Undercover RN: The ER experience

The discomfort started at around 10:30 p.m. as I was driving home from an awesome night of dancing with friends.  The discomfort was under my sternum but it felt like gas – gas in my chest.  No worries, I thought, a little bit of hot ginger tea and perhaps some peppermint tea and a hot water bottle and I’ll be fine. 

Then the pain came – substernal, stabbing, relentless.  The pain radiated to my back between my shoulder blades and down the fronts of my thighs.  Down the fronts of my thighs? I had never been exposed to a symptom such as this.  My logical RN mind listed the possibilities – angina pectoris or heart attack?  But down the fronts of my thighs?  That made no sense. 

I crawled into bed clutching a hot water bottle to my chest and moaning “I want my mommy!”  My mother had been dead for over a decade.  No position brought relief as I alternately moved from side to back to side.  The first time I attempted to get up my legs felt weak, unsupportive, and I almost fell.  Clutching the footboard I attempted to stand but rolled back on the bed.  A heart attack began to seem more possible. 

When I could finally get up I walked around my home.  The words “GI cocktail” kept going through my head.  I had none of the ingredients: Donnatal, viscous Lidocaine, Mylanta.  In fact my medicine cabinet only contained ibuprofen.  I mixed up some baking soda in warm water and downed that.  A modest burp followed but the pain remained.  After that I was able to sleep for perhaps a half hour. 

For 4 hours I alternately walked or lay in bed, all the while clutching a hot water bottle to my chest.  Something was wrong, terribly wrong, and my body needed expert help.  I do not take going to the Emergency Room lightly.  As an uninsured person and RN, I stay away from doctors and hospitals (except for work) preferring prevention with diet, exercise, and supplements to cure.  During one episode of leg weakness I wondered if I was even able to drive to the ER and shouldn’t I just call an ambulance.  Economy shouted “No!”  

I did not know how long I would be at the hospital or what tests they would run so I removed my navel ring, packed my phone charger and other essentials, filled up the cat “vacation water” that would last for 7 days, and cleaned out their litter box. 

I drove to the closest ER – a hospital where I used to work – and signed in at 0406.  No one in the ER knew me nor was I asked my occupation.  For my complaint I wrote “Substernal pain radiating to back and down fronts of thighs.”   I was immediately whisked back by a triage nurse and had my vital signs taken by an aide.  My blood pressure was a bit high for me but still in the ‘normal’ range for others.  My pulse was 90.  My temperature was not taken.  Then an EKG was done.  Even without my glasses I could see that it was sinus rhythm – a normal beat.  The RN and aide exchanged looks.

“It’s probably your gallbladder,” said the triage RN. “I had mine taken out as a gift to myself at 44…You don’t need your gallbladder.”  How casual.   The stabbing substernal pains continued as I alternately moaned and grunted while I rocked.  I even said a choice word or 2.  The pain was that bad.  It even hurt to touch my sternum.  My ribs – the floating ribs on both sides – were also tender to touch.  I chose to walk, not be wheeled,  back to ER room 7 where I was given a gown and asked to change.  On my way to the room I came face to face with a hospital staffer who recognized me.  My cover blown, word then quickly spread that I was a RN. 

In room 7 the RN did an awesome job of starting a left antecubital 20gauge IV.  With gloved hands she expertly drew the ordered labs from my IV then converted it into a saline lock.  The triage RN later came into the room and said “You could have told us you were a RN.”  An accusation?  She had a sheepish look on her face.  Would I have gotten better service?  What would have been different?

The doctor came and palpated (pressed on) my abdomen.  “Tell me if this hurts,” He said.  My abdomen did not hurt.  The pain was below my sternum, radiating to my back and down the fronts of my thighs.  For some reason he and the doctor that followed wanted the pain to be in my abdomen.  My symptoms puzzled even the doctors. 

“I’ll get you some pain medicine and anti-nausea medicine,” He said.

“But I am not nauseous.”  To my ears I sounded like a petulant child.  My voice was tremulous, weird. 

