Finishing up my clincical rotation this morning would have closed out my 12th and busiest week of the accelerated nursing program thus far, but something went undeniably wrong.
I had planned to take an extra day off this week from running as I needed some recovery, so with my exam yesterday, dinner plans with my cohort and clinicals calling for me to rise at 5:30 am on Friday I figured Thursday would be a good day to take it easy on the running. I finished up my exam not feeling I had done well enough for an A, but passing. I was excited that the hardest part of the week was over, having only clinicals, a few medication sheets and a care plan of action for the H1N1 virus to do before the end of the week.
I laid down at 1:00am going over in my mind all the things I needed to get done in the next 3 days for school and work. It was going to be tight, but doable. I kept thinking and thinking about my care plan of action and debated whether I should just get up and start working on it or at least "lay" in bed for a few hours and let my body rest with the possibility of a few moments of restful sleep. It didn't happen. I tossed and turned and could not shut my mind off. I watched the time tick away until 5:30am when I rose and prepped for clinicals. I knew the day would be rough with no sleep, but hey I have functioned and even run a marathon on little to no sleep.
I arrived a little before 7:00am and was standing at the nurses station taking report when I felt weird. I started to lose my hearing and my throat closed a little, I closed my eyes and tried swallowing a few times. I felt dizzy and debated whether I should sit for a moment, but having had this happen a few times in the past I figured it would pass, so I continued to stand and take report.
I believe in that moment, I closed my eyes one final time before the details became fuzzy and I had a blank spot in my memory. I kind of remeber hearing someone say my name a few times and feeling arms around my torso and then I felt myself moving into a seated position and my hearing started to return a little and I opened my eyes to find every freakin' nurse on the floor surrounding me, talking, throwing a BP cuff and a pulseox on me. I heard someone ask if I was diabetic another nurse grabbed my finger and lanceted my finger for a glucose test. I was so disoriented as I heard abnormal BP and pulse numbers being called out. "Oh F*ck!! What the hell had just happened to me? I kept swallowing and my hearing slowly got better, but a wave of heat washed over me and I felt shaky and sweaty. I didn't know what the hell was going on. Piece by piece I had discovered I had passed out.
I was so embarassed and disoriented. I couldn't get my bearings and nurses were surronding me. I heard they had paged an emergency doctor and within a few minutes there he was hustling down to me. I tried to tell everyone I was fine. Yes, I had eaten breakfast, no I was not diabetic. Yes, I knew my name and my date of birth. I was alert for cripes sake!!! It was determined, I had to go to the ER for testing. A few nurses said they had seen my eyes roll back in my head and my lids flutter. It was crazy. Those were signs of seizures and mini-strokes. I insisted it was because I was tired and had not been able to sleep the night before. My clinical instructor believed me, but gave me a bunch of sh*t about how she couldn't believe I would come into clinicals on no sleep and that I should have called said I wasn't coming in. Ahhh, yeah right!!! This is mandatory state board required hours, I can't miss!! I was so mad and upset. I hadn't purposefully passed out! I really wasn't looking forward to the trip to the ER either. F*ck!!
One of my classmates took me down in a wheelchair after I had been pumped with 600mL of flud. We didn't have to wait and I was wheeled into a private room, but before that they had me go in the bathroom and give them a sample. Fine I had to pee anyway from all those fluids. Once in the room I had to change out of my scrubs into a patient gown. The nurses came in and began monitoring my vitals. They stripped my gown and hooked my up to a 12-lead EKG to monitor my heart and took a few vials of blood. I was really not happy now!! After they got my blood they hooked up an IV with about 1000 mL of normal saline. My urine test had come back showing I was slightly dehydrated, key word slightly. They pumped me full of fluid anyway. It was only a matter of minutes before I started shaking from the IV fluids, so my friend covered me with a blanket. To top it off I had to pee again, but hooked up to all this equipment it was going to be hard to go anywhere. I had an IV in my right arm, 10 electrodes with wires coming off my chest, a pulse oximeter on my left index finger and a blood pressure cuff on my left arm. Damn!! I asked the nurse to unhook me, but she refused because I was at risk for falling and I would have to use a bed pan until my blood work came back. What?!?! I was NOT using a f*cking bedpan. I asked how long it would take and she said about an hour and a half. I refused the bed pan and told her this was ridiculous and I was done with this. I wanted all the testing stopped. I was going to leave AMA (against medical advisement).
The doctor came in and I explained to him my very limited health insurance would not pay for all these tests and I had to pee and I was fine!!! He told me I would not be able to get back into clinicals without a doctor's approval and he would only do the bare minimum testing. They were fairly certain I had had a vasovagal response, but they wanted to confirm I did not have a heart attack, so along with the EKG, they were checking my tropinin and creatine kinase levels in my heart and they wanted to do an x-ray of my chest for calcium deposits. CK should be < 4, Troponin < .01. I agreed to those tests as I really needed the clearance for clinicals.
The doctor left, but I still had to pee. My friend unhooked the IV bag from the stand and then I unhooked the EKG wires from my chest while she paused the monitor and removed the BP cuff and the pulseox. We made a break for the bathroom across the hall and I was never so happy to sit on a toilet and pee!!
We went back to the room and hooked me back up until I was taken for x-ray and then brought back. I was so impatient. I figured, I am 32 heatlhy as can be. I couldn't have had a heart attack, but then I started thinking, one day I may enter the hospital and my chances wont be this good that nothing is wrong. Man I hate getting old. I hated being the patient. I felt so helpless waiting for results so I could get on with my life.
My friend had decided to stay with me through it all as I could wipe my ass and her other patient upstairs could not, at least until or clinical instructor came down and popped her head in. She wanted to check on me and tell me to take it easy and not stress out and then reprimand me a little bit too. Arrggghhhh!!!
Finally, the doctor came in! No calcium in my heart, EKG was normal, troponin <.01 and Creatine Kinase inn my heart was 4.7!!! WTF!!!!!!!
The doctor said he thought it was a fluke and I was a healthy runner. Creatine levels increase when muscle breaks down. My creatine in the skeletal muscle was a little off, so maybe it is the same for my cardiac muscle too. Needless to say, I remember having no chest pain, just being very aware of my heart rate feeling high that morning.
I know myself and I know my body. I did not have a heart attack. I have low blood pressure and when it remains the same while my heart rate increases blood is pumped out of my heart too fast! When the left ventricle has no blood to pump a person will pass out if blood pressure does not increase to bring it back to the heart resulting in a person passing out. I passed out.
It was somewhere around 1:00pm when they finally released me with strict instructions to go home and rest for 24 hours. I felt confident I would make it home. I knew if it happened again I would have less than 2 minutes to stop my truck and pull over before I would completely passout. I also called a friend and talked to her on the phone just in case.
Home and in my bed I began rehashing the events of the day, instead of shutting off my mind and resting as prescribe. It seemed so unreal. I have never been admitted to the ER for an uncertain and uncontrolled condition. It was definitely eye opening for me. I hated the feeling of helplessness. I hated the idea that something really bad might have happened. I hated the fact that I couldn't control it!!
I have spent everyday since running and being very thankful I have my health.