Crash #ReedsyTalk

Trigger warning: This short story speaks of chronic illness and depression. It is deeply personal and fiction based on my life.

Autonomic dysfunction: A condition which affects your body’s ability to maintain its automatic functions including, but not limited to, blood pressure, heart rate, temperature, digestion, breathing, and tear and sweat production.

Crash

“Do you know where you are Mrs. Lynn?”

The lights were bright in my vision. I could barely make out the room around me, but I knew that smell. “Smells like a hospital.”

“Do you remember how you got here?” the nurse questioned.

“I… I remember getting up to do something and I felt nauseous and dizzy. Now, I’m here.”

“You fainted. You were driven here by ambulance. I believe your family should be here soon.” She paused and started clacking away at the computer mounted in my room. “I am going to ask you a few routine medical questions. Are you feeling up to it, Mrs. Lynn?”

I nodded my response, and the nurse proceeded to ask all the standard medical questions. What medications did I take? What were my family’s and my medical histories? When did I last empty my bowels? I groggily explained my medical conditions to the nurse, beginning with my childhood and the progression of symptoms into my adult life.

“My! You have a lot going on, don’t you? I’m going to go speak to the doctor and we’ll see what he wants to do with you.” The nurse left the room. She pulled my curtain closed behind her and left me to adjust to my new surroundings. A striking difference from my living room.

A few minutes later, I was able to take in the room around me. My eyes adjusted to the bright lights. The dry erase board on my wall remained empty. It contained no names for my care team, no up-coming tests, no medications, or any other clue as to what was going on with me. The big clock on my wall ticked away. Aside from the TV, computer, and one chair, the room was barren. Then, I overheard my nurse speaking at the desk near my room.

“She was transported by ambulance for loss of consciousness. She stated that she had previously been diagnosed with autonomic dysfunction. Minor symptoms such as poor circulation and low blood pressure began as far back as she can remember. Her symptoms have worsened increasingly over the years. Her stomach is paralyzed; she eats via feeding tube. Tachycardia, shortness of breath, excess sweat in the cold, chronic dry eye. The list goes on. You can see my notes here.”

“She fainted? How long was she unconscious?” I assumed this was my doctor’s voice.

“The 9-1-1 call was made at 18:09, she arrived at our ER at 18:21 and regained consciousness a couple minutes after arrival.”

The doctor hummed a tune for several seconds. He must have been looking over my chart. “I suspect she has an extremely rare form of autonomic dysfunction that may become terminal but there is nothing I can do here. This is beyond my scope.”

“Are there any tests we can do to rule out that possibility?” asked my nurse.

“Unfortunately, no. I can do an MRI of her brain to rule out something there, but the other tests she needs, we do not provide in an ER. Her best bet is to go to a specialist.” The doctor’s voice was smooth and untouched by care.

“That is terrible for her. I wish there were something more that we could do.” For this statement, I adored my nurse.

Heavy footsteps sounded through the hall outside my room becoming louder as the person came closer, then faded away. Ten more minutes passed. Then, half an hour. I listened intently as my nurse and my doctor made their rounds, visiting all the patients down my hall. Footsteps pattered back and forth, papers shuffled, keyboards clicked. The hospital was busy. I became antsy as the clock over my door ticked away the time. Should my husband be here by now? My phone was not with me. Drat!

My door opened and my privacy curtain swooshed open. Finally! “Hello, Mrs. Lynn. I am Doctor Heath. Your nurse told me about your history, I am so sorry to hear your struggles. How are you feeling now?”

I gave him a half smile. “I’m still a little dizzy. I feel like there is cotton in my brain,” I explained.

“Hmm.” He looked at my chart on the computer. “It looks like your blood pressure was extremely low when the ambulance picked you up. It’s still on the low side. Did you take your blood pressure medication today?”

“Like clockwork. I have alarms set to remind me.”

“Hmm,” Doctor Heath said again. “I’m going to start an IV. Your bloodwork showed some possible dehydration.”

“I am on a feeding tube. I get the same amount of hydration every day. It has been balanced perfectly with my weight and formula intake.”

“I suggest you speak with your dietitian and increase your daily fluids.” He looked me over. “Do you mind if I listen to you?” Doctor Heath lifted his stethoscope to his ears.

I nodded and let him perform his routine check. Heart; tachy. Lungs; clear. Normal intestinal grumbles.

The doctor seemed happy with his findings thus far. How infuriating? “The nurse will be in soon to start your IV. Do you have any questions for me?”

Fog brained, and still reeling from the unconscious state I had previously been in, I shook my head “no” and the doctor left me. He pulled the curtain closed in another swoosh.

The clock ticked by nine minutes. Then, my nurse entered my room with an arm full of IV supplies. She had just threaded the catheter of my IV when my husband, Tom, entered the room.

He spoke while Nurse -I glanced at her name tag- Becky finished my IV and hung up my bag of fluids. “I’m so glad you’re awake. You gave us quite a scare. Sorry, I'm late. I had to calm the kids down and get everyone fed before I could head this way. How are you feeling?”

“Hey, baby. I feel like crap.”

“Has the doctor talked with you yet? Do they think it was your autonomic thing?”

“He didn’t tell me, but I overheard him talking to my nurse about it being a potentially rare and fatal type of autonomic dysfunction. He told her they can’t do tests for that here. He didn’t say anything to me about it though. He just said I was dehydrated and had low blood pressure, so he ordered an IV.”

