It
was not the type of call that I was expecting. "This is EMS, Lori wants
you to know she is having shortness of breath & EMS is taking her to the
hospital." Working as a nurse practitioner, I felt it was important to
clarify. "Are you talking about my sister Lori, or about a patient of
mine?" "She said she's your sister ma'am." Oh. Okay. I took a second
to process the information, walked to an area of the nursing home I was in
where I could have some privacy and called Lori's cell phone. She answered.
There was a distinct sound of panic in her voice. She said that she was having
shortness of breath. I could hear the voice of whom I suspected was a paramedic
in the background. I could barely get a word in before it sounded as if she
fumbled the phone. The line went dead. I
stared at my phone and then put it up to my ear several times, checking for the
sound of her voice. Any sound. But, there was no sound.
I was about 45 minutes away seeing patients at a nursing home when I received the call. I started on my way back to Lakeland. I made a few calls on my drive back. Thank goodness for Bluetooth. I don't think I could have held a phone in my weak, shaky hands. I called my husband to let him know what was going on and my work so they could call the rest of the nursing homes on my schedule & let them know I wouldn't be there. Almost back to Lakeland now. So much traffic on Hwy 92. Get out of my way!
It took about 10 minutes to find a parking spot in the parking garage. A full parking garage is not a good place for an impatient woman. Finally, an open parking space! I pulled into the space & darted for the stairs, grateful I wore scrubs & sneakers to work today. I ran down the stairs, because it had to be faster than the elevator and I'm too impatient to wait for an elevator anyhow. Once in the ER, I was directed to the visitor area. The kind lady opened the door for me with her badge and said "See that Exit sign at the end of the hall? Once you get there, she's in the third room to the right." As I walked through the bustling ER, I envisioned Lori sitting on the stretcher with tubing up her nose providing oxygen, talking on her phone. I thought, "As soon as I walk in the room she'll start telling me what I need to do in her big sisterly way."
Shaken from my day dream, a nurse in black scrubs darted out from what seemed to be nowhere and pulled the curtain closed in front of me. Wow, I know they are all about protecting patient’s privacy, but come on, she is my sister. "Who are you?" Asked the steady and firm nurse. I explained my relation & stated my name as if under interrogation. "What do you know about what happened?" asked the nurse. "Well, my sister was having shortness of breath & called 911" I said as I envisioned pushing the nurse out of my way. "Aren't you taking HIPPA a little far here lady?" is all I could think. "A few things have happened since you talked to your sister". Oh no. My heart sank. All I could do was stare at her with saucer sized eyes & wait for the details. "When the paramedics got her into the ambulance, she went into cardiac arrest." Asystole. The worst heart rhythm possible. "They did CPR & after 5 minutes they revived her and she was in a-fib with rapid ventricular response. This is what her heart looks like now" she said as she held the EKG in front of my face. Wow. I haven't read heart rhythms in years, but that QRS wave looks an awful lot like a Bundle Branch Block, generally a sign of a more severe heart attack. "She has a tube in her throat for an airway & she is unresponsive" the nurse continued to spew bad news at me. She opened the curtain and there my sister lay, lifeless on a stretcher. Yep, the nurse wasn't kidding, there's a tube in her throat. In fact, wires and tubing were plentiful. I started to feel chest pain myself. Is it possible to have a sympathy heart attack? Or was this merely a symptom of my own breaking heart?
