Went to the ER...

Well after much prodding from lots of you and a very worried about me respiratory therapist sister-in-law, I went to the ER last night. I will say that when you drop the "short of breath" line, they move you right on through. I was just doing a lot of deep sighing and yawning to catch my breath. Met with the doc who almost immediately began to discount my symptoms once he saw in my record that I take an antidepressant/antianxiety med. He did repeat blood work. He came back in and said, and I quote, "This is more a case of freak out". Great. Seems I'm just crazy. Let's just go ahead and find me a nice rubber room now. And could I please have my straight jacket in a royal blue--goes awesome with my eyes. Obviously there is going to be an anxiety component in place when you are terrified you are going to drop dead in front of your kids.

But am I crazy? My hemoglobin was 9.5. Hematocrit was 30. Wasn't given a ferritin value. When he told me the numbers were up my first reaction was, "Oh, good!" Because really, who wants a blood transfusion if they don't have to have one? He said he was going to give me a prescription for Ativan to help with my "freak out". Afterall, it's good to be calm when you are about to have a cardiac event! I am mad at myself because I didn't think to ask what would cause my hematocrit to jump 3 points in a day. Really what I thought when he told me that was that the #s at the original doc were messed up given their original error. Upon researching it a bit once home, I found that apparently if you are dehydrated it will artifically elevate your numbers because of decreased fluid volume in your blood. I was really busy yesterday and had really only had my cup of coffee and a few sips of water to take my vitamins and it was bout 8 when I got to the ER. Granted, even if my numbers where still 8.9 and 27, their threshhold for transfusions were a hemoblobin below 8 with a hematocrit lower than 25, unless there were significant symptoms of decreased oxygenation (my O2 was 100%), racing pulse (mine was 77) or chest pains, which I wasn't having.

So this is all to say that I guess I'll live until I have my appointment Tuesday with the new hemotologist. I am going to work on hydrating myself well so there is no question that my results are accurate. Now I'm going to go sell my firstborn to afford the freakin' ER visit. Actually, I think I'll just go ahead and forward that bill right to the first hemotologist that screwed up because after all, had I had appropriate care in a timely manner, there would have been no ER visit at all!!

Hope everyone has a great weekend. I'm off to rest. At least the doctor did say I should be taking it very easy, so no cleaning for me!! That was well worth the price of the visit!!

Take care,

Denise

I would just like to reassure that you will not drop dead from a hemoglobin of 8. Yes, you may need some iron infusions, which I tolerated quite well after some complications from the VSG. Some people do have side effects from the infusions, but they are not widespread. Just something to be aware of.  Fatigue is usually the main symptom for someone with a hemoglobin of 8. When the drop in hemoglobin occurs gradually, your body adapts to it surprisingly well. It is when it happens rapidly, such as after surgery or another means of rapid blood loss, that people are more symptomatic. Shortness of breath can be a symptom of low hemoglobin. Try to relax and use the ativan for the anxiety that all this stress is causing you. I don't think that you will have a cardiac event unless your hemoglobin drops very low. Hemoglobins of 8-9 are a bit low, but not enough to cause a cardiac event.

Seems like the doctor thought that your anxiety was getting the best of you. You're not crazy, just anxious, which can cause people to think that they are going crazy. Your vital signs are quite good, especially the pulse rate and oxygenation level.

Gail

Thanks for the note Gail. Always good to have reassuring stories. My plastic surgeon did say that people with chronic anemia tend to compensate and adapt relatively well, as you said. I think the couple episodes I'd had in the last week with my heart racing while I was lying down (I have bradycardia, so that was really out of the ordinary) in combination with my blood pressures running low, feeling a bit short of breath, especially so with exertion, and then hearing my numbers weren't great (and with the urging from those that are very experienced with this stuff),  I figured I'd better be safe than sorry. Prior to hearing of numbers, I was really was thinking all my symptoms were a function of my body struggling to get well from this darn plastic surgery and just being run down. 

I think the assertion about the anxiety bothered me not because it wasn't true--I'm sure it was--but because it came directly on the heels of his going over my meds.  I watched my mother die in the hospital because her mental health history caused doctors to completely dismiss her complaints as anxiety when in fact she had a collapsed lung and truly couldn't breathe. This just hit a little too close too home. I just wonder if that would have been the first thing he went to had I not had the meds on my record. Regardless, I think I am going to be okay, but much like you have pointed out, will just need some iron replacement therapy. Can't wait to see how much better I feel after that!! 

Thanks again for the reassurance!! 

Boy oh boy call the Whambulance and truck in the cheese it's gonna be a long weekend for Denise.

