Summer 2014: ER Visit #2

Looks like my spidey-sense proved right again.  In only 14 hours or so of not feeling any better whatsoever, Liz took me back to the Emergency Room where they took things a big more seriously this time.

dude-and-driver

Home sweet home, Mr L!

As usual, I was immediately taken back, and they got me immediately started on some nebs.  Because it hadn’t been that long since my last visit, the same respiratory technician was there to get things started.  Liz pointed out I don’t really wheeze, and the RT mentioned again that everything sounded fine.  Just like earlier that day though, when the doc took a listen it was immediately pointed out that I sounded EXTREMELY diminished.  I sometimes wish I knew how to identify all the different kinds of noises I make while breathing.  I also know that my perception of how I’m doing isn’t always what’s actually going on.

The RT was in and out pretty quickly as the trauma rooms seemed to be full of people in much more serious trouble.  Before my first neb was barely started, she was being called away to maybe intubate some poor soul a couple rooms down the hallway.  When it comes to medical stuff and waiting, I always remind myself they’re taking care of the worst-off first.  I’ve been that guy before with 6 people hovering over me for two hours while others have to wait.

The NP assigned to me was someone I don’t think I had met before.  She took great care of me and had a lot of great tips.  It reminded me of talking to Dr Wenzel’s nurse while at SARP last Fall.

  • Ask about updating vaccines with the resurgence of pertussis and other diseases
  • Piggybacking benadryl and allegra works a lot faster than zyrtec
  • Benadryl + pepcid can knock out allergy attacks pretty quickly, especially if your throat is tightening up
  • Look into lung strengthening

Another 125mg solumedrol IV push, and some magnesium sulfate via IV drip got things turned around for me.  The solumedrol was doing its thing, but my airways kept tightening up over time.  My oxygen saturation was constantly setting off the alarm bouncing between 88% and 91% most of the time.  In August or September last year there was talk of trying magnesium during an ER trip.  I was impressed with how quickly it seemed to work and much more deeply I could breathe afterward.  It actually kept me in good breaths for 12hrs after leaving the hospital.

They sent me home with orders to neb duoneb every 4x/day with albuterol in between.  My prednisone has been bumped up again with a slow taper down, and they threw in some levaquin for good measure.  There are a lot of people with nasty respiratory viruses at the moment and I like to play it safe.  I haven’t had pneumonia for almost 8 years now, but the thought of it still scares me.

This morning I went in for spirometry before drugging up.  I felt horrible and they wouldn’t let me go until my doc was paged and checked up on me.  Numbers were low and lung function diminished, but things weren’t bad.  They stressed to call them immediately if things worsen though.