Tuesday, October 26, 2010

My life exploded (Part III).

Day 2
"E, I need you to wake up." I look up and Dr. Nolan is standing over my bed in green OR scrubs. "Did anyone from behavioral health come to evaluate you last night?"
"No." I reply.
"How are you feeling?"
"Do you still feel like hurting yourself?"
"Okay. Well, I think Dr. Martin, one of the psychiatrists, will be over soon for a consult later this morning. After that we'll go from there."

New nurse, Sarah. She comes in and explains that Dr. Nolan wants to run an IV antibiotic for the infection. I talk to her for a few minutes as she sets up the antibiotic, and then she leaves. I lay in bed for a minute, and then glance at the IV tubing hanging from the pump and realize that it was never connected to me and is creating a puddle on the floor. I laugh. I guess if anyone has shock-value and could distract a good nurse, it would be me.

Sarah walks back in sheepishly, and examines the bag which is now totally empty. A while later, a second bag arrives from pharmacy and she hangs a new bag of antibiotics.

I go back to sleep. I don't remember if I was tired by this point or if I just didn't want to deal with being awake.

I wake up to MiniMan and my husband standing in the doorway. MiniMan is scared. I didn't expect him to be. He's been to the ICU many, many times. He knows most of the nurses, who adore him and his curly blond hair. He knows where we keep the graham crackers and who will give him toys and stickers. I guess he knew something wasn't right when he saw me in bed instead of walking around, wearing scrubs.

I ask my husband to bring him over, let him sit in the bed, but MiniMan shakes his head and clings to my husband tightly. He starts to cry. He doesn't want anything to do with me.

"Has the psychiatrist come yet?" My husband asks.
"I talked to your nurse on the phone two hours ago and she told me he was on his way over."
"I don't know.. I haven't seen him, maybe something came up. I'm sure I'm not a very emergent patient."

My husband explains that he has to go, that he has to drop MiniMan off with his mom, that he would be back. I hug him, pull the covers up around my neck, and fall back asleep.

Dr. Martin knocks on the glass door.
"Hi, I'm Dr. Martin. I'm one of the psychiatrists."
"I know." I remember seeing you at the hospital coffee stand flirting with nurses and telling them that all women should really take the time to treat themselves to a facial more often. Probably not all women, however, have your salary.

"So.. can you tell me what happened?"
I sit up and try not to act upset. "I had been taking some classes at the big state university: physics and chemistry to complete my premedical prereqs. I was also working full time doing overnights here as an aide. It ended up being kind of tough because a lot of nights I just didn't get to sleep. I'd go to school all day and then work all night and go back to school. I recently learned from my physics professor that we were going to have three exams over the course of the semester (not finals) that were going to be at 9:00 p.m. on Monday nights (this wasn't in his syllabus). I had e-mailed the professor telling him that I had a conflict, that it would be insane for me to take my two-year old son to daycare there, then drive him home when the daycare ends at five, and then turn around and drive back to school (1.5 hours each way) and then drive home again. My only other option would be to hire a babysitter on campus (or nearby) to watch him until ten, who would have to put him to bed, and then I'd have to wake him up, put him in the car, and then wake him up and put him to bed again. This just didn't seem fair to my son.. Anyway, my professor e-mailed me back and told me that he was sorry, but that he couldn't help me and that it would be impossible for them to proctor three exams for me, that I'd have to figure out a way to make it work... When I got the e-mail I just sort of lost it. It was early in the morning, I was getting ready to go to class. I was so upset I just got back into bed and cried. My husband couldn't figure out what was wrong, he couldn't calm me down. I told him that I just wanted to sleep and he forced me to get up and I couldn't calm down so I took a lorazepam that my GP had prescribed PRN for anxiety. I barely ever take them. My husband wouldn't let me go back to sleep and I don't know. I just took the whole bottle. I didn't think about it, I just did it. I wanted to sleep.
"You work in this unit, right?"
I nod.
"Do you see a lot of patients who overdose?"
I pause. I guess we see a lot of patients who overdose, but if you think that I had some kind of scheme have a vacation in the hospital, let me tell you, having your coworkers undress you while you are unconscious is far from therapeutic. "Probably more than many other units in the hospital."
"Do you think you might harm yourself again?"
"Do you think you would benefit from spending some time on our unit?"
"I don't really think so. I've floated to the mental health unit before and I don't think I would really be very comfortable there. I don't really feel like this is still an acute situation and I'd like to get out of here as soon as possible to get back on top of my coursework."
"Okay.. Is your husband still here?"
"He had to drop off our son."
"All right. Well, when he gets back, have have your nurse call my unit. I'd like to talk to him as well."

