BOOMERRANG

Pitfalls of an Emergency Room Visit Part Three

Finally... I was moved to a regular adult room around 9:00pm.  It would not be until 12:30 am that the vomiting would cease.  The morphine drip was keeping the pain at bay.  It was a long night.  I tried to sleep, but the fear that the vomiting would return if I let my guard down only provided brief moments of what appeared to be resting.

 

 

At 5:00 am I heard someone come into the room.  It was my primary care physician, Doctor Zachary, making rounds.  Dr. Zachary had been our doctor for over eighteen years, since my youngest son was an infant.  He approached the side of the bed.  “Doctor Zachary?”  My mouth felt like it was full of cotton - dry with the most horrible lingering aftertaste - not able to wash my mouth out because all liquids had been halted. “What in the world is going on?” he asked me.

I recounted my experiences that had unfolded over the last four days.  “Dr. Zachary, I could not keep anything down.  Then when I stopped eating and drinking I still kept vomiting.  I told them I have not had a bowel movement since Monday night before I broke my ankle.  I don’t think anyone is listening to me.”  He pressed on my abdomen.   “Did they do an x-ray?” he asked.  All I could muster was a faint “no”.  “I am going to order an x-ray.  We have seen in some instances, when the pelvic bone has been broken, that some patients will develop a bowel blockage,” he said.  “I will check back in and see what the x-ray shows.”

 

Shortly after Dr. Zachary left, I called for the nurse.  I had a sudden urged to get to the bathroom.  IT was my first bowel movement in four days, it was small but it was a start.   I had been off of the Percocet for about 13 hours now.  About a half hour later they rolled a bed into my room to transport me down to x-ray.  As they helped me over onto the bed and started toward the door, I asked them could I go to the bathroom first.  I had a second bowel movement.  Amazing how the body is equipped to rid itself of toxins and the dangerous peril of not being able to do so.

 

It was about an hour round trip before I was back into my room. I was starting to feel better, and my fear was beginning to subside. The phone in my room rang and I answered it.  It was Dr. Zachary.  “Did they tell you what the x-ray showed?”  “No,” I said.  He said, “You have a bowel blockage.  They are postponing surgery until tomorrow.”   “No, they can’t.  Why?” I asked.  “They can’t do surgery until the blockage has moved.” he said.   “Did they tell you I have had two bowel movements and I am getting ready for a third one right now?” I responded.   “No,” he said, “I will be down to examine you.  I have to clear you for surgery.”  

 

Instead of examining me, the staff at Iowa Orthopedic Center just kept changing my medication.  Their attitude was, “just give it a little time.”   I just knew that something was terribly wrong.  I remembered a supervisor I had a few years earlier.  She all of a sudden started throwing up.  He husband brought her to the emergency room.  She was diagnosed with the flu and sent home.  Later that night she was brought back to Mercy Hospital by helicopter, where she died from a bowel blockage.

After Dr. Zachary’s examination, it was determined that the blockage in my bowel had moved.  Surgery was still on for 11:00 am.

Stay tuned for Part IV

PITFALLS OF AN EMERGENCY ROOM VISIT – PART TWO

I had no reason to question the emergency room physician’s referral to an Iowa Orthopedic Center Surgeon, who’s affiliated with Mercy Hospital.

The next morning, as soon as their office opened, I phoned them to set up an appointment.  The scheduling desk scheduled an appointment for me with Dr. Kinney.  Great news!  Not so great was the fact that my appointment was not until the NEXT DAY at 9:00 am. I was a little rattled that it would be still another day before I could consult with a surgeon.   Perhaps the pain medicine provided a buffer to the pain and my brain lacked the clarity to comprehend more than my immediate need. I mean, after all, wasn’t setting the bones and securing them from movement the beginning of the healing process?

Of course it had to be my right ankle, which would prohibit me from doing numerous activities, but the most important being the ability to drive myself to the doctor appointment.  I had to rely upon family members and friends for some of the very basic activities that I obviously had taken for granted up until this point.

Finally Wednesday morning came and I met with Dr. Kinney.  After the normal conversation, and a brief glance at my x-ray, he informed me that he does not do surgery on Thursdays. I must have looked like a country bumpkin.  “You’re joking, right?” I asked.  He shook his head no. “You’re kidding me, right?” I said, trying  to find hidden laughter behind his eyes.  There wasn’t any.  “We’ll try to schedule surgery for Friday.   My scheduling desk will call with the date and time.” he concluded.

