The Other Side of the Bed

They say, as nurses, you always want to be on our side of bed. That in comparison, giving the care is way easier than receiving the care. After being in the field for some time now, I've wonder if this saying held as much weight as it's been said to have. Yesterday I had the pleasure of getting a little taste of the truth.

It started on Tuesday while I was on my morning walk with Tybee. I was still in my scrubs, after finishing a shift. We were about a block and a half away from home when the concerning pains began just to the left side of my mid chest. I felt dizzy and weak and recognized the weight of my phone in my right tunic pocket in case my legs gave out on me. I managed home and upstairs where I plead my symptoms to a still groggy mom (another perk of moving back home: in-house consultations). She took my blood pressure with her home device and it was a little low for me. I showered, ate, felt a little better after sitting on the couch for a bit, went to bed at 11am and slept gloriously till about 8pm. The pain came and went the couple of hours I was awake that evening but for the most part, I ignored them.

Yesterday was worse. I took Tybee to his hair appointment early in the morning, I ran some errands, and then I went to the restaurant for a couple of hours to cover while dad was out. Thats when it got concerning. It was just a constant dull pain all morning but the intensity increased as I got involved in the work. The spinning and lifting and side-stepping that's involved with quick-service made me feel dizzy, light-headed, and off-balance. I eventually just stopped and sat on the prep table in the back of the building next to the screen door and waited for mom to come back. I felt short of breath and could feel my heart race as if I had just got done with a major workout at the gym when all I did was make a couple of milkshakes. Mom finally returned and sent me home to "rest and cool-off." I showered, had a yogurt  laid on the couch, but still the pain was constant, dull, like someone had a grip on my heart that I could feel and they were occasionally giving it a tight squeeze. A few hours later mom came home and we assessed and reassessed the situation. Our options were many: We could go to the general clinic but I was afraid they would say, "You're 26 and having chest pain? What the hell are you doing here? Pay us $100 to see you and go to ER." We could go to the Beaumont after-hours clinic. But I was afraid they would say, "You're 26 and having chest pain? Why didn't you just go to the ER? It's right next door. Give us your co-pay and go there." And the obvious, ER. But I was afraid they would say, "Your EKG is normal, there is nothing wrong with you. Give us your money, go home and relax." None of the above looked appealing. All I wanted to do was hook myself up to a cardiac monitor, see what my MAP was, and if I was throwing PVC's in my heart rhythm. Nurses really do make the worst patients. As mom said, we never seek the help for ourselves but we are so quick to criticize someone else for not seeking attention sooner.

So when we analyzed the pain, duration, and intensity, and realized that it has gotten slightly worse then yesterday, mom finally said, "Go get ready, I'll take you in." The escort at the door asked if I needed a wheelchair. Not ready to give up my independence yet, I said, "No, I can walk." He probably doesn't see that very often. I wonder if I was the most calm person to come in complaining of chest pain that registration has seen. As soon as they snapped that ID band on, I was forced into a wheelchair and pushed about 30 feet to a stretcher. Really...I could have walked. I already knew the itinerary: Stat EKG, vitals, basic history. I watched as the tech placed the familiar stickers on my legs, arm, and chest and was ready to catch a glimpse at the print off: "normal sinus rhythm, normal EKG." I knew it, there's nothing wrong with me. But I was still having the pains. After just a few minutes, another tech came in and wheeled me down a long corridor, I swear, to the very end of the department, to the very last room and backed me into a private room that must have been a closet before. I was handed a gown, told to take my bra off and once I was changed, I was connected to a bedside monitor, and vitals taken again. Finally, I could analyze my rhythm. Perfectly normal. My MAP was 79, I was perfusing. By this time, most of the intensity was gone. It was still there a little but not as bad a couple of hours ago in my living room. A nurse came in with a computer and started to ask the same questions I ask my new patients, "What's your pain on a scale of 1-10, can you describe it to me, any past medical history, any cardiac history, any surgeries, do you feel safe at home, any thoughts of hurting yourself or others...?" By this time she had written me off as "not cardiac," as she said I was having the pains for greater than a day, activity makes it worse, and the fact that I'm 26 were, according to her, indicating that it was more than likely not cardiac related. Mom was quick to tell her that my older brother had a coronary when he was 20 and it took them 3 days before they decided to bring him in so she wasn't reassuring her whatsoever. As soon as she left, mom said, "She's wrong, activity does make chest pain worse." and I agree, that's what a coronary is, increased oxygen demand on the heart from increased activity. Nurses...we think we know everything.

Thumbs up waiting for Xray

A resident came in a few minutes later to assess me, ask me about the pain, read my vitals, etc. I mentioned how I had recently had all the vaccines for my overseas trip next month and asked if any of that could possibly be contributing. (I was told I have a murmur a few years ago and I thought about the possibility of vegetation growth since they were live vaccines. Sometimes medical knowledge can be a curse). She brushed that possibility off. Shortly after her came her attending. At the same time, a tech was preparing to "work me up" as she called it--get my labs and start an IV. She was a talker...entertaining but awkward. As the attending was ready to leave, he told her, "no labs, we're just going to get a chest xray." As the tech asked, "Really?" He said with a smile, "Sometimes less is more." Mom and I were then left with Shirley the tech for about 15 minutes as she talked about how she had a ruptured appendix in Florida and she was taking Motrin for it thinking it was nothing which led to a red eye back to Beaumont and 15 days hospitalized  Then she was all into my trip to Uganda and what it was going to be like. She liked to talk.

She finally left and we were just waiting for xray to come and get me. It was another trip down a long slim hallway (really, they couldn't have made them any wider knowing they were constructing an ER?) to a small, familiar room. "Take a deep breath and hold it." Then it was back to my little private room. Mom and I didn't even have the pleasure of people watching or eavesdropping.  We really were secluded in this little room. About 30 minutes later, the resident returned and said my chest xray was completely normal, the chest pain is probably musculoskeletal, and I should go home, rest, and take some Motrin for pain.

After a couple of signatures, I was handed my discharge papers and was free to get dressed and go home. My co-pay was less than I was afraid of and in the end, I was glad I went to have it checked out. Even though it was essentially nothing. My chest pain was pretty much gone as I walked with mom to the car. When I returned home, I suddenly felt exhausted and quickly passed out. This morning, I don't have any chest pain. Funny I was right when I thought option C and they would say, "There's nothing wrong with you, go home and relax."

So I would have to agree that the saying is true. It is better to be on my side of the bed providing the care than being the specimen in the bed. It was super awkward sitting in the stretcher being pushed through long skinny hallways feeling like you were in the way while some complete stranger pushes behind you. It was awkward only having this thin ugly gown on to cover you as strangers in hallways watched as you wheeled passed them. I was glad to put my clothes on and walk out the same way I walked in. I was very thankful. Besides, I just had an ER visit and I escaped with no pokes, no labs, no IV, and no GI cocktail. All in all, it was a successful night.