Well, let's see. After posting my last entry I went downstairs to the couch and was lying there reading. About an hour later my nose started bleeding again. :P I'm an old pro at this now, so I grab a kleenix and go to the kitchen where I acquire a plastic bowl. Back to the couch where I can lie down with my head hanging over the side, bleeding/spitting into the bowl. I remember Monday's nausea and have no desire to repeat it. It's difficult, though; there's a lot of blood kind of sneaking down the back of my throat, but I do my best. I try the nose clip (which they were nice enough to let me take home from St. Mary's on Monday) but my nose is too bloody and it keeps slipping off. Back to just pinching.
After fifteen minutes or so with no slowing down, Jim (who'd been thinking of going back to work after bringing me home from the doctor's office, but decided not to, wonderful man) called 911 and we got another ambulance out here. It's not quite so much of an emergency this time; I know what's happening and I'm more annoyed than frightened. By the time the EMTs decide to take me in there's about a cup of blood in my bowl. (For reference, if you ever hit a quarter cup you should get worried enough to call the doctor.) They empty it for me before taking me out to the gurney. Another ambulance ride, with me sitting up this time, bent over my bowl with gauze over my nose. I'll admit that when they were rolling me out, past some of the neighborhood kids, I decided to give this one kid who got closer than any of the others a thrill by raising my head a bit as we passed by him. I'm sure he had some status on the playground for a while, describing how gross and bloody the ambulance woman was. :)
We get to the hospital (Memorial again, by Jim's request, and I'm not urgent enough for the ambulance guys to argue for the closer one) and by that time my nose is slowing down. Great. I was actually annoyed by this; three doctors so far had looked up my nose and found nothing, everything looked fine, and I damn well wanted there to be something for them to see this time. :( I also discover that arriving in an ambulance does not automatically get you a bed. I got a wheelchair in a hallway, then a nurse talked to me while another one talked to Jim -- triage, I think. Then they sat me back in the hallway until I got my wristband. By this time I was starting up again and had gone through quite a lot of gauze. The puddle in my bowl's getting impressive again. They start wheeling me again and I figure I'm going to a bed, but no, I end up in the same damn waiting room I was in the first time on Monday. [sigh] I sat there hunched over my bowl, a bit lower than before since I had clots dripping down from my mouth stalactite-fashion and didn't want to make anyone in the ER sicker than they already were. :(
We're there for a while. I honestly don't mind, when it comes right down to it. I wasn't in danger, and I wasn't in pain, and if there were other people worse off than me then I had no problem with them going first. It was just depressing to be back here, again, for the same thing. It was warm, and my face always sweats like crazy, so I was just in dandy shape.
Somewhere in here I sort of wandered off. Jim said my responses when he spoke to me got slower and slower, and I finally passed out, or close to it. He went up to get some help. He says that finally at that point it looked like he'd always thought an emergency room should look, that there were five or six people swarming around me doing stuff, and they got me back inside and to a bed really fast. There was about another cup of blood in my bowl at that point, plus whatever I'd been unable to keep from swallowing, so I guess I'd finally lost enough to need prompt attention. I got another saline IV and people taking my BP and drawing blood for tests (seems they could've just held something sterile under my nose for a while, but anyway...) and a bunch of other stuff I don't remember very well. I did some more swallowing, since you can't really spit when you're lying down, and I do remember throwing up at least once later on -- I sat up to vomit over the side of the bed. Thanks, folks. Jim says I passed out again at that point.
At some point, Dr. Hunt went by. He's the doctor I saw the first time, on Monday afternoon. He was a really nice guy, and when Jim said "hi" he stopped for a minute. He remembered me. Jim told him what had happened since then. He said, "This is your third trip to the hospital, your fourth physician encounter, in three days? I am so sorry," and he really looked and sounded like it. I don't blame him, though; by the time he saw me I wasn't bleeding any more and there wasn't anything in my nose he could see that looked like a wound. Turns out it was "posterior" bleeding, which means it's way the heck up in your sinuses where they can't see with the little hand-thingy they usually use. Dr. Hunt offered to take my case, and I'd have liked to have him, but he was running around really busy with his own patients so Jim said no thanks. He stopped by a couple more times, and did end up helping out.
