Thursday, March 13, 2008

Gallbladder issues

Let me start this with my apologies first as I'll be adding a few gross pictures towards the end of this post. This is my attempt to put some order to the last few weeks, to share some things learned along the way and hopefully, help someone else avoid the near fatality we almost suffered.

Sunday, February 17th, 2008, 0100 hours. My 43yo spouse, white male, physically fit, awoke with severe stomach pains. He had been a bit uncomfortable before going to bed and the pain had escalated as the night progressed. He was in so much pain that he needed to go to the ER. His stomach was also incredible distended and he couldn't close his loose pants as the swelling was so severe. I drove slowly over the four miles of bumpy dirt road as each bump caused him dire agony. Once I hit pavement, I got him there as fast as is safe.

Once we arrived, he asked that I drop him at the door as he didn't think he could walk from the parking lot. I dropped him off and parked as quickly as I could. I found him doubled over leaning on a planter unable to stand inside the ER. No one was there to help him. I found someone, begged them to help him ASAP, and I filled out the forms. They got him into triage and started taking his vitals. The triage nurse was more distraught over his flailing and inability to sit then getting through with her job so he could be moved along to seeing a doctor.
Finally, she got him admitted to the ER.

At this point, the staff had decided that 'white male', 'middle age', and 'severe abdominal pain' equaled 'kidney stones'. They had their diagnosis. The doctor came over and asked him if he had been vomiting which at which point, he did in fact do just that. They gave him a shot of strong pain killers to which my spouse blessed them as it knocked him loopy and helped him handle the pain.

The doctor ordered a urinalysis, an x-ray and a CT scan. This all took awhile as it was a record breaking night that night in the ER and they had patients (including my spouse) lined up in the hall. After many hours, they finally came back with the results and said they found nothing out of order except his white blood cells were high but they said that could have been from the pain and not a concern. They decided he wasn't passing a kidney stone and just needed to 'fart'. Yep. That's what they told me. "Keep your windows open on the way home."

I was quite a bit upset with this and insisted it had to be more then that as I knew this man and he wouldn't have insisted on going to the ER if it wasn't bad. The ER doctor then decided he would check his appendix. They gave him a drink that had to soak into him for two hours then they would do a CT scan with contrast. While we were waiting, and he was sleeping (they were keeping him very doped up) I called my girlfriend and told her what was going on. She started asking where his pain was exactly and I told her on the right side just below his ribs and it wrapped around to his back. She started asking a few more questions then told me it sounds just like what she had. The gallbladder! She told me to insist they check his gallbladder so I went and found the doctor and asked him to check it. He said they were looking at everything with the CT scan with contrast and if it was the gallbladder, then it would show up.

More time passed. The test was done. Finally, after eleven + hours in the ER, they came back and said the CT scan came back fine. Nothing was wrong. Maybe it was stress. Maybe it was gas. Here are some prescriptions. Let's give him one last shot for pain, and follow up with your doctor. We were sent home.

Monday, February 18th, 2008, morning. Due to the nature of my employment, I had no choice but to go to work. My spouse drove himself to the doctors and tried to get an appointment. Thanks to the drugs he was prescribed, the pain had eased some and the heated seats made the car one of the more comfortable places to be. He couldn't be seen that day but was able to get an appointment for the next day. As he was still in a lot of pain, he decided to visit our chiropractor. They fit him in and the doctor adjusted his back and listened to his story then did a bit of his own 'testing'. He counted out ribs then pressed in a particular spot on my spouse's back which made my spouse yelp. Our chiropractor explained that the place he touched was connected to a nerve that is connected to the gallbladder. He told my spouse to go get his gallbladder checked.

Tuesday, February 19th, 2008, Unknown time. My spouse was finally able to get in to see the doctor but alas, the doctor was on vacation, so he was actually going to be seen by the doctor's assistant. By this time, my spouse was beginning to have trouble walking upright. He was leaning badly as standing straight really hurt. He was starting to have trouble breathing. He was gasping for breath after each sentence he spoke. The doctor's assistant looked over the ER's records of what happened on Sunday. She ordered more tests. She found the white blood cells were escalating at a rapid rate. She said that the ER should never have sent him home! She didn't know what was causing the infection so she prescribed a general antibiotic while they waited for the test results. During this appointment, my spouse asked to have his gallbladder tested and was TOLD it wasn't his gallbladder.

