Topic: Emergency room for experience (update)

[Gene]

Humans are resilient and there are lots of them.  No real need to save them all.

 

And I mean that in a kind way, seriously.

[HondaMan]

Lloyd: I totally get the "mental" part: I just had my lower back rebuilt last August! I still miss part of September from the drugs I had for the pain/recovery stuff, so I had to lay off the bike parts for a while, there, didn't want to screw something up(!). The sudden doses are a shock to the system: after about 2 weeks the metabolism stops careening around and the brain fog lifts. Then it takes about a week for the kidneys to remove it from the blood, and the nearby adrenal cortex stops reeling, letting things settle down. It's a bit like throwing new bullet connectors in where old burnt ones used to resist the alternator power's trip to the battery: the battery chemistry takes a shock, boils off some water, then the plates absorb the new acidity and release enough electrons to re-balance it all again.

...you're one of the very few who know what I'm talking about!

[BobbyR]

+1 on Mark's observations.

LLoyd you have gone through a trauma. You get swept up in an event in which you have have no control over, and it is something very hard to deal with short term. My recent cardiac patients suffer a mild depression from all the drugs coupled with the realization that you are indeed vulnerable, when you were always very much in control. I am a control freak so I know. The bottom line given to me by my cardiologist was you either handle it, or it handles you. 

The drugs alter your body's response to things like adrenaline, mess with your clotting time and probbaly have other side effects. Once you figure how to set your trim properly it all improves. You are still the man you were before the event.

[Yamahawk]

^^^ +1 I concur heart-ily... 

Charlie

[Davez134]

In reflection,  I've surmised that the Hospital Emergency center is primarily involved with whackos, so that is how they initially see anyone who walks through the door.  It's a wacko til proven sane (or docile) mindset.  At the very least, a confined assemblage of refugees begging for mercy.  The only way to get around that treatment/attitude is via the local EMTs.

I think the advice given in prior posts above is quite valid.  An ambulance ride is right in the emergency center wheelhouse and the EMTs can bypass the 10 ft poles most of the attendants in the emergency center have incorporated to distance themselves from anyone outside of their unit of influence.  The people being "handled" is just a means to an end.  A necessary evil needed to get paid and fit into their tight social network under their overseers purview.  Only the EMTs can hope to crack that armor, because they are almost "one-of-them" and encounter similar "whackos" on a regular basis.

Glad you're back home and OK now. Ill comment on this though as I've been a firefighter and Paramedic for almost 15 years now. Part of the problem with our emergency health care system is that there are are so many people who go to the emergency room for "routine" things instead of going to their own doctor (if they've even bothered to find one) I've even had people tell me they called 911 because they want to go get a checkup," or 20 yr olds with a tummy ache.  When you walk into a hospital, unfortunately you are now assumed to be fine until proven otherwise! If you ever feel these symptoms again call for an ambulance. We can start treatment, do a 12 lead EKG right away saving valuable time if needed. Rest up and get well!

[TwoTired]

Thanks All,

+1 on Mark's observations.

LLoyd you have gone through a trauma. You get swept up in an event in which you have have no control over, and it is something very hard to deal with short term. My recent cardiac patients suffer a mild depression from all the drugs coupled with the realization that you are indeed vulnerable, when you were always very much in control. I am a control freak so I know. The bottom line given to me by my cardiologist was you either handle it, or it handles you. 

The drugs alter your body's response to things like adrenaline, mess with your clotting time and probbaly have other side effects. Once you figure how to set your trim properly it all improves. You are still the man you were before the event.

I have no illusions of invulnerability.  Been through this before and have felt far far worse. 
2006 Left bundle branch block and angiogram.
2008 PE and pneumonia. 
2010 PE and pneumonia again.
2018 HT and stent.

I'm well aware there are less days ahead than behind me. I'd certainly rather spend them in AZ than CA.  I'm about 3/4 there with the move, and now in limbo.
The thing is, I actually feel pretty good and am able to get on with what need doing.  I can manage the drug side effects.  I don't really understand the doctor's stipulation to do nothing but a 20 minute walk every day and lift less than 10 lbs.
Ok, I'm not in Charles Atlas shape.  But, there's no physical impediment to lifting 50 lbs or more. (Been doing such for weeks and months).   And 40 minutes is literally a walk in the park (short one at that).  I rather rely on moving around just to keep myself warm.  But, I'm not even allowed enough movement to do that!  Really, is circulatory function so at risk?
I wish I could tell if it was just excessive conservatism on the Doc's part, or if he's just used to dealing with lethargic, sedentary patients.
Makes it hard for me to take him seriously.
Am I really the only one that asks "why"?