So I'm still lying there with my saline drip and my BP cuff going off at intervals. Dr. Caruthers (my current doctor) came by and said they were going to pack my nose. She showed me this thing about half an inch wide and about four inches long. She said it was basically a tampon for your nose. :/ She got me laying flat with my head tipped back and dripped this stuff she claimed was a numbing agent into my nostril. It dropped straight through to the back of my throat, and I swear it felt more like hydrochloric acid, at least twelve or fifteen molar. :( It burned and stung like hell, and the back of my throat still hurts when I try to talk. At that point it hurt constantly. She got the pack in, with the plastic handle dangling out and taped to my cheek. It was annoying but didn't actually hurt, or maybe my throat pain was distracting enough that I didn't notice. My throat and I get to lie there and they leave me alone for a while.
Dr. Caruthers came back and said they were going to admit me and were Real Close to having a bed. Well, real close stretched out into an hour or more with nothing but some vague assurances from various people in scrubs. Jim asked Dr. Hunt next time he came by, and he asked around and came back to tell us that my blood tests had come back and they'd upgraded my bed request. I was more anemic than they'd thought, and they wanted one with more monitoring, now, in an area where there are fewer patients per nurse, so the bed they'd originally been looking at wouldn't do and they didn't have any of the kind they wanted for me. It would've been nice if someone actually assigned to my case had taken the 90 seconds it took to explain this. [sigh] But it looked like there might not be any of the right kind of bed available. It's about 11:30 at night by now and it seemed to Jim that there weren't likely to be any discharges at that time. I could think of one reason why there might, but didn't want a bed badly enough to hope for it. :/ Dr. Hunt said someone might be moved to a different area and he'd see what he could find. Finally some guy came down and said they had one and I'd be going shortly. This is good; it had started to look like I'd be spending the night in the ER and it's impossible to sleep in there unless someone hits you with a hammer, either physical or chemical. I just wanted peace and quiet and sleep, and maybe a clean gown and clean sheets, although neither was at the very top of my list at that point. Jim thanked Dr. Hunt next time he went by, and he said "Tim did it," so I guess Tim was the guy who'd come down with the bed paperwork. I'm sure he did it because Dr. Hunt asked him to, though. If he ever moves from ER medicine to GP, I want him for my doctor. :)
Eventually a couple of nurse-types come and wheel my bed away. I end up on the sixth floor, in a very nice one-bed room with its own bathroom and a window. There's sort of a partition-wall going across 2/3 or so across the room between the bed and the bathroom, so I'm mostly private from the hall even though the door's always open. About four more nurses get me moved over to the bed, out of my filthy gown, cleaned up and into a fresh one. Once I was settled down, Jim asked if I minded if he left. I said not at all, and shooed him out. He left me a book to read and said he'd be back the next day, soon after visiting hours started.
A little after that my regular doctor (Dr. Leidl, the one I'd seen on an appointment that morning) came by and looked over my charts and asked a bunch of questions. He rearranged my meds, since some of the regular ones can raise blood pressure, and prescribed a couple of new ones. (Which brings me up to nine prescriptions, by the way. [sigh] I'm pretty sure one of the new ones is temporary, though.)
By this time I wasn't tired (my sleep patterns are weird, and the reason for some of my meds) so I just lay there reading my book. At about three, someone came in to draw blood for tests. I finally fell asleep at around five, and blood lady came in at six. [blinkblinkyawn] You know how they stick you and then fill three or four little test-tube thingies, when they want blood for tests? The lady who came at six had one little tube thingy and three bottles, I swear. [flail] They weren't huge, but jeez.... They were about the size of those bottles soy sauce comes in, not the straight ones but the ones that are fat at the bottom and have a narrower neck. She took a couple of ounces for each one. I felt like asking for a sign to hang around my neck -- I'M ANEMIC, PLEASE LEAVE ME SOME BLOOD! I got my BP checked a couple of times in there too. I dozed a bit after that, but didn't get much good sleep.
Around 10:30 or so the nurse's aid came in to ask if I was done with my tray. I said I hadn't eaten yet. She looked kind of surprised and went back to check. Turns out they had me on... I don't remember the acronym, but it means "Nothing Passes Her Lips." They wouldn't even give me water, except for a sip or two when I had to take pills. I wasn't dehydrating any more, since I was still on the saline drip, but combine no water with the impossibility of breathing through my nose, and my mouth felt like.... Heck, I can't even think of anything. Trust me, it was awful. I read and slept some more. Some time in here my nose tampon got saturated and started leaking. I had a nice big splotch on the shoulder of my gown, and another one on the towel some smart nurse had put on my pillow.