The disappointment began to set in on the ride home.  It would be another two days before the bones would be set and the healing process would begin.  Never have I experienced a broken bone such as this.  Never have I experienced such pain.  I had been on the pain med Percocet for three days now.  While I understand this to be the pain med desired by many, unknown to me, it carries a toxic effect upon the body.   

Approximately 30 minutes after returning home, I began vomiting. By noon I was exhausted and unable to keep the pain medicine down.  I called the surgeon’s office, who called the pharmacy with a prescription that was to reduce the nausea.  My cousin left work and picked the prescription up.   I couldn’t keep it down.  She called the surgeon’s office.  They called in another prescription for nausea.  Still, to no avail, the vomiting continued.  The vomit was getting nastier and I could not ascertain where this ugly, vile substance was coming from.  I had not been able to keep anything down all day and it was now 2:00 p.m.

  Another call to the surgeon’s office produced a new prescription - this time for pain medication.   But by 4 p.m.I still could not keep anything down, and the pain was unbearable.   I knew I was in serious trouble.  I asked my cousin to call the surgeon’s office and let them know that we were going to the emergency room.  I wanted someone to perform surgery tomorrow, on Thursday, because I felt I could not wait until Friday.   They told my cousin, “She can’t do that - we have people waiting.”  My cousin told the staff person from Iowa Orthopedic Center, “You don’t understand, if she keeps throwing up like this she will NOT make it until tomorrow let alone till Friday.”  Finally they agreed to have one of their surgeons meet us in the ER.

We returned to the hospital. It’s normal to see people waiting in the emergency room, however not all day.  There was not a vacant examining room to be had. I sat in a wheel chair in the lobby of the emergency room for what seemed like an eternity. An elderly gentleman’s wife had brought him down from a rural hospital for care that the smaller local hospital was not able to provide. She said “We have been here waiting for admission since about 1:00 this afternoon. I should have let them transfer him by ambulance, and then we would not be waiting all this time for a room.”  It was 5:00 p.m. and there didn’t appear to be much hope of resolving this situation quickly. So I sat there, clinging to my small waste-basket I had brought from home.  At around 6 p.m. Dr. Mark Farber from the Iowa Orthopedic Center approached us.  He advised me, “We will get you admitted this evening and work you in for surgery tomorrow,” as he wrote his name on my knee with a marking pen.   The question now would be when would a room become available.  I already knew the older gentleman had been waiting for most of the day.  You would have thought that there was some type of major tragedy and that there were thousands of people waiting to receive medical treatment. But no such event had occurred.

Another hour passed and I began vomiting into my little wastebasket  I had refused to part with. This puke was nastier and more vile than before.  The staff at Mercy Hospital, upon observing this, quickly wheeled me down to the children’s wing. I was transferred to a bed, an IV inserted, and a bed pan exchanged for my little blue wastebasket.  This room with decorations for a child was where I would stay until an adult room opened up.

STAY TUNED FOR PART THREE

American Health Care

PITFALLS OF AN   EMERGENCY ROOM VISIT – PART ONE

I am sure that most of us at one time or another has known someone if not ourselves, who needed to make an unplanned trip to a local hospital. 

My unplanned journey begin last year on September 18^th. I was headed down my basement stairs to put some homemade chicken soup in the freezer, when I missed the last step, falling into extreme agony.  The pain from my ankle was excruciating as I moaned and yelled for my youngest son, who was a Senor in High School.  My son asked, “Mom what are you doing?’ I couldn’t touch my ankle as if for some reason I thought holding my ankle would make it feel better.  “I fell.  Help me up the stairs I can’t walk on my ankle.”  He picked me up and carried me upstairs and into the living room.  Knowing he had school work to do I called a friend to take me to the hospital.

As the shock set in the pain began to subside.  I waited in the recliner with an ice pack resting atop my ankle.  I hoped it was only sprained.

When we arrived at the emergency room at Mercy Hospital in Des Moines Iowa the number of patients waiting to be seen was so great that we were led to the lobby of the main entrance of the hospital.  My foot propped upon a chair, my friend and I waited for four hours. Finally someone came and wheeled me to get an x-ray. 

Sometime later a young emergency room physician approached us.  “Well you are going to have to have surgery on that ankle.  It is broken in three places”  I felt surprised and relieved at the same time.  While I had not had a broken bone since my youth I was relieved to know that the end was in sight or so I thought.  “Are we doing surgery tonight?”

“No, we are going to get you footed for a boot and get you some pain meds.  He handed me a piece of paper and said” Here is the name of an orthopedic surgeon, call the office tomorrow and set up an appointment for surgery.”

As my friend wheeled me out to parking lot confusion washed across my face. No surgery tonight? Set up an appointment?  I have medical insurance why are we waiting?