An evening at the emergency room - oh what a joy...

Miscellaneous and Personal Stuff I Must Share
41

The best may be yet to come. You’re familiar with the phrase “no good deed goes unpunished,” right?

The monday before Memorial Day my mom needed to go to the ER because she thought she might be having a heart attack (she’s had a not-too-severe one before) so I brought her. We got there around quarter to nine.

After doing her paperwork, they had her wait. For an hour. This upset me, but I later found out they didn’t think she was having a heart attack. You think they could have mentioned this to one of us, though! While we waited a couple brought in a kid about a year old who had a really bad chest cold.

Mom gets seen first, and the kid about a half hour later. After eleven I finally get to see my mom, and find out that she’s not having a heart attack, but if we hadn’t brought her in just then she probably would have, or had a stroke because her blood pressure was sky high. Meanwhile, we can hear the kid crying because he’s getting chest x-rays and it’s scary. (I don’t blame the kid for being scared)

We wait and wait and finally a little before 2am she’s released because her BP has dropped to a safe rate. It’s pouring by the time we leave…then there’s the drug store, and finally home. I ended up missing the first half of the work day because I don’t think it’s sane to go to work on 2 hours sleep.

Thursday night I begin to feel a bit like I’m coming down with something. By the next night it’s clear that I have a bad chest cold, and a cough that won’t go away. I spent all three days of Memorial weekend in bed because I’d caught the little bugger’s cold. Luckily I didn’t get as sick as he apparently did, but it took almost 3 weeks before the cough went away completely. All along my mom bizarrely insists that it must be “allergies” causing the same symptoms that were evident in the sick kid. Okay…

No good deed goes unpunished, I tell you. Start taking vitamins now before the screaming toddler’s germs get you.
rfgdxm, The hospital probably just wrote off the cost of your surgery. My buddy Tom had to have heart surgery last year, and there was no way he could afford to pay, so the hospital ate the cost. They do that sometimes if you’re uninsured, aren’t old enough to collect SS, and don’t make enough to ever hope to pay the bill.

42

It is efficient (mostly) and it is fair. The ER is not “first come, first served”, but whoever is in the most need. Some conditions are more emergent than others. A gunshot wound takes precedence over a broken arm, for example.

When you arrive at the ER, they do what is called “triage”, which means take stock of your condition, and see if you need IMMEDIATE treatment. (At least, I think that’s what it means) Sometimes, if it’s not busy, (meaning no life-threatening, dire patients), you might get treatment right away, or you might have to wait until they take care of someone who needs attention right away.

A broken limb hurts, but it won’t kill you. A heart attack will.

Watch ER sometime. Yeah, it’s drama, but you usually see some asshole with a sprained ankle bitching because the car accident victims get taken care of right away, while he’s been there for three hours.

43

last may i woke up from a nap feeling a little queasy. within hours it had escalated to full-on ‘throwing up everything in my system, and then some’. it’s not the first time it’s happened, so when i couldn’t even keep down ice chips i asked my boyfriend to take me to the hospital.

we got signed in at the ER (that took two hours)…and then were left in the waiting room for another 4. i was way too sick to go home; the only time i could get up was to haul ass to the bathroom to throw up nothing - oh, wait, until i got to the contents of my lower intestine and found some bile or antifreeze or something equally disgusting and not-meant-to-come-up-that-way.

finally, FINALLY, we got a room. it must’ve been 4 am; all i know is i gave up on running back and forth and was just slumped over the sink in the women’s room when the boy came to tell me they’d finally called us. i had asked. i had broken into tears that i could not control. i had long since emptied my stomach and bowels and it was starting to chew itself up. I TOOK A ONE HOUR NAP. this was way too long to wait in the ER.

anyway, we get settled in this room and are there for another three hours. the doctor came in, seemed surprised when he pushed on my stomach and i winced and confirmed that it hurt (OF COURSE IT HURT, YOU TURD, I’VE BEEN THROWING UP FOR SIX HOURS), and ordered x-rays and a bag of fluid. yes. three hours. my poor boyfriend was awake with me the whole time, afraid to go to sleep.

i decided next time, i’m taking my chances and staying home. especially when they tried to stick me with a $2,400 bill.

