“There’s your problem right there,” said the hospitalist as he
lifted my left elbow, in my newly occupied room at St John’s hospital, during
my admission history and physical. As I looked at my elbow, I saw a sight
that wasn’t there 2 hours earlier in the Emergency Department. My left
elbow had dusky, purplish discoloration and was swollen to approximately three
times its normal size. Finally, what was happening to me started making
sense. However, what was about to come, I never would have imagined.
It was Wednesday, December 1, 2010. Early that morning I had
awoken with night sweats, shaking chills, and a high fever. With my
wife’s help, I headed to the bathroom thinking my symptoms were caused by the
Betaseron injection I had administered prior to going to bed that evening.
These symptoms are not uncommon side effects to patients taking
betaseron. I had become all too familiar with them over the previous
sixteen years, however, occurring less frequently the previous decade or
so...and less severe.
I crawled back to bed, thinking that sleeping the few hours left till
sunrise would help me recover my strength. It didn’t. When I woke
at 6:45, my symptoms had worsened. “Maybe a few more hours of sleep” I
thought. I informed work I was using a sick day and went back to bed. I
woke up at noon feeling even worse. Unable to open my eyes, let alone get
out of bed, I knew it was more than a reaction. Something bad was
happening. My wife called an ambulance.
In addition to an ambulance, two fire trucks and three police cars
came I’m told. I have no recollection. Despite not being able to
open my eyes, I mapped the route we took by the turns the ambulance made and
was able to fairly accurately tell where we were. Even in my altered
state, the fun loving jokester in me persisted. When the ambulance was
almost to St. John’s Hospital, I asked for the siren to be turned on.
After all I WAS in an ambulance.
Being brought in by ambulance to the emergency room is a great way
to avoid the typical several hours ER waiting room wait. Though I don’t
recommend it.
Once in the ER, the scripted, controlled chaos of the medical
staff began as it does for any patient brought in by ambulance. IVs were
inserted into my veins for hydration and potential medication administration.
A blood pressure cuff was strapped to my left arm. A pulse-oximeter
was applied to my finger to monitor the oxygen content of my blood. EKG
leads were applied to my chest to monitor my heart rhythm. Chest X-rays,
urine, sputum, and blood were obtained. All to “rule out the usual
suspects”.
As I lay on the gurney in the room, waiting with my wife for my
test results, I began noticing a dull, intermittent irritation to my left
posterior elbow, the intensity and caliber of which worsened seemingly
unnoticed as the hours past. By early evening, the dull irritation
transformed into a sensation of hundreds of tiny little needles, rapidly
jabbing into the skin of the back of my elbow.
“Uh, Dr. Yanuck, are you feeling okay?” a nurse asked. “Aside
from being on a gurney with IVs and monitors strapped to me in an emergency
room, I’m doing great.” my jokester replied. Why do you ask?”
“Is your blood pressure usually 90/60?”
“Ruh Roh.” This was definitely no side effect.
-To be continued-
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