Thursday, February 21st, 2008, Unknown time. I was getting really worried, as he was barely able to get up off the couch. He hadn't been able to eat since the Saturday before all this started. Even drinking a little fluid, caused him pain. He had asked for some Ensures, as he was quite aware that he had to get something into himself if he was going to able to continue fighting whatever was happening to him. I remember him telling me as he laid there that he felt as if he was being poisoned.

My spouse had his follow up appointment this day. Once again, due to the nature of my job, I was unable to drive him. He said he could manage as the car was still the most comfortable spot to be. (Thank you VW for designing great seats!) He drove himself to the doctors and she became quite alarmed when she saw how badly he was deteriorating. He was now barely able to stand hutched over, and he was out of breath before he could speak a full sentence. He was pretty much gasping each word. She sent him for MORE TESTS!!

He called me at work, and he sounded so desperate. He told me he was at the hospital and needed me to get a ride there. I called for someone to PLEASE come in and take over my SHIFT!! I finally got relieved and got to the hospital. I thought for sure that they would be admitting him. Nope! They ran their tests and even though he could barely speak, and couldn't walk, they sent him home again! I was scared to death that he wasn't going to survive. My mom said that he looked like a shriveled up old man. He had aged terribly in only a few days. He was withering away at a fast rate.

Friday, February 22, 2008. 0530 hrs. My spouse's phone rang. It was the doctor's assistant calling to tell him to get to the hospital ASAP. He needed to be admitted as he was suffering from severe pneumonia and the infection wasn't slowing down even with the antibiotics. It was still escalating at an alarming rate.

I got him to the ER before 0600hrs. They put him in a closed room and started oxygen on him as by this time his O2 levels were drastically low. The ER doctor (different one) came in and looked over all the test results then told me my spouse wasn't that sick then he left. He did order a few more tests. I talked to the ER nurse, and she agreed that it sounded like it was the gallbladder. She said she use to work as an Operating Room Nurse and she told me which tests to insist they do to rule out the gallbladder. I wrote them down so I wouldn't forget them.

As her shift change came, they rolled my spouse off for more testing. Once that was done and he was back in the room, he asked for ice chips as the O2 was drying out his throat and making it hurt plus he was dehydrated. I went and found the new nurse and asked for ice chips. When he brought them to me, he told me that the doctor was planning on releasing my spouse and sending him home.

I freaked out and asked,"You're going to send him home so I can watch him die on the couch?!?!?!?"

At that the ER nurse laughed in my face and said,"He's not that sick. He's not going to die. He's a Firefighter and they are like a three year old who runs around full of vim and vigor until they catch a little cold."

I went back and told my spouse what he said and that they planned on releasing him! He gasped out for me to run across the street to the doctor's office as it should be open by now, and tell them what was going on. So I kissed him good-by and begged him to hang in there.

The doctor's assistant saw me right away and was shocked that they were refusing to admit him! She told me if they dare release him, not to take him home. Bring him to her as he needs to be in the hospital! He had already done the antibiotics at home and it wasn't working! I asked her to please run the tests checking the gallbladder to which she stated, "It's not his gallbladder! He has severe pneumonia, a severe infection and one side of his heart was now enlarged! He keeps insisting that it's his gallbladder and it's NOT!"

She did make calls that did get him admitted. At this point, I don't even know if her calls were needed. By the time I was back by his side, he was going into respiratory distress. They finally took his illness seriously and admitted him. They finally started giving him stronger antibiotics to fight the infection.

Friday, February 22, 2008. Afternoon. The floor nurse had to re-ask all the same questions that had already been answered multiple times. This procedure took forever as she was continually being called away for other things. During this time consuming questioning, the events of the morning were covered. I told her about the rude ER nurse. At that she asked me to talk to the hospital's Administration as this particular hospital knew they had gained a bad reputation and they were trying to fix it.

