My Visit to ER

My Visit to the ER

I tested an Ontario hospital emergency system last Friday and I can tell you that it is noisy, boring (after the pain is relieved) and efficient.

About 6:30 that evening, I began to experience pains in my shoulders, elbows, wrists and the right side of my chest. I thought of four possibilities, gastric reflux; severe indigestion, pleurisy, the last and least possibility, was my heart. I have experienced the first three conditions in the past but my heart has always been strong and there is no history of heart problems in my family. At 7:30 I decided to go to a nearby emergency clinic, I thought I could be in and out with a prescription in hand in a few hours. Fat chance. The waiting time was estimated at three to four hours. My pain had lessened after an hour so I left the clinic without seeing a doctor. As I was driving home, I realized that I was taking a risk by traveling alone when my condition could possibly be serious. I did not have any friends or family nearby that could have driven me so I exercised my independence and drove myself.

When I got home around 9 p.m. I sat down to watch the Blue Jays and Expos ball game and within a short time, the pain got worse, now I was getting worried. My grandson Robert would be home from work soon so I thought I would talk to him before deciding on a plan of action but while I waited, I would have a lie down in bed. If it were pleurisy, the pain would be relived in the prone position. Not so, I think I was in bed for about ten minutes when I called myself a stubborn old goat and got up again. The hospital was the only logical choice. When Robert came home, he was very kind and did not call me any names although I certainly deserved it for taking chances with my health.
He just said, “Good choice, Oma”. I let him drive because my condition would have made him very nervous had I taken the wheel.

The nurse in Triage asked about the pain. “On a scale of 1 to ten, Mrs. Salsman, what would you consider the intensity of your pain, where 1 is minimal and ten is severe?”
“Eight,” I said immediately, There was no doubt in my mind that any moment my chest was going to either cave in or explode.

The nurse asked Robert to get a wheelchair; he was just going to roll me into the waiting room when she said, “No, I’ll take it”. A few seconds later, I was in a bed in ER with about forty feet of tubing and wiring in me, around me and stuck to me. One nurse was saying breath deeply and one said please bend forward. I was not sure I could do both at the same time since I was tangled up in the tubes and wires. I managed.

“Describe your pain, Mrs. Salsman,” the nurse asked. “Is it throbbing, sharp or pressure?”
I had to think about the choices. It definitely was not throbbing. When I stub my toe it throbs, no, I thought, my chest was not throbbing.
Next choice – sharp. Well, I thought, when I stick my finger with a knife while peeling vegetables, that’s a sharp pain. No, sharp did not describe what I felt.
So that left pressure. I guess that would feel like a vice gripping my chest and arm. Definitely not pressure, I thought.
So what is left? There was actually a bit of all three but not one in particular. “All three,” I said triumphantly.
“It can’t be all three,” said the nurse smiling indulgently, “It has to be one of the three.”
Damn, I thought, I am too tired to think. Okay, I’ll choose pressure.

Once the choice was made, things moved quickly. The pains had been present for about four hours by that time so the staff moved efficiently. First, I was given oxygen and that seemed to relieve the pain in my chest but not my shoulders and arms.

One of the things that struck me even in my discomfort was how dirty the floor was. Someone removed my shoes and I immediately stepped in a gob of something, which stuck to my sock along with a large piece of something quite indescribable. I lay on the gurney for several hours looking at this gob, wondering just what contaminant was being transferred to the sole of my foot. Chest x-rays were taken while everyone left the room, my fellow patients were left to absorb any wayward rays. Later when other patients got their x-rays taken, I was in the same boat. At some time during the night, I was transferred across the hall along with the gob, there to languish until morning.

Now, I must admit that I lead a very sedentary life and I am somewhat overweight. My activities include moving from my computer to my TV, the kitchen and occasionally to the grocery store – by car, of course. My redeeming feature is that I live in a condominium with one bathroom upstairs and one downstairs, so occasionally I am forced to ascend or descend a flight of stairs. When necessary, I do my housework. Oh yes, I also do my gardening which consists of sticking some artificial flowers in a hanging planter once a year. I used to take them down in the fall but last winter I found that they added colour in contrast to the snow in the back yard so now I just remove the faded ones in spring and add new ones from Wal-Mart. It works for me, Martha, and that’s a good thing.

Now back to the chest pains. I was certain the discomfort was not associated with my heart but I’m not the professional medical worker so I did not protest too loudly. I was admitted to the hospital at some time on Saturday morning. Time was irrelevant but I should have taken notes because during the next three days, four different doctors asked me the same questions; when, where, how often and what was I doing at the time. They had the notes and I forgot details as soon as things happened so finally I just said, I forget. That seemed to satisfy them and it prevented them from checking their notes and correcting me each time. By this time my pains and discomfort has long ago vanished.

My visit lasted five days. It must say it baffled me how university educated dieticians could come up with such uninteresting and insipid menu at mealtime. In the five days I did not encounter a green vegetable except a spoonful of peas swimming in beef gravy. Neither did I see a fresh fruit or vegetable until the last day when I special ordered a salad. I was happily accommodated with this special order but I was informed it would take awhile because he would have to go downstairs for it. The wait turned out to be forty minutes. The salad was a wonderment to my waiting stomach. It consisted of a leaf of wilted iceberg lettuce and three slivers of grated carrot along with a thin slice of lemon. Now I must correct myself – the lemon slice was a fresh fruit but if it was meant to be squeezed onto my salad, it was a disappointment. It was wafer thin and contained less than a drop of juice. I ate it whole, peel and all as I imagined my legs bending with rickets if I didn’t soon get some vitamin C.

Early Sunday morning I was awakened, I burped and splattered the floor, myself and the outside of the bathroom door with vomit. I have an unusually strong stomach so I do not know what brought on the eruption but it was the first such event since I was pregnant forty years earlier. I can only attribute it to the unnecessary heart medications I was taking that my stomach rebelled at the assault.

The cleaning staff arrived some thirty minutes later and cleaned up the floor. The bathroom door was a different matter, and when I left Tuesday afternoon, it remained unclean. The doctor ordered a stress test before my release and if it showed an absence of a heart problem, I was free to go home. The minimum level of fitness for a female of my age is three minutes on the treadmill. I lasted two minutes and forty seconds so all my stair climbing and gardening at home helped me to maintain a less than average condition. There was no trace of heart problems so I was discharged. I can say this for socialized medicine. It works. I rested from my strenuous lifestyle for five days and lost two pounds. That was probably from the daily laxative, which emptied my bowels and the vomiting which emptied my stomach.

I was sent off with more heart medicine and a nitro patch on my arm of course, the nurse cannot stop medications without permission even though heart problems had been ruled out.

I never did get a diagnosis but I can offer a non-professional one. I just happened to have an asthmatic attack at the same time as my arthritis found a new residence in my shoulders, elbows and wrists. There you have it, chest pain with radiation to my arms and elbows. Next time this happens I will use my puffer, take two aspirin and not call ER in the morning—I am not having a heart attack.


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