12 August 2011

Journeying Into Old Age

Yesterday, I had my first real experience on the journey into old age, and it wasn't fun.

I've not been feeling well for a while now; at the beginning of the month I was having "stomach issues" and I've just generally been feeling pretty run down.

Around 7pm yesterday evening, I began experiencing a great amount of pain in my chest, which made it difficult for me to breathe. I wasn't doing anything physical, and hadn't done anything physical in a while. In fact, I was sitting on my bed, as usual, on my laptop computer.

I called a few friends to see if I they had any idea of what might be happening, and was able only to get hold of one. She suggested that I go to the emergency room ("ER") right away, as chest pains might be related to the heart.

At first, I postponed such action as it didn't feel like my heart, per se. But as the minutes ticked by, the pain became worse, and it became increasingly difficult to breathe. The pain spread to my shoulder, back, neck, and head. The best way I can describe it is that it felt like someone was standing in the middle of my chest, on the inside. There was pressure but the pain mostly originated from within my body.

It wasn't the sort of tightness I normally would have associated with an asthma attack. I'd never before experienced anything like it. The pain increased exponentially as I inhaled, and it got to the point where I could only take very, very short, shallow breaths.

Twenty minutes after the pains began, I called 911, and reported that I was having chest pains and difficulty breathing. I have VOIP service from my cable company, and they advertise providing E-911 services with their VOIP service.

The 911 operator asked me where I lived, and I had to give him my address. It was quite difficult to talk, mostly due to the fact that I could only take very short, shallow breaths. He then told me to hold on and wound up transferring me to an EMS operator, where I had to repeat myself, including giving them my address.

I have verified with the cable company that the E-911 service that comes with my VOIP phone service through the cable company automatically transmits my address to the 911 call center. They are, however, running diagnostics to ensure that it was transmitted correctly yesterday.

There's no reason I should have had to spend just over two minutes on the phone with 911 to get an ambulance to show up. In my opinion, what should have happened was that as soon as I said I was having difficulty breathing, they should have asked if I wanted an ambulance sent to me and if I responded in the affirmative, should have read my address to me and asked if that's where I wished the ambulance to be sent.

I went outside of my apartment building to wait for the ambulance, which arrived pretty quickly. Once they got me inside of the ambulance, on the stretcher, they prepared to head to hospital, and the ambulance broke down. They had to radio for another ambulance to arrive, which took less than five minutes.

The EMS response was very good, in my opinion, and they treated me well. They allowed me to write down answers to questions (such as contact info, insurance info, medications taken, allergies, etc.) so I wouldn't have to talk, as they saw I was having difficulty with that. They took my pulse, blood pressure, and performed a few EKG, as well as measured my oxygen levels.

So once in the second ambulance, we took off for hospital. They asked which hospital I wanted to go to -- there are two of them in Yonkers. The one I'd gone to in the past (for less serious health matters) was supposed to be the worst of the two, so I opted to go for the one that's supposed to be better.

I was taken (on the stretcher) from the ambulance into the ER and placed into a room. I would say that approximately one-third of the rooms in the ER were occupied when I arrived. The first person I saw who came to the room I was in was the registration clerk. He took my insurance information, and was kind enough to take other information he need from my phone.

After about 20 or so minutes of being in the room, the triage nurse came in to see me. She hooked me up to the blood pressure and oxygen monitors, and took my temperature. As she was doing this, she began asking me some basic questions, such as what medications I was taking and if I had any allergies. Since I had already given this information to the EMS technicians, I was somewhat peeved that I had to repeat myself, as EMS techs usually transfer that info to the ER the few times I'd been taken to the ER by ambulance in the past.

She finally got around to asking me what was wrong, and I began telling her. As I was describing the symptoms I was having to her (which was difficult as I the pain was getting worse and it was extremely difficult for me to breathe, due to the pain), she left the room. I mean, she actually walked out on me while I was talking to her, without saying a word. No "I'll be right back" or anything.

Even more time passed, and another technician came in, who performed an EKG on me.

Approximately two hours after I entered the ER, the doctor on call finally came in to see me. She was very nice, and listened to all of my concerns. She examined me, and ordered medications as well as a number of tests, including a slew of blood tests. She advised me that she didn't think I was having a problem with my heart, and I agreed with her as it didn't feel like that. The doctor told me that the muscles in my right shoulder/neck were having severe spasms, and were impacting on the nerves, thus causing all of the pain and discomfort I was experience, which in turn was making it difficult for me to breathe.

