Pericarditis – my admission diary

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26th December 2013 (written on the 27th)

On the 22nd December I started feeling something strange in the middle of my chest.  I shrugged it off l just like I would an idiot’s comment behind my back.  By evening it became uncomfortable.  I had dozed off in the afternoon.  In the mean time someone had broken into our house and pushed some 80 grade sandpaper down my throat.  It was on fire.  Acid reflux was my diagnosis!

Omeprazole and a binge of Maalox only made it worse.  In the following 3 days I just went from bad to worse and slept sitting on the armchair.  Did I just say I slept?  A total of three hours over three nights.

Yesterday was not good.  It was the first time ever that I ate less than an ant on Christmas day!  The central chest pain started radiating to the left hand side.  Breathing was laborious.  I had a feeling of impending doom……but the stubborn me had decided, hospital tomorrow.  So here I am!  Well, why did it take me so long?  Putting it very simply, because I knew the bloody drill.  I am a nurse and I have been admitted last year with a different kind of chest pain.  It was pleurisy.

  • Bloodwork, venous and the so-fucking-painful arterial
  • Chest x-ray and electrocardiogramS (a lot of those)
  • A scan of the pulmonary artery
  • Pain meds (Hopefully)

Well, most of them were done in Urology.  Huh?  What does the Willy Ward have to do with chest pain?  Well, I went in to say hi before I went down to A&E and one of our residents would not let me out of the ward before they ‘prepared’ me for A&E.  So a lot of tests were done before I was (or had to be) wheeled down to the A&E department.  The rest of the tests were done in a jiffy but, I was not clear for takeoff yet.  I needed an echocardiogram now.  It was done by one of the Emergency Physicians, a twin brother whom I have known since he and his brothers were junior doctors.  We had a result there and then: a small pericardial effusion, nothing serious.

So the Pulmonary artery was clear and the pericardial effusion was nearly insignificant.  So, where is the pain coming from?

I’m eventually transferred to a cardiac medical unit, constantly wired up and monitored.  The nursing staff there, wonderful.  My pain, impressively worse.  Everyone in the six bedded room was by now asleep except the lady just opposite my bed.  She must have been eighty something and was constantly surrounded by a buzz of grandchildren, some of which were my age.  One of them was extremely persistent and they let her stay a bit longer.  The mumbling from the opposite side was as constant as the bleep bleep bleep of her monitor, but it bothered my very little.  The major let down was that again, sleep would not come…..and I was by now exhausted.  The pain, ugly.  The bedding….aaaaargh.

Some time that night, whilst the guy on the left was snoring his way to gagaland, an experienced nurse (Joe) came by.  I think that looking at the slave monitor at the nursing station he must have noticed that my heart was speeding at a 140-150bpm.  He understood that I needed to be reviewed.

1.00am – two junior doctors are examining me….and I’m getting slightly pissed.  I am a nurse and DO NOT want to be a difficult patient.  I understand that they have to do this but I need something for the fucking pain, and I need it yesterday.  I get it at last – sublingual glycerin trinitrate.  I doubt it will help me but since I’m in BAD PATIENT MODE I say so.  In 30 mins I feel better already.  I am seen by a senior doctor who prescribes some pain medications (Ibuprofen).  (I have met one of them doctors later on when I resumed work and told him that his decision was good, I was wrong, I felt better, I was now sorry.  Good for you reader to know that I took this off my chest as well.)

I look up to the monitor and notice that my heart rate slowed down to 90bpm.  I’m tired and finally, the bleep bleep bleep is distant, faint, gone.

“Kevin…..Kev…..Kev”  I find a young smiling nurse.
“Hi.  (I smile but what I really want is to grumble, turn round, fart, and dose off again)  “What time is it please?”
“It’s 5am and you’re due for your pain meds.”
“Oh thanks!  I’ve had some sleep at long last.  I think I’m off to the shower.”

27th December – Day 2 

“I’m very tired.  I woke up at 5.30am.  Managed to sleep very little for the past four nights.  I think that even though it was the worse pain ever, the worse thing about this admission is not the pain.  It’s being away from home, not being able to see, play, hug my son, Karl.  God I miss him.  I spent the past 2 days at home not lifting him at all because of the pain and I felt so guilty already.  In the past 15 months I always slept home with Karl except once when I had an ugly cold and then yesterday.”

