Health Updates

Looks like I’ll be here in the hospital for a full 72 hours while the cultures grow (testing for a variety of bacterial infections), making my return home sometime Monday at the very earliest.  Until I’m better, I’ll twitter health updates and they’ll post to the top right of this blog page.  Thanks for all of the lovely support.  You’re keeping this quiet hospital room filled with friendship.

Budget cuts in the E.R.

Look, I know we’re in a recession.

I know that times are tight, money is a problem, and hospital emergency rooms are overcrowded and underfunded.  I sympathize.  Really, I do.  But I had a very difficult experience on Thursday night as a direct result of a budget cut that eliminated the phlebotomists in the emergency room at our local hospital — one that may have put me in danger — and I’m writing to tell you about it.

I arrived at the E.R. at 8:30 p.m. with a high fever and a history of Stage IIIC inflammatory breast cancer.  When the E.R. nurse came to draw my blood 3 hours later, I told her that I had had a lot of chemo and my veins were pretty bad.  My right arm is strictly off-limits because of the lymphedema, so the veins in my left always have to be used for blood draws, and they’re not fully over the chemo yet.  The nurse scoffed and told me, “There’s no such thing as chemo veins. I’ve never had a problem.”  She put a small IV in my hand, and, 20 minutes later, picked my best vein (the only one people can usually get) for the second blood draw, a small one.

By the time the preliminary tests came back and the doctor determined that I would need a CT scan, that nurse had gone to lunch.  The doctor reached for my arm to be sure that the IV was in place, and was surprised to find that the IV stub was the wrong size.  It couldn’t be used for the CT because the contrast (iodine) couldn’t be flushed in fast enough.  She began to look for another usable vein, and was frustrated not to find one.  She called in another nurse.  No luck.  So the doctor began to try to prick new veins, but failed repeatedly to draw blood.  She decided to reuse the one that had been stuck earlier, sticking it closer to my heart in an attempt to tap it for new blood.  But it had been used already, and the blood clotted in the needle.  She jabbed a nearby vein, but it blew.  While I recoiled in pain, she tried — and blew — another vein, leaving me with two cm-sized purple scars and soreness on my arm today.

All this time, she ranted loudly about the incompetence of the first nurse, who took my good vein for a simple draw, leaving her nothing for the CT, when a CT was likely from the beginning.  Over and over she blasted her, alternating her incompetence with pronouncements on my need for, “an immediate CT, one which you should have had days ago!”  Finally, she said, “We can’t wait any longer,” and told the 6 ft tall male nurse to invert the bed, putting my head as low as it would go.  When I asked her what she was doing, she told me, “I’m going to put this needle into your neck.”

Needless, to say, I began to panic and shake, and had a very difficult time of it.  She did get the needle in, and the CT technician arrived soon after (apparently the IV only became an issue the minute my turn had arrived for the machine) to take me for my test.  He, on the other hand, was nothing but kind, with encouraging words.  The pillow on the CT table was so soft, and he talked to me like an equal, not a science experiment.  By the time my test was over, I was calm again.  He offered me the pillow and a blanket, two amenities not easy to come by in the E.R., and I was finally able to be comfortable while I waited for the test results.   Well, as comfortable as you can be with an IV in one hand, two blown veins in the elbow, and an IV sticking out from the side of my neck like Herman Munster.

Test results that would show whether or not I had cancer again and my lifestopwatch would have to be reset.  Because, you see, it wasn’t enough that the E.R. doc scared me with her jabbing and her frustration with the nurse-who-wasn’t-a-phlebotomist, but the E.R. doc also went on and on about whether or not it was cancer recurring — an occurence which my oncologist (at another hospital) has since assured me is almost never marked by a sustained high fever.

Days later, I’m still shaken by this, and when the phlebotomist came in today for a blood draw, I braced myself for a difficult time, warning her that my veins were shot in the same way that I had the original E.R. nurse.  She saw the purple clots and very carefully chose a vein nearby that I couldn’t even see.  The blood draw was quick and almost painless.  It was incredible.  I asked, “Is it because we’re on the oncology ward that you’re so good with chemo veins?”

“No,” she answered, “I’m a phlebotomist.”

I’ve since found out that the hospital fired or reassigned the phlebotomists working in the E.R. as a cost-cutting measure.  There’s not a single one down there.  And that includes the nurse who scoffed at me when I told her from an E.R. bed, “I have chemo veins.”

Moving in

Am on treatment with IV antibiotics in hospital; feeling a little better, much happier now they’ve backed off the “oh, it’s a tumor” insistence. Honestly…. Just because I have HAD cancer doesn’t mean that an illness always IS cancer.

As it turns out, it’s probably the same flu that you and your kids have been fighting off. But my body isn’t as strong as it used to be, and it’s not fighting it off very well. My white blood cells are way down, I have very little energy to move about, and the fever is still at 103′ after six days. So I’ll be moving into the hospital for a few days for IV antibiotics and close monitoring.

I do have some good (and some scary) stories to tell, but forgive me if I’m not up to reliving them today.

Thanks for your sweet notes and expressions of concern. I debated whether or not to tell you … but I’ve always been honest with you, so why stop now?

Status

I’m in the hospital again, waiting for tests.  They don’t think it’s the flu, but aren’t sure what, and they’re worried.

Am itching to get home again.

How not to fix a fever

It would have been funny … if it weren’t my body, I suppose.