My husband is back, minus MiniMan. He meets with Dr. Martin, who agrees that it would be okay for me to go home without getting locked in the psych unit. I silently rejoice. I would get getting out. Dr. Martin leaves, then my husband, who is going to stop at home and bring me some clothes and shoes. It will take a while to get the discharge paperwork together.

My legs are killing me. My nurse, Sarah stops in my room to take out my IVs.
"My legs are really achy."
"Might just be from staying in bed so long." She walks out to complete some paperwork.

I ring my call bell. One of the aides comes in. "I'm having these body aches. I really don't feel good." In retrospect, I probably should have been direct and just asked for Tylenol, but for whatever reason, it doesn't occur to me.

I'm lying in bed crying. The monitor is alarming because I'm tachypneic. Dr. Nolan walks in.
"Well, I didn't expect to see you like this." He remarks.
"My legs really ache. I don't know what's going on."
"I don't see how I can send you home like this. I'm going to talk to Dr. Martin again."
"I need to get out of here. I need to get back to school."
"No kind of school is worth dying for. Clearly you're not ready to go home."

Dr. Nolan comes back in, tells me that he's talked to Dr. Martin, that they have a bed for me in the psych ward. I start bawling hysterically, begging him to let me leave.
"I can't lose my license over you. I can't guarantee that you won't hurt yourself when you get out of here."

Sarah comes in with some Tylenol for the leg pain. My husband walks in behind her, tells me he's talked to Dr. Nolan, and reiterates that I won't be discharged -- that Dr. Nolan said my discomfort was "a cry for help."
"Have you had your Celexa?" My husband asks.
"Not since Monday."
My husband walks out of the room following my nurse.

"She hasn't had her antidepressant in three days," he says, following Sarah out to the nursing station.
"It wasn't ordered," she replied.

Sarah comes back in with the Celexa.
"Some nurses are going to be over from the mental health unit soon to walk you over," she says.

A male nurse and a pysch tech arrive. I walk through the halls of the hospital with them, hoping no one will see me.

My belongings are being checked by one of the nurses. "You'll have to have your husband take your sneakers home, they have laces." I now have no shoes. My pants have a drawstring and are also confiscated and replaced by faded elasticized scrub pants. I now am the stereotypical psych patient, I haven't showered in days and wander around in hospital pants and beige non-skid socks.

I am starting to feel really bad, again. My legs are aching and it's freezing in my room. I get under the covers but I just can't get warm. I finally get up and try to turn up my thermostat, but it can only be turned up with an allen wrench or something. I walk out to find one of the nurses, who comes back in and turns up the heat.

I still can't get warm. I wander out of my room and ask for another blanket. One of the nurses returns and throws it on my bed.

The blanket doesn't help. I decide to call my husband, see if he will bring me a sweatshirt and sweatpants. It's so cold here. I don't know how they can leave it like that. I wait in line to use the phone.

Some gaunt woman in black stretch pants is angrily gesticulating while she yells into the phone. She says some closing remarks, hangs up the phone, and then mutters "fuck you, you cunt," walking away.

I'm shivering. I ask one of the nurses for another blanket.

My husband arrives. I tell him how cold I've been. He puts his hand to my forehead.
"You're hot. Has anyone taken your temperature?"

He walks out, and comes back with one of the nurses who is carrying a thermometer. She takes my temperature. It's 103.2.

Friday, October 22, 2010

My life exploded (Part II).

