Life at 15 WTFS Per Hour- Part 2
So, where did I leave off...
Ahh yes, the wonderful second admission. There I am in resus waiting to be transfered, my lovely matron sat opposite me joking I'd do anything to get out of nights... and she's kind of right!
Finally, I'm being moved to the ward, here is to at least a little bit of sleep.
Now, there is something about a medical assessment ward that either draws nurses in, or terrifies the hell out of them.
Safe to say, I'm the latter of the two types of nurses. I am an intensive care nurse through and through, I have no idea how these nurses survive a shift and still leave wanting to come back the next day. They get anything and everything coming their way and they genuinely do not stop. I was in utter awe watching them over the time I spent in.
I finally left A&E, adrenalined up at about midnight, I had the nicest porter transfer me, and the dreaded question came....
" I know you don't I? You look dead familiar"....
Oh god.. now, what do I do? Do I deny all knowledge and pretend I am a complete stranger, with the risk of when I am back in work bumping in to them again and feeling awful that I lied? Or, do I fess up that I'm a nurse, go through the- "Which department do you work in" and then dodge eye contact for the rest of my working life? Yes seriously, this is how my brain works- the steroids and adrenaline quickened this up even further and threw in even more scenarios.
I fessed up...
"Yeah, I'm a nurse on NICU, not exactly how I planned to spend my night to be honest."
There was the moment of mutual acknowledgement that, realistically this was really shit... Everyone knows that being an inpatient sucks.
"Oh mate, I feel for you. I hope you're not in too long. I'll let the nurses know you're one of them"
Facepalm..... this is what I was trying to avoid. I didn't want people knowing I was a nurse. It doesn't mean you get treated any differently, it was more for my pride. I didn't want them to think I understood what was happening to me, because I didn't, I still don't. I was slightly worried that them knowing I was a nurse actually could be worse for me because they may not explain things I needed explaining.
I am an adult nurse by background, I did 3 years in adult ICU, but I specialised in Neonates and now my adult nursing is a bit rusty.
I have very limited knowledge of what was going on with me, to be fair, so did they- I needed them to treat me like Joe Bloggs off the street, not think that I may understand complex immunity stuff... It made me panic a little, which looking back now probably seems stupid, but I'm sure we have all had that professional bias that because you're in the profession, you're going to have the knowledge in that area.
Once I was comfy ( I use the term very loosely) in my bed, I did what all HCP's HATE..... I GOOGLED!!!!
Why I did, I don't know- but I tried to be a sensible googler (I'm not sure that's a word, but lets go with it for now)
I tried to keep to scientific research, I tried to ensure that information was coming from reliable sources. I was awake all night, trying to understand everything I could about anaphylaxis, even to a cellular level- knowledge and science are my friends right? That way, if a fancy word that I don't understand comes up with the consultant tomorrow, I'm not going to look like an absolute idiot. Surprisingly there really isn't all that much about anaphylaxis, which made me feel even more infuriated. The knowledge I was hoping to gain wasn't there.
Again, this is how brilliantly my brain works when its in over drive, not just from the stress of the situation- but some pretty hefty drug doses.
Over the course of the night, again I was a terrible patient. I refused to buzz my bell, I got myself to a point where I couldn't catch my breath- so the sensible rational person in me, got out of bed and staggered to the nurses station... They could hear me coming before I even got there.
"Why on earth didn't you press your bell? It's what we're here for!!!" I got a very stern look.
"Well, I thought I would save you the trip, I can set up my own neb its no problem!" this sentence alone took me well over 2 minutes to deliver just from purely not being able to breathe!
As I was frog marched back to bed, a very lovely doctor came to review me whilst the nurses went to grab some adrenaline nebs. Obviously, the first thing that comes out of my mouth "Oh, I'm so sorry, I really hope I haven't disturbed your break. Honestly, I can have a neb and I'm sure I'll be fine."
The look of disbelief on his face was rather amusing.
"You realise you're the patient now, you need to let us look after you- you're really not well! No more trying to be the nurse" Great... he knows I'm a nurse, this really doesn't make this more embarrassing at all, let me just pull up my static covered NHS Blue blanket to cover my strawberry blotched face!
Ok, I'm not going to lie, by this point I really didn't feel well. The air I was breathing felt like thick hot soup that was filling my lungs. The burning rash was coming back again, and I was starting to feel shaky.