44

Oh lord, don’t even get me started on the cost. I don’t know what I would have done if I didn’t have insurance. For once I say: thank you Kaiser!

I received a bill from the hospital to the tune of $8700. I ran through their list of services provided: the barium sulfide (I think that was what it was called) that I drank before the CAT scans was $900. I had 5 CAT scans…you can only imagine how much of the bill that was.

In the end, I paid $100 and only $100. Thank goodness for insurance.

45

Two part problem with the ectopic pregnancy above.

One, if you’re bleeding profusely, but mopping it up with something, then you have to SAY SOMETHING otherwise they won’t always notice you’re bleeding.

Second, bleeding from a woman’s vagina is often discounted, because it’s normal for blood to come out of that orifice. The trick is getting them to believe you when you say it’s abnormal, excessive, etc. Which gets back to saying something.

46

In Colorado, it is illegal for the docs and nurses to speak with you about money before treatment. It is an ethical thing that also has a sound legal basis. If you, as a patient, had to choose your treatments because of cost, you could make the wrong decision and then sue the hospital for millions. Plus the PR for people dying because they were refused treatment for being poor would be hell to deal with.

-Tcat

47

Waiting sucks, but you have to wait because many ERs just can’t handle the volume of patients that come in. As Guin said, hopefully they’ve triaged you properly and you’re “in line” in an illness-appropriate position.

Because ERs have to treat and stabilize emergent conditions without asking about payment first, many people without insurance will not see a doctor, wait until some problem gets to that level, then go to the ER. Then when the bill comes they either get on Medicaid/-care, make payment arrangements, or just dodge bill collectors. Other people may have insurance but not want to waste time/money on seeing a doctor, until the problem gets so bad they can’t ignore it any longer. Lines in the ER wouldn’t be as bad if preventative care was more emphasized and covered better by insurance, and if we didn’t have such a huge problem with uninsured people.

Cook County Hospital here in Chicago has sliding scale payments for poor people or waived payments in some cases - the idea is that this promotes better public health - and so as you might guess, their ER can be absolutely swamped. They also have a major trauma unit, so many ambulances will end up taking patients there in those cases as well. A coworker’s mother-in-law was taken there for a hurt knee (fell down the stairs), and ended up waiting all night because the place was so packed.

48

Thanks.

49

Actually, it’s federal law (EMTALA) that makes it illegal for them to discuss payment with patients before offering treatment. It also keeps hospitals from turning away indigent patients or shuffling people around to other hospitals. Once you show up in the ER, they have to see you.

50

What did you have? Just a stomach virus?

51

I would like to take this opportunity to thank those faceless angels of mercy who have helped my family and friends over the years in times of crisis.

You have seen us at our worst and have shown only compassion and given us excellent care.

When I was puking out one end and having some business on the other end, you said it was ok and made me want to weep from your niceness. No one should have to put up with my shit, literally and physically.

When I hurled all over the lobby floor. Puked all over the bathroom and broke a commerical grade toilet. You didn’t make me feel like a heel for pulling a Linda Blair on the single worst physical day of my existance.

When I was trying to tell bad jokes during the dizzy spells and you laughed, it made the barfing not so terrible for a microsecond.

When you gave me extra gack dishes, a blanket and plastic bags for the rather unfortunate 4 hour drive home ( which went better than I could have ever hoped.) I was grateful.

When I was in labor, you all were peaches. Just freaking peaches.

When my In Laws had to be scraped off the road and deposited at the local hospital and had hours of surgery each. You consoled and councelled us. During their long recovery, there was a sunny face always at the ready.

If one nurse did something not right, there were three to come along to make it better than we could have ever asked.( except the food. Gah!)

When my mother hit rock bottom emotionally, the care received from the various angels was exactly what she needed to help her realize she needed professional help. ( Parrotting what I had been saying for years, but what do I know?)