At first I told her I didn't need to pursue it as we were past the ER now and my spouse was finally getting treated. She insisted, then my spouse chimed in and said it might help someone else in the future get better treatment. So I ended up telling the Administration what happened. They were rather upset and felt that person should probably consider another job.

The hospital doctor came in later and looked over my spouse. My spouse asked him to check his gallbladder. This doctor said, "You are a 'fit firefighter'. It's not your gallbladder." Then he looked at me and said, "I'd believe gallbladder if it was you but not him." I later learned that they have some rule of five "F's": Female, Forty/Fifty, Fair-skinned, Fat.

Nice.

Anyway, later that night another person from Administration came in to talk with my spouse. He told them of what he had been through, and pleaded with them to PLEASE get the tests run that would rule out if it was his gallbladder or not.

Saturday, February 23, 2008. They finally checked his gallbladder!!! We believe it was ordered by the last person from the Administration. The tests came back that there were four things wrong with the gallbladder which would be causing the severe infection. This led them to calling in a surgeon. The surgeon said that my spouse had really been jerked around. He would order one more test to verify that it was indeed the gallbladder.

At this point, I've lost count of all the tests ran. All but the right tests ran. According to the surgeon, once the CT scan came back with nothing, they should have run an ultrasound. Gallbladders don't show up on the CT scans so the ultrasound is the complimentary test to run.
I'll have to look up just how many redundant tests were run. The surgeon said he would operate Sunday or Tuesday as he was being given an award Monday and wouldn't be available to perform surgery.

Sunday, February 24, 2008. They couldn't do the HIDA scan this day as my spouse still had too much stuff in him from the bone scan they ran. The test would have to wait another day. My spouse was feeling a bit better as he was beginning to be able to breathe again. He hadn't been being fed as they kept running tests so it was going on over a week since he last ate much of anything.

Monday, February 25, 2008. They finally did the HIDA scan. The results came back with nothing. WHAT?!?! Nothing?!?! Nothing meaning that the contrast or whatever they put in to flow through the gallbladder, wasn't even going into the gallbladder! They scheduled my spouse for surgery as an add-on that day with the surgeon's partner.

Monday, Februry 25, 2008. 1500hrs (3pm). They rolled my spouse to pre-op. My youngest son (10) was with me as we kept him company there. They told us it would be half-an-hour in pre-op then one hour in surgery then half-an-hour in post-op then onto a floor with RN's not LPN's. We waited and laughed and tried to stay upbeat. My mom joined us.

3:45p It's suggested we leave as he will be going in soon. I decided it would be a good time to feed my son as it was becoming a long day. We (my mom, son & I) go to a local buffet and eat. As it was getting close to the hour being up, we hurry back to the hospital waiting room.

5:00p Still no word. I ask what's happening and they check. He's still in surgery.

6:00p Still no word. I ask again. Still in surgery.

7:00p Still no word. I ask again. Still in surgery. I'm really scared. This is taking more then one hour!

8:00p The surgeon finally comes out to talk to me. He looks exhausted. He hands me pictures and tells me it was the worst gallbladder he had ever seen. He apologizes that he wasn't able to take a look at the hernia (wasn't going to fix, just peek to see what was happening). He said this gallbladder had all his attention and he really flushed him out. He wouldn't be going home tomorrow as originally planned. Maybe in a couple of days once the drain is removed.

Here's the pictures:

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Cutting the fatty tissue away.

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The ruptured gallbladder.

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The cauterized area after removal.
Far more area then it should have been had it been removed in a more timely fashion.

8:30p I finally get called back into post-op. I kiss and hug my kids and send them home knowing dad's doing OK. My mom joins me as we go back to see James. They tell us he won't remember anything he says but he is awake and talking.

I grab his hand as he's still hooked all up and he starts talking a bit. He says he's having trouble breathing. He asks for a mask. He was on nasal canula O2. The nurse laughs and says that's typical for Firefighters/EMT's, they're men who have to be in charge. She turns up the O2 and gets him a mask as his O2 levels were dropping. I start trying to cheer him on. "Breathe, James, breathe!"

He signs that he's having trouble. He doesn't think he can keep it up. He asks to be bagged. He needs someone else to breath for him as he can't continue. His O2 levels are still dropping.