" Take a deep breath for me"... his very cold stethoscope making its way around my chest...
Was he kidding? A deep breath? Who does he think I am... some opera singer ready to belt out Pavarotti's greatest hits... I can barely get enough in just to move my chest let alone a deep one.
My lovely nurse comes back in through my curtain- I'm feeling guilty that the other 3 women in my bay are now all probably awake because I just cant catch my breath.
"We're going to need some more IV steroids, I'd get another IM Adrenaline ready, and do 3 back to back nebs- adrenaline, ipatropium and salbutamol- her chest sounds awful. Oh and a fluid bolus. Also, can you bleep the senior Reg, he needs to come and see her!"
BRILLIANT..... Even I know that you don't bleep the senior reg at 3am without being 100% sure you're absolutely need to.
Right... try not to panic. Panic is only going to make this worse, Just think, you need a bit of PEEP- purse those lips together when you breathe out to try and keep those alveolar open...
So there I am, sat with another sexy Neb on my face, doing my best duck lip pout to give me a little bit of PEEP, with the cold clammy dripping in sweat sexyness that comes with this much adrenaline, plus wild hair and no makeup... I mean, what hot young successful doctor would not think I'm the epitome of desirable with that kind of a look going on.
So, steroids go in- and seriously guys, they really bloody hurt when they go in, so when they say slow IV push, please do it slowly.
IM adrenaline and chlorphenamine goes in, my arm now resembling a small blackberry bush of bruises.
Nebs are wafting in my face-, imaging its one of those nice cool facials you get at a spa ( it really isnt)
And a bag of IV fluids to sort out my blood pressure.
Now, the only issue I had here with the IV fluids is that, as we've already gone through... I'm a nurse. Here I am on my second litre of fluids- when does a nurse ever get 2 litres of fluids within a couple of hours. I don't think I've ever needed to pee as much as I did that night.
But at least the kidneys are working... Woooooo... go my favourite organ!!! ( and I'm being serious, they really are my favourite organs, I even have a crochet kidney called bean who has a crochet water molecule friend called marvin)
Anyway, I'm digressing.. we can come back to the many adventures of Marvin and Bean another day!
So, there I am, sweaty, grey, heart rate through the roof, peeing for England and all sense of dignity gone. Then in comes doctor number 2... I mean, guys, if you want to spend time with me its fine, but late night bedside calls really are a bit much.
This time all dignity goes, the chest is listened to, but then the dreaded- we really need to check all your skin to see this rash spread... BRILLIANT!!!!! Here I am stood in knickers- which are covered in sausage dogs saying Ooo Lala, and a bra that isnt even remotely the same colour or pattern. Every wobbly bit of me out and exposed. I am LOVING this moment, I mean, absolute highlight of my week, having one senior doctor staring at my wobbly awful body, and the junior doctor looking slightly embarrassed in the corner- MATE I FEEL YOUR EMBARRASSMENT, no one needs to see this on a good day, let alone right now . . I really did earn the title of strawberry walrus of the north west.
A few moments pass.. do I crack a joke? Do I stay silent... give me a clue doctor man. You've just been sat staring at this rash for longer than I thought you might... Social anxiety kicks in, and my brain decides to break the awkward ice.
"Body like Kim Kardashian right.. I'm sure I can balance a champagne glass off my butt too.. do you think that will help get rid of the rash".
Awkward corner doctor chuckles- result, senior doctor looks up with an awkward smile on his face.. I don't think he even knows who Kim Kardashian is...
"Well, you've had the medication, we'll continue with the nebs over night and contact the specialists in the morning..."
Ok, the Kim Kardashian joke was a flop... I don't think he was in the mood for joking at 4am.
Amazingly, even with all the exams and hustle and bustle in my little blue curtained bay, good old Enid opposite me slept through the entire thing... her snore was like no other.
By the time we got to 7:30am and change over, I was well in to double figures of how many nebs I was having. They would last for half an hour, then It would feel like breathing through soup again. The nurses were amazing, nothing was too much, even a bell going every half an hour. Thank god for lockable cupboards by the bedside to store a mountain of nebs in to save their legs.
I eventually fell asleep for 10 minutes, before being awoken to the sound of a cup of tea being placed by my bed... i'm not going to lie, there is nothing better in this world than a cup of tea made for you and two slices on NHS toast. There is something magical and healing in those two things.
