Thursday, August 12, 2010

Learning to Live in England, Part 23

Or, But This Tour wasn't on Our Itinerary!

I'm perfectly well now, but have had an unexpected stay in an English hospital. It began on the midnight that separates Monday from Sunday; right about then, my heart just skipped right out of rhythm. The irregular beating, with breathlessness, kept me awake all night.

We waited until it was 8:00 a.m. in Richmond (1:00 p.m. here) and telephoned our cardiologist, who said to go get treatment right away. So we walked from our flat two blocks to the bus stop and hopped on the bus for Southport, because the Ormskirk Hospital is just for children nowadays.

The same bus stops right outside the hospital, so twenty minutes later we arrived at the emergency room, which here is called the A&E Department (Accidents and Emergency).

We were a bit concerned because we aren't a part of the English NHS (National Health System) and our only insurance is, of course, American. But when we asked the lady in Reception, she raised her eyebrows and said, 'It isn't like America. Emergency care is for everyone.' Then she added, icily, 'We are civilized here.'

I was seen right away, within ten minutes. Within the first half hour, I'd had all my vital signs taken and an electrocardiogram and was in a hospital gown and a bed.

After that, I lost track of time, but there was a very nice young doctor from Pakistan and a very nice Philippino nurse, male, but I was in no position to be picky about gender. 'Turn you back to me,' he instructed, so I did and he slipped off the hospital gown. 'Now turn back around,' he said, 'and slip your arms in.' He was holding the gown between himself and me, to obscure his view. I had put it on the wrong way and he had put it right with extreme tact.

They hooked me up to an IV and dripped a medicine into me for a longish time, in hopes it would cause the heart to reset.

It didn't.

By now a consultant had arrived (senior doctor; Consultant being the highest rank). He was consulted and was firmly against 'interfering' with my own caridologist's treatment.


He directed that I be sent home.

Demetrios, however, objected, pointing out that the irregular heartbeat posed an immanent danger of bloodclot (and death, of course). So the young Pakistani doctor apparently refused to do as directed and kept me. I also heard a beautiful young doctor from India seemingly interceding on my behalf. She said, twice or three time, 'But it's unfair, isn't it? It's unfair!'

At any rate, they decided to keep me overnight for observation. I urged Demetrios to go home, and he also thought he should, to telephone our cardiologist again while it was still office hours in Richmond.

I remember having a chest x-ray, 'Because of the chest pains,' they said. The chest pains were so mild I had forgotten them. On a scale of 1-10, I rated them one-half.

Then my bed was wheeled through some more corridors and I asked, 'Am I being taken to my room now?'

'To your ward,' the male nurse from the Philippines corrected.

Oh. Okay. They have wards here rather than rooms. Demetrios says every hospital has a handful of private rooms, saved for infectious patients or those who for any other reason require isolation.

The ward contained 5 other women, all of whom appeared to be older than I. One of them grinned at me and nodded her head; it took about two minutes to realize she was quite demented.

I was quite sleepy by then and do not remember much, but I do remember being offered tea several times. Finally, not having eaten all day, and having missed both lunch and supper while in the emergency room, I asked for, and was given, a snack box, containing a ham sandwich, a delicious apple, some cookies (digestives), some cheese, and I've forgotten what else; I couldn't eat it all.

I had brought with me a prayer book, a book of Sudoku, and the book about the ancient Greeks, which I haven't yet finished. So I alternated among those, and was saying the evening prayers when one of the patients, a sweet-faced old lady with short, curly, white hair, wearing pink plaid pajamas, got out of her bed and began going around to each of the other 5 beds to chat with her fellow patients and wish each one a good night.

When she came to my bed and we had chatted a few moments, I asked her name, and she said, 'Margaret. Sister Margaret, actually; I'm a nun.'

So I asked which order, and she told me, but I've forgotten, and then she asked me my order!

I had brought earplugs with me, luckily, but just as lights out time came, I was put on a trolley and transferred to a ward in the Cardiac Care Unit, still with only six beds, but much larger.

The night nurse was a beautiful woman from Ireland named Hughna. She was as sweet and kind as she was gorgeous.

At some point in the night she repeated the IV drip, during which I fell asleep, more or less. (It's hard for me to sleep flat on my back, and all the things into which I was plugged prevented my turning over.) I remember Hughna telling me, 'You're fine now,' as she unplugged the drip, but I didn't know whether to beleive it. I could see the monitor and I could see the wild fluctuations every time I moved. I should have known she was telling the truth, because otherwise I wouldn't have been able to sleep at all, from the palpitations and breathlessness.

