Balls and Walnuts
more than you ever wanted to know
Not all cylinders firing
One thing about age: you can’t function as well with a cold or with too little sleep. So while my cold may be in its last gasp, I still need my sleep. Oh yeah do I need it.
I had an emergency case last night. The case didn’t run late, but it was one of those situations where despite my best efforts, things could still turn bad. When my pager went off at 11:30, my heart started pounding because of course I thought the worst. In fact, the ER doc from the local hospital was calling me out of desperation because none of the other Bako ENTs would answer his call. I couldn’t help him, and he was grateful to me for returning his call (probably frustrated as hell that the only person to return his call was the one person who contractually couldn’t help him), but my heart was still pounding.
I managed to get to sleep by 12:30, but it was a fitful sleep filled with fantasies of things going wrong. I’d wake up hoping it was morning, that many hours had passed, because the more time that passed, the more likely it was that my patient had gotten past that interval of risk. That he had, in fact, been discharged, sent home, hopefully sleeping more comfortably in his bed than I was in mine. Eventually I settled into something resembling a more restful sleep, only to be roused at 5:45 by some officious little dweeb of a nurse who needed a verbal order to extend my patient to 23-hour observation status. He couldn’t have waited another hour to call? Apparently not.
There’s no sleeping after a call like that. I contemplated getting up early (main advantage being, I could take myself out to breakfast) but I was just too tired. So I lay there exhausted, half dead, too tired to get up, too wired to sleep.
All day, I kept forgetting to finish things. No patient “quality issues” of course, just some sloppiness . . . blanks not filled in, messages not sent. I remembered, sometimes hours later, to pick up the threads. Things never quite flew apart.
Take out food was made for days like this.
D.
How does an ENT case turn emergency, anyway?
I was having three migraines a week from sinusitis at one point-everything too swollen shut to drain, running low grade fevers for months…but I didn’t figure I could go to an ER until I started getting neurological symptoms, you know… seizing, or passing out. I was actively hoping for them, because it meant I’d actually get treatment.
We get some of the scariest emergencies because we work in the airway. Airway swelling and bleeding in and around the airway are two biggies for us. Other urgencies/emergencies which are less dramatic (though not if they happen to you) are sudden hearing loss and ear pain, which I promise you can be excruciating. There are also problems within the eyes and brain secondary to sinus infection. There are particularly nasty fungal sinus infections which can eat the flesh away, and yes, we do have to deal with the notorious flesh-eating bacteria problem (medical term: necrotizing fasciitis) every so often — I see it perhaps once every ten years.
Earaches are just below abscessed teeth.
I went on a trip with an infected ear…it was hurting all the way there and most of the way back until a series of hills caused the drum to burst. Then much better.