A night in the hospital

Friday night after dinner Keith started feeling "off" - he said he was light-headed and felt like his blood pressure was up. Keith described the sensation a "wave" coming over him. A test on the home blood pressure cuff reported blood pressure of 190 over 100. Yikes!

We rushed over to the local Doc-In-The-Box where a dishevelled, overweight, and slightly gray (that's skin-tone, not hair) doctor who looked suspiciously like Captain Kangaroo talked with Keith, did an EKG and promptly called the EMT guys at Dallas Fire & Rescue, saying that Keith was throwing irregular heartbeats and needed to go the hospital.

The EMT guys, bless their hearts, are from the big city, and just couldn't get too worked up about a middle-aged man feeling "off" and having blood pressure ranging from 170 to 190 over 90 to 100. "It's not really critical under it's at least 250 mam" I was told. They also confided that the Doc-In-The-Box guy calls them "all the time" with anything slightly abnormal.

Somewhat assured, we sent the EMT guys on their way, and then decided to go ahead and go to the hospital on our own.

Having lived 2 blocks from Baylor downtown for 3 years, we elected to go to Medical City as we decided it was a big enough hospital to provide decent care, but not so big that would be overrun with gunshot wounds, bloody car crashes, and the other grizzly stuff that a bigger trauma hospital gets.

Medical City brought Keith in, did a general assessment, and then gave him nitroglycerin to bring down his blood pressure. (I think the first reading here was around 180 over 100). Weirdly, it didn't seem to me that the nitro worked - they gave him 3 separate tablets and his blood pressure only came down to the 150's. (My impression of this drug has always been from books and movies - you give someone a tablet and their blood pressure falls back to normal levels magically.) We stayed in the E.R. for most of the night doing the blood work to test the enzymes for a heart attack. Thankfully, that wasn't the problem. A chest X-ray showed a slightly enlarged heart and a bit of fluid on the lungs.

The E.R. physician and P.A. were both very solicitous (although is it just me or is it weird to be talking with a physician who is chewing gum?). After talking with Keith they decided to put him in the Observational unit for the rest of the night and to get an ECHO Saturday morning.

The ECHO guy came Saturday morning and did an ECHO in the room so I was able to watch. I asked him to keep an eye out for the subvalvular web and to pay close attention to the "gradients" on either side of the heart. According to the ECHO guy, he doesn't see a subvalvular web at all - but does see an obstruction.

Our nurse badgered Baylor for several hours about the cardiac catheter reports from last week, and finally got a copy of those for the cardiologist to review. According to Dr. Snyder, Keith has an obstruction (an extra piece of skin, tissue/membrane), but it's not acute, so we should go home and sort it out next week with the cardiologist.

We got home Saturday afternoon around 3:30pm, absolutely exhausted. I'd phoned my book club girlfriends earlier in the day since book club was scheduled for last night, and they moved the meeting from our house to a restaurant so the rest of the day was clear. Keith took a long nap on the couch, me on the bed, and then last night we went to bed after watching swimmer Michael Phelps make history at the Olympics.

Today we are taking it easy. We have an appointment with the cardiologist tomorrow, so hopefully we will learn more then. I'd like to see how the ECHO tests Keith has had over the years have changed.

After the many visits to the V.A. with Dale (Keith's dad) over the years, it really does seem like hospitals are the microcosm of American - the classic melting pot of people from around the world who are banded into this small village working together to treat the sick and injured. The door to the room was open yesterday and I hear (but don't see) a voice asking "You want hot ling?"
"What?"
"You want, hot ling?"
"What's a hot ling?"
"You know, spicy meat in casing in nice soft bun. Comes with chip and coke?"
"No thank you, I bought my lunch from home."
Apparently an organization or employee group was selling a hot link lunch yesterday for employees.