Thursday, November 19, 2015

7 days in and still no real answers

SO if you've actually been reading this blog (thank you!) you'll notice that there's been a drop in my posts even though there's things been going on in the life of Nurse Dee.

Well it all started last week (we'll say monday for shits and giggles) and I had a headache, decreased appetite and nausea (no vomitting) and been monday and wednesday I had a fever off and on - it seemed that when I had the nausea really bad that I also had the fever. The highest it got was 38.4 C/101.2 F. The other temps were <38.0 so I didn't go to the hospital. Figured I could just get over "whatever" this was.

So thursday rolls around and my husband gets fed up with me saying that I'm not feeing well and tellls me that I either need to put up or shut up.... in other words - go see a Dr or stop complaining!

So I grabbed some stuff and off we went to the hospital - no temp at the hospital but because I had had a high one the night before I was considered a SIRS alert and was seeen a bit quicker.

About 6hrs later I finally see someone - the nurse practitioner - now I'm ok with them - I know that often they will know just as much or more than regular docs but this one seemed real unsure about what to do with my symptomolgy. She calls in the MD and he makes the decision to do blood work and a CT - those come back clear and I wait some more.

When I see the Dr again he decides he wants to do a LP (lumbar puncture) which I thought would be valid given my symptoms - my neck was stiff and my vision turned hazy that day which is actually why I agreed to go in.

Anyways - he also has a call in to the neurologist (one I actually know and converse with on my unit) and he comes in JUST as he's (the ER doc) creating his sterile field and said he wants to ask some questions and proceeds to. I think he got 3 questions in when I told him I needed an emesis basin in case and I think he asked another question and a wave of nausea hit me and of course I reacted - trying to keep the stuff down - and he thought I was just being emotional about the question! Hahahaha. So I think he asked about 2 more questions and I answered by vomiting.... he was so astonished! Oh to just picture his face! He said "yep, I think that's about enough, we may want to reconsider doing the LP in her condition" Hahahahaha

They gave me some Zofran and 20 min later we did the LP - not simple and certainly painful! But we got the fluid.

Before doing it though I made sure to have him check my opening pressure (see I am learning things from school!) and that that's really important! So when he opened the first kit and it didn't have it he ensured that he found one that did.

Well good thing I pushed for that because my opening pressure was 36!!!!!!!!!!!! High normal is 20 so it's no wonder I was in soo much pain. And let me tell u pain.... after the hour of being supine/lateral, I got up to go pee - OMG the pain..... it was searing from the LP injection to my neck like someone was stabbing me or something. I could no longer look left/right or put my chin to my chest without excruciating pain - I couldn't lay flat with my legs down - when they had me do that I was in tears!

So they admitted me. They said the fluid looked clear and the results of the LP came back clear so we didn't know what was going on. Then we did a MRI/MVA where we look at the veins and artieries and such of the brain to see if there's somthing going on there. Nope - that pretty much came back clear - the neurologist said that I had a slight compression of some area that is often associated with a condition called iopathic cerebral HTN.... but he didn't see me til the Saturday and in his notes indicated that he wanted a therapeutic LP done on me to drain 40cc of fluid!!! That seems like an awful lot! The MRP refused, indicating that he wasn't confortable taking that much, neither was the anesthesia consult MD because if u take off too much,u could cause herniation and thus death unless dealt with immediately.

Now, my hospital might be huge but we do no have neurosurgery on stand-by! So if I did herniate then I would die or have severe deficits - just what I always wanted!!!

So today finally came when the same neurologist was back in house and he came to see about doing the LP - said the risk of herniation is about 1% and risk of low CSF is 5%, so I consented.

The fellow that he has on service with him is also an anasthesiologist by trade and said that she would do the tap.... and didn't bother numbing me at all!!!! Said that it can "screw up/shift the anatomy" and make it more difficult to get into the space. I think it was utter bullshit but who am I to say?!

So now they want this tap done under x-ray/fluroscopy/CT/MRI - whatever the hell it is! And who knows when that will be!

I just told my MRP (because we've known each other for 4+ yrs now) that I think it would be better to just go to the hospital that specializes in this sort of thing.... tomorrow we will see. I didn't see him tonight before he went off.

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