Jim came in early that afternoon. I got my BP checked and more blood sucked. We just sort of hung out. My new doctor (I don't think you're allowed to have the same doctor for more than about 36 hours) said that an Ear, Nose and Throat (ENT) specialist would be coming by to look at me, and then they'd be discharging me. I wasn't terribly pleased by this, and neither was Jim. I'd come in through the ER three times that week so far, and didn't want to be sent home and have to do it again. :( Oh, and they were keeping me off of food and water was in case the ENT wanted to do "a procedure." Great.
The ENT guy came back late that afternoon, I think, and took a look, although there wasn't much to see since I still had my pack in. He said he didn't want to take it out because removing it could remove whatever clot had formed, and start the bleeding all over. By this time I wasn't actively bleeding any more, just blotting watery bloody whatever from my nose. The ENT guy said that it was like soaking a sponge with something red, then trickling water through it. The water'd come out stained red until finally all the red was gone. He wanted to leave my pack in until, and I quote, "There's nothing coming out but snot." [laugh] I got the impression that a chunk of the ENT guy was still an eight-year-old who delighted in snot jokes. I guess you'd have to be, though, to make a career out of it. Anyway, he says that with my BP still high he wanted me to stay another night, and that he or an associate would come by again tomorrow. It took a while to get that through to my regular doctor, but I was allowed to stay over Thursday night. They even gave me dinner on Thursday. :) It was actually pretty good, turkey and gravy and mashed potatos, green beans (a bit overcooked, but I've had a lot worse), salad, fruit cup, milk and mint tea. I went to bed around 10:30 or so, and only got woken up to be stuck once or twice.
Woke up for real about 7:30. I still couldn't breathe through my nose, so my mouth still felt awful, but at least I could drink some water. I hung out, read some (Jim had left me like six more books the previous day [grin]), got my vitals taken a few more times. I was wondering when breakfast was served, but didn't want to be a bother and call someone just to ask. I was pretty hungry still, though; mind you, I'd fasted for about 18 hours from Tues. to Wed. because of the tests Dr. Leidl wanted done, so I'd been without food for a lot longer than just my time in the hospital. :/ So I waited like a good, cooperative patient, until the nurse's aid came around for something else at like nine or so and I asked when breakfast was. "You haven't eaten yet?" Umm, no. It took about another hour and some discussion with my doctor (which I heard, since it was in the hall right outside) to discover that they were still going by my Do Not Feed orders, even though they'd been cancelled the previous night. I got breakfast eventually, slept some more, then got lunch a couple of hours later.
My doctor's talking about sending me home again. Jim argued. I did some arguing, but my throat still hurt so I didn't say as much as I wanted. Finally the ENT guy's PA came through, a lady who was very pregnant and due "any time now," to take another look. She said they usually wanted to leave the pack in for at least three days, which would be Saturday night or Sunday morning, but, well, that's Sunday, and this is a three day weekend, so I could make an appointment to go in to their office and either she or the doctor would do it on Tuesday. Lucky me, I get three extra days of having this thing hanging from my nose. :P She gave Jim their office number so he could make an appointment for me, but said I could just come in at nine on Tuesday and they'd see me just fine. My doctor, later on, however, said no, that I had to go see one of the "plan" doctors instead. [rolling eyes] She and Jim went back and forth on that, since our plan has offices and clinics all over the area. We don't have a car, and he didn't want me to be sent to some doctor thirty miles away, when the doctor who'd already seen me -- who was on our insurance, even if not a member of the right medical group -- was a convenient block or two from the hospital. More arguing.
Oh, through the day I had my BP checked a few more times, after having been on the BP meds for twelve hours or so. Now I'm going the other way -- one was like 96/76, and another was like 93/68. I swear, it's all those people who took blood for testing. Like letting air out of a tire, eventually the pressure's going to go down. [rueful smile]
The doctor said she'd get me an appointment with the right doctor, and gave Jim her pager and service number to call her the next day and find out what was going on. OK, fine. I got sprung from the hospital Friday afternoon and we took a cab home. I spent the evening and night and morning on the sofa, sleeping and reading and going through kleenix. By the ENT guy's test [cough] I could have my pack out right now, but I'm not about to take it out myself, so I guess I'm stuck with it until Tuesday. Late this afternoon I felt brave enough to try the stairs, came up here and got on my computer.
My thanks to everyone who left good wishes with my last post. I'm hoping future posts on this topic will be short updates, rather than rambling novels like these last two. We still don't know for sure what's causing all this; I'll let you know as soon as I know.
Thanks and hugs to everyone,