“Are you sure they were talking about you? You could have heard them talking about someone else. If it had been about you, you’d think the doctor would have told you.”

“I’m pretty sure he was talking about me. How many people have the issues I do? He wouldn’t say anything to me anyway, because he doesn’t want to risk misdiagnosis.”

“See, he isn’t sure! That is a good sign.” He was being annoyingly positive.

“Not if he’s right, and no one will help me.”

My husband went quiet for a while, so I turned on the TV and flipped through channels. “There’s nothing good on cable anymore.” Anything to change the subject. I knew my husband did not want to hear about any of this. I was awake and talking now. To him, that meant I was okay.

The TV droned on in the background, some car show Tom wanted to watch, and the clock ticked on. My IV bag slowly deflated as it filled my veins with saline solution. Another hour fifteen minutes passed. The bed hurt my back, and I shifted my weight. Then, my beloved nurse walked in.

“Hi, Mrs. Lynn. It looks like your IV is about done. I’m going to take your blood pressure really quick. Are you feeling okay?” She pushed a button on the machine connected to my cuff.

“Feeling as well as I can under the circumstances. Is my blood pressure still low?”

The nurse let the machine finish checking my pressure. “Ninety-five over fifty-eight. Still a little low but it’s an improvement.”

“How low did her blood pressure get?” my husband asked Nurse Becky.

My nurse pulled the computer into her view and clicked at the mouse. “It looks like the lowest was sixty-two over forty. That is exceptionally low, it’s no wonder she passed out. We are hoping that getting her some extra fluids helps maintain her blood pressure so this doesn’t happen again, at least for a while.”

“When can we get her back home?” Of course, Tom wanted everything back to normal. Things like this meddled with his daily routine and made him uncomfortable. He could not cope with it.

Nurse Becky turned toward me and said, “We will monitor you for another,” she glanced at her watch, “forty-five minutes. If your blood pressure and heart rate stay within normal range, you will be discharged to go home. The doctor suggested you follow-up with your cardiologist and recommended you find a specialist who manages autonomic disorders.”

My heart sank. There was no help for me here. Stabilize and discharge. That was the ER way. “I can’t see my cardiologist for another three months. No openings. There are, also, no autonomic specialists in this state. They are terribly difficult to find. Would anyone at the hospital know where to look? The Maynard Clinic denied me. I don’t know where else to go.”

“Hmm.” I had heard that too often today. “I would call the cardiologist to get on a cancelation list. I will ask our case management team about the autonomic specialist.”

“Okay,” I sighed. “Thank you.”

Nurse Becky disappeared back into the long hallway whence she came. Tom and I sat there for forty-five minutes. My anxiety raged at the lack of help I had. The blood pressure cuff blew up and checked my pressure every ten minutes. It squeezed my arm like a vice each time. I thought about the irony between the pressure on my arm and the pressure I felt in my mind. My blood pressure was low, but not too low.

My nurse finally came back carrying a stack of papers. “Are you ready to get out of here?”

“As ready as I can be.”

She leaned over and handed me my discharge paperwork. “We got lucky, your cardiologist was on call. We were able to request an earlier cardiology appointment for you. Next Wednesday at 9:15 am. I also asked our case managers about the autonomic specialist. They had no idea but suggested calling around to some of the university clinics near here to ask about a specialist. I really hope you can find something. If this happens again, please come back.” She sounded sincere enough. “Can you sign here, please?” She pointed at the bottom of a piece of paper on her clipboard and handed me a pen.

I signed the paperwork, then stretched. My body hurt from this God forsaken bed.

Nurse Becky gently removed my IV and taped a cotton ball over the prick mark. “Get up as slowly as possible, Mrs. Lynn.” Nurse Becky supported me as I sluggishly rose out of the bed. She helped me put on my shoes.

“I will get the car,” Tom said.

“We will meet you out front.” Nurse Becky left the room and promptly came back with a wheelchair. “Care for a ride Mrs. Lynn?”

I smiled at her. She was sweet to me. Her charity and magnificent chariot warmed my heart. “Ride away!” I sat down in the chair, and she pushed me toward my freedom. As close to freedom as I got anyway. She helped me climb out of the wheelchair and into the car Tom parked beside the front door.

“Get to feeling better, Mrs. Lynn. Don’t hesitate to come back if you need us.”

“Thank you. You were wonderful.” I meant what I said.

Nurse Becky smiled as she closed the car door behind me and waved as we drove away.

“I don’t understand why no one will help me.” My eyes burned with tears that would never exit my body. I was feeling down, especially after having overheard my doctor about a possibly terminal illness. I did not feel I was taken seriously. I never felt that way.

“We will find you a specialist.”

“Can you help me call around? Or, at least, find me some phone numbers?”

“I can try. You know work keeps me busy.”

Another sigh. The absent tears burned again. “Thanks.” What a daunting task, to sift through phone numbers, phone calls, lists of university clinics, and full notebooks. It would be never ending. I felt defeated. There was no help for me. Not here. Not anywhere.

We pulled up to our house. The sun had set for the day and left us in the dark.

Tom had been quiet the rest of the way home. I thought he might be thinking about what had happened to me. Instead, he had the nerve to ask, “What did you plan to cook for dinner tomorrow?”