As I’m writing this, I’m going crazy in an isolation room due to the airborne precautions I’m stuck on. Feeling crazy must mean I’m feeling better since the first few days here at the hospital flew by when I was unstable. I came here on June 6 after having (what I thought) was just a bad flu, fever and weakness from being sick. Little did I realize that I had left lower lobe pneumonia (likely bacterial), sepsis/possible toxic shock syndrome, proximal muscle weakness related to metabolic myopathy, fever/rash from possible viral illness with possible autoimmune cause for all of this (still unknown). You know you’re sick when you get to ER, skip the line and get pushed straight to a bed with an immediate ECG, holter monitor glued on, and nurses trying as hard as they can to get some IV access in your already dehydrated veins (7 attempts for 2 accesses were not a fun time for someone who already hates needles). Being a healthcare professional in the acute setting meant that I needed to know why everyone was worried and why blood tests/xrays and fluids/antibiotics were being pumped into me so quickly. But the staff calmly did their jobs, told me what I needed to settle my fears (without worrying me too much) and doing what they could to help. I later found out that I had a very low blood pressure, crazy high heart rate and was tachycardic, hence even more urgency.
(The moment of happiness when you get confirmation of discharge orders!)
I’m finishing up this post 6 days post discharge. Why did I decide to post this? I learned a lot being a patient for 7 days and writing tends to be a cathartic platform for me during tougher times. My admission is nothing CLOSE to as terrifying and emotionally difficult as many of my patient’s/colleague’s experiences but it’s always a good thing reflecting back on experiences and what I learned from them. The first few days back home were not fun and the nights were even worse. My brain could not get itself out of the admission, constantly thinking about the emotionally draining moments. At night, my mind forgot it was no longer in the hospital, thought my IVs were still intact and had weird dreams/hallucinations that I needed more tests, that I wasn’t at home and that I was alone in the isolation room. For my own mental sanity, I went back to work earlier than I should have but my body wasn’t ready for it – I definitely thought my 26 year old body could handle going back to work the day after being discharged but I was exhausted from every step I took on the wards (and my team could tell). Do I regret going back to work? Nope. My mental sanity needed it. We all cope and handle things in different ways and my manager was extremely understanding of that.
So, what did I take away from this admission?
I am appreciative of:
- The nurses. They were always so proactive, advocating for my care when I couldn’t the first few days, and helping me get through the emotional waves – the ER nurses at Royal Columbian Hospital are amazing. There were many breakdowns throughout the week but they knew exactly what to say (and how to say it) to get me through. The one moment that stuck out the most was a morning when I had an emotional breakdown. I was fluid overloaded in my lungs and still had the pneumonia. My biggest fear is not being able to breathe and having an admission where I struggled so hard to catch any breath was terrifying. That morning, I realized I couldn’t catch my breath and I started to panic. The nurse came to my room immediately, showed me my oxygen saturation, empathized with my experience since she also had pneumonia previously as well, and focused on my breath until I calmed down. I can never thank her enough for those few minutes she stayed with me when I felt so down and defeated. I appreciated how busy nurses are during their 12 hour shifts while making you feel that your care is the most important and not a burden on their insane days.
- My parents, partner and friends. My parents and partner were there everyday to keep my mind busy, stomach full of delicious food and just to physically be there even if it was in silence. And having friends come by (even for a short time) brought back normalcy into the days I was in isolation and brain occupied that there was a life outside the hospital walls. I can’t thank them all enough for being around.
- The doctors and referred specialists. I was lucky enough to have Internal Medicine as my primary doctor and a very keen Resident who was always around to answer my questions. They involved many other physicians in my care including Infectious Disease and a Rheumatologist to make sure all bases were covered and that little details were not missed. It helped that they knew I worked in a hospital since they explained all their thoughts in detail and made sure I understood their care plans before implementing them. They also advocated for my care immensely to help speed the admission along (and get that ++fluid off my puffy body after having 3 days of fluid resuscitation!) You’re welcome to the Internal Medicine CTU students/Resident since I was apparently a very interesting case that they learned a lot from!