So, it's time to hear my fate... here comes ward round! Already, my plan is to persuade them to let me go home. No one needs me here blocking a bed, and I've gone an hour without needing a neb... I am a full blown rock star, basically the queen of using my own lungs!
The process starts again, lets go through the history.
- Allergic to mandatory training apparently
- 3 anaphylactic shocks in a week needing to be in resus
- No I haven't changed my washing powder
- No I haven't changed anything in my diet
- A crap ton of adrenaline and steroids
- May have had a slight reaction last night
- My Kim Kardashian jokes aren't a hit.
As I sit and go through things with him, my chest becomes tight once again, and my burning rash appears- the look on the doctors face one of mystery and wonder at this burning scorching pain coming across me.
They listen in to my chest again- and agree the wheeze is bad, almost metallic in sound.. well, in all my years of chest auscultation, I've never heard of a metallic sounding chest- maybe I have an actual Iron lungs, not just the old school medical treatment.
I get a neb put back on me, and they watch as my rash spreads- thankfully, the sausage dogs are kept hidden this time.
I'm a mystery... there is nothing different in my life that could be causing this... they're at a loss.
"But why is my breathing so bad. The first two attacks, I had a couple of nebs then I was fine. Why have I now got this horrendous wheeze and I'm so steroid and neb dependant?"
It probably seemed like a stupid question, but It made no sense, I've never been asthmatic, I've never had problems with my breathing ( apart from after a run when I'm pretty sure I could cough up an entire lung- but that's because I'm fat and unfit)
I've never had allergies (bar a couple of antibiotics) why out of nowhere was this happening and how on earth do I make it stop?
I didn't get the answer I wanted....
" We don't know...."
Brilliant. Really not the answer I wanted.
"We'll speak to the specialists, but you're not going anywhere until things are a bit more settled"
This, this was NOT the news I wanted to hear. I wanted to go home... I wanted to see my guinea pigs and sit on my couch and pretend this hadn't happened. Not spend another night with my cell mates.
So I hit up the family whats app group-
"Hey guys, no need to worry, but I'm having to stay in. Needed more adrenaline, steroids and fluid bolus over night, and needing a lot of nebs. I'm good though, so don't worry. The girls have been amazing and are sorting things out for me."
As you can imagine I got a few responses... my personal favourite from my mother who asked if a fluid bolus was like an enema.... I swear my family try to kill me off just in making me laugh. I assured her, it was nothing like an enema.
One of the best things about being an inpatient- not that there are many, is how you get to see in to so many different peoples lives. Over the space of 48 hours in my little bay of 4 beds, I met 6 different women- some of their stories I will go in to, because frankly they had a huge part in this admission...
I have a feeling, my eager plan of doing this in 2 parts my not be realistic... this may need to be trilogy of a blog post, so I apologise now for waffling...
But we'll come back to those shortly..
So, here I am sat in bed watching the world go by, needing neb after neb just to get through the few hours... Then comes a different rash- one I've not had before, all over my feet, and one that I didn't spot. Thank god for nursing best friends coming to keep my company.
So, being the good patient that I am, I wait for a while to see if it goes, no point in bothering people if its not planning on staying. So I wait, but no... this one is here to stay, and looks slightly more suspect than the other. I hold off, not wanting to pester... but friends vetoed that and in comes in the doctor.
Now, I hate anyone going near my feet. there may have been a slight issue with a verruca when I was 6 being cut out when I was little before the anaesthetic had taken effect... apparently, even a 6 year olds kick to the gentleman region can hurt. So, you know, medical professionals near my feet is not a thing I'm overly ok with.
But I put on my big girl pants and let the very nice doctor look at it... And he had the brilliant... I dont know WTAF to do with this, look on his face.
You could see his internal BNF flashing before his eyes... what other medication can I give you for this.. why do you look like you have a meningitis rash on your feet when you don't have meningitis...
"Err... I'll be right back, try not to worry"
Ok... well, that's the universal message for, you may need to worry a little bit.
So, the very lovely consultant from this morning walks back in... and again takes hold of my feet... Every part of me wanting to hurt him a little.
"Well, this is interesting, is this anywhere else?"
Oh christ... please don't ask me to get my wobbly bits out again.
" Its going up my legs but not on my abdomen of chest..."
Hmmmmmm.... right. We'll be back.