When my various brothers have been in various levels of ICU to MICU to Hospice, you have shown great compassion and professional care for hopeless lingering cases.

When my various brothers have been at and finally and mercifully through deaths door, you have been proof that you are angels on earth.

I don’t know how you do it, but from anyone who was too ill or distracted by their woes during their stay, I would like to say thanks.

52

Oh, that was even better - they didn’t know. They asked if i wanted more tests to determine if it was a virus or food poisoning. Since the symptoms and time it would take to burn out were about the same, i declined.

I’ve got my money on food poisoning, though; I ate a questionable cup of yogurt at work earlier that day.

53

I’ve worked in as an emergency room doctor for three years or so. We have seen a lot and put up with at least as much as the patients.

The process is not efficient (from a patient perspective), but it is fair. And I think most emergency rooms place a high priority on proper triage, doing a difficult job well. The fact you and your sore throat may have had to wait is not the emergency departments fault. The fact that you think your small cut (and a small cut to the scalp bleeds like stink but stops with a little pressure) requires immediate intervention does not make it so.

I don’t knock the people who come in with chest or abdominal pain, but are diagnosed with bronchitis or stomach flu. These are often difficult diagnoses to make, made after ruling out lots of nasty things with similar symptoms. We cannot always give you one diagnosis. Our job is to try to rule out the nasty possibilities even as we try to treat them, just in case. If we can rule your differential diagnosis down to stomach flu or mild food poisoning,

I work hard to see you as quickly as I can. I really do. Yet it is unbelievable how many people begrudge it if they (gasp) see me “eating on the job” by stopping for a mere five minutes, to eat my only meal in a twelve hour shift. We take the abuse from the drunks and drugged, try to stay compassionate, don’t laugh at the tale of woe that brought you here (and many of them are doozies), try to keep your costs down as much as possible (I work in Canada, which does not cover medicine costs, etc.). We do a little good for lots of nice people and more than a handful of jerks. If you are pushy, insulting, obnoxious – I’ll see you first if you’re the next patient who should be seen. I’m not above chewing you out if you’re asking for that.

In short, a fascinating job, very difficult to do well, high stress, opportunity to meet all types of people under poorly controlled circumstances. Most ER docs burn out young. I still love the work. I think it is much harder to work in a smaller place where you often lack the specalist help and machinery that larger centres take for granted. I’ve learned to reach a little beyond my grasp, and generally know when I shouldn’t be trying to reach a little further.

54

Damn submit. If we can rule your diagnosis down to mild food poisoning or stomach flu (not appendicitis, etc.) then it often isn’t worth your time and money to go further (unless suspecting E. coli H157:O57, very sick, several people involved, public health issue…)

55

And a full moon, at that!

56

Whenever I go to the ER with asthma related issues I’m normally put in a room rather quickly but I have to wait in there for HOURS. After a nurse gets an X-Ray of my chest I’m left to wait for about five hours until a doctor comes, confirms it indeed was asthma, gives me a script for prednisone, and sends me on my way.

About two years ago my friend stepped on a beehive and we were attacked by a cloud of angry bees and I, being the slow runner, got stung no less than 15 times on my legs and twice on the arm and face. I was swelling up rather badly so my mom took me to the ER. We waited in the waiting room for maybe four hours and were finally seen by a doctor. He told me to watch if the swelling decreases and put meat tenderizer on if it hurts too bad. He also prodded the stings quite a bit, which I was rather annoyed about. It wouldn’t have been too bad at all if I didn’t have a phobia of vomit and someone was constantly throwing up a few feet away from me. I nearly fainted, which I guess would have been nice because I would have been seen faster…

57

I’ve experience both the good and the bad side of ER treatment.

The Bad: Two separate hours-long waits with my ninety-year-old father who was vomiting every ten minutes due to a severe hiatal hernia. The first time they sent him home with a perscription for oral Reglan. :eek: :mad: Obviously, you can’t keep down an oral medication if you are vomiting every ten minutes. Tjhe second time a surgeon was consulted and he was whisked off to ICU and had surgery the next day. Approximately half of his stomach and part of his large intestine had popped through his diaphram. Needless to say, I don’t think much of that particular hospital.