If my body were a car, say, with an engine that was overheating or there was something amiss with the fuel injector, and they made me wait day after day for “Joe” to call me back and let me know what needed to be done.  And then Joe never called back, and “Bo” was the supposed guy to talk to the next day, and he didn’t call me back either.  And then I finally got to talk to the AAA guy, not the right guy, but someone who could tell me whether the problem was serious, and he chastised me for not bringing it in because it could blow up any minute.  And that I could bring it in 13 hours from now, no sooner, and please just sit in it and think about things until then. And then I’d have to take it several places for the tests, because God forbid the same fix-it-shop be able to open the hood AND look under it AND check the oil AND fix it.  Oh, no, that’s four different places, and yes, the engine is still overheating and yes, this is very serious, and why didn’t you bring it in on Monday?

That sounds ridiculous, right?

And yet … Saturday night I spiked a fever of 103.5′, tossing and turning terribly throughout the night, gasping in pain with every breath.  I was apparently too drowsy to really realize it, but I woke in the morning feeling absolutely awful, and the pains in my chest reduced to sore muscles from the exertion (could it be that I’m not as fit as I think I am?).  I was in and out of it all day Sunday and Monday, up to 104.4′, never below 102′, and I called the doctor at 9:00 Monday morning to speak to a nurse.  I was pretty sure it was the flu (since, you know, it’s going around … the WORLD) but needed to know whether to stay home and away from other possible infections or come in and see if there was something to be done about it (and I’m totally against unnecessary antibiotics, so I didn’t jump unnecessarily).

So I called just after 9 a.m. Monday morning.  The front desk receptionist at the doctor’s office put me on hold.  For 8 minutes.  When I realized that I’d been shunted nowhere, I called back, explained my symptoms, and asked for an appointment.  No can do; all the same day appointments had been booked (before 10 a.m.) and they don’t schedule tomorrow’s until tomorrow morning.  Well may I speak to a nurse?  Click.  Ring.  To another phone that was never answered.  After another 10 minutes, I hung up and called back (again).  Explained again that it was rather urgent and I just needed to know whether to go to the hospital or not, since I had a history and all.  She took a message and told me to wait for a return call.

I waited.  And waited.  And waited.  I lay there lethargically, unable to make decisions, and with no interest in watching TV or reading (for once) as my fever climbed to 104.4′ despite Motrin and Tylenol.  Just before midnight Monday, my fever broke violently, and my chills and shaking turned to sweat.  I watched my temperature drop to 100′, and 100′ has never looked so good.  Tuesday at 5 p.m. a nurse returned my Monday 10 a.m. call.  The office was closed.

Tuesday night my fever returned, and the pain in my chest returned too, wracking the right side of my lungs and making me shudder with every breath, first on the right side and then in the center.  It was awful, but really weird, and not something I thought deserving of the ER at midnight.  (Everyone knows the morning nurses are much kinder and tests move more quickly.)

It was an awful night, but then I remembered a trick to dealing with our health care system that requires physician approval before going to the ER … if one wants insurance to pay for it … and I do.  I called the after-hours answering service at 7 a.m, before the doctor’s office opened.  The physician on call called me back (eventually) and was alarmed that my fever was so high and I hadn’t been seen.  When I explained what had happened with his own office, he just sighed and said, “Unfortunately, I hear that all the time.”

Whaaaaaaaat?  as my two year old would say.

Regardless, I followed his direction, called the office at 9 a.m., dropped his name, and told them that he had insisted that I be seen that day.  (I’ll speed this up; I’m getting pretty tired too.)

When An hour after I arrived for my appointment, I was ushered into an exam room.  By this time, my fever had gone back up and I was shaking with chills again.  Very uncomfortable, nervous.  Listening to the doctor chat with a 40-year patient next door and zoning in and out.  After a quick exam and listen to my lungs, he folded his arms and said, “Tell me about your cancer history again.”  “Mmmm-hmmm.”  “Here’s the thing.  I’m not hearing sufficient lung function in there.  Whether or not it’s a tumor, it’s almost certainly pneumonia.  I suspect it’s a tumor because of the way you describe the pain on the right side, in a line.  When you try to breathe, the pain is breaking along the tumor and shooting up and down the right side.”

The what?  Dude, I came in with the flu and you’re sending me out with a tumor?

“Here’s a referral to get an x-ray.  Go.  Go now.  Do you have someone to drive you?”  My dad came and picked me up, as I had been in no shape to drive, and we drove across town to the radiology center.  I figured we’d have to cross back a different way to get blood drawn too, to check my white blood cells, so settled in for a long day.

There’s a whole nother post about waiting for hours in the doctor’s office (and then the radiology center) with the flu, and receptionists uncaring about contagion, but I’m exhausted tonight, so I’ll cut to the chase.  I had an x-ray, I was told to wait, the right guy came back from lunch and read the x-ray, they called my doctor, and he sent a message back to me to go home and wait for further instructions.

Two hours later he says that the x-ray was pretty normal, nothing acute showing there, and that rules out pneumonia. “What about the tumor?” I said.  Oh, they didn’t see one,” he said. But I knew what to ask as a followup: “If one had been there, would the x-ray have picked it up?”  “No,” he said.

So he jerked me around about a tumor for several hours today without even ordering the test and the truth is that he doesn’t know and isn’t particularly interested in finding out.  But if I’m still running a fever on Friday, I’m to call the office again.

Yeah.

That’s going to happen.

My husband went out to pick up the antibiotic, and I collapsed into a deep sleep for several hours.