So, yet another antihistamine is thrown my way... more nebs... more steroids, and I'm starting to feel a bit deflated that no one really seems to understand what is actually going on.
My amazing friends stocked me up on fresh pyjamas, mountains of magazines and sweets and lots of conversation. They even went to check on the guinea pigs for me. I couldn't ask for better people. Even if they do start the conversation with
"Holy crap, you really do look like a bag of shit".
By now, its about 2pm, and a lovely lady opposite me who had taken Enid's place (don;t worry guys... she went home to snore her heart out there) starts chatting to me. We form a good bond and I explain that I feel like a bit of a fraud that I'm in for a bad allergic reaction, and bad breathing.
She explained that she was in as they thought she had had a stroke- she was only young, not even 50, and you could see it really worried her, it was potentially life changing for her. We had a long chat about how she was feeling, and it was good to feel like I could help someone again. The need for being a nurse is inherently embedded in me, and not being able to care for people in a traditional way was really getting to me. We both sat there realising we were helping one another out, just by being there for one another.
Its amazing how people open up, to you when you are all as vulnerable as one another.
Its like a sisterhood where we've all felt our dignity has gone, and where we all want to support one another in getting home as soon as possible. We share face wipes, toothpaste and dry shampoo, rotate the magazines so we don't get bored, and talk about why we're all being kept captive.
Although we all may be sharing an experience, one thing that we had no control over was the fact that our information was being shared regardless of whether we wanted it to be.
That is no way a reflection on the teams- but what we have to remember is that the blue fabric curtains are not soundproof- they dont even begin to muffle the conversations you have behind them. No matter how low a toned voice you have, the people surrounding you will hear what is being said.
We had all been really open with one another about why we were all being held hostage, but when you over hear someone getting devastating news, it changes everything.
I sat and listened as they broke the bad news to my new sister in arms, and I was devastated for her. She had no one with her when she got this news, the news that the stroke symptoms she had experienced were actually symptoms of a brain tumor. The doctors came out from behind the non sound proof blue curtain and left... leaving her sat alone, having just received the worst news imaginable.
I got up, walked over and sat with her whilst she cried, I held her hand and sat with her in silence as she tried to process what she had just heard. It was all I could do to help her, I felt useless. I felt guilty that she was going through the worst moments and I was in because of a stupid allergic reaction.
We became close over the next few days, joking about breaking free, what her bucket list was going to include. She made jokes about my wonderful strawberry hue that was forever coming and going, and my lungs addiction to nebs and steroids. It really is amazing how you can become close with strangers.
Whilst on my, what felt like 100th nebuliser of the day, and chatting to one of my wonderful friends who had come to save my brain from insanity, I sat and my nursing radar started to go off.. something wasnt quite right. I looked up to see my new friend standing up with a terrified look on her face, everything in her hands fell to the floor and she began to have a uncontrollable spasms. I ripped my mask off and went to get her on the bed, she grabbed my hand hard and looked at me unable to talk. I left my friend with her- another nurse, so she was in good hands, as I rushed up to the nursing station.
" You need to come quickly, the woman in my bay is having a seizure... and has signs of a stroke."
a young nurse looked at me, with big wide eyes... obviously completely confused that a patient was saying this to them.
"I'm a nurse, seriously, I'm not joking you need to come now."
At that point the other nurses listening in all rushed to her, whilst I tried to catch my breath and make it back to my own neb.
Thankfully, she was fine, and was looked after amazingly. When she moved later that evening, I was heartbroken to be loosing a roommate who I had gotten on so well with- but again, the kindness in strangers is an amazing thing, and we swapped contact details and have kept in touch.
*** Please note that full permission was given to share this story, but i have ensured no names have been used to protect identities ***
The next few days were much the same, more flares, more nebs, more steroids. It was exhausting, I couldn't sleep without waking every hour for another neb. It didn't matter how hard I tried to not have them, the decision was often taken out of my hands. I knew that if I could go 24 hours without nebs I could potentially get home. I tried everything, each time failing in spectacular fashion.
By day 3, I was exhausted- both physically and emotionally. I felt I was getting nowhere, so when my parents arrived after a nearly 200 mile journey, you can imagine, I had a little wobble.
I wanted desperately to go home, I wanted this to be sorted.
