Shimoniac Jones

I didn't lose my mind – it fled in terror.

Archive for the tag “diagnosis”

Hospital-ity

At about 1500 this past Saturday, I whacked my elbow on the corner of a wall whilst lurching about ever so gracelessly at home. The impact itself didn’t register on the Richter scale, but it was harder than my usual clumsiness. I spoke a few choice four letter words, rubbed the elbow and staggered away.

Since I work the midnight shift, I was actually headed for bed, which might have contributed to my ungainliness; this time, at least. Six hours later I woke up for some food and social interaction with my family. My elbow was more than a little stiff and sore at this point, so in addition to food, I ate a painkiller. It was naproxen to be precise.

As the rest of the evening wore on, in spite of the painkiller taken, my elbow got more and more painful and was stiffening up considerably. I crowded the next dose of naproxen and iced the elbow; nothing doing, the arm kept on hurting worse and worse, while the range of motion grew more limited.

Finally at about 0630 Sunday, I was pacing the floor sweating and swearing with the pain. I made the decision to go to the local Emergency Department. Dressing to be able to leave the house without getting arrested was an exercise in interpretive dance and putting on my jacket was a teeth-gritting experience I don’t want to have again.

I arrived at the hospital about 0700. Now the local procedure at this hospital is for patients to rub their hands down with sanitizer, then click a mouse key to print out a full-sheet form asking if you have a new or worsening cough, or if you have travelled to any designated areas in the past year. If no, `x’ the box and don’t read any further. Since I didn’t have a cough, and haven’t travelled to the areas I quickly `x’ed the box and went to the triage nurse.

The first thing the triage nurse asked me for was the form and my Health Card. The Health Card is a form of I.D. that tells them I’m allowed to access their services. So, next she asks me what brought me in this morning. I manfully bite back my knee-jerk response of “Taxi”, and tell her my elbow really hurts, and what I think caused it. She asked me if the accident happened at work, this time I couldn’t resist and replied, “No, I can be clumsy at home, too.” To be fair, if this had happened at work they would have had to open a WSIB file, and double the paperwork.

Before she had a chance to ask, I pulled a piece of paper from my wallet and told her that it was a list of the medications I’m currently taking. Pro-tip, if you’re taking prescribed medication, supplements, birth control, or something like that, write down the list and carry it with you at all times. Your intake nurse will appreciate knowing this and being able to note it in your file, it can prevent unfortunate drug interactions which might lead to suboptimal patient results like a slight case of death.

Now she asked me to take off my jacket.

Ordinarily this isn’t a big deal. Today my arm hurt. Taking off the jacket only wrung one whimper and a gasp of pain from my manly machismo. Then she had me do a range of motion test with the sore wing. When she asked me to straighten it out I said, “No.” She asked me if it wouldn’t straighten, or if it was too painful to straighten. I told her it was too painful. Done with me, she sent me on to the next station of my medical adventure: Admitting.

I had to walk around to the other side of the desk which was a good ten yards away to have my Health Card returned and receive, if not a dead tree, then certainly a major load-bearing branch. I got my card back watched the Admitting Nurse affix stickers here, there, and everywhere. Including on my hospital I.D. bracelet, which was colour-coded red. When I asked for purple, she told me that was for Psychiatric patients. I said, “Well…” “No” was the firm reply. I was then directed back past the triage station, down the hall, on the left, to Ambulatory Care. That just means people who came in under their own power, not on a gurney.

So I show up in Ambulatory Care and hand my half-inch of paper to a receiving nurse, who receives it and offers me an only slightly uncomfortable seat in this waiting area. I cast an eye over my fellow sufferers. On the left is a stooped little old lady in a push chair; on the right is a twenty-something male with an ice bag on his right thigh, squirming like a little kid who has to go to the washroom. Then there’s me, a particularly lumpen and hairy member of malehood.

I considered my choices and decided to take a chair where I could watch the both of them, the nurse’ station, and the television. When I came in the TV was playing the fireplace channel, the taller of the two nurses decided to change the channel (boo) and we wound up watching what, at first, I thought was a different fireplace channel, turns out it was CNN covering the California Wildfire Season. The on-scene reporter’s barely concealed glee at the suffering and destruction was too much for me, so I tuned it out in favour of watching what was happening in the room.

From out of one of the treatment rooms came a tall, shinny emo-looking male(?), who asked one of the nurses if he could step out for a smoke. The nurse let him know that he wasn’t a prisoner and could go if he wanted, but that if the doctor came to see him in the mean time, he would lose his place in line and have to wait even longer to see a doctor. Emo-boy bounced, and I watched the nurse take a file from one slot, fairly high up, and put it in the bottom opening, one step above the circular file.

