Δαφνη Ευτυχια Αρθουρος

Let me start with the results: I'm not completely better, but I'm less dizzy than I was and I have some pills that help. The EKG and CAT scan showed nothing interesting. I have referrals to ENT and neurologist, but have not yet phoned to find out whether those specialists have sliding fee scales I can afford. Yesterday and today were pretty much used up recovering from the seventeen-hour ER adventure -- even feeling less dizzy, I was too damned tired out from such a long day/night to be able to do much else.

(skip past waiting-room ordeal)

Backing up ...

Tuesday afternoon, starmalachite dropped by and suggested that I let her take me to an emergency room, as my primary physician had instructed me on Monday. I didn't really want to go, not really feeling well enough to face what I knew would be a long day, but I knew that if I didn't take advantage of her offer, I would find it all too easy to keep putting it off, and having the company of a friend would make the ordeal more bearable

We got to the University of Maryland Medical Center around half past one in the afternoon, and began the long stint in the hideous acoustic environment that is the UMMC ER waiting room. Entering through the wide glass sliding doors, one immediately arrives at the information desk, with its thick glass window and a slot for passing paperwork through facing the door ... and bearing a sign saying, "Come around to the side, we can't hear you through the glass." So right off the bat, there's evidence that the space can't be used as it was intended, due to the acoustics. After waiting in a short line at the information desk and getting checked in, we were sent off to the left to wait to be called for triage. A bunch of chairs linked together in groups were positioned in such a way that no seat was out of the way of a television speaker, and the echoes were so bad that even with normal hearing, folks carrying on normal conversations in the area bounced around enough to become a constant roar in the background ... so the tannoy had to be turned up to the edge of distortion to cut through the babble (making consonants a bit indistinct). After being called into a triage room, we waited until I was called to registration -- to the right of the information desk -- where I signed the "you can bill my insurance if I have any and I'll try to pay if I can otherwise" form, and sat down in another area with chairs all pointed at a television (this one fortunately at a lower volume), to wait until a quarter past ten at night, to be taken from the waiting room to the emergency department proper.

Nearly nine hours in uncomfortable chairs, in an oppressive acoustic environment that would've been draining even if I hadn't been dealing with hyperacusis already. And spending more time upright has been making my dizziness worse, so without any room to really lie down, between the dizziness and fibromyalgia pain, I wasn't in any shape to walk, cane or no cane, by the time they were ready for me. Fortunately, starmalachite had seen this coming, and had spoken to an orderly a couple of hours earlier to ask that they bring a wheelchair when my turn came.

A long and painful day, and I hadn't gotten in to see a doctor yet. I had taken Ultram while waiting, but it was already wearing off, and I was on the verge of calling it a wasted trip and heading home. Apparently the ER had a lot of patients who needed to be admitted, they were having trouble finding beds for them, and the backlog meant they didn't have room for more patients coming into the ER. But at long last someone came for me with a wheelchair, and after nearly taking a tumble trying to stand up to get into the chair, I was on my way out of the waiting room Purgatory.

As I Tweeted (some of these were also posted here):

2:44 PM Apr 28th	At UM Med Ctr ER, waiting for triage. [ starmalachite] drove me.
4:34 PM Apr 28th	At hospital ~3 hrs; not yet past waiting room.
6:09 PM Apr 28th	Only result so far: feeling much much worse. Still in waiting room.
7:48 PM Apr 28th	Hyperacusis + hospital = teh suxxor.
7:50 PM Apr 28th	Sounds leaking past earplugs give impression of industrial music + whale song.
7:51 PM Apr 28th	Feels like world is on verge of turning inside out in combo of Dali & Lovecraft.
7:52 PM Apr 28th	Still in waiting room.
8:34 PM Apr 28th	(Tweeting more updates than I'm posting to DW, LJ, IJ, etc.) Stillllll waiting to be seen @ ER.
8:42 PM Apr 28th	Walked in under my own power w/ help of a cane. Feeling so much worse now, not sure I can still walk.
8:43 PM Apr 28th	Wish I'd programmed VCRs before leaving house. Whoops.
9:53 PM Apr 28th	Food helped a little. (Yay tahini.) Still wobbly, still hurting, still in waiting room.
10:17 PM Apr 28th	finally headed to exam room
6:04 AM Apr 29th	No phone signal in bowels of ER. Just left. Going to pharmacy.
6:05 AM Apr 29th	Will post ER details to journal later.

[I don't know why Twitter showed some of those as "posted from web" and others "posted from txt" when they were all sent from my phone. *shrug*]

So at around a quarter past ten Tuesday night, I was finally wheeled fron the waiting room to the ER, parked briefly in the hall while someone finished disinfecting the examination room from the previous patient, then transferred to a bed where at long last I could lie down to wait for nurses and doctors to get to me (another 45 minutes, I think, but I'm not sure ... I was just glad to be lying down, and to be in a quieter environment, though I still wound up using earplugs because the intermittent noises were uncomfortable with my ears acting funny even though most of the time it was pretty quiet).

