How low can she go?

I no sooner wrote about benignly neglecting my children and garden than the phone rang and it was T.D. calling from the (giant) University Hospital ER. Where she had already been in an exam room for five hours. (SCREW HIPAA and the horse it road in on. What is this crap where you don’t call a 19 year old’s mother? That’s rhetorical because, doing the work I do, I know all about HIPAA. Screw it.)

The story was she was getting ready to go kayaking with a couple of buddies and passed out cold. Then they couldn’t revive her very well and when they did she passed out again with terrible pain in her lower belly. So these two lads called for an ambulance but just assumed someone would call us.

After 11 hours the ER staff decided she was "probably okay." The best hypothesis they could come up with after extensive tests and ultrasounds was that she got dehydrated enough to throw off her ketones and hypotensive, passed out and simultaneously had an ovarian cyst that ruptured, which is extremely painful and requires emergency intervention. Or, in this case, 11 hours of benign neglect.

The thing that had them puzzled was her low blood pressure and heart rate. She never really got above 76/48 and a pulse of 52. But then they didn’t have the background information her mother could have supplied if they’d bothered to call. She’s an alien, remember? This child never has had much of a pulse or blood pressure; she just cruises through life barely batting an eye, let alone pumping blood. There must be some connection between this and her ability to live underwater.

That ER? They were stacked up like cord wood. All 31 exam rooms were full, gurneys lining the hallways and the family waiting room had been emptied out to further triage patients. T.D. was fortunate enough to have an exam room with a TV (they must anticipate long waits) but the only station was some ESPN 24 hour boxing channel. She said after the nurse took her blood and urine and started an IV she took a three hour nap and the pain was already mostly gone. When she woke up from her nap she asked for a phone to call her parents but they were too busy for another hour and then when she got the phone she called both her Dad and me, and by extension F.G.

We all three arrived at the same time and spent the next several hours sitting with T.D. and talking about how to furnish her apartment when she leaves for college next month. Very bizarre. Also, I must have "helping person" flashing on my forehead in subcutaneous neon letters because along the way I was translating for a Russian speaking person who had questions about where to put her urine specimen and then  I was calming down a street person on a gurney in the hall. They were busy enough that no one had noticed that he still had his bottle in a brown paper bag and was sipping away and getting increasingly agitated as time passed .

At 2 AM the nurse returned to say that T.D. could have a snack from the vending machine and F.G. produced an entire box of Cheezits. At 2:30 AM the head ER physician came in and was careful and attentive and gave her a good once over after reviewing all her tests. He had to ask her to stop chewing so he could listen to her heart. He explained that the cyst had ruptured and was self-resolving so we could take her home and have her followed by her internist and then he noted that she just seemed to "run low" on her vital statistics. They had taken those every fifteen minutes or so and even got her up and moving to see if they could elevate her pulse. With activity she got up to 53 for a minute, then settled back at 51. He told her to drink more fluids and eat more Cheezits and that was that.

So. Another example of how T.D. is a freak of nature.  And another example of how things can often heal themselves, given a somewhat attentive eye and the company of those who love you. Which reminds me: I am going to start writing, as promised, about why one should be skeptical of psychotherapy. As soon as I thank my lucky stars and get some sleep.

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20 responses to “How low can she go?

  1. Ite’s unfortunate that Emergency Rooms are so overwhelmed, having become the “doctor of first resort” for many people. Then the personnel seem to dwell on their problems, rather than thinking through the things they should be doing for and about patients, as in calling you. But I like the ending advice: “Take two Cheezits and call me in the morning.” Classy.

  2. What a relief. I’m glad she’s ok!!

  3. I am glad to know that she is okay; I always thought my pressure was low, but hers beats all I have ever heard of in a living human!

