Dealing with Emergency Care, Hospitals and Doctors
This is part of the series, Misleading Gallbladder Diagnosis Leads To Better Diabetes Management
July 8, 2004, was all about hitting bottom. I could sink no lower. After returning home on Wednesday, July 7th, with the recommendation to see a GI doctor, I rested quietly, moved slowly and never left the house. I went to bed, still not feeling great. At 5 AM, I woke up running to the bathroom. When I finally sat up, I said, “We need a different hospital” What I was vomiting was deep green and bloody. I was starting to have chest pain and my back was in spasm; it was difficult for me to even stand up! I felt as though my body was seizing up.
Through a friend, we were able to get the head of endocrinology at Washington Hospital Center to meet me at 6:30 AM. But within only a few miles from our house, I started having serious heaves. It was hard for me to catch my breath. At the same time, the chest pain was increasing and I was trying to press my hands into the muscles to ease the pain. My husband drove with his hand on my back to help the pain I was having near my kidneys.
My husband finally pulled the car over and we realized I needed a hospital closer than 9 miles away. He pulled into a fire station and asked for help getting an ambulance. A few minutes later, the ambulance arrived and I asked where they were taking me. I was desperate not to end up in the system that had gotten me here! I asked, pleaded and begged to have them take me to Washington Hospital Center, but it was outside their jurisdiction. I was too sick, too weak and feeling lost to fight. I got in the ambulance and headed for a different INOVA hospital.
When I arrived at Alexandria Hospital, the ER doctor came in and asked, “What’s happening?” I was wreathing with chest pain and had given her a sample of stomach stuff. She said, “This is complicated, but I want to give you some Benedryl and Tylenol.” Within a few minutes the chest pain started to subside. She told me the chest pain was due to an allergic reaction to the phenergan, a medication used for nausea. Due to the fact this hospital was connected with the last, the ER doctor already looked at the scans from the day before and she asked if anyone had spoken to me about the condition of my gallbladder. I said no. She simply said she needed to get a surgeon for an opinion and she left.
My husband’s eyes spoke volumes, and I asked him to make some calls. I closed my eyes and tried to rest hearing the conversation of the ER doctor organizing the nursing staff in the hallway, “Priority #1 is room 3, does everyone understand this? Repeat it back to me.” Priority #1, room 3 ,was me.
In the fogginess of medication, fatigue and fear I slept with my ears on alert. I could hear everyone; the women next door to me calling for help, the doctor trying to track down the surgeon and ordering another scan for me. I just surrendered; it was beyond me to work out this problem. All of us have a breaking point and this was mine.
While my eyes were closed, I felt a finger slide across my eyebrow; my mom had arrived from Philadelphia. I started to cry and said, “They said it’s complicated and I don’t know how to fix the problem.” Tears welled in my mom’s eyes too and as she kept her hand on my forehead, she pulled up a chair and we sat in silence.
The ER doctor arrived and said that it was time for another CT scan. She explained that the surgeon would be down shortly. They were cutting me into his schedule, and she left.
As they were moving me to the gurney to leave the CT scan, the GI surgeon came in and asked everyone to leave. He explained that my gallbladder was 3 times its normal size and my liver was twice its normal size and he needed to take the gallbladder out as soon as possible. He promised that if he did this, by tomorrow I would be eating solid food. I told him if he stopped the vomiting he could take anything he wanted! He assured me he only needed my gallbladder.
They wheeled me from the CT scan directly into the pre-operating room. They had hoped to get my blood sugar numbers down, but had been unsuccessful. After seeing the last scan, Dr. Omeesh felt they could no longer wait. He was pretty sure the numbers would decrease once the gallbladder was out. I asked if this was diabetes related and he said no, that 40% of the population will loose their gallbladder and I was just one of the numbers.
Due to my complicated arrival to the hospital and post-op, I developed 3rd spacing - a condition where the body is traumatized and can’t absorb the fluid into the organs and so excess fluid is passed into the skin. I gained a whopping 36 lbs and looked like a marshmallow! Because of the third spacing, I needed stay for 4 days in ICU. One of those days, Dr. H was the endocrinologist making rounds. With my mother and husband in the room, she proceeded to tell me that I needed to take better care of my diabetes, and that this would NOT have happened if I had been working at better control. My mother’s piercing blue eyes never left Dr. H and when she walked out of the room, mom made one comment… “Find a new doctor.”
What I would have done differently:
Honestly, I will say that the ER doctor was on top of it! She did exactly what I needed her to do: she took control, worked with basic ingredients to help stabilize my body and gave me the medical attention I so desperately needed. What was happening was so far beyond my being able to help myself that I had one choice to let someone else figure this out! We are so vulnerable when this happens and this is the time we need doctors and hospitals! And we need them to work for us! I lucked out with a great doctor who stuck with me for the entire day!
After Dr. H had blamed my diabetes management as the problem, it was clear to see the problem wasn’t just me. I met with the gastroenterologist, Dr. Omeesh, for my post-op, armed with many questions regarding why the gallbladder was not diabetes related. He gave me research and articles to back up his answer. When I asked for a referral he sent me back to the same group my endocrinologist was part of, and I decided I wanted something different. I never put Dr. Omeesh in the middle, regarding Dr. H. Instead, I simply asked him the questions and never spoke of blame. This tactic gave me the ability to learn what I needed to know, and my resource, Dr. Omeesh, was willing to share his field of expertise. My self-advocacy was just beginning!
Read the whole series:
Ann wrote for HealthCentral as a patient expert for Diabetes.