Sunday, February 20, 2011

Urban Truths of the Emergency Room

If you thought the night at the hospital with Doogie Howser waving his miraculous Panadol at me was a joke, then brace yourself  for this post.

After Lance first begged me to take him to the hospital, we presented at Emergency EIGHT times over the next month. We were desperately waiting for an appointment with the podiatrist, and then our beloved endocrinologist - the man who diagnosed Lance back in 2002, and who had been seeing Lance every 3 months ever since.

Until then, we were on our own. Lance, Google, and Me.

At one of the eight A&E admissions, a doctor told me that Naproxen, a drug used for period pain, could be useful in settling down this "mysterious pain". She wrote him a script and told me to give it to him 3 times a day. It did nothing.

The second time, a doctor questioned me at length for forty minutes, asking me if my separation from his Dad could have been a trigger for this "mysterious pain". (We separated in 2003. At this point, it was late 2008/early 2009.) After he psycho-analyzed me, he too presented me with a bottle of children's Panadol.

The third time, a very junior intern asked me if we had considered acupuncture. I told her that at this stage, I was willing to try anything.

Big Mistake..

 The moment I mentioned that I would consider it, she had the name of an acupuncturist written on a piece of paper and then practically pushed us out of Emergency.

The forth time, we were seen by a doctor whose Mother language was not English. He was more confused about the pain than I was.

The fifth  time, I called the ambulance.I knew that the paramedics would get him "behind the scenes" and we wouldn't have to wait...wait...and wait some more.  Lance was so overwhelmed with pain that he couldn't speak. He was hyperventilating, desperately communicating to me with his eyes. Those beautiful baby blues expressed so much fear, so much pain, so much despair. My child was averaging four hours of broken sleep a night.

 All I could do was hold him tight.

The paramedics appeared - one male, one female, and one young female student who was doing the "rounds" with them. They appeared very confused as to why Lance was in such a state when his blood sugar levels were normal. I explained the story so far as consisely as I could to the male paramedic. He said, "It sounds like he has an all over body neuralgia related to his diabetes - that's what it seems like. One thing I know...

"He's certainly in distress, aren't ya mate?"

He gently patted Lance's head, and stroked his arm while he asked me some more questions.

The pressure to perform was on for the young student ambulance officer. The male paramedic asked her what she thought was suitable treatment for Lance.

She asked me if Lance had ever had the "green whistle", and suggested it would alleviate Lance's obvious distress and anxiety.

Lance hadn't ever had this kind of treatment. He was instructed  to inhale and exhale deeply whilst sucking on the end of the whistle. Within about two minutes, he seemed much more relaxed, and maybe even slightly dazed.

The female student paramedic asked him if he felt any better.

He didn't reply.

She gently shook his leg and said, "Lance? Do you feel any better?"

Lance gasped, as if he had just been woken from a nightmare. His face was etched with sheer terror - I will never forget how horrified I was when my gentle, sweet little boy proceeded to punch her repeatedly several times in the arm, with every bit of strength he could muster.

I held his little hand back - his knuckles were white, he was clenching his fists with such might.

The male paramedic asked the student if she was okay. She seemed shaken, but she said she was alright.

(The other female officer stood back, observing, and writing down notes.)

Student Paramedic then asked me if Lance had any behavioural issues that they should be aware of, or if he could be a danger to them or to himself.

I replied, "None, and NO.  How he reacted to you was obviously a reaction from the medication he just inhaled."

She shook her head repeatedly, and quickly informed me that she had never witnessed such a violent outburst, and that "people are usually relaxed and quite sedated" afterwards.

(I wanted to ask her exactly how many times she had administered the "Green Whistle" to be able to make such a claim. I chose to bite my tongue, though. These people, especially the male officer, were so kind, and sympathetic - I could tell they were genuinely concerned about Lance's state.)

It was decided that Lance would attend the hospital via ambulance. After the medication wore off, he grimaced and asked the student officer, "Did I really punch you or was that a bad dream?"

"It was for me!" she replied.

Mama Lion didn't appreciate that comment, and Student Paramedic obviously knew it, by the daggers I shot in her direction.

"It's okay mate, these things happen. I've had worse." she added.

The fifth visit, Lance was fortunate enough to be examined by the Paediatric Registrar.She listened very carefully, and spend a long time reading over the notes her colleagues had made.

She was the very first person who found it odd that this sudden onset, severe, neuropathic pain commenced after the commencement of insulin pump therapy. To her knowledge, there was no connection though;she just voiced that it seemed strange. She "pulled some strings" and got Lance an emergency appointment with the hospital registrar for four days time. She also wanted Lance to start on a drug called Carbamazepine - an anti-convulsant and mood stabilizing drug. I was initially confused as to why he would need to use anti-seizure medication for pain, however, she explained that it was often used off-label for many severe pain disorders. I agreed, and he started that night. We were told that it would take at least two weeks before we knew if there would be any signs of any improvement.


Would we still be living this nightmare in TWO WEEKS?

The kindness shown to me by that Paed Registrar reduced me to tears. She was a mother herself, and she was concerned, even though yet again, her examinations of Lance found him to be neurologically intact. She promised me that she would write a letter of support to the Hospital Paediatrician.

The other times don't warrant mentioning. They were such a waste of time and energy. In the end, Lance begged me NOT to take him to the hospital anymore.

"If I have to have this pain, I just want to have it at home. No more hospital, okay Mum?"

"No more hospital, sweetheart."

Those words haunt me to this day. Mothers aren't supposed to make promises they can't keep.

1 comment:

  1. I continue to cry through your story. Lance was sent to you for a reason. Your strength and determination inspire me.

    Much love to you!