Friday in the ER

If you haven’t read “Thursday in the ER”, please scroll down to that blog entry before reading this one…

Let’s pick up right where we left off.  It’s midnight, it’s now Friday, and we have just been put into an ER room…  Blood work, blood pressure, temperature, vitals, listening to my chest and lungs, checking for swelling of the ankles, hooking me up to an IV for saline and possible medications.  Doctor #1 walks into the room and begins his routine of asking basic questions, all of which I already answered for the triage nurse.  He leaves the room, we presume, to wait for the results of my blood work, but we will never see or hear from Doctor #1 again.  It’s now well past 1 AM, I am laying on a hospital bed with a saline drip in my IV, and Florence is sitting on the stiff chair in the corner of the room.  Doctor #2 comes in around 3:45 AM to discuss the results of the blood work and tell us what they think is going on.  Chemotherapy kills the things that need killing (like a small nodule on the lungs and microscopic entities in the blood), but it also kills the things that we like to keep around (like white blood cells that help your body fight off infection).

One main component of white blood cells are the neutrophils, which serve as the primary defense against infections by destroying bacteria in the blood.  When your white blood cell count is reduced, that also reduces your Absolute Neutrophil Count (ANC).  When your ANC is below normal, the condition is called neutropenia because the body is at a greatly increased risk of infection.  My ANC was extraordinarily low, so I needed to be placed in protective isolation.  The isolation is designed to protect me from everyone else, not to protect everyone else from me.  In the ER, this means that they keep the door closed, I have to wear one of those surgical masks, and anyone who enters the room has to wear a mask too.  It also means that they need to admit me into the hospital for observation, to give me antibiotics to kill off the infection, and to give my body time to grow its ANC back to normal levels.

Half an hour later, Doctor #3 comes in to confirm that they are admitting me and to let me know that they have begun the paperwork process to get me transferred to a room upstairs.

As dawn breaks and the East Coast is starting to wake up, Florence and I are still sitting in the ER, I have managed to sleep for an hour, and Florence may have dozed us for fifteen minutes.  We call my Mom who is at our house to ask her to take care of Sadie for the day.  We call my Dad who is at his house to let him know that we are still in the ER and he makes plans to join us there later in the morning.  After my Dad shows up, we meet Doctor #4, an incredibly helpful infectious diseases doctor who does a fantastic job of explaining what’s going on within my blood system and how they are going to attack the infection.  He’ll be watching me for the next couple of days as I recover from the infection and my ANC rises.  He tells us that we should plan to be in the hospital for 2-3 days, and that they are working to get me into a private room (because I need to limit my exposure to other germs and people).

Hours go by, I am sitting on the hospital bed working on my laptop, Florence is sitting on her chair working on her laptop, my Dad is sitting on his chair reading the paper and getting us stuff to eat and drink.  Seriously, for hours, we treated the ER room like it was our personal cubicle.  And, the ER was getting crowded.  Apparently, the hospital is filled to capacity (which explains why I’m still not in a real hospital room), but the ER is also filled to capacity.  In fact, the ER halls are filled with other people laying in hospital beds.  Imagine back to the days of ER (Clooney, Wyle, etc.) whenever they did one of their “mass tragedy” episodes and they had so many people that the hospital was literally bursting with patients…

Late morning, we meet Doctor #5, who is a member of the oncology team at Sloan Kettering, so she is much more familiar with my records and has already spoken with my oncologist.  She too was helpful in giving us information, but unable to help us get a room.  Three hours later, Doctor #6 comes in and is completely useless.  In fact, she was more of a disruption than anything else because I had to put a work conference call on mute so that I could deal with her.

So, let’s recap where we are.  It’s now 2 PM, we have been sitting in this ER room for 14 hours, they’ve been trying to admit me into a real hospital room for the past 10 hours, the ER is literally overflowing with patients and I have seen SIX different doctors.  While some of the doctors did add value and provide new information or perspective, every single doctor went through the same routine of listening to my chest and lungs and then asking all the same questions about my cancer history, my latest chemo treatment and my symptoms.

Finally, after numerous false starts and countless statements of “you’re going to be in a room in five minutes”, I was moved up to an actual hospital room at 5:45 PM, a mere 21 hours after my arrival at Overlook Hospital for 21 hours!  And thus ended my Friday in the ER…