The Good: About one month ago my husband suffered a major heart attack. His coronary artery was 100% blocked and he would have died without the excellent emergency care he had. Even though he “walked” into the ER, he was whisked immediately into their trauma room and stabalized. He needed transport to the Coronary Care Unit at another hospital and would have been helicoptered there if it weren’t to bad weather conditions. I was able to ride in the ambulance which took all of 13 minutes to cover the approximately 15 miles. He was immediately taken in for a heart catheterization and stent insertion. His cardiologist said that 50% of people who have the same type of attack die before getting to the hospital. Another 25% die while they are there. I honestly feel he wouldn’t be here today if it weren’t for perceptive swift care he received at the first ER.

58

My only complaint about the wait was from when I was about 9 years old. I had fallen off my bicycle and broken my leg. X-rays had been taken, and even my 9yo eyes could see the fracture, so we settled in to wait for the orthopedic doctor to arrive… from a hospital about 10 miles away… a 20 minute drive, tops.

The snag was that this putz of a doctor, knowing he was on call for both his main hospital, and the outlying “branch” hospital where I was being treated, decided to ride his bicycle to work that day… :wally

5 hours of waiting later, during which I was not allowed to eat anything (tough for a 9yo after 8pm), he arrives and puts the cast on… saying he was sorry over and over for the delay.

He apparently wasn’t seeing other patients at the main hospital, but rather was trying to find a ride to the hospital where I was being seen. Irresponsible in my opinion.

-Butler

Oh, one more thing. Never take the offer of “an experimental stitching technique”, to reduce the scar size. My scar on my knee is now bigger than the original wound. Great job Doc. :smack: This wound happened just a year after the broken leg.

59

My only 2 visits to the ER were horrible.

I broke my arm in 4 places when I was about 13. Got rushed to the hospital around 6pm and waited there til after midnight. By that time, they decided to just wrap it up and send me home til tomorow when the doctor would be in to reset it. I didn’t sleep one minute. Every time I shifted I would get horrible pains in my arm. Can’t remember if they gave me something or not.

The second time was when my brother had his kidney stones. We waited in the room for about 2 hours. His eyes were totally glazed over and in severe pain. There happened to be another gal in the room with the same problem. My god the suffering those two were going through. It was nearly too much. Amazingly after taking my brother in, not 15 minutes later we were able to see him and he was bright as a daisy. Just some tylenol 3 or whatever it’s called and some shot. They gave him a little urine strainer that I thought was absolutely hilarious for some odd reason.

60

I have to second speaking up if you think your symptoms are worse. Ivylad had a bad reaction to some medicine he was taking, and it made him not able to hold his head up straight (it was cocked sideways over his shoulder) and not able to keep his tongue in his mouth. We took him to the ER, and we were told to wait.

About 30 min later, he begins to shift in his seat, unable to get comfortable. I very nicely went up and told the nurse that Ivylad was starting to hurt, and could we possibly be moved up. Then Ivylad walked up.

He must have scared the hell out of the nurse. His head is cocked over his shoulder, his tongue is sticking out of his mouth, and he’s trying to explain what’s going on. They immediately rushed him to the back, and I saw one doctor glance at him and immediately yell for cortisone or whatever it is they give for an allergic reaction. His symptoms abated almost immediately.

My one bad experience in the ER happened when I was pregnant early with Ivygirl. For some reason I started bleeding a bit heavily and we thought I was having a miscarriage. We rush to the hospital (Ivylad was in the Navy at the time, so it was the Naval Hospital in San Diego) where some young corpsman, apparently thinking he’s being helpful, tells me if I’m having a miscarriage there’s nothing they can do. This is not something I want to hear just that second, so I start crying my eyes out and Ivylad goes to have a “word” with the corpsman.

Turned out everything was fine, but sometimes I think a bit of tact would not be out of line.