Progress Notes

Becoming the patient – It’s not easy, folks

Anup ShahBy Anup Shah, MS4

In June of 2013, I came down with the strangest illness. The events leading up to my visit to the hospital are almost as laughable as how bad I was at being a patient. But I want to share with you all the whole story because I now realize two things:

1. How much we take our patients for granted when we ask them to do the simplest tasks

2. How much we put them through when we are still learning to do basic medical procedures (especially drawing blood!)

One Sunday morning while studying at Panera Bread, I started to get the hiccups. I tried holding my breath and drinking cold water to no avail. The hiccups were minimal so I decided to ignore them and go on with my meal.

As I took a swig of iced tea, I hiccuped at the same time and aspirated some tea. That’s when the coughing fits began. I couldn’t stop coughing for the next hour. I decided to go home and take a nap and two hours later I woke up feeling feverish with convulsing hiccups.

That night, the hiccups worsened and I intermittently drank a liter of diet coke throughout the night and took Motrin and Tylenol to keep the hiccups and fever at bay.

It didn’t work. I was up at 4 a.m. and left for my clinic at 7:30. I was miserable all day. The hiccups were so bad that I thought my insides were going to collapse on themselves.

In the afternoon, I saw a patient who had a history of schizophrenia and bipolar disorder. My hiccups were so bad that the second half of our encounter was him giving me medical advice about my hiccups and he told me I should go to the hospital. I was still reluctant. On my way out the door, I made the executive decision to go to the Urgent Care Center because I was still feeling feverish.

I (somehow) drove myself to the Urgent Care Center in Baytown since both of my parents are medical professionals down there and I’d be able to avoid long wait times.

They took my temperature. 103.5. I couldn’t believe it! I next went to the ER where they drew my blood and established IV access. The nurse stuck me with the needle FOUR TIMES before she finally found a vein and said to me, “sorry, I’m at the very end of my shift.”

As annoyed as I was, I couldn’t be upset with her because I knew I would do this to a patient a few months later on my medicine rotation (update: I did…6 times). This was followed up with IV fluids, breathing treatment, a chest X-ray, and IV antibiotics.

Once I’d had fluids for a couple of hours, I felt the need to use the restroom. Again, this was not an easy task with an IV. I’m so used to just popping up, using the restroom and then resuming my normal activity, that when I had to drag the IV pole with the backside of my gown open for everyone to see, it felt like the longest bathroom visit of my life. NOW I feel terrible for leaving the room and not helping my patients use the restroom.

Now every time a patient asks to use the restroom, instead of leaving the room, I always ask if I can help them. If they say no (which I probably would have too), that’s okay. At least my conscience is clear.

Ultimately, the ER doctor told me that I was probably in the early stages of aspiration pneumonia and that the hiccups were because the aspirated fluid had gone into my right lower lobe and was irritating my diaphragm. I was given Baclofen (a muscle relaxant) and some oral antibiotics.

Not something you see every day, but I’ll tell you the biggest positive I got out of this: on my medicine rotation, we had a patient who had intractable hiccups and I suggested we use Baclofen (what was given to me) and the attending agreed. Definitely made me feel like my visit to the hospital was worth it. Maybe.

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