I felt like I was failing myself, that for some reason, as a nurse I should miraculously be able to sort my body out. The most ridiculous thing I know, but that was my thought process. Not to mention the guilt of letting my amazing team at work down.
I cant begin to tell you how amazing they all have been, the amount of out of hour visits to keep me sane had been amazing.
I tried to do as much for myself as I could, but even simple things like walking the 100 yards to the bathroom wiped me out. I didn't understand what was happening, but neither did anyone else.
All the way through, I desperately tried to stay positive- there was no hope in going home for the weekend, but that's ok I thought. I can cope with this. I just need to keep positive.
There were odd moments of comedy over the weekend. My dad forgetting that he had headphones in when watching the FA cup final and cheering loudly out of the blue made everyone's heart restart. Or the newly qualified nurse who came to give me an injection whilst my matron was sat there...
"I cant believe I'm having to give an injection to a band 7 on my second day, with a matron watching"
You could see her poor hands shaking... I felt for her, so I opted to inject myself .. we don't want to scar brand new nurses straight off the bat.
I managed to survive the weekend, with only one more episode of anaphylaxis- but still, I was stuck on nebs, antihistamines and steroids. It felt like the end was never in sight. Monday morning came, and the consultant decided it was time to call in respiratory. We had maxed out on the allergy side so now we need to go all guns blazing on the respiratory side.
We decided to see if we could manage just on inhalers- lets see if my neb addiction could be curbed. I mean, thank god I was only addicted to nebs!
So I'm feeling positive.. we're going for the inhalers- lets knock this out of the park!!
So here I go, inhalers a spacer and a sexy peak flow to boot! I mean, my peak flow was BOSSING at 110 out of 900 as an average. Absolutely killing it.... or it killing me- but I like to look on the positive side.
We got to 11am before I was pressing the buzzer- I was using every muscle available to me to be able to breathe- this was not right. This was the first time I really started to get scared. But again, my nurse brain kicked in... if you panic, you wont breathe. Stay calm.
Literal seconds later, the reg was next to me- listening in again, and deciding that the inhalers weren't cutting it- back to higher dose steroids and nebs I was heading. This was pushing me further and further from home... No, this wasn't ok. I wanted to be home, I was desperate. I wanted this to stop now. I couldn't take anymore of it.
"Take a deep breathe in"..... FFS!!!!
ARE YOU ACTUALLY SERIOUS
I CANT TAKE A DEEP BREATH IN!!!! my brain was screaming at her to stop asking me this. If i could take a deep breath in, I wouldn't be in this god forsaken position.
Before I knew it I was panicking, I was crying, I couldn't do this anymore. I was at the absolute weakest and broken I had felt. This was enough. The doctor stopped and moved in front of me. She sat down, put a neb on my face... Internally I was screaming at myself that I had failed something so simple... I didn't want another neb FFS... but she stopped and held my hand.
She didn't say anything for a little while ... she just sat and held my hand as I cried and apologised over and over.
"I know you're scared and frustrated, I know that we have no idea why this keeps happening, but you don't have to be strong all the time. You need to realise you're not well, and whatever is going on, its not going to be a quick fix. We just need to get you safe."
It was a moment I felt utterly weak and broken, but then I felt angry at myself for even feeling that, when others around me were going through so much worse. I felt selfish, I felt stupid and I was angry at myself for not staying strong enough to deal with this.
In my head, this was a stupid allergic reaction... I should be fine. Its amazing how your brain can dumb down something far more life threatening...
That night, I sat and couldn't sleep, I was annoyed at myself and at my body for failing the most simple of tasks. I was sick of nebs, I was sick of drugs and cannulas and injections... and I was only 4 days in... which made me even more annoyed, there are people who do this for weeks on end, and I had managed 4 days before I needed to cry. I needed a good night sleep, and that wasn't going to be coming any time soon.
Thank god for Steve Jobs and the iPad for keeping me distracted.
I was hoping that the next morning, the respiratory specialists will at least think of something, anything to get me off the nebulisers, and a step closer to home.
I didn't imagine I would spend another week in hospital before even being close to going home.
So... I think i was right in thinking this is going to be more than a 2 part post...
We've still got another week to go before I've even been discharged.... A week that includes a visit from my sister- which in itself is pure comedy value for all of you on here... If you've ever needed hospital dating advice, my sister is the queen of it..
So, I will leave this post here, and will post the rest before the weekend for you to all enjoy.