Cheers,

[Jerry Rxman Griffin aka MuthaF'er]

Perhaps the doc is concerned about the stent holding in place at least initially? I haven't been through this yet so it's pure speculation on my part. I'm sure one of the OLD guys here can clear this up. You didn't tell him/warn him you're an engineer did you? LOL Hell, maybe he thinks you're old or something  Just take it easy initially and try to keep that oneryness in check.

[TwoTired]

...Part of the problem with our emergency health care system is that there are are so many people who go to the emergency room for "routine" things instead of going to their own doctor (if they've even bothered to find one) I've even had people tell me they called 911 because they want to go get a checkup," or 20 yr olds with a tummy ache.  When you walk into a hospital, unfortunately you are now assumed to be fine until proven otherwise! If you ever feel these symptoms again call for an ambulance. We can start treatment, do a 12 lead EKG right away saving valuable time if needed. Rest up and get well!

Interesting comment.  And I now agree that EMT contact is likely best for time sensitive health needs, for sure.
I always have made the doctor's office the trip for non-immediate medical help.  In fact, when I had my first PE and pneumonia encounter, I waited a week and a half before limping into his office.  It was nearly too late, and he sent me off to the hospital almost before I got into his exam room.  He and his office paved the way for admission, though.
But mostly, I've been fortunate that the appointment wait times have usually been reasonable or the staff wedged me in to an available slot.

However, I was surprised to learn that standard procedure in AZ was Emergency first for all needs, and your primary doctor just does follow ups, as their office visit schedule is generally booked for months out ahead.
I remember thinking this was slightly odd.  Perhaps the lower population base makes this a more efficient process?

Perhaps the best approach is to just not get sick?   

Cheers,

[dave500]

years and years ago I busted my left elbow after crashing into a big dog as I was riding a bicycle,got a mate to drive me to ER and he went home,im waiting hours and nearly my turn when some #$%* walks in looking quite ok and says to the desk nurse "I think ive taken an overdose"and they usher him through.

[Yamahawk]

Lloyd,
  Perhaps it isn't the stent so much as the insertion site of the heart cath in the groin area. I believe it is prone to rupture until it heals up fully, and they may not want you bleeding out if the femoral artery opens back up. They usually lay a 25lb weight on the site for a day, while you are recuperating, and it might feel ok, but your lifting 50lb might not be the proper thing until it heals up. They do want you to heal, and that's one of their suggestions, that you take it easy.
A friend of mine's brother-in-law had open heart surgery, and wanted to drive a car sooner than the Dr wanted him to wait, and he ripped his sternum open, driving a car, and bled out and died... he probably should have listened to his Dr. ...
I hope you get a little help with the lifting, and all that, as you need to take it easy. It all will be there next week, or next month, and we want you to be there too.
Charlie

[HondaMan]

I think Jerry may have it right: I once was the Controls Engineer for a team of engineers who made a machine that built Heart Stents. It was an interesting process, all the steps! One of them was the application of the surface treatment that allows the medicine attached to it to encourage the blood vessel to grow onto, and grip, the medicated stent. The surface was 'roughed up' almost like a knurl, and it had to be specific in depth of the metal displacement so the flesh could grip it, 'just so'. I remember wondering, the whole time I worked on it, if one of those might someday end up inside me? So, I made sure I did a REALLY good job of it!

[TwoTired]

Charlie,
They did my heart cath from my wrist.  The wound is looking pretty good with little chance of it opening up without something pretty aggressive going on.  Its pretty easy to protect.

I had an angiogram back in 2006, through the femoral.  The wrist allows much faster recovery, imo.

Cheers,

[TwoTired]

One of my doctor questions is if I got a drug-eluting stent or a plain metal one.  From my reading, it seems plain ones require shorter therapy drug periods.   Which, intuitively, seems it should be the reverse effect...
But then, we all have these chaos machines to deal with...

Cheers,

[BobbyR]

Thanks All,

+1 on Mark's observations.

