Late Entry: A Visit to the ER

For various reasons, I've been off line for several weeks.
It didn't stop me from writing, though.
So the next few posts are "late," "late, late," and "late, late, late" entries.
It's a good excuse for catching up--as some of these entries are far later than just "a few weeks."
Hope you enjoy.
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July 30th

Went to the ER last night.
In fact, just came home from the ER and it's 6:15 in the morning.

It's not something I wanted to do.

Going to a Level 1 Trauma Center late at night, gumming up the works, when what the Trauma Center really needed from me was to stay away, so they could do their real job.

I went because somehow, while eating / slurping a brothy noodle bowl, I swallowed something that lodged in my throat.

It's a strange feeling, to be thinking, "Uh-oh. Something hard and not noodly is in my throat, And I can't cough it up and I can't move it down."

I tried.

At first it just felt funny, but there was no pain. But when I swallowed, it went deeper, and my throat started to hurt.

Since it was 10:00 at night, and I was home alone, I started to worry.

What if this worsened, and I got into real trouble or incapacitated. Then, what would I do?

I didn't think the object in my throat merited an ER visit, but where else was I supposed to go?

Meanwhile, the pain was getting worse.

I stopped swallowing because each swallow HURT.

I figured if nothing else, I could sit in the waiting room (since I knew it would be an extended wait), try to swallow, and hope the object would work it's way down--with emergency services nearby, in case of a bad outcome.

By this point, I'd become fairly paralyzed from the neck up, afraid to swallow—almost afraid to move in any way. So, I mobilized my legs, got myself dressed, and drove myself to the ER. Which, despite the continued increase in pain, and my rising hypochondriacal concerns about what the heck I had swallowed and what kind of damage it could cause (read "perforation"), made me feel better.

You know something is not right when sitting in an overcrowded ER waiting room, with the clock approaching midnight, makes you feel better.

The ER was a slice of city life in the middle of the night. Fluorescent lights eliminated the dark. It was crowded, but surprisingly quiet, except for the loud blare of the TV and miscellaneous coughs, sneezes, and muted conversations. Those in most need were already laying in an ER bed. Those of us in the waiting room were low on the triage list—with a long wait in front of us.

It turned out that, on this particular night, the hospital was under a "code purple." All hospital beds were full, and new admissions were being lodged in the ER, reducing the number of ER beds available, and increasing the wait time in the waiting room.

My x-rays were done before midnight.

My complaint was listed as "minor soft tissue trauma".
Minor soft tissue trauma? I was definitely pretty low on the triage list.

The wait continued AND my pain increased.
A lot.
Swallowing was excruciating, and sent my throat into spasm. The pain would increase in waves after each swallow. When I turned my head to the right, it hurt more. I clutched numerous wadded-up damp-with-spit tissues and tried to avoid swallowing.

The worst was a minor post nasal drainage that I couldn't control, leading to several involuntary, painful swallows.

Sometime after 2 am, I swallowed involuntarily, and something moved, painfully, lower into my throat. And then stuck. Or, so it seemed.

I considered going home, but since they had already taken x-rays, I figured I should see if anything showed up and, besides, I was still having excruciating pain with each swallow. I was getting tired..

At 3 am I got a bed. My resting BP was 150/90. Heart rate 55. My normal BP is something like 117/70.
I propped up the bed, so I could sit up and close my eyes without saliva running down my throat.
I still had an extended wait, so they turned out the lights, and I actually dozed a little.
I think this allowed me to finally relax, because when the doctor came in, the pain, although still strong, had eased a bit.

Dr. C. had a great bedside manner, especially after a night treating life and death and now being tasked with treating a "minor soft tissue trauma." He said my x-rays were clear, but he still wanted to take a look.

By inserting a scope.

Up my nose.

This is what I learned: When you're in a whole lot of pain, you will do anything on just the promise of making it stop.

He said he would insert a numbing gel into my nose, then a numbing spray into my throat.
I tried to sound like this was OK with me.
But what I was really thinking was of the story of a friend, who had been in a terrible hang gliding accident (now recovered), and who had told me that having an "NG (naso-gastric) tube" dropped down her nose while she was conscious, was one of the most awful experiences she could remember.

Dr. C began squirting all kinds of things up my nose and into my throat. Gel and Liquid things. He was extra solicitous—making sure I felt no pain: nose-throat-nose--uh oh—better have you gargle. Those of you who know me, know I panic in water. Having all this liquid inserted into my breathing pathway was getting in the way of oxygen acquisition. The amount of gel and liquid going into the back of my throat made me swallow, which hurt. I started to tear up, which, of course, further clogged up my nose with mucus, so that when Dr. C sprayed liquid into my throat, I felt like I couldn't breathe.

It was not a happy time.

Then, Dr. C showed me a narrow black instrument, with a lo-o-ng tube, and said he would put it up my nose.

I immediately closed my eyes.

Even with all of the numbing gel, getting that tube up my nose still hurt. I didn't feel the part where it dropped into the back of my throat. Dr. C could only insert it so far and then directed me to make certain noises to open my larynx and improve the view.

The view was obscured by "a lot" of mucus.

Dr. C said I must have an irritation in the area with all the mucus.
My take on it was that 7 hours of swallow avoidance coupled with allergies and post nasal drip had allowed a pile of mucus to build up—(hypochondriacally) maybe even on top of whatever it was that was in my throat.

When the smoke cleared, Dr. C said he couldn't see anything, but thought that whatever had been in my throat was gone—and gave me a prescription for narcotic pain killers, lidocaine numbing gel, and anti-reflux medication The pain was so severe I really didn't believe that whatever was in there was gone, but once the doctor said there was nothing as far as he could see, I felt I could go ahead and REALLY swallow.

I left the hospital at about 5:30 am, picked up a large cup of coffee, headed for home, made cheesey toast for breakfast, swallowed through the pain, and fueled by the pseudo-adrenaline of an unusual experience, went to work. All the cheesey bread swallowing must have done the trick, because by this time my throat wasn't hurting so bad, and in fact, less than an hour later the pain was essentially gone.

Initially, I didn't talk about my night, but wondering how I might appear, asked a co-worker what I looked like. She said "Great! You're wearing makeup today."
When I looked in the mirror, I realized that the rosy red lipstick she saw was really the raw bloody skin of lips that had been roughed up by spitting into hospital paper towels all night long.

I made it until 2 pm then, tired of looking good at work, caved into an impossible fatigue, went home and slept.

I didn't fill my prescriptions. I've had too many close encounters with people addicted to narcotic pain medication to ever think of these as anything but a last resort. The doctor assured me that everyone has reflux, and that I would feel pain from it--but I didn't. The lidocaine numbing get? Well, I immediately thought, "Would this be good for sore muscle recovery?" and stashed the syringes in my fridge.

Over the next few days my lips progressively scabbed over and peeled.

I chalked up my NG tube experience to learning something new: one last thing I would worry about if it ever came up in the future--and a whole lot of empathy for those who have one.

You know what they say—I'll try anything once.