Tuesday, May 01, 2007

When to Call the Ambulance

I originally chose this image for this morning's post because I think I may be starting to have hot flashes. I'm only 46; isn't that too young? Because my mother's had breast cancer, I can't do hormone replacement therapy, or even the herbal stuff that mimics it, so if these are hot flashes, I'm just going to have to live with them. The ones I've had the past two days aren't too bad, though.

However, the image fits my mood this morning for another reason: I'm furious.

My mother's back in the hospital. I learned this when my sister called from her job a few minutes ago. "Mom's in the ER because she came downstairs and said she thought she might be having a heart attack. She was having chest pain, you know, like a band around her chest. She wasn't sweating or anything, but I drove her to the hospital anyway. I could have called an ambulance, but driving her myself was faster. Anyway, she's there, and they're giving her tests, and she seems to be fine."

I love my sister, and yelling at people doesn't work anyway, so I tried to speak calmly. "Well, it sounds like it worked out. But for future reference, if you think someone might be having a heart attack or a stroke, call 911."

"Well, I could have, but I didn't. The symptoms were hours old."

I thought, but didn't say: You thought she might have been having a heart attack for hours? CALL THE FREAKING AMBULANCE! We were worried about her AAA-repair surgery last week because the stress test found some calcification of her aorta, remember? Hello? Cardiac symptoms? Call 911!

I called the hospital and eventually reached my mother's nurse, who appears to be the world's nicest person. She said that Mom couldn't talk to me, but that she was being transferred to another hospital -- the one she was in for her surgery, but which is farther from my sister's house -- and gave me her room number.

I said, "And of course you can't give me any medical information because of HIPAA, right?"

The nurse laughed. "All the tests are coming back negative." (I guess that, strictly speaking, this doesn't violate HIPAA, since she didn't tell me what kind of tests they were.)

Through my huge wave of relief, I said, "But if the tests are coming back negative, why is she being admitted?"

"Because that's what happens when you're eighty-one years old and having chest pain. With her history, there's no way she's going to be discharged."

I asked the nurse to tell my mother that I'd called and that I love her; the nurse said she certainly would. I hung up, still furious.

This is one of those family-dynamics issues; my sister's older, and my family considers me a bit of a drama queen (who, me?), so the fact that hanging out in an ER for over two years has actually taught me a few things tends to get discounted. Something similar happened after Mom's surgery three years ago: she wasn't feeling well, and my sister minimized it, and I pushed for going to the ER, and Mom wound up having to be admitted with a bad infection.

So my sister's probably never going to take my word on medical issues. But for the rest of you, please take this to heart: If you think someone even might be having a heart attack or stroke, you can't act quickly enough. See? The American Heart Association says so too. It's not just me. And you don't have to have hung out in an ER for over two years to know this stuff: everyone should know it.

Study that page, please. Learn the symptoms. Here's another page about stroke warning signs from the American Stroke Association. Please note that the ASA doesn't endorse the "Smile Test," which all of you have probably received via e-mail 8,800 times, just like I have.

Ambulances aren't just very fancy, expensive taxis. They're mini-hospitals in their own right. Paramedics can do things for your loved ones that you can't, and they can do some of those things in your home -- before you or your loved one even gets to the hospital -- and they can get through traffic a lot more quickly. The "driving in our own car is faster" reasoning simply doesn't hold up. What are you going to do if you're driving your car and you, or the loved one next to you, suddenly slumps over, unconscious?

Yes, I'm trying to scare you. If someone's having stroke or heart attack symptoms, you should be scared, and act accordingly. Please. For the sake of the people you love, call 911.

Oh, and on another medical note, this week's Grand Rounds is up.

Oh, and nice nurse from Philly? Thanks for bending the rules a little to reassure a frightened daughter!


  1. Anonymous9:10 AM

    Having just asked a mutual friend to say I was glad to hear about your Mom, I now read that she is back in, although with negative test results. I'm sorry.

  2. That's a good list of stroke symptoms. I applaud it. :-)

    I might add -- if you have any reason to imagine that you might be experiencing one of those strokes, really, seriously, do go see a doctor. Even if it's Christmas. Even if you're afraid the doctor or your family will laugh at you and call you a drama queen when it turns out to be nothing.

    I'm tremendously blessed; neither of my strokes did lasting damage. But this is scary stuff and it's worth taking seriously.

  3. I'm glad things are looking okay, Susan!

    I cannot tell you how much I agree with your call 911 statement. We see it almost once a week; the patient who headed for the hospital in a car, "so they didn't have to wait for an ambulance" who would already have the IV, drugs on board, and be doing better by the time they finally role in our door...

  4. Excellent PSA.

    Sorry that your Mom's back in, but that isn't unusual given today's very short lengths of stay.

    She may still be metabolizing anesthesia (fat soluble medications). This can cause all sorts of transient issues, one of which is angina. It's all for the good, as she can be closely monitored for infection, and she can receive fluids parenterally.

    Many times family members react in the way your sister did becasue it's a kind of protective mechanism - a disbelief, if you will. Still maddending, nonetheless.

    Keeping you all in my thoughts-

  5. Hope your Mom continues to be ok, and I definitely agree about calling 911 - better safe than the consequences.

  6. Man... I can sympathize with your desire to chew out your sister. Although it probably wouldn't have done any good.

    I hope your mom's condition improves. It just doesn't do to take chances at her age.

  7. Hi Susan. Hope your mom gets an all clear really soon. I'll continue praying. Hope your next exercise session comes soon too. (g)

  8. Great post. Thanks for the link to the AHA. I linked it to my mother who decided to go to the EYE DOCTOR when she sudddenly went blind in one eye (she's 65). And then didn't want to say anything to me until 3 days later because she didn't want to upset me.
    Thanks again!

  9. Oh, no!! Poor Susan and poor Mom!! It is so hard to be far away when dealing with family dynamics. It's not any easier when one is closer, but gosh, the distance and consequent feelings of helplessness and fury are the pits. Warm hugs to all.


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