The nurse calls the other nurse over. Their shift is done once James is out of post-op. They hook him up to an O2 tank and put it on the bed with him. They run him down the hall until they realize that my mom is chasing them with a cast on her leg. They slow down for her. They dump my spouse with the floor nurse stating that his O2 levels were higher then they were then they fled the area.

The floor RN starts to hook everything up to the wall and remove the O2 tank from the bed. I say good-bye to my mom as it's getting late and been a long day. She leaves. James starts signing that he can't breathe. He was begging to be bagged (emergency care jargon for using a bag value mask). They check his O2 levels and it's down to 85%! (Normal should be around 99%. 80% and you are dead.)

They call in the Respiratory Therapist who checks his O2 level and he gets 85%. They attempt to draw blood from his artery from his right arm. No blood! His system is shutting down. They go to the left and get a little and run it off to check it.

Everyone leaves the room except James and me. He squeezes my hand and stops breathing! I run after them screaming, "He's not breathing!!"

They run back, pull out the crash cart and start unhooking him from the wall. Off he goes to the ICU at full tilt. The nurse didn't even stop to pick up his file. He just gave the bed a shove and ran through the nurses' station grabbing papers then left the station from the other end and re-grabbed the bed and kept running.

At the ICU, I get the door slammed in my face! I later learn that as they were going, they asked my spouse if he wanted me in there. He shook his head no. (He later explained that no one should ever see someone they love get worked on.) I was sent to the waiting room and on the way there, the Respiratory Therapist who had just drawn the blood, stopped me to show me the results. The O2 level in my spouse’s blood was 61. He explained they should be at 500! My spouse was dying. Possibly a bleed out somewhere.

I called his best friend who came to the hospital to wait with me. They finally let us see him. He looked terrible but alive! I was so happy and scared. His O2 level was so low! They said he was admitted to the ICU for congestive heart failure. Remember, he's only forty-three and was in great health prior to this episode! Most people go home after gallbladder surgery not to the ICU!

His lungs were compromised from the pneumonia and were now partially collapsed and filled with fluid. He wasn't able to breathe in enough oxygen. He was in the ICU for three days then back on the RN's floor for another two.

He's now home, and still healing. It still hurts when he eats. He's starting to gain back his strength. His breathing has become stronger. I've still got my husband. For that I am thankful.

The question we can't seem to get answered is how do you make them take you seriously and how do you make them order tests? This surgery was delayed because everyone kept insisting that a "Fit Firefighter" couldn't have gallbladder disease therefore they refused to look! The surgeon said it was already leaking everywhere. That's why he felt as if he was being poisoned.
My spouse almost died! All because he was in good shape? Something must change in how people are treated as no one should become this sick nor die from such a curable illness.

4 comments:

jugglingpaynes said...

Vicki, I am so sorry your family had to go through all of this. I'm crying for you. You did everything you could under the circumstances and I'm surprised they didn't do the gallbladder test just to shut you up.

Please, please speak to a lawyer. You have this all in writing now. Just let a lawyer read it and take it from there. This is unacceptable and the hospital needs to be held accountable.

I love you and I am so thankful that James is on the mend in spite of the hospital.

Cristina

ComfyDenim said...

I'm surprised they didn't do the test, too. It made me think how often do we believe those that "know more than we do" -- I didn't know a gallbladder needed an ultrasound.

I just want to hug you. What a harrowing tale. And your other doctor...I'd really want to slap her. "Not the gallbladder, huh??"

Oh, May God Restore!!! Completely and totally!!

bethanyrae said...

O wow. I knew it was bad, but not that it was this bad! You must have been so exhausted in so many ways when it was finally all over. Thankfully the Lord was watching over, even when "people" who should have been, weren't. You know, they say medicine really is more of an art than a science in the diagnostic area. These decisions on what to test are determined by so many strange factors. I had that angry helpless feeling when trying to push my mom through the system for her cancer. They were so lackadaisical about it. Making her wait weeks for appointments when they knew the nodule had broken and it was spreading. I had to work SO hard to make things happen.
So glad this is over for you.....(that's a plural you)
bethanyrae

nigale huskey said...
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