A few minutes seemed an eternity, but I knew it was time to call my siblings. The nurse gave me the okay to use my cell phone in the room, but afraid that Lori would hear me, I went to the other side of the room. Fighting back the tears, knowing I had to be strong for them, I called my brother and explained what was going on, the whole time my eyes were fixed on Lori's motionless body. Then I called Joann, who quickly became upset. As I was explaining things to Joann, a tall man with thinning red hair walked in. Dr. So & so (as if I'd remember a name right now) introduced himself & I hung up with Joann. "Your sister is in bad shape" he said with empathy clearly evident in his blue eyes. More chest pain for me. Good thing there is an empty stretcher in here, I may need it. "She's acidotic & has a glucose level over 600. It was over 800, but has come down some. Her heart rhythm is abnormal and her blood pressure is very low. She has signs of congestive heart failure. I would expect to see all of this going on in an 80 year old, but not in a 55 year old." I know Dr. Red-hair had a lot more to say & ask, but the mind tends to go blank when overloaded with this kind of information. Again, my eyes stayed fixed on Lori's body, which has yet to so much as flinch. "We're going to transfer her to ICU in a few minutes" the nurse informed me. Feeling as though my knees would no longer allow me to stand, I sat back down in the chair across the room. I listened as the nurse gave report to the ICU nurse. Information I should clearly understand with my medical background made absolutely no sense to me. It was as if she were speaking a foreign language. This happens to other people. Not to my family. I sat, frozen, my eyes fixed on Lori as my mind willed her body to move.
The nurse informed me that I would not be able to see Lori for at least 45 minutes as they assessed her in the ICU. I stumbled outside and walked aimlessly, trying to figure out what I needed to do next. You know in the movies when you see a person walking and they are unaware of what is going on around them, deafened to all sounds? That was me. I saw a bench in the parking garage and sat down, placing Lori's purse on the bench next to me. "I need to call her work", I thought. Damn, I don't even know the name of the company she works for. I looked through the 2 wallets in her purse 3 times each before I found a business card from her work, which was in the front slot of wallet #1. Not surprised that I missed it the first 3 times. I don't know if I could have found it if it jumped up & bit me. I called her work & informed her supervisor what was going on. Then I sat there, on the hard bench in the parking garage for 30 minutes, staring at the opening & closing doors leading into the hospital, wishing I never had to go back in, but knowing I had to.
Somehow I found my way to the ICU. Don't ask me how though. I floated there for all I know. I walked through the ICU doors after the sweet little lady volunteer waved her badge in front of the box on the wall. An eerie feeling swept through me as I remembered the last time I was in this ICU, when my best friend's mom was a patient here. Overwhelming emotion flooded through me. Scanning the room numbers, I finally saw room 16. As I walked closer my chest began to hurt again. I walked in the room and approached Lori in her new bed. I touched her cold, pale skin and couldn't hold back the tears anymore. Still, she lay lifeless and I still believed I could will her body to move. No such luck. With once again weakened knees, I walked to the chair by the window and sat down. I couldn't take my eyes off of her. "Open your eyes dammit!" I shouted in my mind, apparently not loud enough for her to hear. Sometime later, Lori began to move. Not in the way I willed her to, but in jerking, seizure-like movements. This can't be good.
At some point the nurse directed me out to the waiting room. Thankfully, my husband Chris had made it here by now. We sat in the waiting room for a length of time I do not recall, waiting for the ICU doc to come out and talk to us. In walked a tall, thin woman who looked incredibly attractive with no makeup on. I stared into her eyes hidden behind thick, black framed glasses. "I'm Dr. So & so" she said, (really, who can remember a name at a time like this?). I listened as she gave me another speech about what bad shape Lori is in. As she painted the bleak state of affairs, I couldn't help but feel grateful that I don't have to deliver news like this to patients or families. I don't recall all she said. I can't remember a name right now, you think I can remember all the details here? I must paraphrase: "She was without proper oxygenation for a while, she is having seizure like activity, which is generally a bad sign, we don't know how well she will recover neurologically" the doctor empathetically informed me. "Do you know what her wishes are?", "If you have family to call, you may want to let them know in case they want to get here", "Is she religious? Do you want a priest to pray with her?" The attractive doctor with thick framed glasses was full of questions I was not fully prepared to answer. "We will do everything we can" she confidently stated. "There is a procedure called the Arctic Sun protocol that we do for patients in this situation. We will put her in a therapeutic hypothermia in hope of preserving brain and heart function. We cool her body down slowly over a few hours and keep her at the goal temp for 24 hours. Then we slowly rewarm her body temperature and wait to see if she wakes up neurologically. There are no guarantees, but this is her best shot at recovery." Envisioning Lori's lifeless body, I knew we had to do whatever we could. So a few hours later, when her body stabilized, the cooling began. And so did the waiting...