LLoyd you have gone through a trauma. You get swept up in an event in which you have have no control over, and it is something very hard to deal with short term. My recent cardiac patients suffer a mild depression from all the drugs coupled with the realization that you are indeed vulnerable, when you were always very much in control. I am a control freak so I know. The bottom line given to me by my cardiologist was you either handle it, or it handles you. 

The drugs alter your body's response to things like adrenaline, mess with your clotting time and probbaly have other side effects. Once you figure how to set your trim properly it all improves. You are still the man you were before the event.

I have no illusions of invulnerability.  Been through this before and have felt far far worse. 
2006 Left bundle branch block and angiogram.
2008 PE and pneumonia. 
2010 PE and pneumonia again.
2018 HT and stent.

I'm well aware there are less days ahead than behind me. I'd certainly rather spend them in AZ than CA.  I'm about 3/4 there with the move, and now in limbo.
The thing is, I actually feel pretty good and am able to get on with what need doing.  I can manage the drug side effects.  I don't really understand the doctor's stipulation to do nothing but a 20 minute walk every day and lift less than 10 lbs.
Ok, I'm not in Charles Atlas shape.  But, there's no physical impediment to lifting 50 lbs or more. (Been doing such for weeks and months).   And 40 minutes is literally a walk in the park (short one at that).  I rather rely on moving around just to keep myself warm.  But, I'm not even allowed enough movement to do that!  Really, is circulatory function so at risk?
I wish I could tell if it was just excessive conservatism on the Doc's part, or if he's just used to dealing with lethargic, sedentary patients.
Makes it hard for me to take him seriously.
Am I really the only one that asks "why"?

Cheers,

I was under the 10lbs rule for a while. They don't want you to throw a clot since they were fiddling arond in there.  They should have given you a card from the manufacturer with a serial number and the location it was placed in should be noted on the card. Chances are they gave you a drug eluding stent which is now preferred. The drug slows down the tissue growing into the stent to prevent scar tissue and over growth in the stent,

 That requires an anti clotting drug. Brilinta is very good but the Ins Co like Plavix since it is cheap.  Plavix is a joke. I needed a Prostate Biopsy and when I told them I was on Plavix they laughed and said "you and every 10th person that comes here is on it and we handle it easily.

[Yamahawk]

Cool Lloyd, that's a way better healing point in the wrist. And I am on Clopodigral (Plavix) also, it seems to work ok, I bleed easy when I stick myself with a screwdriver or anything sharp I'm using to pry or scrape with, but then it still clots and stops lol...
Now, the statin drugs... they started me on simvastatin, and it killed my memory... I forgot to turn off the water in the sink... the burner on the stove.. and that's a common side-effect of statins. I'm on atorvastatin (Lipitor) now, and its way better on my short term memory lol...
Charlie

[TwoTired]

Still learning about my new drug panel.
Brilinta ($400/mo.)
Xarelto
Low dose asprin
Lopressor
Lipitor
Imdur
Losartan

Hope these aren't all lifetime companions. But, i'm sure some are.  Had to get a bigger pill case.  Can almost laugh about it...almost.

Cheers,

[jgger]

Probably won't be able to sneak up on anybody now...............you might rattle when you walk!

[demon78]

Lloyd. Having gone through the failing body thing, got lucky no stent, but pills, holy #$%* more #$%*ing pills, you get almost afraid to mention symptoms because there's a new pill, ahh good, is that the one that'll turn me into a green fuzzy orange ? What are the side effects ? DR says if that happens call me right away, after I get back from Tahiti in the meantime Dr soandso can handle it. First thought is it stacked red headed lady ? No I've just put months in training you to put up with my strange sense of humour and that fact that I don't hear so well, also when I say I don't want a certain popular drug it's because I've gone through the side effects and they are no fun, my gout kicks in and I begin to cripple up like Quasimodo, so I have to go through it again ahh piss. As far as City versus Rural goes here there is a massive upgrade going on in Ontario, so the facilities are roughly comparable but generally the rural people/Nurses are less tight assed because they have had to suffer through all the drunken farm boy's doing something stupid and most of the Prima Donna's have gone to the city, also they are used to working with a little bit less so if something is needed every one pitches in and usually they know everyone so if they are not friends at least the know the weaknesses that need covering. I find when you get to certain age they tend to feed you pain killers of varying degrees of potency possibly because you're #$%*ing about old wounds that the new medications are causing to kick up. The thing I found for me and only me is to put them on the shelf, the pain reminds you that you are alive, also some of the side effects are interesting but not functional. Of course then they ask how the pain meds are working out and you say I'm not taking them, eyebrows go up and you have to go into a long winded explanation. I consider my self really lucky that I don't have the pay for any of this, Med's or treatment, because some of med's are spectacularly expensive and they've sorted out that the blood thinner that I'm using now allows me get by without injections and I can have the occasional suds, (well maybe I shouldn't, but ). Life/Death thing it has been explained to me that I'm at 5 grand and that there is a hole in the Glycol system, I'm not going to make it home so do I say #$%* it or do I ride it in, skid across the finish line with a bottle of single malt in one hand and a Blonde in the other. I'm thinking, thinking, thinking.
Any how sport ain't Modern Medicine a treat, have fun, mortality maybe overated.
Bill the demon.

