Wednesday, August 5, 2009

Fun things to do in the ER

I am exhausted. So is Chris. I think Bob is, too. I'm really sorry about that.

Yesterday, at around 3pm, I started feeling pain on my right side, just under my ribcage. As I moved around making dinner, it became worse and I started having trouble breathing as a result. Each time I tried to take a full breath, the pain became acutely sharp and would stop me in my tracks.

I knew Chris would be driving home from work soon, so I determined to wait until he got here before I let him know that anything was going on. My rationale was that it didn't feel like an emergency and I didn't want him driving home during rush hour in a distracted frame of mind. When he called me from the road I told him about the pain and said that I'd like to get it checked out. Of course he got stuck in horrible traffic, but he handled the situation really well and I'm very proud of him.

We managed to get to the ER just shy of 5:30pm. Because I've had a bone marrow transplant, I was ushered right in and isolated from the sick people in the waiting room. The pain was getting worse each time I tried to take a full breath, so I resolved the problem by breathing in a shallow manner.

To spare you all of the gory details, the ER doctor suspected that I'd had a pulmonary embolism, or a blood clot in my lung. Not exactly what you want to hear as a recovering transplant patient, but a better diagnosis than most others that it could have been. I had a chest x-ray which showed no abnormalities. Once my bloodwork came back clean and the doctor could see that my kidneys were healthy, a CT scan with contrast was ordered.

Things were happening in a strung out fashion since the ER started hopping shortly after I arrived. I think there were 2 car accidents and a handful of other emergencies that were definitely more life threatening than mine. I think the CT scan happened sometime around 11pm. By then, the pain in my side had jumped to a 6 on a scale of 0-10 and was coming on more frequently.

As soon as the CT results were available, the doctor came in a little surprised. No clot could be found regardless of the fact that I was presenting with all of the classic symptoms. However, the pathologist could see that my lung wasn't inflating to its full capacity and that the exact spot that was causing me pain had collapsed. The ER doctor still felt that there was the chance of a blood clot and after consulting with my transplant doctor at MDA, ordered an ultrasound of my legs. The ultrasound happened sometime before midnight and I could see for myself that my veins and arteries were clear.

The official diagnosis became pulmonary pleurisy with no apparent cause. This just means that the tissue of my lung where it's collapsed is inflamed, so it hurts to draw a full breath. In order to get over it, I have to draw a full breath. It's a catch 22. In the meantime, the doctor that took over for the first ER doctor came in and offered me a painkiller. I thought that he was going to give me a Tylenol or something like that, so I accepted. A few minutes later, a nurse came in and injected morphine through my IV.

So I was stoned out of my mind and my side still hurt, but I was in such a stupor, I couldn't articulate it. That's why I hate opiates. They don't do a thing for me, except make me feel sick.

The same doctor came back and asked me if I'd like a prescription for a painkiller and if I'd like another shot of morphine or something. Yes to the first, but a definite no to the latter.

I was finally discharged sometime after 2am with a prescription for oxycodone and feeling awful from the morphine. Chris was starving and exhausted. We picked up the drug and some food on the way back to the house. As soon as we got home, I threw up. I knew it would happen since it happens every time I get opiates.

Sadly, I threw up again right after I had something to eat. By now, it's after 3am and I'm just tired and want to go to bed. My side still hurt and it had been a horribly long day. I got to sleep until 7am when the phone started ringing.

Coincidentally, I had an appointment with my local oncologist today. It worked out very well, since the ER doctor wanted me to see Dr. B. just to be safe. There was a mix-up with scheduling and although I'd made an appointment and had an appointment card, I wasn't showing up in the system. They were able to squeeze me in, but Dr. B. wasn't actually at the clinic when I arrived.

The hospital hadn't contacted the doctor's office, so he was surprised to hear about last nights adventure. He was great and suggested that I take an anti-inflammatory in order to reduce the swelling of the tissue around my lung. His sentiment about the painkiller echoed mine and he even went so far as to liken taking the opiate to masking a scent with perfume. You treat the symptom, but not the problem. I was in total agreement. I'd rather reduce the inflammation and actually start the healing process over taking a pill that will make me dysfunctional and mask the problem. The oxycodone remains untouched in favor of an over the counter pain killer.

The pain in my side is still present, but has lessened in its intensity. I promised Chris that I would take it easy and have been sitting up in bed doing absolutely nothing since I got home this afternoon. I have a follow-up with Dr. B. next week. He wants to check on me to be absolutely sure that things are headed in the right direction. Lucky me, it's the day before my big dentist's visit to have a cavity filled and a new crown placed. No big hardship, since I get to see some of my absolute favorite people, Drs. Toi and Cyndi Nguyen. Love them.

So there you have the very long and drawn out short version of what happened yesterday. I'll post if there are any changes.


Nancy said...

OMG!!! I'm so sorry you've had such a hard time. I certainly hope that you are on the mend and that everything is fine. Glad you went to the ER and got squeezed in to see your local doc.

Continue to get lots of rest.... Feel Better SOON!!!! love, nancy

Ronni Gordon said...

Wow. What an ordeal. When I had morphine it made me crazy; I said some really weird things. I did take my share of oxycodone for terrible pain. It made me a little out of it but it did help the pain.

Glad you're home and resting and that it wasn't anything terrible.

PJ said...

Boy Ann, you've been having almost as much fun as I have. They offered me morphine today for pain related to radiation, and I too rejected it.

Hope they get to the bottom of this soon.

Anonymous said...

I know how you feel about opiates. I don't see how anyone can like them let alone become addicted. Every time I've ever had one I got nauseous and agitated.