I was about 45 minutes away seeing patients at a nursing home when I received the call. I started on my way back to Lakeland. I made a few calls on my drive back. Thank goodness for Bluetooth. I don't think I could have held a phone in my weak, shaky hands. I called my husband to let him know what was going on and my work so they could call the rest of the nursing homes on my schedule & let them know I wouldn't be there. Almost back to Lakeland now. So much traffic on Hwy 92. Get out of my way!
It took about 10 minutes to find a parking spot in the parking garage. A full parking garage is not a good place for an impatient woman. Finally, an open parking space! I pulled into the space & darted for the stairs, grateful I wore scrubs & sneakers to work today. I ran down the stairs, because it had to be faster than the elevator and I'm too impatient to wait for an elevator anyhow. Once in the ER, I was directed to the visitor area. The kind lady opened the door for me with her badge and said "See that Exit sign at the end of the hall? Once you get there, she's in the third room to the right." As I walked through the bustling ER, I envisioned Lori sitting on the stretcher with tubing up her nose providing oxygen, talking on her phone. I thought, "As soon as I walk in the room she'll start telling me what I need to do in her big sisterly way."
Shaken from my day dream, a nurse in black scrubs darted out from what seemed to be nowhere and pulled the curtain closed in front of me. Wow, I know they are all about protecting patient’s privacy, but come on, she is my sister. "Who are you?" Asked the steady and firm nurse. I explained my relation & stated my name as if under interrogation. "What do you know about what happened?" asked the nurse. "Well, my sister was having shortness of breath & called 911" I said as I envisioned pushing the nurse out of my way. "Aren't you taking HIPPA a little far here lady?" is all I could think. "A few things have happened since you talked to your sister". Oh no. My heart sank. All I could do was stare at her with saucer sized eyes & wait for the details. "When the paramedics got her into the ambulance, she went into cardiac arrest." Asystole. The worst heart rhythm possible. "They did CPR & after 5 minutes they revived her and she was in a-fib with rapid ventricular response. This is what her heart looks like now" she said as she held the EKG in front of my face. Wow. I haven't read heart rhythms in years, but that QRS wave looks an awful lot like a Bundle Branch Block, generally a sign of a more severe heart attack. "She has a tube in her throat for an airway & she is unresponsive" the nurse continued to spew bad news at me. She opened the curtain and there my sister lay, lifeless on a stretcher. Yep, the nurse wasn't kidding, there's a tube in her throat. In fact, wires and tubing were plentiful. I started to feel chest pain myself. Is it possible to have a sympathy heart attack? Or was this merely a symptom of my own breaking heart?
A few minutes seemed an eternity, but I knew it was time to call my siblings. The nurse gave me the okay to use my cell phone in the room, but afraid that Lori would hear me, I went to the other side of the room. Fighting back the tears, knowing I had to be strong for them, I called my brother and explained what was going on, the whole time my eyes were fixed on Lori's motionless body. Then I called Joann, who quickly became upset. As I was explaining things to Joann, a tall man with thinning red hair walked in. Dr. So & so (as if I'd remember a name right now) introduced himself & I hung up with Joann. "Your sister is in bad shape" he said with empathy clearly evident in his blue eyes. More chest pain for me. Good thing there is an empty stretcher in here, I may need it. "She's acidotic & has a glucose level over 600. It was over 800, but has come down some. Her heart rhythm is abnormal and her blood pressure is very low. She has signs of congestive heart failure. I would expect to see all of this going on in an 80 year old, but not in a 55 year old." I know Dr. Red-hair had a lot more to say & ask, but the mind tends to go blank when overloaded with this kind of information. Again, my eyes stayed fixed on Lori's body, which has yet to so much as flinch. "We're going to transfer her to ICU in a few minutes" the nurse informed me. Feeling as though my knees would no longer allow me to stand, I sat back down in the chair across the room. I listened as the nurse gave report to the ICU nurse. Information I should clearly understand with my medical background made absolutely no sense to me. It was as if she were speaking a foreign language. This happens to other people. Not to my family. I sat, frozen, my eyes fixed on Lori as my mind willed her body to move.