“Some pain medicines might make you nauseous.  You should know that, you’re an RN.” 

I had just been spanked.

I just clutched my chest and moaned. 

At around 05:30 the ER RN came back with 3 vials.  “I’m going to give you Zofran, Demerol, and Toradol.”

“How much Demerol?”  God I sounded like a drug seeker! 

“Only 25 mg but you can get more if you need it.”

I explained to her that 25 mg of Demerol was the highest amount of narcotic I had ever taken and that more would not be necessary.  I did not tell her that for my hysterectomy I had only taken ibuprofen. 

I watched as she popped to tops off the bottles and drew up the medications without gloves and without using alcohol.

“Aren’t you going to clean the port with an alcohol wipe?” I asked.

“I could,” was her simple reply as she continued with no gloves and no alcohol.  Apparently she did not get the “She is a RN” memo.  She checked my arm band and called me “Hon” but did not verbally verify my name or date of birth.  I get that Courtney with an “i” seems daunting for a first timer to pronounce.  

I was in too much pain to argue or insist.  Obviously she protected herself by wearing gloves while drawing blood but saw no need to protect me from her germs and the germs of others she had touched when accessing my IV. 

Soon I was in la-la land with no care in the world.  I slept for about 2 hours and when I woke up the pain had gone from constant to intermittent and from a 9 to 6 or 7.  I was still hurting. 

An abdominal ultrasound and chest x-ray later and I discovered that my gallbladder was perfect and my lungs had a thing which I already knew about.  The second doctor came up with the diagnosis of GERD and wrote a script for a PPI – Prilosec 40 mg by mouth daily – a medication that would take 4 days to take effect.  I mentioned my thoughts of a GI cocktail to her and she asked if I wanted one.  I thought about it then decided against it and I am glad I did as later at home I came across a study online that stated that Mylanta by itself was just as effective.  That would have been one expensive 30 cc shot.

I was discharged in pain but with no pain medicine. 

The rest of the day on Friday was intense for me.  The pain was less than it had been in the ER but it was still there.  I also had abdominal bloating but still no abdominal pain.  I looked pregnant and could no longer “suck it in” and noticed that whenever I drank anything the substernal pain increased.  That day Mylanta was my drink of choice.

On Saturday I felt weak but much better.  Then the diarrhea began. 

Today is Sunday.  I feel weak.  Diarrhea continues.  My sternum and ribs are still tender to the touch.   I have been eating foods that alkalinize the blood and body.  The pain is a memory.

Looking back I can see the path that led to the acute acid attack.  My diet that Thursday night was french fries with ketchup, a shot of tequila, and a margarita.  That is a lot of acid.  The Standard American Diet (SAD) is all about acid.  I am looking into consciously incorporating more alkaline foods into my diet not just avoiding excess acidic foods. 

Having looked at life from both sides – as a patient and a nurse – I now realize how much judgment I hold towards people who we, in the medical field, label “frequent flyers’ or “drug seekers.”  To a prejudiced and untrained mind I was a typical drug seeker.  I presented with weird symptoms some of which suggested a heart or a gallbladder attack – which were ruled out with the typical tests.  I was coherent one second and moaning the next.  I could have been pretending.   I could have just wanted drugs. 

For me as a RN there is a lesson here, a lesson of non-judgment when dealing with the pain of others.  There is also something my body is telling me, something I cannot ‘stomach’.   I think I already know what it is.

Courtni ~ The Soul Muse

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About Courtni

Nurse, healer, artist and deep thinker ...
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2 Responses to Undercover RN: The ER experience

  1. Roger Schwartz says:

    More green smoothies… counter the acid of the SAD….
    NIce read Courtni… I like your style.

    • Courtni says:

      Thanks Roger. Time for a run to Costco for that super duper giant bag of spinach :). I am also consciously incorporating alkaline water (vs. RO), coconut water, lemon water, and alkaline foods.

      Courtni

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