Sunday, September 11, 2011

12 Hours: My ER Déjà vu

My last bid for the Canadian healthcare emergency service was two and half years ago when a chicken bone cut through my esophagus. The 7-hour wait time made me swear that unless, God forbid, I was dying, I would never go back to ER again.

Unfortunately this time it was hub's turn. He is an extremely healthy person that rarely gets sick. As a healthcare professional, he actually knows how to take care of himself (the joke is most of them don't. An example is that they give patients annual physical but never bother to take one themselves).

Here is an hour-by-hour replay of the events from this past Thursday.

I was on a long phone conversation with an important client. Anthony barged into my office (which he's never done before): "I am going to see our family physician." I had no time to react nor could I before he closed the door and disappeared.

He called me on his way home to tell me that he had Tinnitus in his right ear. Our family doctor believed the Eustachian tube was blocked, and asked him to take some OTC decongestant. After he got home he immediately took a Sudafed, and things started to go downhill from there (unrelated to Sudafed just to be fair).

He started to feel the room spinning, couldn't hold himself steady, and minutes later, he had his first projectile vomiting.  

Not long after I helped him lie down before he threw up again and again for four times.

That's it, we are going to the emergency. I rushed him to a community hospital nearby, waited in line for 15 minutes to get to the Triage, and another 15 minutes to complete the registration. We were given a red file folder which meant high priority case. Not bad at all so far. We then moved to a room filled with 10+ more patients, sat there and waited for an ER doctor.

A nurse called our name, and we were led to a curtained area by an ER doctor. The doctor, without looking into his ear or checking his eye movement, told us that Anthony's symptoms were very typical Ménière's Disease. It could be temporary or chronic but there's no way to be sure (yes, he actually told us that. What I learnt later on was that Ménière's is a diagnosis of exclusion). The doc gave us a prescription and a referral to an ENT specialist, and by 8pm we were on our way back home.
The world in hub's eyes that night
The projectile vomiting continued, and there's no sign indicating that he was going to get better on his own. My brother-in-law D (works in Internal Medicine of that hospital) and mother-in-law L (was a Cardiac OR nurse before she retired) earlier suggested that we went to a downtown teaching hospital where they are better equipped with skills and technologies to help us. An ENT resident might also be on call there that night.

Hub was exhausted and wanted to lie still to avoid vomiting. I was able to convince him to give the downtown hospital a try. 404/DVP was never so sane to me, and it only took us 30 minutes to get there.

Triage and Registration was fast, but the nurse did drop a nuclear bomb on me: "oh, I am sure the doctor would want to order a CT scan to rule out stroke or anything else worse." The word stroke had me frozen for a few seconds. 30 minutes later hub was given a bed at the Rapid Assessment Area to rest.

We waited for the ER doctor to come.

We waited for the ER doctor to come.

I had no where to sit or lie down, so I went to an empty waiting area and dragged a chair myself next to hub's bed.

We waited for the ER doctor to come.

We waited for the ER doctor to come.

My neck, shoulders and back were killing me. I went outside the room to hunt down the doc. The ER doctor was nice enough to explain to me that he was the only one working the ER that night, and after he stitched up a patient's chin he would come over.

Contrary to the community hospital which considered hub's condition severe, this prestigious downtown hospital gets the most complicated and urgent cases such as heart attacks, strokes, gunshot woulds, etc. Understandably, we were not on the priority list to receive treatment. As much as my in-laws wanted to help us, they are also very ethical and chose not to influence the process. I've watched enough legal dramas such as The Practice and Boston Legal to see how much it sucked for those that were pushed down on the list due to lack of influence or ability to jump the line, so we wouldn't do it.

Hallelujah, the ER doctor showed up! He looked into hub's ear, checked his eye movement, prescribed 500ml normal saline and Gravol IV, and ordered a CT scan -- basically everything that the ER doc at the community hospital didn't do for us!

The IV dripped on, and hub was wheeled into the CT room.

The ER doctor popped in, and shared the good news that hub's CT scan was negative -- no acute intracranial mass, hemorrhage, infarct or fractures! In layman's terms, that meant they ruled out stroke and brain tumour.

Crap! The street parking outside of the ER ends at 7:30am. The ER doctor suggested that I moved the car to the front entrance and put the emergency break on. For the first time in my life, I felt so legit to park next to numerous "Fire Route No Parking" signs!

We were given a referral to the ENT Resident Clinic inside the same hospital, and discharged from the ER.

My eyes still tried to get used to the morning sunlight. Flashbacks of IV drips (yes, hub was sleeping and I had nothing to do but to stare at the drips) still lingered around. But fortunately, we were once again done with our wait at the ER, and hub received the most thorough diagnosis we hoped for. The even better news is that his condition continued to improve slowly.

I will spare you my ranting on Canada's healthcare systems. Instead, you could read my hub's more rational version on the similar subject here about "Why the wait?"

I hope everyone has had a better week than I did.
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