The nurse informed me that I would not be able to see Lori for at least 45 minutes as they assessed her in the ICU. I stumbled outside and walked aimlessly, trying to figure out what I needed to do next. You know in the movies when you see a person walking and they are unaware of what is going on around them, deafened to all sounds? That was me. I saw a bench in the parking garage and sat down, placing Lori's purse on the bench next to me. "I need to call her work", I thought. Damn, I don't even know the name of the company she works for. I looked through the 2 wallets in her purse 3 times each before I found a business card from her work, which was in the front slot of wallet #1. Not surprised that I missed it the first 3 times. I don't know if I could have found it if it jumped up & bit me. I called her work & informed her supervisor what was going on. Then I sat there, on the hard bench in the parking garage for 30 minutes, staring at the opening & closing doors leading into the hospital, wishing I never had to go back in, but knowing I had to.
Somehow I found my way to the ICU. Don't ask me how though. I floated there for all I know. I walked through the ICU doors after the sweet little lady volunteer waved her badge in front of the box on the wall. An eerie feeling swept through me as I remembered the last time I was in this ICU, when my best friend's mom was a patient here. Overwhelming emotion flooded through me. Scanning the room numbers, I finally saw room 16. As I walked closer my chest began to hurt again. I walked in the room and approached Lori in her new bed. I touched her cold, pale skin and couldn't hold back the tears anymore. Still, she lay lifeless and I still believed I could will her body to move. No such luck. With once again weakened knees, I walked to the chair by the window and sat down. I couldn't take my eyes off of her. "Open your eyes dammit!" I shouted in my mind, apparently not loud enough for her to hear. Sometime later, Lori began to move. Not in the way I willed her to, but in jerking, seizure-like movements. This can't be good.
At some point the nurse directed me out to the waiting room. Thankfully, my husband Chris had made it here by now. We sat in the waiting room for a length of time I do not recall, waiting for the ICU doc to come out and talk to us. In walked a tall, thin woman who looked incredibly attractive with no makeup on. I stared into her eyes hidden behind thick, black framed glasses. "I'm Dr. So & so" she said, (really, who can remember a name at a time like this?). I listened as she gave me another speech about what bad shape Lori is in. As she painted the bleak state of affairs, I couldn't help but feel grateful that I don't have to deliver news like this to patients or families. I don't recall all she said. I can't remember a name right now, you think I can remember all the details here? I must paraphrase: "She was without proper oxygenation for a while, she is having seizure like activity, which is generally a bad sign, we don't know how well she will recover neurologically" the doctor empathetically informed me. "Do you know what her wishes are?", "If you have family to call, you may want to let them know in case they want to get here", "Is she religious? Do you want a priest to pray with her?" The attractive doctor with thick framed glasses was full of questions I was not fully prepared to answer. "We will do everything we can" she confidently stated. "There is a procedure called the Arctic Sun protocol that we do for patients in this situation. We will put her in a therapeutic hypothermia in hope of preserving brain and heart function. We cool her body down slowly over a few hours and keep her at the goal temp for 24 hours. Then we slowly rewarm her body temperature and wait to see if she wakes up neurologically. There are no guarantees, but this is her best shot at recovery." Envisioning Lori's lifeless body, I knew we had to do whatever we could. So a few hours later, when her body stabilized, the cooling began. And so did the waiting...
Published with permission of Lori Poma
