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I loved my first weekend in the ER. Absolutely loved it!
At the end of the first day, a man drove up to the ambulance bay saying "baby now. baby now." He didn't speak much english. Shannon was handed a bundle of blankets. He ran into the crash room yelling, "someone get the mom! someone get the mom!" Once in the crash room, I watched him open the bundle. "Oh, oh, oh. This is small. So small. Oh, small." In the blankets was a bloody, blue baby. She was born 16 weeks early. She weighed 1.2 pounds. She was gasping for breath. Once she was stable, she was flown to Crawford-Long hospital. The mom retained the placenta and was bleeding heavily. I'm pretty sure she ended up having a hysterectomy.
A 24 year old woman came in with abdominal pain. Turns out, she had a tumor the size of a cantaloupe stemming from her right ovary. She had surgery, and is OK now.
I also helped hold a 1 month old boy in place for a spinal tap. Thankfully, he wasn't a screamer.
I got a new nickname in the ER-Majik, instead of Majeski or My Jet Ski. I like it. =]
Now, for my health:
- I have high cholesterol. We're talking 250, folks. Sucks for a 21 yo.
- Some of my neck problems have been figured out. The dura mater on my first cervical vertebrae is too thick, pushing my nerves.
- Also, my extra rib has grown longer, pushing on my nerves.
- I have carpal tunnel in my right wrist
- I have a "bump" in my 5th cervical vertebrae. It's been there for a while, and yes, it's still causing problems. It's from Degenerative Disc Disease.
So now I have a consult with a orthopedic neuro doctor. Hopefully he can give me a special kind of epidural into the thickened dura mater to reduce its size to relieve some pain. Please no surgery!
Rocky's too sexy...
crocs at the crab shackOver the weekend I had a patient whose story brought me to tears.
She was 94. She fell and hit her head 2 years ago and was just brought to the hospital by her 3 children. She had a huge wound on her forehead that drained constantly. She was so sweet to talk to, and very appreciative. Dr. Perez showed me her CT scan. An infection has eaten through a quarter of her skull. When we changed her dressing she screamed in pain. She begged us to stop, and thanked us for taking care of her. As we cleaned her wound, we actually touched her brain. We saw bones of her skull. The smell of the infection was overwhelming. Blood dripped into her eyes. After redressing the wound, I walked out in tears.
Another patient was a fun 70 year old. I would sit with her for up to an hour at a time. We talked politics, religion, and relationships. She was fun.
Another patient had to be restrained because she was very confused. She would get up and walk the halls with her robe untied, showing the whole hospital her ass. She also tried to hit nurses and aids. We ended up getting a sitting for her so she wouldn't be left alone.That's all from me for now.
playing with riley on a study break
Just finished my last week in the ICU. I'm glad. I learned a lot, but it's just not my thing.
Saturday was so dull. I read 3 chapters in my textbook. Yeah. I got a patient who had inhalation burns from a cocaine binge. Her throat was so swollen. When her tube was taken out, her stridor was so loud it could be heard everywhere in the unit. She was re-intubated, which was interesting to watch. The doctor was unable to visualize her vocal cords because of all the swelling, and said that the patient had been breathing through a tiny slit.
Sunday the unit was full. There was no one available to sit with the cocaine patient (she's a 2013-drug overdose. she can't be left alone), so I got nominated for the job. She was awake, so I handed her some paper & pen. We talked that way for a while. She wants help. Good for her. Her 17 year old daughter had been in DFACS custody until she disappeared from the case worker.
That was pretty much it.
I had a patient expire on Sunday afternoon. First time it's ever happened to me when I was actually there for the whole thing. We knew it was going to happen soon on Saturday, when her O2 saturation dropped into the 80's. After lunch on Sunday it was in the 50's, with a ventilator. We called in the family. When the sats got into the 30's we turned off the monitor. Then she coded.
Her color drained almost instantly. Her face turned to an ash gray color. A black-green fluid bubbled out of her mouth when we pulled the vent tube. Serous fluid started to pour out of every opening in her body: eyes, nose, wounds, IV site, everywhere. Her eyes rolled back into her head; the whites also now gray. The body was already stiff from her severe third-spacing. We tried to stop the spouts of fluid and clean her up before allowing her family to view her. People crammed into the small ICU room to say goodbye.
An hour and a half later the funeral home arrived. Her body was strapped onto a stretcher and covered with a velvet cover from the funeral home. When she was being moved, I noticed that her blood had settled to her backside, which was purple. It was still warm. Her front side was cool.
I cared for her for 3 weeks. I watched as she deteriorated. I saw her last breath.
Her family cried. Her husband hung his head.
I wasn't sad. I wasn't upset. I wanted to learn more. I watched.
I feel so eerie. Like I should feel something more. But I don't.
I had a hard time falling asleep last night.
Rocky, my mutt. The bottom picture is when I was sick yesterday. He stayed that way with me all day.
Yeah, I was sick yesterday. Overall weakness, n & v, and pale. I tried to go to school, but wasn't there but an hour. It was the first day of class that I've ever missed. Damn! There goes my perfect attendance. Haha. My senior year in high school, I missed 85 days, almost half the year. My, how I've changed. I hated missing the first day. But once I got home, I called Mom. She came over & cooked for me, played with Rocky, and took care of me. She stayed until Ben got home, so I was well taken care of. And now I'm better and trying to catch up on school work. Of course I had to miss Acid-Base balance.
That's all for me.
A sunrise on Tybee Island.
Yesterday was a blur. But clinicals weekend #1 is over =]
I was assigned a patient who has had an incredible amount of health problems in her 55 years. She had multple sclerosis, which had affected her for 30 years. She came in last week just feeling crummy. A chest x-ray showed that her lungs were inflamed, so the docs diagnosed pneumonia. Her abdomen was scanned, and turns out her intestine had gotten twisted into a knot. Surgery was performed to removed part of her intestine. When I walked in her room Sunday morning, her abdomen was distended & tender, usually a bad sign. Her entire body, except for her face, was swollen and pitting. Her heart rate was in the 140's, pretty high. She was also unconscious, thank goodness. She had 3 consults that day. She was very high maintenance, but I barely got to see her b/c so many people were in & out of her room. After her consults, she was taken to ICU to get better care. I went to radiology with her to get another CT scan of her abdomen. Her heart rate got up to 207, extremely high. The tech in radiology took the time to explain her scan to me. Her bowel had perforated (opened inside), releasing fluid, fecal matter, and air into her abdominal cavity. Medical emergency. She was rushed back to ICU while the surgeon was called. I learned how to distinguish between air, fluids, and organs on a CT scan. Last I heard, she was in surgery.
Once she was no longer on the floor, I helped the nurse I had been working with, Katie, and tagged along with Ali & her nurse, Rose. I had a patient that I just wanted to hug. She also came in with a cold, and was diagnosed with pneumonia. The docs found some heart issues with her. One of her valves wasn't functioning correctly, causing high blood pressure. She was scheduled for an endoscopy today, and may need surgery. What made her situation worse was that she gave birth to her 2nd child 2 weeks ago. She was so upset, and there wasn't much I could do about it. I brought her soup & magazines, but that was all I could do.
I helped Ali & Rose again with all the dressing changes. Even in just a day you could tell a big difference. Things went faster; I remembered more than I thought I would.
Then, the day was over.
Monday is my day of rest. =]