Little old lady asked a few times if she could have a drink of water, the nurses, not knowing why she was there were hesitant, but finally looked in her file and figured she could handle three ounces or so. Little old lady was overly grateful. Squirmy asked if he could get some more ice since his pack was water by now. The other nurse agreed, disappeared, was gone five minutes and came back with two coffees, and a tiny ice pack. The coffees were for the nurses, the three ice cubes were for Squirmy.

It’s now gone 0800, and the head nurse decides we’ve been good captives to this point, so she puts us into various treatment bays. I now can’t see or hear the TV, but I have a good view of the room across from me. The lights are low and someone in a chair is snuggled with the patient in the bed. I can barely hear that they’re murmuring to each other much less what they’re saying.  As a voyeur certified people-watcher I’m disappointed horrified by the lack of privacy these two have.

I pull out my e-book reader and try to concentrate on a story. Before too much longer, Dr. Young scurries in. First place he goes is the room across from me. Turns the lights on and starts talking to the patient, a woman who was suffering from a dog bite to the face. At this point I’m feeling not quite so bad.

She said that the fault was hers. Turns out the dog belonged to a friend, she got into the dog’s space, wouldn’t listen to the dog’s warnings, got bitten. I suspect alcohol, or stupidity, may have played a factor.  She got her wound sterilized, sutured and had gauze put on.  The sutures were the dissolving kind and would disappear on their own.  When the doctor was done, he snapped off his gloves and left the after care instruction to the nurse.

The next contestant was Emo-boy, who hadn’t returned from his nic flit. Nurse said he’s been MIA for an hour. Doc says keep the file for a couple more hours, and then return it to Admitting for disposition.  Or was that disposal?

Next was Little old lady, she turned her ankle and someone over-reacted. The doctor asked questions and probable palpated the joint. I didn’t get to see. Nothing broken or swollen, Rest, Ice, Compression, Elevation, painkillers as necessary, if it gets worse, come back in. Listening to Little old lady I think she had a minor case of lonely too. Turn an ankle, go to the hospital, and talk to people. It happens.

Squirmy’s turn had arrived. He’s suffering, and I do mean it, from a constellation of first- and second-degree burns to his upper right thigh. Damn, compared to Dog-bite Lady and Squirmy, I feel like a fraud. Doctor Young debrides the wound, that means he takes a scour pad and scrubs Squirmy’s leg like a pot with crusted-on gunk. Having had that treatment before I can tell you it’s not nearly as much fun as it sounds. He leaves the nurse to bandage the wounds and instruct about after treatment.

Now it’s my turn. Since I got here the arm got worse, then started getting better. Dr. Young palpates the joint, tests range of motion, and other stuff. Asking me about how I had done this to myself. The diagnosis: Impact Tendonitis.  The main tendon and muscle attachments to the lower arm are right where I smacked myself the previous day.  I didn’t hit the meat, I hit bone.

He asked if I wanted prescription naproxen. Prescription-level naproxen is 500 mg; over the counter (OTC) naproxen is around 375 mg. Prescription you take twice a day, he allowed that if I wanted to I could take OTC naproxen three times a day for a couple days, as needed. Ice the elbow if needed. If it doesn’t get better, if it gets worse, falls off, etc. I should see a doctor soonest. Have a wonderful day.

I only got a diagnosis. I didn’t get any treatment or medication, and I feel a whole lot better. My arm still hurts, but now I know why. Ignorance is scary. Scary makes pain worse. I was imagining bone chips, fractures, burst nerve sheaths, weird-ass stuff. Now I know and I feel better, relatively speaking.

Dr. Young left the booth; I gathered my stuff together and followed. I told them that I hoped not to see them any time soon and walked out. The whole visit only cost me a couple hours, and the price of a hot chocolate and donut from the hospital coffee shop.

In Canada we have socialized medical care, something which seems to terrify many Americans for no reason that I can determine. In actuality socialized medicine is like fire insurance, you pay a premium at set intervals and if your place burns down you get a settlement to help you pick up the pieces. Only in this case your premiums let you get to see a doctor, get a diagnosis, and get treatment, all without having to put a second mortgage on your first-born.

People complain about long wait times and what treatments are disallowed, or allowed. I guess I’ve been lucky; I’ve never really had anything to complain about regarding hospitals aside from the incredibly nasty food when I was an in-patient years ago.

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