margaritaboy said:
Hey! How about a freakin' update for god's sake. You can't get on this forum and claim severe abdominal pain, be called a tool by some posters, and then not give us some resolution here. We EM folks need some continuity of care and some follow up. No matter what your condition, please crawl over to the computer terminal and put us out of our misery. Give us the goods. Did you have AAA, or was it food poisioning or what? Are you 6 feet under today, or did you go to the ER?
Ok OK. Relax. Wanted to catch the last friends. But it sucks, so I'll post here instead. What is AAA?
I found the whole experience really interesting, and am SUPER interested in hearing what anybody on this forum has to say about it.
Let me clear up a few things first. I posted to this forum originally because I have become sensitive to the fact that people often over-use the ED. As i said, I didn't want to be considered a tool by the ED staff when I presented myself to the ED at 2 o'clock on the morning with what would be considered the equivilant of a hangnail. So, my purpose was to find out how the ED staff would recieve me if I did go, and it turned out to be nothing at all. After all, had it turned out to be a heart-attack, then I would not have had to worry about being seen as a tool (if only).
OK, so here is the whole story:
I started to get some pain in my abodmen when i woke up wednesday morning. It progressively got worse all day. By 11 am, I was bloated and distended, and I had a generalized dull pain around the whole abdomen and up under the sternum. No fevor or nausea. But no desire to eat, either. I took some pepto, and had about ten seconds of relief and then the pain came back. I tried mylanta at around 9pm, and then again at around 10:30pm. At 10:30pm I tried to hit the sack, but the pain was much worse when laying down. However, when laying, the pain was NOT much worse under the sternum (which is what I would have expected had it been heartburn), but rather in the abdomen. And, as i said, I really didn't get any relief from the antacids.
At around 11:00, I started this thread (I think - I may be off by an hour - it's hazy a bit) and hemmed and hawwed for about two hours, trying off and on to go to bed. But the pain started to interfere with my breathing - and at that point I decided to hit the ED. I got there at 2:15 am.
In Cleveland we basically have three major hospitals. County (Metrohealth), the Cleveland Clinic and University Hospitals. There are about 12 smaller hospitals in Cleveland, but they are ALL owned by CC or UH. I went to a smaller one owned by the Cleveland Clinic near my house.
When I got there there was nobody in the waiting room and the triage nurse took me right away. Normal temp. BP was 120 over 70 (I rock, because I'm a bit overweight). Took 10 minutes to do the insurance thing, and then I went into the waiting room. Triage nurse took me back about 5 minutes later. Went to the room and realized I was the ONLY person in the ED at this time. It has about 25 beds, and is located within the city limits of Cleveland, so this was a suprise.
The first person to see me was a PA. Took my history and did a VERY thorough physical exam. He answered all my and my wife's questions with what appeared to be enthusiasm and knowledge. Then a nurse came in and inserted an IV in the crook of my arm. Is this a "periferal line"? Anyway, I noticed that the nurse was actually considering an area on my wrist at first, but abandoned that idea almost immedietly. I asked why he had first considered the area around the wrist. He said that he suspected that he would be back in less than two hours to take this IV out, and that had he thought I was going to be there longer than that, he would have used my wrist rather than my arm. This suggests to me that the Nurse had already (correctly, as it happens) determined that I did not have a condition that would require admission, and in fact, would not even require a stay longer than a couple of hours. Good nurse as far as I was concerned. Anyway, hooked me up to a bag, started it dripping, and left with four vials of the good stuff.
Perhaps some of you can tell me what these four vails were for (ie, what tests were run on them).
I waited in the room for about 20 minuted after the nurse had left and a person from X-ray came over to transport me to X-ray. This was a suprise. The last time I had had what I figured was food poisoning, i was out of town on vacation. I sucked it up for three days and finally went to the hospital on the island after my temp hit 103. There, they took blood, told me I had an infection, gave me a cocktail of
something or other - which totally knocked me out for a couple of hours - and then sent me home with an anti-biotic with STRICT instructions to stay out of the sun (on Hilton Head Island at the height of summer - which i ignored, and thereafter suffered the worst skin itching in my entire life - I wanted to die). The point is, the last time I had this, I didn't get any X-rays. So, I was suprised by this.
Now, regarding the X-rays, I am curious. Was this CYA medicine, or was it indicated because I had no fevor? Do you suppose they were ordered because they figured that they needed to do
something for me because they figured that I was expecting
something. I'm not making a judgement one way or the other - just asking. I'm curious.
Anyway, they took one shot with me facing the film, away from the film, and my side to th film. They also took one with me laying on my back with the film under my back. So, four shots in all.
Went back to the room and waited for about a half an hour. The pain got pretty bad during this period, so much so that I found myself breathing deeply to help out a bit. Most of this pain was under my sternum, but it radiated to my back as well. At that point the ER doctor came in. And said that my blood work showed "nothing", but that my X-rays showed that I was "totally full" down there. So, there was NOTHING wrong with me in the end - which was why I was so reluctant to go to the ER in the first place. My worst fear was that this was heartburn or something, and that is what it appears to have turned out to be (the doctor said "indigestion").
Ten minutes later the nurse came in with what they called a "GI cocktail" which he said consisted of Lidocain, antacid, an anti-spasmatic and a stool softener. It contained Colase (which one is this?). I sucked it down and got no relief. The nurse told me to suck down plenty of MOM when I got home (followed by two glasses of water - you can imagine how full i felt after that, having already felt bloated when I went in). They discharged me at about 4:30 and I felt worse when I left than when I went it.
I finally fell asleep at about 5am, and despite all the MOM and water, have not had a BM all day. Nor even the desire to have one. Strange. But, I have to say that I feel MUCH better around the abdomen but still have a lot of pain under my sternum.
So, in the end, it turns out that nothing was wrong with me. I am a paying customer, so the hospital loves me, but I'm guess the staff does not.
I presented all this detail because I wanted to get the opinions of the regulars here about whether what went on in the ER seemed within normal parameters. EM is a field that I am interested in, and I thought the experience was interesting, if uneventful (as I said, the last time I saw a hospital was about 10 years ago).
As I said, I'm embarrased that i wasted the time of the ER staff. I should not have gone. But what is done is done. That said, I'm pretty satisfied with the experience and service I got. Everybody was really nice and more tolerant than I would have expected at 3 in the morning (Not that I am a demanding patient - I basically kept my mouth shut the whole time I was there).
So, it was nothing. I'm guessing the rest of it will blow over by tomorrow morning.
judd
