{"id":486,"date":"2018-10-28T20:55:14","date_gmt":"2018-10-29T00:55:14","guid":{"rendered":"http:\/\/caregivertocaregiver.info\/?p=486"},"modified":"2018-11-04T16:30:13","modified_gmt":"2018-11-04T21:30:13","slug":"to-admit-or-not-to-admit-to-the-hospital-that-is-the-question","status":"publish","type":"post","link":"https:\/\/caregivertocaregiver.info\/?p=486","title":{"rendered":"To admit or not to admit (to the hospital)…that is the question"},"content":{"rendered":"

This is the second part of a series that began with I’ve looked at caregiving from both sides now.<\/em><\/p>\n

Soon I was transferred to an examining room where the poking and prodding began. (If you discern that I did not consider this to be a pleasant experience, you are correct.)<\/p>\n

My blood pressure was out of whack (197\/103) and dropped by about 30 points when I stood up (orthostatic hypotension). The triage nurse made three (painful) attempts to draw blood before calling for the phlebotomist to perform the venipuncture. She succeeded, painlessly, on the first try. The lab report was \u201cperfectly normal.\u201d<\/p>\n

Walking to the in-room toilet was a gigantic effort. The strange sensations in my fingers had intensified. The hospital gown felt like a sponge. It was a relief to see the cheerful emergency department doctor until he diagnosed me as \u201cdehydrated\u201d and informed me I would be able to go home after administration of some fluids via IV. My first thought was \u201cI hope they send the phlebotomist to start the IV,\u201d but then the reality of the doctor\u2019s words hit me. Dehydrated? Go home?<\/p>\n

Gingerly, I proposed the possibility of another diagnosis \u2013 maybe Lyme disease or Guillain\u2013Barr\u00e9 syndrome. Without further ado, the doctor curtly dismissed this suggestion.<\/p>\n

Randy and I shared a questioning glance before my husband dutifully spoke up. \u201cBut she can\u2019t even walk\u2026what are we suppose to do?\u201d<\/p>\n

This question appeared to annoy the doctor who shot back, \u201cOkay, then. We\u2019ll do a CT scan.\u201d<\/p>\n

At that point I remember thinking, \u201cWhatever this turns out to be, it\u2019s going to be expensive.\u201d Immediately, I scolded myself and determined not to think about the cost of care again until I recovered (from whatever this was) and was back home.<\/p>\n

The proficient tech that accompanied me for the CT scan was an example of what health care workers should be: concerned, compassionate, and competent.<\/p>\n

When she returned me to the ED, I requested\u00a0<\/em>(the ED nurse may have considered that I insisted<\/em>) that the phlebotomist start the IV. She did so skillfully. After the first bag of saline was administered, I attempted to stand but had no muscle strength or coordination. I slumped in a blob on the floor. It had been about four hours since we arrived at the hospital and my condition was deteriorating.<\/p>\n

The admitting doctor walked in, introduced herself and informed me that my CT-scan was normal. The process of ruling out \u201ceverything else\u201d had begun. I was unaware that Hoyt, my physician-assistant son-in-law, had just sent a text message to my daughter Rachel, asking for an update on my situation. Hoyt also mentioned that the possibility of GBS had crossed his mind. Even though the first doctor had pooh-poohed that idea, Rachel thought it was worth mentioning again. This time, the doctor seemed to give GBS a wee bit of consideration, but remarked something to the effect that, \u201cIt is very, very rare.\u201d<\/p>\n

When GBS was later diagnosed, I tried to be generous with my evaluation of how the diagnostic process had been handled. Yes, GBS is rare: one or two cases per 100,000 people every year. But when I eventually returned home and was emotionally ready to research GBS, Wikipedia\u2019s first paragraph on this subject read:<\/p>\n

The initial symptoms are typically changes in sensation<\/u>\u00a0 or pain along with muscle weakness<\/u>, beginning in the feet and hands.<\/u>\u00a0 This often spreads to the\u00a0arms and upper body, with both sides being involved<\/u>. The symptoms develop over hours<\/u>\u00a0 to a few weeks\u2026some are affected by changes in the function of the autonomic nervous system, which can lead to dangerous abnormalities in heart rate and blood pressure<\/u>. <\/em><\/p>\n

\u00a0<\/em>And from the second paragraph: The cause is unknown. The underlying mechanism involves an autoimmune disorder in which the body\u2019s immune system mistakenly attacks the peripheral nerves and damages their myelin insulation. Sometimes this immune dysfunction is triggered by an infection<\/u>\u00a0 or, less commonly by surgery and rarely by vaccination. <\/em><\/p>\n

In the above paragraphs, I underlined the symptoms or signs that I reported or that were revealed in the ED. If only I had described my fingers as \u201chaving a change in sensation\u201d rather than \u201cfeeling squishy,\u201d maybe the doctors would have had greater diagnostic ammunition. Wikipedia does note that a diagnosis of GBS is usually made based on signs and symptoms, through the exclusion of alternative causes, and supported by tests such as nerve conduction studies and examination of the cerebrospinal fluid<\/em>.<\/p>\n

Those tests were to come later. But first, the admitting doctor concluded I should not be sent home but admitted to the hospital. The next 24 hours were distressing for both my family and me as my symptoms grew wore. There were no further attempts to diagnose, and therefore, no treatment was available. I began to think I was dying.<\/p>\n

The next installment of this four-part series, which I have entitled, This is not a comedy show!\u00a0<\/em>will be available on 11-05-18.<\/p>\n","protected":false},"excerpt":{"rendered":"

This is the second part of a series that began with I’ve looked at caregiving from both sides now. Soon I was transferred to an examining room where the poking and prodding began. (If you discern that I did not consider this to be a pleasant experience, you are correct.) My blood pressure was out of whack (197\/103) and dropped by about 30 points when I stood up (orthostatic hypotension). The triage nurse made three (painful) attempts to draw blood…<\/p>\n

Read More Read More<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[21],"tags":[27],"class_list":["post-486","post","type-post","status-publish","format-standard","hentry","category-personal","tag-guillain-barre-syndrome"],"_links":{"self":[{"href":"https:\/\/caregivertocaregiver.info\/index.php?rest_route=\/wp\/v2\/posts\/486","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/caregivertocaregiver.info\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/caregivertocaregiver.info\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/caregivertocaregiver.info\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/caregivertocaregiver.info\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=486"}],"version-history":[{"count":4,"href":"https:\/\/caregivertocaregiver.info\/index.php?rest_route=\/wp\/v2\/posts\/486\/revisions"}],"predecessor-version":[{"id":492,"href":"https:\/\/caregivertocaregiver.info\/index.php?rest_route=\/wp\/v2\/posts\/486\/revisions\/492"}],"wp:attachment":[{"href":"https:\/\/caregivertocaregiver.info\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=486"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/caregivertocaregiver.info\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=486"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/caregivertocaregiver.info\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=486"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}