Welp, it's happened again. After waiting longer than I should have, I called the advice nurse about my increasingly uncomfortable condition. She said I needed to be "seen" within the next four hours; I should go to Urgent Care or the ER. Mkay? The nearest Urgent Care run by my HMO was 47 miles away. There is a Primary Care run by another outfit in my little town, and as it happens they take my insurance, so I've been able to go there for immediate care, but not this time. They wouldn't be able to see me for at least 24 hours. Low on staff, high on patients. Mkay?
So the choice was the Urgent Care way out there. They could see me in a couple of hours.
I got there and was informed they were running behind, but they'd get to me as quickly as they could. It was only about an hour later (c. Noon) when I was called in to the examining room. BP and temp were OK; I was alert, coherent, ambulatory -- with some difficulty. Described symptoms and problems.
"Dude, you need to go to the ER, stat."
Oh fuck. I hate the ER. Nothing but turmoil, stress and strain, lack of care, waiting and waiting and waiting while the place fills up with more and more suffering, disease, madness and pain. What is the point.
The nearest ER as it happened was another 15 miles or so away, and the Urgent Care said they would call over and let them know I was coming, and they said it would probably be less of a wait there because they would probably have fewer patients.
Mkay. We get to this ER, and truth was there were hardly any patients in the waiting room. Five, maybe six. Most had already been triaged. Some had been seen and were waiting for test results.
It was calm. Very little obvious suffering. Quite a few people came in while I was waiting for triage (c. 30 min). Nearly all were members of one family there to see their relative who was being treated inside. They were allowed in two by two.
Triage was straightforward, and I was told to wait in the lobby. They'd see me inside as soon as they could.
More patients came in while I waited. More visitors came to see the one special patient as well as other patients in treatment. Some of those who arrived were in really bad shape. Extreme pain, unable to walk, one couldn't even sit and her wheelchair ride was torture for her. Some appeared to be having strokes or heart attacks.
And believe it or not, all of those I saw in serious distress were treated promptly and compassionately by the very young staff, none were left to linger unattended. Some were treated directly in the lobby, others were wheeled or ushered into the ER treatment areas, but none were neglected.
This was astonishing. I have never been in an ER where staff did not neglect the patients, ignored their suffering, even disparaged those who sought treatment. I have never been in an ER where prompt treatment of severe conditions was the rule. I have been in ERs where staff had no interest in or consideration of patients waiting, and where patients died while waiting without any care at all. The cynicism and contempt for patients in some ERs I've been in has been off the charts, and it's happened so often, in so many different ERs in California and New Mexico, I took it for granted as just the culture of these places. It's outrageous, but there you are.
This was an entirely different situation altogether. I didn't need immediate treatment, though I would have appreciated the pain medication I eventually received had it been administered while I waited. I got an xray within an hour of arrival, but had to wait to be "seen." My distress was minimal compared to some of the patients who sought care, and everyone who needed immediate care received it compassionately. Those of us who had to wait mostly did so with equanimity; so many others were in much worse shape than we were.
After about 5 hours waiting in the lobby, I was called in to the treatment area and assigned a room where I was introduced to the nurse and CNP who would be treating me. Both were kind and positive. As it turned out, the nursing staff would have a shift change in an hour, but the CNP stayed with me throughout.
Treatment would take just about 8 hours. During that time, I received a CT scan, pain medication, Ringer's lactate, anti-nausea and anti-inflammatory medication, and two different treatments for the condition I was there for. Neither was fully effective while I was there, but I was discharged with a prescription for another medication to take if the ER treatments didn't work within the next 6 hours or so.
When I read the after visit summary, I noticed that the CNP had missed a finding on the CT scan -- I had a hernia -- which which was probably a contributory or precipitating cause of the problems that sent me to the ER. Oh. I suspected the hernia, and I pointed out the odd swelling and pain in my groin, but it was not recognized by me or anyone else for what it was at the time. The CNP said it was "gas". And I saw on the CT scan report that there was considerable build up of "gas." But missing a hernia with obvious symptoms (I realized later) was odd.
The treatments that were administered in the ER did work effectively the next day at home, so that part of the problem was taken care of, thankfully. The hernia has not been addressed yet, though the swelling and pain are not as severe.
It seems to me, I've had this condition before -- a hernia, that is -- and after several weeks, it self-repaired. We'll see. It's not fun, but it's bearable. Primarily it limits my movement.
What I can say about the overall experience in the ER this time is that it was worlds better than any ER I've been in (for myself or on behalf of others). Even though part of my problem was missed by the staff, or perhaps not missed but dismissed as not that important, I was treated with consideration and respect, was given needed medications and treatment, was tested and imaged to a fare-thee-well, and discharged with explicit instructions and medication prescriptions with orders to return promptly to the ER if none of it worked.
Well, it did work, and I'm grateful.
Now to deal with the hernia... 🤪
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