ER: It Was More Fun On TV

{See previous post, I’ve Fallen & I Can’t Get Up for Part One of this tale.}

I’ve Fallen & I Did Get Up

I’m about to provide you with a crash course (pun intended) on the signs and symptoms of a concussion. If you are a parent or a coach, you may already know how to recognize a concussion, because chances are, one of your kids or team members has already had one. However, if you are a member of the erect, bipedal hominid group of creatures (i.e. us humans), you probably ought to learn how to recognize one, too. To wit……

From the site

A concussion or closed head injury may be caused by a sudden fall [or] jolt or [a] blow to the head[Initial sx may include] changes in vision, headaches, nausea, vomiting, drowsiness, loss of memory or dizziness. Watch for:

* Confusion, [or is easily] distracted and cannot do normal activities
* Stares blankly
* Delayed answering of questions
* Slurred speech
* Stumbling or clumsiness, uncoordinated or cannot walk a straight line
* Cries very easily or becomes angry easily or exhibits extreme emotions
* Problem with memory, repeats self, repeatedly asks questions, unable to recall words or objects
* Loss of consciousness

Other symptoms of a concussion: Confusion; Loss of memory about accident; Headache; Nausea; Difficulty with memory; Slowed thinking; Tiredness; Change in sleep; Unbalanced; Dizziness; Ringing in ears; Increased sensitivity to light or sounds; Mood changes – sad, irritable, non-motivated; Blurred vision.

From the site

There are different grades of concussion:
* Someone with a grade 1 concussion can have some of the symptoms listed above, but with no loss of consciousness and with symptoms ending within 15 minutes.
* With a grade 2 concussion, there has been no loss of consciousness but the symptoms last longer than 15 minutes.
* In a grade 3 concussion, the person loses consciousness — even if it’s just for a few seconds.

If the concussion isn’t serious enough to require hospitalization, the doctor will give instructions on what to do at home, like having someone wake the person up at least once during the night. If a person with a concussion cannot be easily awakened, becomes increasingly confused, or has other symptoms such as vomiting, it may mean there is a more severe problem that requires contacting the doctor again.

The doctor will probably recommend that someone with a concussion take acetaminophen or other aspirin-free medications for headaches. The person also will have to take things easy at school or work.

So, I fell on some black ice and I landed flat on my back on concrete. I did not lose consciousness, as far as I recall, but I did void uncontrollably and I hurt all over. Once my adrenaline kicked in, I dragged myself up, holding onto my car, went home, changed my wet clothes, and took care of a few things so I could go to the ER. One of those things was to let my boss know what happened because this was an incident that occurred during the fulfillment of my job, so there are forms and procedures for those kinds of things. So, I got the info I needed and proceeded to the local emergency department.

Generally speaking, being a clinician who needs some medical attention is advantageous. Other clinicians are usually nice to you and try to hustle a bit so you’re not waiting around forever. Sometimes, it doesn’t make any difference whatsoever, and really it shouldn’t, because clinicians and doctors should be nice and compassionate and conscientious toward everyone. In any case, I had my ID badge on when I hit the ER, so I was a marked woman, so to speak. But I can’t decide if that made things better or worse.

Here’s the basic ER timeline: I arrive in the waiting area at about 5:00 p.m. There are about 4 other patients, and their various friends and loved ones, in the waiting area. I am now not comfortable sitting, standing, lying down or in any other position I can assume. I feel very, very tired suddenly and just want to lie down and take a nap. I wait 20 minutes for someone to talk to me. Finally, a volunteer with a clipboard talks to me, takes my name and a general description of my problem to give to the triage nurse. I wait about another 30 minutes.

The triage nurse calls my name. I enter her office, sit uncomfortably and tell her what happened. I yawn and get my vital signs taken. Much to my surprise and alarm, my blood pressure is about 155/80 and my heart rate is over 100. I’m always normal, so the nurse and I chalk it up to pain and distress. She asks a few more questions and has me return to the waiting area. I wait another 30 minutes.