Things I learned:
- Hospital food is the worst. As a dietitian, I already knew that but when you’re a patient receiving the food, you really understand the reality of it. The healthcare system needs to invest more money into food service in the hospital – food is medicine. If I didn’t have my parents and partner bringing my dinners each day, I would have lost even more weight than I already did. My weakness and isolation requirements prevented me from being able to purchase food from the cafeteria which made me feel helpless at times when the meals were unappealing. Another thing I struggled with was lifting the tray lids and even the lids to soups/fluids/ meal items from my proximal upper weakness. I was lucky enough to have nurses who helped set up my meals but it made me realize how meal set up is such a huge barrier to patient intakes when staff are too busy to help patients with this task. (The pretty green paper didn’t fool me..)
- How it feels receiving IV medications/fluids. I was pumped with lots of different things including many IV antibiotics, various IV electrolytes, IV fluids (including normal saline, plasmalyte, and immunoglobulin) and even diuretics. In the hospital, I’ve ordered some of these fluids not thinking much of it. Little did I realize how much electrolyte replacement hurts in peripheral veins (IV potassium phosphate was the worst) and how quickly IV lasix works! It’s these weird little things that have made me take a step back and think of how my patients must feel when they receive all of these medications/fluids.
- Showers are amazing. I will never take a shower for granted ever again. 7 days of towel baths and the amount of grime that came off me when I got home and had that long shower made me really appreciate what I nice bath can do. Having to use a commode for the first couple days and the impact of the IV antibiotics on my GI tract made these showerless days even worse. But I do thank my mum for being there many mornings to help me wash up when I physically couldn’t do it myself.
- The importance of advocating for your health. I was lucky enough to have so many awesome nurses and referred specialists to advocate for my care. But being under the care of a teaching unit with medical students and Residents was an opportunity to learn from them and teach them at the same time. If you know me, I’m VERY vocal and constantly asking questions. I made sure I knew every medications and IV I received and which tests I was getting done. I was pretty vocal with the Resident who cared for me of things that I didn’t agree with and made sure he made me aware of what he was ordering for me. One thing I know he took away from having me as a patient was making sure he ordered everything he needed at one time rather than constantly making order changes throughout the morning rounds. An example was blood work – I would get poked multiple times each morning due to order changes made by CTU.. and I was extremely annoyed by this. By making the Resident aware of how these order changes impacted my care as a patient, he then changed his way of working to make sure we as patients didn’t get poked and prodded more than we needed to.
- Understanding why patients always ask “so when am I going home?” As a healthcare professional, I always get asked that question by patients.. and it drove me nuts. How could you think about when you’re going home when you’re not even stable and still so sick?! Guess what, this chick asked that question on day 2 of the admission – yup, I was that annoying patient asking that stupid question. When you’re stuck in a hospital, regardless of how sick you are, you need that time frame to get you through the stay. It’s an end goal, something you’re trying to achieve, something you’re looking forward to each day, that tentative discharge date. To my disappointment, it was delayed by a couple days. Yes, I got annoyed and frustrated and upset but in hindsight, I understand why they were being cautious. But I now have a better understand of that darn “when do I get to go home” question whenever my patients ask it.
I learned much more but don’t want to make this post longer than it is. How am I feeling now? I’m tired. And it’s frustrating. I just want to have the energy and drive like I did 2 weeks ago but it’s taking me longer to get there than I like. My brain is slowly getting out of “you’re in the hospital” mode and I’m slowly getting back into my routine of acute care/private practice work. I have an appointment with the Rheumatologist/Internal Medicine in the coming weeks for further follow up to make sure I’m still doing well and to rule out a possible autoimmune cause for all this weirdness (and yes, that aspect does scare me). I am so grateful to be home but also so thankful for everyone involved in my care. Fingers crossed I get some good news during my follow ups in the coming weeks!
I’ll be posting more nutrition nerdiness in the coming weeks so stay tuned!