A Heart Transplant ER Moment

| April 10, 2012 | 0 Comments

As of  04-10-12, 3,166 persons are on the national wait list for heart transplant.

I remember a time when my mother gifted my father with a hunting dog.  Ginger was six months old.  She was a beautiful English Setter. Ginger was a Christmas present.  We were all so excited.  As Christmas day proceeded, out came the cowboy uniforms, cap guns and related paraphernalia.

At one point, my younger brother and I got into a cap gun shootout.  During the gunfight, my father noticed that Ginger had left the room.  We stopped our activities and set out to find her.  To our surprise, our gorgeous hunter was cuddled behind a couch in the library.  She was trembling.

My father was concerned. He went to his gun rack, pulled out a shotgun and took ginger outside.  Standing on the front lawn, Father removed Ginger’s leash. She obediently sat down beside him.  Father loaded the shotgun and fired into the air.  Ginger slumped flat down as though shot, which she wasn’t.

Ginger was gun shy.  My father returned her to the breeder and suggested she would be a beautiful show dog.

To a degree, I relate to Ginger’s predicament.  Instead of gun shy, I am officially doctor-shy and hospital-shy.  This is a predicament that besets wait listed patients and recovering patients.  In my case, you could splash a little Post-Traumatic Stress Disorder (PTSD) on top and really have a mess.

Wait List

Wait List

My case is not typical. When you are at a clinic, you meet an assortment of patients in differing stages.  We all realize that it is to our benefit to be there.  But, the doctor-hospital fatigue is unmistakable.

There are several reasons for this predicament.  A certain numbness sets in after countless blood draws, innumerable IV injections, many swan ports and all the rest.  Eventually, you realize that every orifice of your body has been penetrated in some invasive manner. Combine all those delights with heavy doses of steroids and you begin to wonder exactly who you are.

Once, after waiting two hours for a blood draw at Columbia Presbyterian, a nurse approached me with a big sigh.  She tossed her equipment into the lap of my gown.  She seemed agitated.

“Everything okay?” I asked.

“Not really,” she sighed. “I gotta’ draw your blood.”

“Yuh?”

“Well I ain’t too good at it and I don’t like doin’ it.”

This wasn’t exactly how I thought the script would play out.  “Want me to show you how?”

“You know, that might be good.  Let me close this here curtain.”

First, I scrubbed the point of entry with a sterilized pad, Then, I rubbed the vein at the left interior elbow and made a fist.  I moved the needle into the vein.  The nurse had tied on a tube.  The blood began to flow and she changes the tubes as they filled. She was okay about withdrawing the needle.

Heart transplant patients get hospital fatigue because they are subjected to every possible safety procedure.  Unfortunately for me, I had a propensity to feel sick on weekends.

I had such severe pain, that to get me erect, a neighbor had to lift me off the floor.

The Tampa General Transplant Guide and the Columbia Pres Guide list a number of symptoms that could indicate rejection.  Anytime these symptoms surface, you must call the transplant center regardless of time. If you fail to call, you are that intimidating term, NON-COMPLIANT.

This is a pretty accurate encounter with the Tampa General Heart Transplant ER on a night I was paralyzed with pain.

At 1:30 a.m. on a Saturday morning, I could not take it any more.  I called the 24-hour hotline and was instructed to report to the ER.  This is absolutely the worst time to be sick.  The emergency room overflows on weekends.  I was pretty stressed when I arrived.  This is how it went.

First, I was to check-in.  There were a lot of people waiting to check in.  We were in three lines. The check-in counter is staffed with three staff members, but the first receptionist receives a cell phone call and excuses herself before disappearing behind a privacy wall. Her patients shift to the right, making two long lines.

The person at the head of line two is taking an exorbitant amount of time expressing his problem and trying to find his insurance cards. The patient is elderly and clearly frustrated. He drops a cluster of papers from a file folder onto the shiny floor.  The papers slide across the island where a person returning from a water cooler unintentionally kicks them.  There is a lot of scurrying around but nobody in line three moves to help.  We are in the promised land!  The receptionist is methodically completing paperwork as he begins to converse with a friend who appears from behind the wall that has apparently swallowed receptionist number one.

I could stand no longer.  At a 45-degree angle I slump ahead to the lobby and commandeer an idle wheel chair.  I return to the end of line three.  Two paper chasers have moved ahead of me.  Finally, I reach the front of the line.  Phew.

The receptionist excuses himself, pulls a handkerchief from his pocket and blows his nose while facing me!  I immediately ask for a mask, but he doesn’t have one.

I contemplate waiting until Monday.  I decide to get to the end of line two where the receptionist is not on the cell phone and not engaged in a conversation while checking in patients in.  Thankfully, he has masks.

Because the cardiology hot line instructed me to check in and because the nurse told me she would notify the front desk that I was on the way, I expected that registration was a mere formality.

Wrong again!

This dude instructs me to speak up.  He has a lot going on.  He wants to hear my medical life story, which I tell him is in the computer. I ask him if a nurse from the cardio clinic called.  “No sir, not me. Let me ask around.” He arises and heads toward the wall area.