It wasn't until morning I was sure I was fine. I could feel that my heart was steady and strong.

For breakfast, the choice was cereal or toast; I had the toast and some tea.

Demetrios came as I was still finishing my shower, so he got the good news from someone else instead of from me. They gave him photocopies of all the cardiographs, including the latest one, showing normal heart rhythm.

I've got rhythm,
I've got rhythm!

Then it was a matter of waiting two hours for the pharmacy to bring up my new medicine; apparently my body was no longer responding to the old, having become too used to it.

Total cost to us: Zero. I can't think when I've ever been so grateful.

As it was a beautiful day, we took the bus the rest of the way into Southport and strolled along Chapel Street, a pedestrian shopping area. Then we ate at Mamma Mia, best tiramisu in the world. Then we came home.

And I napped three hours, until it was time to go to Stuart's house, for that Anglican discussion group we attend.

I'll write about last week later; we did have some fun adventures to tell you about!


orrologion said...

It is perhaps worth noting that "Emergency care is for everyone" in America, too. Affordable health insurance to pay for that and other medical care is not (yet) for everyone.

I had a similar experience with the NHS after stepping on a nail in Liverpool. I asked the same thing because I wasn't sure they would treat me because I hadn't paid into NHS, not because Americans assume you can't be treated in America without insurance. They saw me, everything was fine.

I was primarily amazed at the lack of time it took to be seen. ERs in the US are all about triage, and because of the lack of insurance ERs are used for all sorts of things rather than just true emergencies - where else to go late at night when you need a doctor? I was amazed by that aspect of your story, too.

Michael said...

I remember once reading on a discussion forum a post by an American contributor who was lamenting the state of his country, (as we all do with our own countries from time to time), and said (I forget the exact words but it was something to the effect of), 'We tell people from outside America that we have to pay for health care and they look at us as though we've just told them we have to pay taxes on air'. It's true. We just don't understand. If we start getting uppity, though, we would do well to remember that we weren't very different in the past.

I'm so pleased they were able to mend you without too much trouble, and that you were well looked after. And how lovely that you got such an eclectic mix of ward-fellows.

I have never had to stay in hospital. The thought frightens me, no matter how many people tell me how well they were treated. I had cause to see a cardiologist over a few months a couple of years ago and that frightened me. I'm glad you could face it with such ease. It must have helped your feeling about the actual ailment.

margaret said...

I am so glad you are well!

When I was young we had 'Nightingale' wards, long rooms with ten beds down each side and a Victorian fireplace at the top. Sometimes they had pianos in them :) Demetrios will remember.

DebD said...

We're about to get a big storm, but wanted to pop in to say that I'm glad you're better.

Love you.

Anam Cara said...

Thrilled everything is now fine. Don't do that again!

Elizabeth @ The Garden Window said...

I am so glad to read that you are "on the mend" and now recovering at home !
It must have been scary indeed, being poorly in a strange country.

Take good care of yourself, dear friend.

Anonymous said...

Dear Anastasia: Waiting for the next chapter of your travel log, it became clear that something unexpected had happened. It was a relief to read your story. I admire the fact that you have made it into a very interesting episode about your stay in England.

By coincidence, two days ago a friend, who knows I have sleep apnea, wanted to know if sleep apnea can cause arrhythmia. Part of what I sent him is this:

Mayo Clinic pulmonologist Kannan Ramar, M.B.B.S., M.D., describes how physiological changes that occur during obstructive sleep apnea episodes affect the cardiovascular system. Sudden drops in blood-oxygen levels increase blood pressure and strain the cardiovascular system. About half of those with sleep apnea develop high blood pressure (hypertension), which raises their risk of heart failure and stroke. Obstructive sleep apnea may be associated with strokes, coronary artery disease and metabolic problems such as diabetes. Repeated multiple episodes of low blood oxygen (hypoxia or hypoxemia) can also lead to sudden death from a cardiac problem in people with underlying heart disease. Also, there is a strong association between obstructive sleep apnea and dangerous heart rhythm changes (dysrhythmias).

I thought I’d pass it along inasmuch as you are probably still wondering what caused your incident. It may or may not be due to sleep apnea, but from my experience, the medical establishment is not all that informed on the subject to take it into consideration.

Peace and Joy!
George A. Marquart