I get called into the ER itself and get led to a curtained exam room. I’m asked to put on a johnny. I do. I also adjust the gurney (one of the advantages of being a PT is I know how to do this) to make it more comfortable, and I lie down on my side and close my eyes. I feel like I could sleep for 10 years. I figure this is because my adrenaline is now wearing off. Some young man comes in, wheeling a computer on a stand, and takes some information so the hospital can get paid. He leaves. I wait for 30 minutes. I think several times that I am so tired now, I just want to go home and go to bed. I figure I’ll wait till 7:00 and then bag this nonsense.

At 6:50, a doctor comes in. He asks me what happened. I tell him. He pokes and palpates my lower back and decides I should have X-rays of my pelvis and hips taken. He tells me that he is about to go off his shift (it is about 5 minutes before 7:00 p.m.) but that while I’m getting X-rayed, he will pass my chart on to the person who takes his place in 5 minutes. He leaves. I wait 20 minutes.

An X-ray tech comes and gets me and brings me to Diagnostic Imaging. I lie down on a miserable table, get positioned, get told to hold my breath about 6 times, then have to get the X-ray tech to help me up. I go back to my cubicle and get dressed. I am really, really, really tired now. I wait another 20 minutes. No one comes over to talk to me. The ER is quiet. A few of my former waiting room comrades also hang out in the other rooms, but no new folks arrive. I wait some more. I am uncomfortable sitting and lying down, so I try standing in the doorway and leaning up against it. My eyes close as I’m leaning against the doorframe. I’m so tired, I think I could fall asleep standing up. Finally, a woman comes up to me and asks me if there’s something she can do for me. I say, “Yes, you can find out if my X-rays are negative or not so I can go home.” She checks my name, goes behind the counter and tells me they are fine. As she is talking to me, an orthopedist I recognize comes toward us. The woman directs him to another cubicle to see a boy with an elbow fracture. She gets up and leaves. Now, I know that you’re supposed to sign something before they let you leave, so I wait until someone else walks behind the counter and I ask her if I’m supposed to sign something. She asks my name and says, “oh, yeah,” and brings me a clipboard. I sign the form, and she gives me some generic instructions about back strain that say I can take an anti-inflammatory for pain and to call my doctor if it doesn’t go away. I go home and sleep badly.

To make a long story only a little longer, I felt like crap that night and the next day. I had a headache, I felt sick to my stomach, I couldn’t concentrate, I was exhausted, I would forget where I was going and I would forget what I was saying. A couple of my friends took a look at me and said they were worried about me. I was worried about me. The day after that, my boss said the hospital sent over a report saying that they had told me to stay out of work for 3 days. I told her that they had neglected to inform me of these instructions. I called my doctor and made an appointment to see him in a few days. I saw him. He did a neuro check and asked me a bunch of questions. Then he told me I had sustained a concussion and to take it easy for a few weeks.

So, here’s the obvious question: why didn’t anyone in the ER pick up on this?

As soon as I emerge a little more from the fog, I am going to be writing some letters. Or maybe I’ll just have a few people read this blog.

Please click on the post title or the comment link below to post a response.

This entry was written by Kathi, posted on Tuesday, February 17, 2009 at 11:02 am, filed under Cognitive Dysfunction & Depression, Health & Healthcare, Life & Mortality, My Work Life and tagged , , , , , , . Bookmark the permalink . Post a comment below or leave a trackback: Trackback URL.

4 Responses to “ER: It Was More Fun On TV”

  1. This is the kind of thing that infuriates me. It is the same everyone… basically sucky service. No follow through. No one gives a damn about doing the best job they can. Makes me ill.


  2. After I had my car accident, while having a seizure, I was left in the room the paramedics wheeled me into by myself. The cop took my statement, then he left. The next person to come in was my then-boyfriend, and I had to wave to him from the bed because the person at the desk had no idea I was there.

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