Wednesday, August 31, 2011

Being a Patient is No Fun. Pt 2

A few weeks ago, I ended up in the E.R. with a dislocated shoulder due to a torn left labrum.  Anterior, I think.  I wasn't sure if describing my experience there constitutes whining, and I didn't really want to write a blog post chock-full of whining...but it was an interesting experience nonetheless and worth retelling if only so I remember it for myself later down the line.

Different E.R visits lead to different experiences based on several factors - understaffed/overloaded, number of patients and what their health issues are, the hospital's location, and the overall personality of the staff, just to name a few.

Regardless, being a patient sucks, and I can't imagine what it must be like for people with serious illnesses that need extended hospital care.  I felt powerless going into the E.R., even though I've been to one before (maybe it's because this time, I felt like it hurt a lot more).  I didn't want to be touched and I didn't want to be pitied either.  I felt the pressure of several years of guilt too - the knowledge that if I had quit wrestling at the first sign of trouble, maybe I wouldn't have had to gone through all this.  I felt anger - if the first specialist I went to had asked for an MRI, maybe I would have found out sooner how serious this was and quit.

I refused to let anyone help me out of my jacket - I did it myself, inch by inch.  She was nice and understanding about it, and I'm thankful she indulged me.  I fought the doc every step of the way though.  Something about her attitude or tone of voice rubbed me the wrong way.  I found her condescending and it made me feel like I was being treated like a kid who didn't want to go to school.  She planned to use the Stimson maneuver, which involves laying face down with the injured shoulder dangling perpendicular to the bed.  She would then attach four saline bags (roughly 10lbs) and let gravity do most of the work.  I know it's an accepted procedure that is coincidentally less violent than other methods, but it sounds ridiculous to this day.  I remember a previous dislocation where the doc and a med student used a combination of scapular manipulation external arm rotation (while I sat upright) to reduce the shoulder and it was totally, undeniably pain-free and took about 1 minute without any meds.  I tried to explain this to the doc, but for whatever reason - whether she was unfamiliar or uncomfortable with that method or if it posed a greater risk to me that she did not explain - she refused.

It took time for them to coax me into a prone position, and then another several minutes for a nurse to gently move my arm to a 90-degree forward flexion.  After that, they gave me an intramuscular shot of Ativan, which hurt AND didn't kick in until AFTER I left the E.R., and I was left to force myself to relax and spasm in pain until a P.A. came to manipulate the scapula.  Feeling your own shoulder slip into place is one part gross (listening to things slide into place) and one part relief.  Muscles that you didn't know were tensed suddenly relax and you can breathe.

I don't know if I was being a difficult patient or not.  IMO, I think the person two curtain-cubicles down was a difficult patient (until they restrained him).  Even though I was familiar with my condition, knew her treatment plan was going to work, and know what it's like to work with doctors, I still didn't want to trust her.  It's a very primal response, not subject to reason.  I'm just glad the doc went and found a nurse instead. The nurse was much nicer and more soothing.  She let me move at my own pace, which also helped.

I'll remember this incident as an important lesson in communication and patience. Someone who is sick or injured, in pain, and confused (and not under the influence of illegal substances) won't trust someone just because he/she has an M.D.  I'll try to remember it even when I'm underslept and overworked.

After that, I wasn't feeling tired and didn't want to go home just to mope around, so I asked my mom to drop me off at my friend's joint-sibling birthday party.   I wore a sling and was just starting to feel the Ativan kick in.  I have very vague memories of that night, because of the Ativan.  I remember sitting in her little brother's jumpy house, being bounced up and down while my friends jumped around and being very mellow.

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