. So that's a scam, and I'm going to tell my insurance company not to pay for that monitoring. Those things have all the effectiveness of Buzz Lightyear's laser.

The other thing was the blood pressure cuff, which was set up to automatically check my blood pressure every so often. Don't be fooled, if you're in the ER, by the fact that the cuff is around your arm: It's not constantly reading anything. If it's not puffed up and ticking, it's doing exactly as much medical care as your wristwatch. Maybe less, since my watch at least has an attractive Buffalo Bills' logo to distract me for a second just before I almost die; or it would have, if I'd had it on.

I didn't have my watch, but I did have a pretty clear view of a clock, and it said it was 7:55 p.m. The nurse and doctor checked in to see how I was feeling, and I said okay, the Pulse Ox fake-read 97%, and the blood pressure monitor told them what my blood pressure had been 10 minutes before, and they said I'd be going home soon.

Then I felt a little sick, and told Sweetie that I might barf. Sweetie tried to help, finding a large garbage can to give me.

"That's a garbage can," I objected, feeling a little more queasy. She looked around and I pressed the nurse call button. "I'll ask the nurse to give me something."

A minute or so later, nobody had come in, and I said to Sweetie "I feel really sick; can you lean out in the hall and see if someone can give me a bucket or something?" My pulse ox, I should note, was fine, and my blood pressure from 15 minutes ago continued to be great.

The nurse then came in, gave me a little pan in case I threw up, and left. A moment later, I thought I was going to throw up and told Sweetie to get the nurse again, and then here's exactly what I remember:

1. A nurse came in, and I closed my eyes and coughed a few times, leaning forward.

2. I laid back and I couldn't open my eyes.

3. I heard someone say they wanted to give me a shot, and would that be okay. I thought I said Sure but I'm not positive that I answered.

4. I tried to open my eyes again, and couldn't, but found that to be kind of nice, anyway, the way it feels nice just before you drift off to sleep at night.

That all took, by my estimate, about four or five minutes, tops. Also, I was very warm -- it suddenly got all cozy in what had been a pretty-cold ER.

Then I opened my eyes again, and the clock said 8:30. Sweetie was the only one in the room with me.

Sweetie said that there had been 3 or 4 people in the room, that they'd given me two shots, asking me permission to do both, and that I'd responded. She said that the first nurse to come in had looked at me and said "Go get the doctor" and then a bunch of people had rushed in. She said that during it all, my blood pressure had dropped to something like 65 over 20.

Which, I understand now, is bad.

I didn't remember any of that; I remembered the one question about one shot (but not getting it.) I'm not sure why they'd ask that of me at that point, anyway? I know we're all crazy about lawyers and lawsuits and suing everyone (and I'm part of the problem) but does it help to ask a person who's nearly dead whether they consent to something? When his wife's sitting right there?

That happened once before to me: After Sweetie had the Babies!, she'd lost a lot of blood and was having a little trouble coming back around. She was awake, though, but kind of loopy and delirious, not making much sense. I was standing by her bed, and occasionally holding one of the Babies! while I watched over her. At one point a doctor came in and described a minor procedure they'd like to do to help her.

"Sure," I said.

"We need her to consent," the doctor said, and looked over at Sweetie and began describing the whole procedure again, including all possible side-effects and other treatment options. "But I recommend this," the doctor said. "And now. Do I have your consent?"

Sweetie, glassy-eyed, looked at me, smiled, and then looked back at the doctor. "What are the side effects?" she asked. After more back and forth like that-- Sweetie talking woozily -- she finally said "Okay I guess," and they did the procedure and she was fine, except for later that night when she told Middle to make sure not to forget her umbrella -- the umbrella Middle hadn't brought, what with it being a hot, sunny day and all.

Sweetie's consent there was worthless, while mine was worth very much -- and the exact opposite played out in the ER after the bee stings. What if I hadn't said okay to the shot? Would they have just slipped me another Benadryl, said "His pulse ox is 97%," and left? I wondered that, later on, as I tried to sleep in the hospital room. I also wondered what they'd done to me while I was out -- what shots they'd given, and why they hadn't given me those in the first place? Why try to gross me out with steroids and give me cold medicine when you had these magic shots that would actually work? Once I'd gotten the effective treatment, the one I can't buy at Walgreens, I felt a lot better -- but I still had to stay in the hospital.

They admitted me, of course. A little after I'd successfully opened my eyes and gotten the lowdown from Sweetie about what had happened while I'd been consenting to things and not having any blood pressure, the doctor came back in and said they were going to keep me overnight for observation in the hospital, so I got to ride up to the sixth floor of the building and get transferred into a bed about 9 p.m. Sweetie hung around a while, making sure that I was adjusting to the room and also that I wasn't going to stop pumping blood through my body again, and then headed home to let the girls and the Babies! know what had happened.

For my part, I laid in bed and tried not to feel the various bee stings itching, and flipped through channels on the TV, trying to sleep as best I could, something that was made harder by the hospital workers coming in every 30 minutes or so to do things to me. Having failed to either get me home or kill me outright in their first course of treatment (Give him stuff he could have brought in with him if he'd asked) they now seemed determined to go the other route, giving me everything they could think of and monitoring all my vital signs and some of the nonvital signs and some signs I think they just made up to get credit for monitoring them, doing that almost continuously throughout the night, which posed a real problem for me, as I had to keep trying to find TV shows that were interesting but not embarrassing. When a nurse or doctor or CNA or someone comes in to take a level or pulse or sample or something else, n
obody wants to be caught watching Invader Zim or Married, With Children re-runs. Or at least no 41-year-old lawyer with bee stings wants to be caught watching those things.

But I couldn't find anything else on that I wanted to watch and be seen watching, so I finally gave up and watched a marathon of Spongebobs and other cartoons, drifting in and out of sleep -- getting my best rest when the CNA who was supposed to check my blood pressure every two hours (because what could possibly go wrong in a less-than-2-hour interval?) forgot, from 4 a.m. until 10 a.m., to do that. I didn't mind. I just rested, and also waited for the doctor's orders that I could eat real food to catch up to the hospital kitchen's notes claiming I was limited to broth.

Next: Out of the hospital, into the era of saying "Boy, I got stung by a lot of bees. I'd better go home early today."

Above: Mr Bunches examines the
emergency adrenaline shot I now
carry with me everywhere, in case I either get
stung by bees
or if I need a little afternoon pick me up.
(The latter is an off-label use.


Renée M. said...

I think I understand the frustrations you felt then-- once, I had an appointment at my neurologist's, seeing as my vertigo was appearing more and more the end, he just asked a few questions and said: youre fine. stop imagining things. And since then, I never came back. said...

Hey Briane P.

Again, I am veryhappy you survived that attack that sounds almost as bad as the Japanese attavck on Peral Harbor (You weren't born yet, but surely you read about it in History class).

I must say I have had my laugh quota for the day. I really like your writing style and humor. You are right up there with Hiassen.

Michael Phelps
David Janssen-My Fugitive (With Ellie Janssen)
The Execution of Justice
The Jockey's Justice (Sep. 2010)
David Janssen-Confidential Conversations With A Friend (Dec 2010)

Penny Giron said...

Sounds exactly like the experience I had in the ER after an allergic reaction to penicillin, except I never filled the prescription for the Epi-pen. Penicillin is much easier to avoid than bees.

Constance said...

Yet another useful entry for me. You keep putting out some great info!