A few minutes after the doctor left me, "my" nurse came into the room, along with a phlebotomist. The nurse administered one of the medications, and they both began poking me to draw blood and hook up an IV to administer some other medication (it took a few tries to fill the eight or so vials needed for all the tests the doctor ordered on my blood work, and I thus was left with a few bandages in different places on my arms and hands--ever since my automobile accident in 2002 where I spent nearly an entire year in hospital, it's been very difficult for phlebotomists and the like to find my veins as most of them had collapsed during that hospitalization).

The oral medication (a muscle relaxant) began to kick in, and as it did so, my pain and discomfort began to decrease.

I was then moved to a different area of the ER, a holding area, and was told that I was being moved there as they were finished treating me. I was finally able to take a normal breath, but breathing deeply was definitely out of the question. If I tried to do so, pain would immediately kick in and shoot from the bottom of my rib cage straight through to the top of my head.

About an hour after she first came to see me, the doctor returned to speak with me. She asked how I was feeling, and said that she could tell, visually, that it looked like I wasn't in anywhere near the pain and discomfort I was when she first saw me. She advised me that my blood work came back fine, except for an elevated white blood cell (WBC) count. However, since I didn't have a fever, she didn't think I was fighting an infection but advised I follow up with my regular doctor.

She then told me that I would be discharged, as it seemed her diagnosis and treatment were working. A bit after 11pm, the triage nurse came in to see me, had me sign the discharge papers and gave me some additional paperwork, as well as a few prescriptions. I was then free to go.

In Westchester County, in which Yonkers (where I live) is situated, most buses stop running some time between 9pm and 11pm. I advised the triage nurse that I came by ambulance and no way of getting home, as I didn't have money for a taxi. She told me that she didn't think the hospital could do anything, but I could ask at the registration desk, which she brought me to as I had to fill out some additional paperwork or answer questions (I can't really remember). The clerk at that desk told me that there wasn't really anything they could do for me. I was left on my own.

Mind you, after I had been moved to the holding area (where they moved me after treating me), I began contacting a number of people I knew in the area who might be able to help me out by picking me up to take me home, or something along those lines. However, since it was fairly late in the evening (although early for me, as I'm a night owl), most didn't answer me and I assumed they had gone to bed, which assumption was confirmed in the morning when they began responding to me but, by that time, I myself had gone to bed).

Long story short, as this story is long enough as it is, I sat in the waiting area for about three hours. Seeing that I was there for quite some time, the security guard approached me and asked if I was OK; I told her that I came to the ER by ambulance and had no way of getting home as I had no money for a taxi, and the buses had stopped running by the time I was discharged (I do have a bus card with money on it, and I did have that with me, useless that it was).

The security guard took it upon herself to make some phone calls, and finally was able to secure transportation for me to get home. I got home around 4am, nearly 4.5 hours after I was discharged from hospital.

I'm still feeling a bit icky, and definitely under the weather. I slept for nearly fifteen hours, when I finally did get home and was able to fall asleep.

As I write this, I can breathe normally and even take a modestly deep breath. At certain points during this ordeal yesterday, I know that my anxiety was kicking in and making things worse, especially during the time I was lying in the ER bed waiting to be seen by someone and having such difficulties and in extreme pain.

It should not, in my opinion, have taken a doctor almost two hours to see me after being admitted to the ER, especially as I was brought in by an ambulance (non-ambulatory, or patients brought in by ambulance, are usually given priority in the ER). The ER was neither particular busy nor occupied, from what I could see.

The triage nurse should not have walked out on me while I was answering her questions, especially without saying anything to me.

The ambulance that first arrived should not have broken down, causing me to be transferred to the second ambulance, increasing the amount of time it took to get me to the ER.

I should not have had to give my address to 911 operators, especially as I was having difficulty breathing, and especially as I had to give it to them twice.

I should not have waited the twenty or so minutes I did before calling 911, after the symptoms first appeared.

If I were younger, I would not be nearly as grouchy and not be complaining so much about this experience.

I guess this was my official "welcome to the You're Getting Old club initiation." It was not pleasant. :-p

I have, however, walked away from this journey with some souvenirs:
Souvenirs from my journey into old age.
I'm glad it wasn't a heart attack -- it could very well have been. The technical diagnosis on my discharge papers is "non-cardiac musculoskeletal" something or other (the ink got a bit smudged--event, perhaps?). Whatever it was, it was quite frightening. It's not often I'd call 911 to be taken to the ER, and it's not something I hope to have to do anywhere in the near future, either.