I have been out of night shifts for more than two years now.

“I’m in pain, uncomfortable, and missing my wife and son.  Fuck you Pericarditis.  Fuck you.”

11am I have just been seen by the Consultant Physician.  She specialises in acute medicine but is also a rheumatologist.  She said I can go off the cardiac monitor.  Non monitored bed.  No wires.  No more feeling like I’m a suicide bomber ready to release the dead man’s switch.  Hopefully I get transferred to my area, Urology.

Yessss, green eyed Nurse Sarah managed to convince the bed managers to transfer me to Urology.  Uro, here I come!!!  Wait, not before a big lot of blood work is drawn.

11pm – Surprize, surprize.  My wife is on duty so she arranged for her parents to drive down to hospital and guess who’s with them?

 Kaaaaaaaaaarl!!!!

I’m in tears as I hug and kiss my boy!  Albeit for a short period of time, we are together, again.  I forgot all about the pain and I’m on top of the world.  Karl has enriched our life to a point that without him we’d be in monotone.

28th December

Nothing but some blood tests.  Hopefully I will be discharged next Monday, 30th.  The pain is continuous but considerably less.

Karl was here again.  He spent some time in my lap watching the Minions, The Egg birds, and Mr. Snail on our tablet.

10pm – I walk round the ward.  3 women sit and chat.  Three others I cannot see but Lord, can I hear?!  A couple of empty beds – that’s a rare occurrence in this hospital!  Back into my room, four men.  I read, one sleeps and snores the hell out of our tympanic membranes, one stares at the wall, the other at the ceiling.  Don’t Maltese people love to waste their time?!

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30th December – The long awaited day!

I was told Saturday that today I’d be discharged home.  The medic taking care of me would not be here but I’d be seen by her deputy.  So it was.  Everything seems to be getting better.  The pain subsiding.  I am to await the review by the Rheumatologist who has a special interest in Reynaud’s (could they not notice that?!).  Downside: I KNOW that the chances of the Rheuma man being informed about me today and actually visiting me are thin at best.

2pm – The chances of being reviewed today are getting thinner, very faint.  I’m pissed, very pissed.  I’ll have to sleep in today as well.  Well, there’s no point in spending my energy on being pissed off.  BUT, (stubborn me is at it again) tomorrow I’m going home, with or without the review.  I’m not spending New Year’s Day in hospital.  Not even if I have to crawl home.  Bright side, I’m eating some homemade soup tonight!  Yaay.

The soup was super!

31st

I was reviewed by the Rheumatologist.  What a review!!  It was impossible for me not to compare to the first examination of the other Consultant under whose care I was previously (not previously during this admission but years before when I first noticed the Reynaud’s signs).  Oh my, what a difference.  Such a detailed physical exam.  He went through all the blood tests and ordered even more, discussed with me both the treatment options and the way forward, he was straight to the point when it came to a diagnosis.  “Well, from what we see here I am pretty convinced that this is SLE”.  He spent over 30 minutes there together with another doctor, a specialist nurse and a pharmacist.  They were not in a hurry (or at least did not show), I was not a number, I was not a bunch of signs and symptoms, I was not a load of results, I was me and I felt really good about the change.

This admission in a nutshell:

Diagnosis of SLE
New Rheumatologist and I like his ways!
New treatment
A big lot of pain
Separation anxiety and loneliness
I read through ‘A thousand splendid suns’
Kept this diary
Rested a lot….and I realized that I needed it.

Kev Sign

4 thoughts on “Pericarditis – my admission diary

      • kev may i cal you kev ? 🙂 ..im a 2nd year student maria cesare ….we soke on the phone about dad ..last week hes doing well and cath should come tomorrow thanks for the help kev ..ive been reading your blog ….and i must say i have tears in my eyes …i know that we all have a cross to bear but belive me i understand and im so proud of you facing it …last year my back gave up on me and i spent 5 months in a chair full of beds sores …from not being able to get up and move …im not bad now and have returned back to school …nursing is my dream it took me 20 years to get here and im not turning back now …pls keep writng on your blog it gives me hope cos i know deep down i wont be able to work in a ward like i have always deamed of ….but aleast ill be a nurse ..thank you kevin god bless …maria cesare 2nd year diploma nursing student ….

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