On Monday evening I had to go to the emergency room. I’ve done this enough times to know the drill. Take the perishables out of the fridge and put them into the freezer. Turn off all the lights. Close the window blinds and set the lamp timer. Get in my car and drive to the Interstate. (On the way, stop at the gas station because my discount coupon expires at midnight.) Get on the Interstate and head south to the hospital.
There were a lot of people in the ER waiting room, but the medics saw me right away. They do that when you tell them the reason you’re there is your heart. Usually they take you right away, I should add, but not always. A couple of times I’ve waited for hours to see a doctor – yes, for a heart issue.
They took me to a small room and hooked up an EKG machine. The machine was smart. It printed its diagnosis at the top of the paper strip that showed my cardiac activity: Atrial fibrillation with Rapid Ventricular Response. While the machine was doing its thing, a woman at a computer terminal asked questions.
Then they put me in a wheelchair and wheeled me to a trauma room. “Why am I in a trauma room"? I asked. “Because all the emergency rooms are full.”
After they have you lying on a cot in the ER or trauma room, they hook up another EKG machine. Then they put an intravenous line into your arm, just in case they need it. The young man who sited the line hit my vein on the first try. The IV needle is large – it makes the way for a plastic tube that goes inside the vein. The plastic tube, not the steel needle, is what stays in the vein. I was glad he hit my vein on the first jab.
A woman I had not seen before came into the room with a computer terminal. She asked questions, most of which I had answered, but I answered them again. The ER people – the nurses and the people from Registration – were nice and friendly. Doctors are another matter; they’re more “all business.”
I received only one med while I was in the ER – a low dose of a med I was already taking every day. I was doubtful another small dose would help me, and I was right.
The room had a small TV mounted on the wall. A nurse gave me a remote control – a white, oblong gadget with a heavy cord attaching it to the wall. It had a nurse call button and buttons to operate the TV. But the buttons didn’t work for the TV. The young man who sited the IV came into the room, and I told him the remote didn’t work. He reached behind the TV and jiggled cables on the back of the set, but to no avail. The TV worked, just not the remote. I had no idea what channels were available, so I asked him to switch the TV on and tune it to a news channel. I would spend the next six hours lying on the cot in the trauma room.
Time passed and another woman came in with a computer terminal and asked me questions. I told her she could get the answers to her questions from the previous woman, but she said she had to ask them, so I answered them again.
Eventually they told me they were going to “keep me for the night.” Meaning: admit me to the hospital. In lieu of treating me, they were going to wait until my cardiologist came in the next morning. So they wheeled me to an elevator and took me up to the fourth floor, and wheeled me down the corridor and into room 464. It was a semi-private room and it had an occupant. After a while a nurse with a computer terminal came into the room and asked more questions. Many of the questions had already been asked and answered. I pointed that out, and she said that the hospital’s computer and the ER’s computer weren’t connected, so she had to ask them again.
It was now 1:30 AM. The nurse said they were going to hook up an IV drip to keep me hydrated. I asked her, “Why don’t you bring me water and let me drink it?” The nurse said she could do that. (Of course, the hospital had a vested interest here: dripping a bag of water into my vein would go on the bill as a large number, whereas a glass of water was free.)
I couldn’t sleep. The nurses kept the door wide open and light flooded into the room. (They kept the door open so they could make frequent checks on the other occupant without the extra trouble of opening and closing the door.) The nurses’ station was just outside my door, and they talked in a normal conversational volume as if it were the middle of the day, and that made sleep more difficult. On top of that, the other occupant of the room insisted on keeping his television going all night long with the sound up. I complained to a nurse about not being able to sleep, and after an hour or so she returned with a low dose of Ativan. It helped a little. I slept for two hours.
The next morning my primary care doctor and my cardiologist met at my bedside. They had decided not to do anything about the a-fib. Instead, they wanted me to take a blood thinner. A blood thinner makes it possible to live with a-fib. I hesitated but they insisted. They suggested Coumadin, a blood thinner with known interactions with other drugs as well as foods. It’s so deadly that you have to get your blood tested every two weeks, at least in the beginning. If you get too much in your blood, your blood will get so thin it will leak out of your veins. You’ll bleed to death internally. I gave a firm “No” to the Coumadin.
They suggested a different blood thinner, and I reluctantly said “okay.” Finally, around 11 AM they let me leave the hospital, but not before giving me a dose of the new blood thinner and a prescription for more. I left, dropped the new prescription off at the pharmacy, and went home. I got on the Internet and looked up the blood thinner they wanted me to take. The Box Warnings were scary. The word “fatal” was used a number of times. Plus, it warned that once I was on it I was never supposed to stop it or there might be a “thrombotic event.” That didn’t sound good.
At some point during the day I realized my heart was back in its normal, familiar rhythm. A doctor would say, “Not so fast, it has to be confirmed with an EKG.” But I didn’t need an EKG. I’ve had this body a long time and I know what it feels like when it’s working well.
I went to the pharmacy to pick up two prescriptions: one was simply a new dosage of a med I was already taking, and the other was the blood thinner. The middle-aged woman behind the pharmacy counter looked at me and said, “We have two medicines ready, but I have to tell you something about one of them. It’s three hundred and fifty five dollars. You might not want it.”
“You got that right,” I said. “Put it back on the shelf.” The pharmacist didn’t blink. Considering the price of drugs these days, I’m sure she’s heard the phrase, “I don’t want it,” many times.
I’m pretty sure I hear someone out there saying, “Why don’t you get prescription drug insurance?” My answer: “I have prescription drug insurance. Next question?”
Anyway, that’s my experience at the ER. If you should go, your mileage may vary.
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