[Yamahawk]

Still learning about my new drug panel.
Brilinta ($400/mo.)
Xarelto
Low dose asprin
Lopressor
Lipitor
Imdur
Losartan

Hope these aren't all lifetime companions. But, i'm sure some are.  Had to get a bigger pill case.  Can almost laugh about it...almost.

Cheers,

Wow... they got you hooked up with some expensive drugs! I am sure the pharmaceutical companies are going to give him a nice bonus for that. But there are some things that can't be avoided, and some that can. I found out that it is medical malpractice for them to NOT prescribe Metoprol Tartrate (Lopressor) and Lisinopril. They had me on both, but I am thinking that the Losartan or Imdur is taking the place of Lisinopril. I don't want to be on any drug that I can do without, and after 10 months, I decided to wean myself off of the Metoprolol and Lisinopril... the latter NEEDS weaning, as I checked the web for info on both. My cardiologist (one of the best) recommended I stay on both, but respected my wishes, and a nod to proceed.. I had already done it when I talked to him about it lol. Anyway, as of today, 4 1/2 years later, I'm on the cholesterol drug 40mg. of generic Lipitor, generic Plavix, low dose aspirin, and Levothyroxine for thyroid. That's my regimen in the morning. Give yourself  time... that's a precious thing that we get less of each day. When your stent is doing its job and everything is ok, you can then evaluate your drug regimen and see what isn't necessary, and what can be changed to a cheaper and just as effective medication. I have some radiation induced proctitis (ouch) that causes some bleeding if I don't watch my diet. The rear shocks on the Royal Enfield 500 Bullet and the solo saddle didn't help that much either, and had a lot of blood last May after riding the wheels off it! My Dr. prescribed a steroid cream... at #120 a tube and insurance didn't cover it... and I am sure that the 'ol Preparation H would do just as well, at about $8 a tube lol... guess which one I would pick? Anyway, there are some things that you, no doubt will research and make an educated decision on, as it IS your body, not the Dr.'s Hope your are feeling better today!
Charlie

[BobbyR]

Still learning about my new drug panel.
Brilinta ($400/mo.)
Xarelto
Low dose asprin
Lopressor
Lipitor
Imdur
Losartan

Hope these aren't all lifetime companions. But, i'm sure some are.  Had to get a bigger pill case.  Can almost laugh about it...almost.

Cheers,

Quite a nice menu you have their Lloyd.

Lopressor is pretty cool, it gives you a runners pulse of about 62 in my case and lowers your blood pressure at the same time.

The Brilinta will cause you to bleed more easily than Plavix. You can get a discount card from the maker knocking your copay down to 18 bucks. These drug companies are using these discount programs for people with commercial insurance and sometimes Medicare to keep the Gov't off there backs for gouging patients and insurance companies. You can find it here at the company site:   https://www.brilinta.com/savings-offers-and-support/brilinta-coupon.html?source=BRL_C_C_163&umedium=CPC&uadpub=Google&ucampaign=BRILINTA_Patient_Branded_Savings&ucreative=Savings&uplace=brilinta_coupon&cmpid=1&device=d&gclid=CLH_i4SJo9kCFQemswodyKEHag&gclsrc=ds

Getting older sucks, I am working very hard at getting older up to a point. Since I am on a clinical trial one of my drugs is free since it is not on the market. The other is on the market at 10,000 a month. They gave me a coupon that knocked my end down to $20.

