Saturday, November 19, 2005

I'm Not Getting Out/399

Interesting, but somewhat frustrating call. Comes in as a seizure with paraylsis. We find a 30ish woman in bed, aphasic with right sided weakness. Family says she had a "gran mal seizure" lasting "an hour and a half." When I ask why they didn't call 911 sooner, they said she has them all the time and the doctors have told them to let her ride them out. The only reason they called this time is because of the paraylsis.

I work it up like a stroke and go lights and sirens to the hospital. En route she starts talking some, but her speech is slurred. She can only very weakly grip with her right hand, and can't move the right leg at all.

En route I ask the husband for her name and date of birth along with meds, etc.

When I patch to the hospital, first my radio is breaking up (as it sometimes does--we have a faulty wire that is sometimes jarred by bumps) On the third try I get patched through to the hospital, but I can't hear them I just hear clicking. I go ahead and give the report, hoping they hear me. Different hospitals in the region have different requirements for patches. The one I go to the most likes them short and sweet. "40 year old alert patient, history of frequent seizures, had a seizure lasting an hour and a half according to the family, now has right sided weakness, which has never happened in the past. Stable vitals. We're six minutes out." The other hospital wants to know everything. (Today I give them a longer version of the first report.) You can call in and say the patient is alert and oriented, and they will come back asking for the Glascow Comma Scale. You say vitals are stable, they want to know the vitals, which is the only thing I can hear them say over the radio now. I give them the vitals 140/80, 80 and 18. Pretty unremarkable.

At the hospital, we stop at triage and I give the nurse the patient's name and date of birth. The patient's husband, then says that's not her name, that's his name and date of birth. His first name is a name more commonly used for women than men. I just shake my head. Why would he think I was asking for his name and date of birth?

When we get into the critical care room, I start to give the story when the doctor says, "I think I know this woman, she has pseudoseizures. She's had this right sided weakness before, haven't you?" I just repeat what the family told me, and introduce the husband. Without even questioning him, a nurse asks him to leave the room for a little while until they are ready for him. I say, you might want to get him to describe what happened because his explanation is atypical. They just nodd and go about their business. The doctor lifts up the woman's right arm, it falls flaccid against her chest.

I leave the room and write up my report. I don't know what to make of the woman's condition. At least there were two doctor's in there examining her. I have never heard of a gran mal seizure lasting an hour and a half and I've never heard of a seizure (acute stroke aside) leaving someone paralyzed or with weakness on one side, but I can see how it could happen.

I followed my treatment plan and did everything I was supposed to. I was just left feeling somewhat frustrated.


Slow day. I'm tired because I stayed up way too late last night watching the final episodes of Lost: Season One on DVD. I only intended to watch one, but then I had to see the next and the next, then the last one was two hours. Ended up going to bed at 12:30. Had a headache most of the day and didn't feel like eating. I ended up watching the Harvard-Yale game on TV, which Harvard won in three overtimes. Everyone has their story of their life if they ever end up destitue and down and out sitting on a bar stool. Sometimes I think mine is I didn't get into Harvard. It actually probably was the best thing for me. I still root for them, even though they rejected me. Twice. Bastards.


Get called for an 86 year old lady difficulty breathing. We pull up and I say to my partner. "I'm not getting out out." He looks at me. "I'm not getting out," I say again. He keeps looking at me. "All right maybe this time, but one of these times, I'm not going to get out. One of these times, it'll be one too many."

"Yeah, right," he says, "Com'on."

Lady has a fever, feels weak. Went to the hospital two weeks ago for same symptoms. Etc. etc. IV, 02, monitor, a little hand holding thrown in.


While at the hospital I see the doctor from this morning. I ask him about the seizure/stroke patient. He says they treated her like it was a stroke, but ewhen they went back through the records, they discovered she is a complete psych. She's been in before for the same thing and there is never anything wrong after they do their battery of tests.

Later I tell my evening shift partner about the call, he recognizes the address and tells me how he went there once and his partner got completely faked out by her too.


As we get back to town, we get called to a nursing home where the commercial ambulance has gone for a patient who is too big for their stretcher. The nursing home says she is 420 pounds. Their stretcher is rated for 350. The woman is protesting that she is not 400 pounds, she is 399. "I think she's right," I say, and wink at the commercial EMT who I work with on Mondays in the city now. "She's just less than 400." She has fallen and has back pain. We roll her on to a board, then deadlift her up onto our lowered stretcher which is rated for 600 pounds. We transport.


I bought some salad at the hospital. Although I deadlifted her awesomely, I want to
get back to the gym on a regular basis as well as eating right. I'm also thinking about shaving my head. I got it cut real close when I went to Mississippi and I am unhappy with the way it is growning back. I'm feeling sort of bare in front on top. I'm starting to look balding. I think a shaved head will help me in the gym. make me feel like a strength-training animal. Plus if I eat sleep and train better I won't be so tired and the day when I decide I don't want to get out of the ambulance will be a little farther off.