Tuesday, July 31, 2012

Visit to the ER

It was an interesting day.  Monday morning I went over to the Toone lab to use their prep HPLC. It was bright outside.  After injecting my compound and coming back to the lab, I walked over to Dave's hood and looked at his computer.  I mentioned that the other Dave downstairs had sent him a text message.  Upstairs Dave said that he was ignoring downstairs Dave.  Then I went over to my desk to check email and look at a journal article on my computer screen.
As I sat down and looked at the screen, I noticed something wrong, or WTF, as they say.  I couldn't read the screen.  There was this weird distortion on the screen.  I immediately rubbed my eyes and it didn't go away.  Being a scientist, I immediately started doing experiments to see what the hell was happening.  Close one eye, distorted!  Close the other eye, still distorted.  There seemed to be a ring of distortion with a clear undistorted space in the middle.  OK, that's weird.  So I close my eyes and cover my face with my hands to keep out the light.  Damn, it's still there.  Except that everything is black and there's this ring of small scintillating polygonal shapes.  It's somewhat like what happens when you look a a bright light and then look away and the image stays with you.  Except that it was different.  More defined by distortion and less by intensity.  And it wasn't going away.
I open my eyes and tell Yazan, a grad student standing by my desk that there's something wrong with my vision.  He looks at me with that what the heck are you talking about look.  In the meantime, I'm doing this constant check of the rest of my body.  Did I just have a stroke?  Numbness, weakness, pain?  Nothing unusual.
So, focusing the clear center of the distorted ring on the computer, I look up webMD and start typing in symptoms.  First head, then eyes, then blurriness, no drugs, no infection, sudden onset.  WebMD tells me to call 911 and get my ass to a doctor.
So I call on Brittany, another grad student in the lab.  Brittany volunteers as an EMT with a local emergency services organization, so she's seen a lot of stuff and anything she hasn't seen, she's had.  She basically tells me to "Man up" and quit whining.  Not getting any sympathy in the lab, I call my wife and tell her about it.  She insists that I go see a doctor, maybe via a first trip to the optometrist.  About this time Tim walks in and I tell him what's going on.  He seems concerned and walks away.  Then Dave walks over and asks what's going on.  I tell him my eyes are doing weird shit and it won't go away, sort of like a visual version of his ear ringing that showed up after his nose job.  Brittany and Dave run me through the stroke assessment routine that they learned from EMT training.  I seem to pass.  Tim shows back up.  He called his wife, a doctor, and she thought I should see a doctor  maybe via my GP first.  I can't get anyone to answer the phone at the optometrist and my GP just retired and the one I was thinking of going to can't get me in this afternoon and suggest going to Urgent Care.  My wife calls and says she talked to Amy, another doctor, and she thought I should do something but not to bother with Urgent Care.  Just go to the emergency room.  Urgent care would send me there anyway.  Dave, whose head got smashed with a soccer ball about a year ago and who wasted two hours at Urgent Care, only to be sent to the emergency room anyhow, concurred.  By this time, the distortion was starting to go away and everyone had arrived at some diagnosis.  The favorite seemed to be a psychedelic flashback from drug use in my youth and an intense inquisition on my drug use in high school ensued.  The final opinion was that I should go see a doctor and that the fastest way was to go to the emergency room.
Brittany, who has visited the ER on numerous occasions, usually to deliver people, volunteered to go with me.  So we took off for the ER.  We tried to get there by only going through air conditioned buildings but eventually we had to go outside and around to the back of the other side of the hospital to get into the ER.  Entering the ER is a lot like going onto a plane.  The first thing you see on entering is a conveyer belt and a walk-through metal detector.  We toss our stuff into the box on the conveyor and the guy asks if we have any knives.  I give him my knife and he gives me a receipt.  "Use this to get your knife on the way out", he says.  That's different from the plane.  You never see your knife again.
We got in line and when it was my turn I told the person at the desk that I had a sudden attack of blurry vision.  It seemed kind of puny.  I would have felt more like I belonged there if blood was spurting out of me.  She told us to have a seat and wait for my name to be called.  Brittany knew the routine pretty good and kept me informed of what was going on.  While we were waiting, she mentioned that maybe I had a TIA.
Eventually, I got called to a Triage room where they got my vitals and asked a few questions about why I was there.  I related the vision thing and what webMD told me.  One of the nurses said "I hate webMD. It causes half the visits to the ER. Anybody that looks at webMD suddenly thinks they're suffering from everything imaginable."  Now I felt even worse about coming.  Why couldn't I be holding a severed limb or something?  My bp was 130/80, a bit high for me. 
When they got through, they sent us out the other side of the room into a hall and led us to an eye exam room.  On the way Brittany ran into a guy she knew from EMT work.  "Are you OK?" he asked.  "Yea, I'm fine.  I brought over a coworker."
In the eye room, two ladies, a nurse and a nurses assistant came in.  The nurses assistant walks in and looks at me and then says "Hey Brittany. Are you OK?" "Yea, I'm fine.  I brought over a coworker."  They ask a few more questions and I relate the vision thing again.  Then they leave and nobody comes in for about an hour.
Out in the hall, a janitor is relating some story about a big fight he had with somebody, maybe a girlfriend.  It's difficult to tell just what he's saying but he's pretty pissed about something.  As his story builds to a loud, though largely unintelligible crescendo,  a young intern walks in and closes the door.  Oddly enough, he doesn't know Brittany.
"So, what's up?" he asks.  I go through the vision thing again and he does a thorough stroke exam, having me push and pull with all my limbs and watching fingers move.  I think he's trying to see if something works better on one side compared to the other, a sure sign of stroke.  But nothing.  Next comes and eye exam.  20/30 in both eyes. It used to be a lot better when I was younger.  Then he leaves the room to get some numbing drops to do an eye pressure test, a test for glaucoma.  While he's gone, a woman comes in to explain the charges and get my insurance info and credit card.  I should have looked before coming.  $250 deductible for an ER visit.  The intern comes back after a while and does the eye pressure test and, some time in there, the nursing assistant gets another bp and a drop of blood for glucose levels.  So far, all normal.  Then everyone leaves the room again.
After a few minutes, the intern comes back in with the attending physician.  The attending physician looks at me and then looks at Brittany and says "Hey Brittany. Are you OK?" She replies, "Yea, I'm fine.  I brought over a coworker."  He then explains that they don't see anything wrong with my eyes and yet, I don't seem to have symptoms that suggests a neurological problem.  "Maybe it was a TIA," he says.
They suggested that, for sure, I should schedule an eye exam and maybe, but not necessarily unless it happened again, I should see a neurologist.  They gave me a number to call if I needed it.
The lady with my credit card came back in and I signed the sheet just like in a nice restaurant.  The original nurse came back in and went over everything again and they took my blood pressure one more time and told me I could go.
So Brittany and I said good bye to everyone, dropped by on the way out to pick up my knife and walked back to lab just in time to go home.
I haven't seen the fuzzy stuff again, so far.

4 comments:

Cousin Robin said...

Thinking of you. Hope it does not come back.

Anonymous said...

This Brittany person saved your life. You should throw her a party.

atma said...

(Late comment here)
Good that you had it checked! It is also a symptom of migraine, I get that a lot, although I know it's quite uncommon.

philip said...

I have since found out what was going on. I was having a scintillating scotoma. I learned this by following hints left on the "In the Pipeline" blog of Derek Lowe.

https://en.wikipedia.org/wiki/Scintillating_scotoma