Fortunately, receptionist number one brings herself and her phone out to the receptionist area.  My guy chats about a call from cardio.  My guy returns.

“Nope, no call.”  He’s getting a little cranky.  “What’s your name?”

I spell my name, “H-i-l-a-n-d.  B. D-o-o-l-i-t-t-l-e.  06-25-45.”

“06-25-45?  What’s that?”

“My birth date.”

My guy hits the keyboard and stares into the screen. “You missed your cardiology appointment three weeks ago.”

I am surprised at this revelation because it is not true.

“No, no I did not miss my appointment.  I was hospitalized three weeks ago and just got out last Saturday.”

“Okay, then we agree.  You missed your last cardiology appointment.”

“Whatever!  Does it fricking matter?”

“Oh yes, sir.  We must keep accurate patient histories.  It’s… well, it’s important.”

“Look, the on-call nurse in cardiology told me to come.  She said you would have my records.  I’m in some pain here, buddy.”

“Well, sir.  I just read you your record.  We got to get you admitted.”

My blood pressure is now through the roof and running a race against my heart to see who can knock me out first.

“Look young man.  I want to check in and see a doctor.”

“Fine Mr. Highland. Tell me you full name… oh yes.  And your date of birth. Oh, I have that too.”

Is this really happening?  Meanwhile, the police come rushing in with a male ambulance case, who is moaning loudly and calling out to unseen persons.  They bypass the registration process.

This is a nightmare.  The receptionist gives me a clipboard with three pages of paper on it.  He tells me to roll my wheelchair into the lobby.  “Someone will call you.”

You wait… and wait… and wait.  I am terrified because I have to go to the bathroom and I might fear I will miss hearing my name called.

Finally, a door opens and I see her.  She is summoning. This woman is going to help.  She wheels me into a very small room.  She takes the clipboard.  She glances at it.

“Do you have any allergies?”

“Do you have a list of your medications?”

“I see that you missed a cardiology appointment?  That’s not very good.”

I am stupefied.  Is this One Flew Over The Cuckoo Nest?  Am, I dreaming?

“Am I dreaming?” I ask.

“No sir.  I just need a few answers and we will review these medications. First I will take your vitals.  You know that drill, right? Then, I will find you a room… if we have any.”

“Look, I am in pain.  I cannot stand up. Do you have cab fare?”

“Just a few more questions… Mr. Highland.”

This woman is Nurse Ratchett!

With the exception of health insurance queries, I answer the exact same questions that registrar two asked.

She takes my vitals.  She wheels me to a podium in the ER. “Mr. Highland here!” she calls.

I am being auctioned.

A smiling young man, says, “Hello Mr. Highland, I’m going to take you to a room.  No TV though.”

“That figures.”

“Just a few questions, sir.”

He asks the exact same questions for the third time.  He seems to be making notes.

“Is there a doctor here?”

“Oh yes, he’s a little busy.  We have a shooting victim.  The doc’ll be with you shortly.”

“What’s shortly?”

“Now Mr. Highland,” big smile “we’re doing our best.”

Really?  Really!

 

The nurse, who is not a nurse but an attendant, wheels me to a room. “An nurse will be right in. Good luck, Mr. Highland.”

 

Good Lord!

 

Finally the curtain opens and what appears to be a nurse enters.  “Now Mr. Highland, tell me why you are here.”  She is looking at the clipboard that already has eight pages.

 

“Ummm, don’t you now?”

 

“Well, I would like to hear you tell me, but first, give me your date of birth?

 

“0-6–2-5-4-5!”

 

“Yes, I have that. Do you have any allergies?”

 

“I am not telling you.  I want a doctor and some morphine.”

 

“You were born in 1945?”

 

“Uh, yuh…”

 

“ Huh.  That’s the year my father was born.”

 

“Is this a dream?  Look! I am in pain. I want morphine?”

 

“Just a few more questions.”

 

She then asks the exact same questions that I have answered thrice.  I lay back on the stretcher and wait… wait… wait.

 

A hurried man comes through the entry.  “Mr. Doolittle (A miracle!) you have some pain in your upper back.

 

“Yes.  A lot of pain, I’m losing it here.”

 

“How much pain?”

 

“Enough that I can’t get out of this nut farm.”

 

“Can you lean forward?  Okay great.  Breathe in.  Exhale.  He moves his hand.  In.  Out.  One more. In. Out.  Okay, sounds clear.”

 

“Is this where it hurts?  He touched my left upper back.”

 

I jump upright and take the Lords name.

 

“Hurts that much, eh?  Sorry have to ask?  Try not to swear.  How long have you had this pain?”

 

“A day and a half.”

 

“I see.  Well I can’t do much tonight.  I can inject some morphine and you can go home.  On Monday, you can call the cardiologist.  She will get you right in.”

 

“What happens when the morphine wears off?”

 

“You have any pain killers at home?”

 

“All of them.”

 

“Dilaudid?”

 

“Yes.”

 

“Take as instructed.  Hope you feel better.  The nurse will be here to check you out.”

 

“Good news, eh Mr. Highland?”

 

Is this real?

 

 

 

 

 

 

 

 

 

 

 

 

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