Night 1
My nurse, Sue, comes in. It's dark now, and the night shift staff has arrived. These are the people I normally work with.

The last time I worked with Sue I had been doing a 1:1 observation on one of her patients: a hyponatremic college student who had been admitted to our unit for the third time. He had intentionally been drinking water by the gallons and depriving himself of salt in his diet. I think he may have had some kind of psychogenic polydipsia going on but I don't know if that was an actual diagnosis. He was confused, hallucinating, and vomiting. I sat next to him all night, talked to him, cleaned the vomit off his body, changed his clothes, his sheets... Sue thanked me profusely for dealing with him and for being patient, revealing to me how much she hated working with psych patients. This isn't really unusual, a lot of nurses I know admit having little tolerance for "crazy patients," not to mention those who intentionally harm themselves.

So here I am, another psych patient. I wonder how many nurses and doctors I'm pissing off.

I have to pee. I ring my call bell; Sue comes over.

"Is it okay if I walk to the toilet?"
"Sure," she replies, untangling my IVs and monitor wires.

It is more effort to move around than I expected. I walk several steps and sit down on the toilet. Sue walks out of my room to give me some privacy.

I stare down at my blood-stained underwear. Awesome. I got my period. I sit there for a minute, wondering if there was such a thing as pre-menstrual insanity, and then ring my call bell again, this time requesting a pair of the disposable stretchy fishnet-type underwear that we give to OB/GYN patients. Sue returns with the (sort-of) underwear and some pads. The pads don't really stick to the underwear. This is going to be great. I have visions of me tossing and turning in bed, soiled maxi-pads stuck to my forehead and my bed becoming a bloodbath.

I stand up, empty my hat, flush the toilet, and report a 900ml void. It is too weird to have my coworkers dump and flush my pee.

I keep waking up to pee. I look up at a big bag of normal saline and realize that I have been receiving tons of fluids, which must explain my continued propensity to urinate. I feel guilty ringing the call bell, making someone come into my room. I'm probably fine to walk there myself.

I fall asleep, and wake up to some alarm going off on my monitor. Blood pressure, 68/41. I fall back asleep.

I wake up again, some other alarm on the monitor. I pulled off some of my EKG leads tossing and turning. I reconnect them and turn on my side, trying to get comfortable. One pops off again. I realize this is going to be an all-night affair.

Friday, October 8, 2010

Back in time

I realize that I hadn't really posted anything in my blog about how school had been going. The reality of it was that things were okay, but pretty much any free time I had I was spending studying or with my family, and as a result wasn't really blogging.

It turned out that I had to commute to school five days a week (initially I thought it would only be three), and then work three days a week (12-hour shift overnights). MiniMan went to on-campus daycare three days a week with me, and those days were nice, because it meant that whenever I wasn't in class I could use the chunks of time to do homework and study.

Chemistry was going really well. My lecturer was good, and I was getting A's on my tests. Even though I was doing well, it was kind of maddening to be in a class with four-hundred other students. The professor was impossible to contact except after the class (he didn't even list his office location or e-mail in the syllabus) and we had to rely on TAs for everything. I was impressed that they had chem office hours 9-5, five days a week, but then I realized that the office hours were in fact, a room filled with twenty students looking for help, and one TA milling around helping one person at a time. Sometimes people would wait forty-five minutes before the TA even talked to them. It was really screwed up.

Physics was going okay. I think that math-intensive courses will always be more challenging for me. My homework assignments took up huge amounts of time. I wasn't able to get everything done on campus and during the evenings, so I ended up hiring a baby sitter on the weekends so that I could spend more time on my problem sets.

When I wasn't in class, I was spending tons of time in the car. The commute was pleasant. It was a pretty drive, but when I realized how much time I was spending in the car (over fifteen hours a week), it started to drive me crazy. I could have been spending that time studying. As a result, I devised a sort of flash card study system which I brought with me in the car. I think this really disturbed my husband. He was convinced that I was going to crash my car through some combination of distraction and sleep deprivation.