You poor thing, you totally did the right thing don't second guess yourself. Up and down and turn it all around right back where you were but a little smarter for the adventure. Panic attack ok, Picnic attack even better ask Yogi.

You don't want the dehydrations, I'll have to send wwwwwwaterboy your way to fix you up. Ativan runs rampant through my family good stuff to have around. If you have to sell first born make sure you wash her off first after being stored in your badonkadonk.

I think I feel ill, no cleaning for me either this weekend cough cough,

Hope you feel better

Tiny Bubbles

I say screw the cheese and just bring on the wine! First Lawrence Welk, now Don Ho--what's up with that Tiny Bubbles. Good to be tiny--huh? I do think it is better to err on the side of caution. Frustrating it winds up being a 1000.00 psychiatrist visit! 

Are you really feeling ill or is that just more kicking poor, sick, too weak to fight back Denise when she's down? :) I ask because everyone I know is getting a cold--myself included. Started with my daughter's friends, then Melissa, then Daddy and me. Tis the season.

Hope you really aren't getting sick.

Thanks Bub

Your normal just a little looney, 1 grand plz thank you have nice day. So in the wrong business, when I get my blood checked for INR my blood thinners 10 minutes tops in her office. The machine is same as chcking bloos sugar, they bill 400 dollars for that WTF! Glad I have health insurance.

ME not sick just playing it up so I wouldn't have to clean yesterday but did anyways. I wouldn't kick you when you are down, maybe roll you into shallow grave but not kick you when you are down.

Looks like the end of April I'll be going hopefully to Colorado to see my buddy and I remembered I have a 1st cousin that lives out there so may get in touch with him to see if he wants to hook up for dinner or something. Creepy there is someone else out there who looks like me kind of like brothers.
 
I'm sending you a care package of cheesy popcorn and #2 pencils to help with your lead deficiency. Maybe eat a bunch of fish and stuff they have lots of mercury and your bypass could start to glow and you could be a walking bypass chart for seminars make big bucks and I wouldn't have to pay hottie support no more and not work 3 jobs that would be great.

Have a good day

Big Bubblezzzz

I often think I'm in the wrong business. I need to find something along the lines of rapping football player actress who has an inside line on some huge stock picks.

Glad you weren't really sick and that you wouldn't kick me, even though you are prepared to roll me into a shallow grave. Is that because you are too lazy to dig a deep one? Couldn't you get the pups to give you a paw with that?

What's this I hear? A trip? That should be a good time--hopefully we'll not have to have the hot tub visual again, but sounds like it will be fun.  Where again in Colorado? It's creepy enough that there is a you out there that looks like you, let alone another one!! 

So now I have a lead deficiency, aluminum deficiency, a cheesy popcorn deficiency, and a mecury deficiency? Before you shoot out that care package, you should know that I also have a diamond deficiency, a gold deficiency, and a medium alligator brogue bowling Burberry bag deficiency--google it--and get to finding that 4th and 5th job to cover that one!

Later (medium) alligator (brogue bowling Burberry bag),

Deficient Denise (I've been called double Dee for years--guess it has a new meaning now!)

 I agree with Bubba. You did the right thing in going to the ER.

I also think - screw that ER doc.  The more doctors you see the more you realize that many of them don't pay complete attention, don't look at things completely and are just plain moronically wrong.  I know you are your own advocate when it comes to your health and you just met one more example of why you have to be.

The good news is that you are ok and you got looked at and judged to be stable (even if the guy was rude or judgemental). You arent in immediate danger and you can rest easier until your next appointment.

Keep your head up!

Moronically wrong--my new favorite phrase!! So dead on!

I'm trying to relax and take it easy until Tuesday. Speaking of which, I need a nap!

I'm so excited to finally feel better--I really hope they'll help me.

Thanks for the encourangement!

Hi. Well I hope you are feeling better.  I would agree that any patient with breathing issues needs an evaluation to rule out blood clot/pulmonary embolus.

As for your blood count, there is really no magic number for transfusion.  I work on Jehovah's Witnesses with some frequency.  Reality and practice really butt head-on when you manage patients who will be haviong surgery without blood transfusions as an option.  It happens to be good medicine, too !

The key is your symptoms, and to a lesser degree your healing.  Patients could need a transfusion at any number if those are impaired.  That's why cardio-fit individuals before surgery kick butt on couch potatoes inbterms of recovery and tolerance of anemia regardless of age or health status.

It would be worthwhile checking your iron profile (transferrin, ferrttin, TIBC) and B12/folate levels just to be sure there is no easy fix there.  Otherwise a balanced diet possibly with protein supplements may be helpful.

Happy healing !