The bottom line is very simple. You and I are about the same age.  When we were in our teens and our Uncles, Parents and Neighbors had a heart attack they could not do squat. Bed rest, some nitro, maybe some blood thinner.  They probably stopped your heart attack as they did mine with no detectable damage.

In light of what could be done in the not to distant past, we are pretty lucky and we can live a pretty normal life unlike those before us who were severely restricted.

[TwoTired]

Did any of you stented people make dietary changes?

Realized any measureable benefit in artery health beyond drug regimen effects?

[Yamahawk]

Lloyd, I'm not stented, but that's because the blockage was at a bend in the artery, and couldn't accept one or they would have. But, after taking my cardiac rehab, and all the classes that come with it, I started adding up my saturated fats. I tried to stay away from trans-fat already, as I realized this stays in the body 7-10 years. But, I like(d) butter, and have creamer in my coffee. I drink about 5-6 cups per day, and the saturated fat in my International Delight coffee creamer was at the daily limit for saturated fat by itself... let alone the butter! So, I did change my diet, and stuck with it for about 3 years or so, then started getting a little butter, and today I am still not as bad as I was for saturated fat in my diet, but I'm close lol... I need to lose about 20lb to be in better shape. I would recommend the cardiac rehab, talk to your cardiologist about it, and have him (or her) enroll you in it, it's covered by insurance.
Charlie

[Sam Green Racing]

LLoyd, I've only just seen this 4 days later and here you are talking about it.
I was 3 weeks before I could use a computer to find out what the hell was happening in the World.
It was 2 weeks before I found out what I had gone through as my memory was a complete blank.
I didn't even know I was in America, hahaha and to this day, still have no memory of what happened
apart from what I've since been told.
The thing is, we're both still here and although things will never be the same again, we have to be
thankful that we got through it.
You are in my prayers for a full recovery LLoyd.
That long distance Honda is of no use without its long distance rider.

Sam. 

[Honda550k]

So sorry to hear twotired. Glad to hear that you survived. Thank you for updating us as well. I'm a fairly new member here about 5 years ago, when I was a student.  I'm rarely active now as a member but check in here and there. You helped me a lot to get my bike running well. What I liked about your posts was that you made me think instead of just giving me the answer. I really appreciate that.

I work in healthcare as a nurse. So I may be able to answer some of your questions. The reason for activity limitations such as no lifting more than 10lbs is the amount of stress lifting can put on your heart. Your heart rate can fluctuate really fast in a short time while lifting weights.  On top of that, your blood pressure increases as you lift heavier weights. The higher your blood pressure is the more your heart has to work to pump blood into your body.

Doctors would recommend more areobic exercises such as walking because it's a steady effort for the heart and one is continuously breathing steadily. Where lifting is a burst of energy and breathing is not as constant (holding breath, etc..).

You're currently taking 3 medications that prevents blood clots (brilinta, xarelto and aspirin).

Lopressor is a blood pressure medication by relaxing blood vessels. It also regulates heart rate.

Lipitors are important as well because it lowers your cholesterol in your blood as well as dissolve existing plaque build up in your blood vessels.

Imdur is for chest pain. Chest pain occurs when there is a decrease in blood flow to the muscles in your heart via arteries of your heart that nourishes heart muscles. Imdur works by dilating those blood vessels to keep blood flowing. Because of the dilation of the blood vessels, imdur also lowers blood pressure.

Losartan is a blood pressure pill that prevents blood vessels from constricting. Just take your time when you're going from a lying to sitting and sitting to standing. It can cause lightheadedness.

For dieting. Talk to your doctor or a dietician who works with your doctor. I'm pretty sure that you'd have to watch your salt and fat intake. I know this sounds obvious but I swear cutting salt out can solve almost anyone's high blood pressure.

Question: did the doctor give you a nitro spray just incase you feel chest pain?

I live in Ontario Canada and unfortunately healthcare here is also just a big business. What's sad is our government keeps on cutting budget for healthcare which puts pressure on hospital staff because of understaffing but the ones really getting screwed are the patients.

Twotired, I'm wishing you a recovery from this. Give yourself time to rest. Take care and God bless.


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[BobbyR]

+1 ^^^^