Passed out while at work…

It was Monday morning, July 12, and I was ready to start back to my internship for a full week since returning from my total thyroidectomy. Today was now two peeks post op, and I could remove my steri-strips today. I was having a hard time determining if I should remove them before or after work, and finally decided I would wait until I came home from work. Well, as I realized, not all things go as planned.

It was about 10am, and I was in a patient’s room in the PICU with my Clinical Instructor, an Occupational Therapist, an OT student and the patient's nurse. The patient’s room whom I was in, was intubated and sedated, so I was delivering Passive Range of Motion (PROM) to her lower extremities. I had completed the stretches on her right leg, so I started working on her left leg. While I was starting to stretch her ankle, I started to feel lightheaded, have tunnel vision and cold fingers. With this, I tried to stay calm and mentioned to my CI that I wasn’t feeling well and needed to sit down. I walked over to the high back nurses chair in the room and sat down. About this time, I was starting to loose more vision, and heard my CI mention how she was going to grab some juice for me. In the meantime, the nurse had noticed all the color in my face had disappeared and my lips were white. She then decided if I were to pass out, it would be best not to do so in a chair that is about 5 feet off the ground. So she walked me over to the bedside couch, and in the meantime she mentioned that I lost consciousness for about 10 seconds.

The next thing I remember is seeing my hands on the couch. I mentioned that I thought I was still on the other chair. I was a little “out of it” to say the least. By this point, Kat, my CI had returned with some apple juice. I started drinking this and realized that sweat was dripping like crazy down my face, chest and back. Since the nurse, OT and my CI were talking about how long I was out, and my color, I asked if my color had returned. With a concerned chuckle, they said, “Nooot really.” They then decided to take a blood pressure reading, which read 57/30 (Well, this is not too good…). The next thing I realize, is there is a full team of residents, PICU nurses, and security in my room. I thought that they were doing rounds on the patient whose room I was in and almost called out to them “Sorry I am in your way. Do not mind me, keep doing what you need to with the patient.” Little did I know that I WAS the patient now. They had called Rapid Response on me and they were now lying me back on the couch, raising my legs, testing my blood glucose levels, listening to my heart and breath sounds, starting an IV (which later on hurt because my veins in my hand were not well inflated, but at the time I felt no pain) and drawing blood.

They had seen my steri-strips and asked me about my surgery. I mentioned to them that I have been struggling with my Calcium levels and that today I had noticed an increase in my tingling. So the next thing, there is a gurney in the room, two security officers and they are talking about transporting me to the next door hospital (Hospital of the University of Pennsylvania) via the underground tunnel. I looked around the room and saw the Rehab Physical Therapy Supervisor standing with my Clinical Instructor, talking about getting my items out of my locker downstairs.

So security is transporting me out of CHOP, through an underground tunnel (which reminded me of something similar to the underground railroad system) and to a pair of elevators that were painted like a rainforest jungle. One of the PICU nurses that was with me mentioned that I would soon realize that I was no longer in a children’s hospital (and boy was she right!). The atmosphere was totally different. When we arrived in the Emergency Department at HUP, there was more security officers and nurses awaiting my arrival (talk about an entrance). This was nice, because I didn’t have to wait to be seen.

So while I was there, they took a lot of blood and urine specimen to determine a reason as to my fainting. I had to go through my whole patient history, medical background and recent surgery. I also had to share with them that over the past 2-3 days, I had been having increased “bowel movements” (ok, I will be mature and say the word I really hate, “diarrhea”). Then all the nurses and attendings were gone for some time, awaiting my results.

It was incredibly nice that the physical therapy department at CHOP ensured that I was never alone. They made sure there was always one supervisor with me at all times. This helped me feel more at ease. It didn’t help that the ED was in the basement and I could not get any signal, so one of the supervisors would take my phone out and informed my parents of what was going on.

Then the attending came back, saying that my calcium levels were low, as well as several of my electrolytes (potassium and magnessium) and they would not feel comfortable with me walking out around society with levels this low, therefore the were going to admit me and give me fluids and monitor my response. Great. I have been out of the hospital for only 10 days, and here I am going right back in. So my supervisor called mom back and informed her and mom decided that she was going to find a flight out of Louisville that afternoon and fly into Philadelphia that night.

If I thought a Western Philadelphia Emergency Department was interesting, I was unprepared for the rooms that were upstairs. Now, this hospital is number 9 out of the top 10 hospitals in the nation, so it really is a nice place (medically) but the building appeared very old and they were squeezing a lot of things into a small place. (But then again, nothing could really compare to the Park Towers at Baptist East!).

So the rest of the day consisted of being admitted into my room, being seen my a team of endocrinologists, a team of internal medicine doctors and my nurse. By the time I got to my room, it was about 4pm. By then, one of the supervisors was out getting me lunch and then they were switching shifts of staying with me. It was really nice to have them around, because nothing is worse than being in a hospital, than if you are in a hospital 670 miles away from home and family. My room was not too bad. I had a roommate who was very sweet. The things that I thought were funny, was that I only had three channels on my TV (fit TV, ABC family, and some MSN news like channel). If I wanted more channels, I would have to pay via credit card to receive more. Also, my phone in the room could receive free calls, but in order to make calls, I needed to pay via credit card. How interesting…

The evening actually went quick. I had been receiving a plethora of fluids (IV, potassium, magnessium, calcium) because the overall reason they thought I fainted and or felt the way I did was due to dehydration and depletion of my electrolytes secondary to the diarrhea. So on top of my imbalance in calcium, I took myself to further levels. The Rehab supervisor was now with me and she generously went back to my room and picked up a few items for me as well as dinner. She stayed all the way until mom was in a cab at the airport (around midnight) before she went home. She was incredibly sweet.

Mom had arrived and it seemed like it was 10 days earlier with the two of us living in the hospital. (Sad thought, actually). Mom and I received the results of my blood tests and it seemed like my levels were responding very well to the fluids and my levels had climbed back up – yay.

So the next morning, the team rounded on me and decided to give me a little more fluids and send me home later that day. This was a good sign, since it took me several days to have my levels return to baseline before. During the day, I was visited by the other PT student at CHOP who came in on her way in for the morning. It was nice to catch up, because we were initially planning to grab lunch together on Wednesday to catch up – so I guess this took its place. And then around lunch time, my CI and one of the PT supervisors came by. It was nice to be far from home, yet still have visitors. Overall, the experience was a good one because the results turned out well. Mom and I made sure to find our own fun in the breakfast and lunch they brought us (they brought both of us a lunch plate that she ordered, which was handy so she didn’t have to walk to the cafe)!

I was discharged around 5:30 and transported down to the main entrance where mom had a decent adventure using the cab hotline to catch a cab. We took the cab about 6-7 blocks to my place and the two of us ventured up to my small room to crash. That night we picked up Italian from up the street and chatted the rest of the night. It was nice to see her again, since the last time I said bye, I was unsure of the next time I would see her. So overall, it was a bittersweet time. Neither of us were happy about the situation that required her to come up here, but we were both happy to have the time to spend together that we otherwise would not have had.

So I thought my excitement for Monday, July 12th was going to be taking off my steri-strips…BOY was I wrong!