Patient stories can be inspiring

I have patient stories to share; one in particular that happened recently. I was working a busy non acute area in April 2012. My partner was on break so I had the area to myself occasionally getting help from my other colleagues if it was too busy. It was 4 am and the area was starting to quiet down. In Emergency to say “quiet”is a taboo, but I can say it here. I had only 1 or 2 patients left. When a 59 year old gentleman arrived with stomach pain. I brought him in an assessment area where I conducted my exam. I erred off with an interview to find out more about his pain. The triage had read 59 year old with epigastric pain radiating to the left scapular area. It was apparent right away how much discomfort he was in. He kept apologizing about wasting ER resources. I assured him that he was not wasting our time. Already red flags start to go up that this pain was more sinister than previously thought. On examination he was slightly overweight. Never smoked and no cardiac history. He started a routine of walking and eating well when this pain started a week ago on and off. He came in this morning because the pain was more intense than before. Hmmm, I thought, pain with exercise? Another flag raised. He was writhing in pain and was a bit sweaty with the pain. He kept saying "I can't believe how bad this pain is, it is unbelievable". Denial! Yep, another flag. One last inquiry about his pain he had said his pain actually started in the shoulder and went around to his stomach and described it as a squeezing pain. Last flag went up. I thought about doing a cardiac workup with an abdominal workup. Since his pain had elements of both, it was best to rule out cardiac involvement. So I quickly did an ECG, which showed a nice sinus rhythm. Nothing sinister there, thank god! Than I inserted an intravenous to draw bloodwork and get ready for some pain medicine. As I sent the blood work down to the lab, the doctor showed up. This happened over the course of a few minutes by the way, in case you were wondering. I showed the doctor the ECG and he wrote up some orders for pain medicine and blood work. The doctor and I were on the same page for the workup. Thinking it was his pancreas or gallbladder but ruling out cardiac, just to be safe. After his first round of morphine his pain was unchanged and I had given him a whopper of a dose to try to dull the pain. He went for a chest xray. Then 30 minutes later the lab had called and said his troponin was 0.91. I told the doctor and we put him on the cardiac monitor. I did another ECG and this time it showed a heart attack. ST elevations in the anterior leads with an irregular beat. Very rarely do we capture an acute myocardial infarction right at the beginning. I immobilized the staff as we prepared to give TNKase an enzyme that is used to break up the clot. The doctor called for a cardiac interventionalist from our cardiac center. By 7 am he was on his way to the cardiac center. He survived and is doing well. If he had waited to come in the outcome may had been so much more different.

Patient stories can be about anything. Do you have a patient story to share? A moment of being in the right place at the right time? Your story can inspire so many people to get treatment as soon as possible. Patient stories can make you laugh and make you cry. Patient stories can be rewarding for yourself and others, the only bad patient story is the one not shared.

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Everybody has a story to tell and I want to hear about it good or bad. Your courage to tell your story may inspire others...

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