  4. *whew* I’m relieved that everything turned out all right, despite the neglect. Hooray for that. 🙂

    It reminds me of my roommate who I had to rush to the ER early one morning for what turned out to be appendicitis. She’s an international student from Jamaica, but when her mother called to speak with her the nurse wouldn’t let her through! Said that my roommate hadn’t paid for it (of course roommie didn’t KNOW that they charged to receive calls). Explanations that the mother was calling long-distance from Jamaica were met with skepticism since the caller I.D. was showing a Canadian area code (her mother was using a phone-card and probably got re-routed etc.). The mother had to hang-up until the nurse notified my roommie that there was a charge and, it being added to the bill, my roommie was allowed to make and receive calls.

  5. You speak RUSSIAN ?? Wow. Hey, I’m glad TD is ok. Sheesh.

  6. You speak RUSSIAN ?? Wow. Hey, I’m glad TD is ok. Sheesh.

  7. So glad T.D. is okay!!! That’s a very scary thing to have to go through. HIPPA Should change it’s name to CYA!

  8. So glad T.D. is okay!!! That’s a very scary thing to have to go through. HIPPA Should change it’s name to CYA!

  9. WOW! What the heck is going on this week??

    So glad she’s ok… ERs suck.

  10. No, Mary, I don’t speak Russian. It’s just that I had a whole lot of time to figure out what this woman meant as she blushed, pointed towards her hinterlands and said, “orn,orn,orn”

  11. Brilliant! Simply brilliant!! I love this story 🙂 Just because you write soooo well. You rock Vicki. And did anyone, by chance, happen to check behind T.D.’s ears for gills, or dump salt water on her to see if scales started to develop around her legs? I saw it once on the picture box. Just checking cause maybe she is, you know, “different” from us…

  12. Hey, didn’t anybody ask what HIPAA is? HIPPA? Whatever?

    I am not asking because I already know.

    I can’t wait for the therapy post.

  13. I too run a low blood pressure, I tell doctors that all the time and yet it still freaks them out a bit. Glad your daughter is ok!!!!

  14. {{{HUGS}}} to highly hilarious helping hospital hostess!

    How IS T.D. going to furnish her apartment??!!

  15. sheesh…leave it to the big hospital. As I told you it was packed when I was there last week. Almost made me want to go back to be an m.d. doctor instead of a ph.d. doctor because then hopefully they would have ENOUGH docs in the ER. We were there from 3 am til 10 pm the next day…it’s ridiculous in there. However, I’m glad to know that T.D. is ok even though the cyst ruptured (ow! I know how painful that can be!)

  16. Ok, I’ll bite. What the hell is HIPAA? 🙂

    (For real. I’ve no idea.)

  17. Sooo….should I put a card in my wallet that says…”in case of emergency please call x and y, it is okay to release my med info to them?” I can get it notarized, too!

  18. HIPPA – HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996

    It had the makings of a good idea but like Social Security, once the politicians got a hold of it and did the tweaking and twisting and let the imbecile Ted Kennedy have a hand in it, it is now a disaster.

    Not only do docs have to deal with the malpractice rates going through the roof, medicare paying less and less along with insurances when you have to join their networks, having to deal with ICD-9 and CPT coding for medical necessity to get paid from insurers at all….all that and now the threat of HIPPA violations with something like $25,000 fine for each occurence.

    Simply put: If your child over 18, or husband or wife has medical care, lab work and such, the doctor or lab cannot by law give those results or medical records to anyone but the patient without written authorization. Probably notarized.

    It isn’t supposed to include physicians consulting with other physicians on a patient’s care but the monetary fines are such that a few docs I know are paranoid about that aspect as well.

    Sorry, Vicki, don’t get me started. Calm….blood pressure back down…OK.

    I AM REALLY GLAD THAT TD IS OK.

  19. I discovered your site fairly recently and have been enjoying your writing. So glad your daughter is okay, and how cool that she has such a loving family to be there for her. 🙂

  20. Vicki and Kind Readers of ‘Outside In’, excuse me for a moment while I let off a Primal Scream:

    EEEEEEE-YIIIIIIIIIIII!

    Ahem. Better now. And I’m glad your girl cub is, as well.

    Vick, you had us all going with your Russian skills.

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