I was seen by two doctors and at least one nurse and at least one orderly (I don't remember whether the fifth person was another nurse or another orderly ... I was not at my most clearheaded by then, though I was starting to think a bit more clearly than in the noise and discomfort of the waiting area). Lots of questions, of course -- I got the impression that they were working mostly off my answers to questions with the tests being just to make sure of what they already suspected or to check for things I couldn't tell them. Also an EKG (which took a lot less time than I thought it would ... putting the stickers all over me and hooking up the leads took longer than taking the readings (oh, and I was later pleased to discover that EKG pad adhesive is to skin and hair as gaffer's tape is to walls and paint -- they were Good And Stuck with respect to resistance to accidental dislodging, but came right off without yanking hairs when I got around to removing them at home)), and a CAT scan (also much quicker than I'd expected, and very, very quiet).

The CAT scan ruled out brain tumor and sinus infection (I have benign, not-uncommon cysts in my sinuses, which I hadn't known before, but they're not pressing on dizzy-making places), the EKG showed no heart issues, and the drugs I'm taking were deemed Very Unlikely to be causing the dizziness. They gave me Ultram and naproxen for fibromyalgia pain at my request, and 25mg of meclizine for the dizziness, along with referrals to a neurologist and an ENT specialist (whom I need to ask about sliding fee scales to find out whether I can afford to go). As I recall, the word was that they still had no clue what the cause was, but had ruled out the OMG-Scary-Admit-Now stuff, and thought the meclizine would help with the symptoms until one of the specialists figured out the cause.

Shortly after the first dose of meclizine, my dizziness changed from the falling/about-to-fall feeling I'd been having, to a spinning and drunk-feeling kind, I felt a whole lot worse, and then a headache hit, hard. I asked, "Does this drug make you feel worse before it makes you feel better? And can it trigger migraine?" and got negative answers on both of those; then I asked, "How quickly does it normally take effect? Should I already be feeling it, or is this too soon?" and was told that I shouldn't really be feeling the effects for another ten minutes or so ...

... So I'm guessing that the icky effects were from an ill-timed, randomly coincidental migraine. That I did not experience similar effects the second and third times I took meclizine seems to support this conjecture.

Finally, one of the doctors performed the Epley maneuver because I'd asked about it -- she didn't seem to think out-of-place otoliths were likely to be the source of my problem, but said that since the Epley maneuver was safe and easy and low-tech, it couldn't hurt. It fely ... interesting, but no magical sudden relief. With the meclizine, I felt significantly less dizzy, but not all the way back to normal. I was given a second dose immediately before being discharged.

After a trip to a drug store, we headed back to my house, and I was home around seven Wednesday morning, exhausted and headachy but at least a little less dizzy. (I'd gotten a little sleep before and after the CAT scan, and the migraine had subsided while I slept, but I was still feeling wrung out from the whole too-long adventure.) I went to bed, and unsurprisingly wasn't good for much the rest of the day, or today.

I got spoken instructions to take the meclizine as needed, up to one every six hours but skipping doses when I feel like I can do without, and printed instructions that say the drug is most effective taken at regular intervals; also, the prescription is for twice the dosage I was given in the hospital ... which I guess means I can experiment with taking the larger dose and see whether it helps more, and if not then I've got a supply that'll last twice as long.

Here's a detail which may prove important: even without the meclizine -- after sleeping past a couple of scheduled doses in a row, I'm less dizzy than I was Tuesday morning. Is it possible that there are multiple simultaneous causes for my dizziness, and the Epley manuever solved half the problem but the effect of it wasn't felt right away? I'm still feeling increased dizziness immediately after moving my eyes too qickly (or turning my head quickly, but it seems to be correlated with rapidly changing visual stimuli more than physical motion of my head. (I guess I should program some animations to test this further. I did notice that both times doctors did the "follow my finger" bit, I got a lot more dizzy and started breathing harder.)

Anyhow, I guess the next big question is whether, with the meclizine, I'm doing well enough to feel safe driving significant distances. And the question after that is whether the neurologist and ENT doc have sliding fee scales.

At least I spent Tuesday afternoon in air conditioning, and by the time I got home Wednesday morning the weather had broken. I came home to a very vocal feline, went to bed, wasn't up in time to go to rehearsal or feeling well enough to deal with the trash and litter box, crashed again, woke up feeling able to stand long enough to wash all the dishes in the sink (though I was hurting by the time I finished), and crashed again. I'm told I sound a bit more like myself on the phone, which is a good sign. Now to see about getting my life back on track, catching up on stuff that's been falling through the cracks, and try to get a complete solution before the bottle of meclizine runs out.