Crash my car, I did not, but be sleep deprived, I'm sure I was. I was yearning to work only two nights a week instead of three, but if I did, I was guaranteed to lose my health insurance and other benefits. This resulted in a sort of bizarre schedule which went something along the lines of:

6:00a.m. Get up to get dressed.
6:45a.m. Start driving to school.
8:15a.m. Arrive at school.
8:30a.m. Go to my chem lab.
12:00 noon Drive home.
1:30p.m. Watch MiniMan, eat lunch, attempt to tackle laundry, make dinner.
5:45p.m. Get dressed for work.
6:00p.m. Leave for the hospital.
6:45p.m. Arrive at work.
1:00a.m. Eat "lunch" again.
7:15a.m. Leave work, pick up MiniMan, drive to school.
9:00a.m. Drop MiniMan off at daycare.
9:25a.m. Park, walk to class.
9:40a.m. Chem lecture.
10:40a.m. Study, eat lunch No. 3.
12:00 noon Physics lecture.
1:00p.m. Physics "discussion" with useless professor who constantly gets confused and gives quizzes during practically every class.
2:00p.m. Study.
4:15p.m. Physics lab with TA who talks way to fast and seems irritated by the prospect of having to teach us.
5:40p.m. Pick up MiniMan from daycare.
6:00p.m. Drive home.
7:30p.m. Get home, figure out some form of dinner.
8:30p.m. Fall asleep on the couch next to husband.

There were always a couple nights like this, days where I had to go to school and then work and then go back to school. Or nights where I had to work, couldn't sleep during the day, and then had to work another night. At first I wondered if I would be able to do it, and then I realized I could. I felt important and invincible. I had a purpose. I was more giddy than tired. It was like being drunk.

Thursday, October 7, 2010

My life exploded.

For over a week, I've been debating whether or not I should blog about what has been going on in my life. My first inclination was not to write -- after all, who wants to announce to the world (or more accurately, my small pool of readers) about how they've failed?

After talking to my husband, I had a change of heart. My blog is an anonymous outlet for me, and I've decided to share my story. It will probably come in installments as a narrative, because I just don't feel that motivated to write about everything all at once. I don't really feel motivated at all. Life sucks.

Day 1:

I'm in the emergency department of the hospital where I work, barefoot, lying on a stretcher. Familiar nurses are doing an EKG, putting IVs into my arm, hanging saline. My husband, somewhere.

“What did she take?” Someone asks.

I wake up in the ICU. I'm in room 8. My shirt is gone. My bra is gone. I'm wearing a gown. I don't remember taking my clothes off. I try to sit up. It doesn't really work. It's like the force of gravity has doubled. I succumb to my hospital bed, fading in and out of sleep.

My nurse (also one of my coworkers), Claire, comes in. I like Claire. She lives in the country, has a little farm with her husband. “Hi E.,” she says. “We're just going to monitor you for a while, make sure you're doing okay.” I close my eyes.

“E.? E, it's Dr. Nolan. Can you tell me what happened?” Dr. Nolan is one of the intensivists. I used to assist him with procedures when I still worked days, inserting central lines, doing lumbar punctures. He must think I'm such an asshole. I wish this bed could engulf me.

"I.. I.. took some pills. I was just really tired. I just wanted to sleep. I had gotten in an argument with my husband about the schedule for my physics class and I was just really tired and upset, and he refused to let me sleep, so I took the whole bottle. " It was stupid. It was stupid and impulsive. There are people here who are actually sick, unlike me. I'm just wasting your time, destroying any kind of once positive rapport we might have had, I thought to myself.

He continued to ask me questions for his history and physical in a detached manner.
"Past medical history?"
"Chronic sinusitis; aseptic meningitis."
"Anything else I should know?"
"I think my finger is infected. I had cut it a few days ago, and it's just been getting worse. I had been waiting to see if it would get better on its own." I held up my hot and puffy finger.

The rest was a blur.

I wake up again. Lauren, one of the aides, tells me she needs to draw blood cultures. I stick out my arm, barely aware of needles, of any kind of pain. I drift back to sleep.