Yesterday morning I was awoken by the all to familiar symptoms of a fever. Shivering and a body that ached all over. A quick check of my temperature showed I was running at a very warm 38.3C.
One paracetamol, one nurofen and an hour later I was sweating my way back to a more normal figure of 36.8C.
Later in the day I emailed my oncologist and asked what he thought. My fear was that I was neutropenic, meaning no white blood cells or neutrophils.
I received his reply yesterday evening. He suggested I get a blood test done to rule out neutropenia.
However he also suggested I get it done at ED (Emergency Department) so that if I was neutropenic I could be treated straight away.
Now I absolutely hate going to A&E or ED or ER or whatever else anyone wants to call it ("hell hole" is one name that springs to mind). Whenever I walk through the doors it's either a six hour wait in an uncomfortable chair or worse as happened last time.. a seven week stay in hospital!
None the less I got up early this morning and ventured off to Lower Hutt Hospital A&E. My plan was to avoid the suffering crowds of Saturday morning sports injuries. There's nothing worse than sitting for hours beside a motocross rider with a foot that's facing the wrong way, or a mountain biker with a dislocated thumb, feeling like you should be making small-talk (or glib remarks), when all you want to do is get a blood test and to get out of there.
When I arrived I surveyed the room. Just two other patients waiting, both kids with a parent.
I filled out the required paperwork and waited for the triage nurse to call me up to the window.
I took a seat very close to the nurses station, figuring that if I had to stay here for a while I could at least entertain myself with my morbid sense of humour by listening in on the stories that the patients would be rolling out to justify their visit.
Ahead of me was a woman in her mid thirties and her ten year old daughter. They were soon called up and the nurse asked them what the problem was.
"My daughter has a problem with her achilles tendon in her left foot, we have come here several times before but it's just not getting better"
Hmm.. me thinks. Isn't that a job for a podiatrist, or at least her GP?
The triage nurse is obviously a very patient woman because in her shoes at this point I would have been showing her the door.
The nurse asks a series of questions and recieves long drawn out whining answers to each question. You know the type, they know they are pushing the boundaries but they figure if they talk long enough they just might sound convincing. Wrong!
All the while the mother's cellphone keeps ringing. Full volume and with a really annoying ring-tone.
Perhaps like the other 99% of the population she too has no idea of what silent mode is let alone when to use it. The nurse remains professional and continues on with her questions.
The ten year old girl is doing her best to look like she is in pain and miserable. However when she takes her mother's phone to answer a call from her sister, she slips back into normal mode and chats briefly before hanging up. Back to being in pain.
"On a scale of one to ten, how would you rate the pain" asks the nurse. "nine" whines the girl.
At this point I hold my head in my hands and I'm barely able to contain my mirth.
Nine on my pain scale is just below ten where mercifully you pass out.
At nine you are unable to speak, think or function at any level other than breathing. Your whole world is dominated by pain, your mouth is dry, your eyes fixed and dilated, pallor resembling that of a dead fish.
Your vision is narrowed to a single narrow tunnel of light and you are unable to process audible sounds let alone speech. You rock back and forth in a grey haze. ..I could go on.
This girl however, according to her mum has a very high pain threshold. So much so it would appear that when she sat down in the waiting room, she was able to jiggle away quite happily and tap both feet including the injured one, in time to some song playing in her head.
What is sad about this situation is not just the abuse of the Emergency clinic for what is quite clearly a long term chronic injury, but that this poor child has been denied proper specialist care by a mother who is either too stupid or too tight to seek it out.
By contrast the next patient was a young fair haired boy accompanied by his dad. He appeared to be about four or five years old. He did not speak the whole time he was there and held one hand over his right eye. Tears flowed silently from the other. I'm guessing he had scratched his eye or something similar as had it been worse I'm sure he would have been fast-tracked. Never the less, he was in pain, did not speak, certainly didn't jiggle and play about or even answer a cellphone call. The nurses gave him a lemonade ice-block to eat while he waited in silence. My heart went out to the little mite.
I had to cut short my study of the patients as the triage nurse decided I should be isolated from the other patients just in case I was neutropenic (luckily stupidity is not contagious). I was taken to a small examination room and a stream of doctors (well two) and nurses (three) came by to ask questions and take blood. I really did not want to be there but the risk from being neutropenic was just too high. In the past I've developed sepsis and been very, very sick after having low neutrophils from chemo and the stem cell transplant.
Then the first result came back, neutrophils 3.1. That's at the lower end of normal. At that point I just wanted out of there! But the doctor was concerned about my heart-rate. I've been mildly tachycardic for several years now and my normal resting rate is around 105-115BPM. Today it was 133 in triage but 114 once in the exam room. I explained this was normal for me. Then he queried my low platelet count of 30 (normal person 150-400) I explained that that too was normal for me. He left me once more and tried (and failed) to contact my oncologist to confer, leaving a voice message .
Two hours after walking through the doors I was set free and told to report back in if anything changed. I'd call that a lucky escape. I'm sure if my counts had been any lower they would have had me in for a few days hooked up to IV antibiotics and all the drama that goes with being admitted. Definitely not something I want to go through (again) right now.
As for the cause of the high fevers.. who knows? There's a stomach bug doing the rounds at the moment, I could have that. I wouldn't know as I currently have abdominal pain and diarrhea from the Adcetris and that would mask it. I've started myself on a course of antibiotics from my vast store of medicines just to be careful. ( and advised my oncologist )
...Ron
No comments:
Post a Comment