Thursday, June 07, 2012

A Night In The Hospital...

This Lunatic was just released from a hospital yesterday.

Well, maybe not "released", as what happened was that I went to a hospital, and once I felt better I demanded they let me out, but you get the idea; I was in the hospital overnight from Tuesday to Wednesday morning.

The first thing I'd like to say is "Thank You" to the staff at Staten Island University Hospital. You folks do a bang-up job, and probably never get any credit for it. Especially when you have to deal with the world's worst patient (i.e. Me), although the part where you woke me up from a sound, bed-wetting slumber in order to give me a sedative still sorta-kinda mystifies.

Anyways. they're good folks at SIUH, and if you have to be ill, why, there's no better place to do it, and no better people to see you through it.

Now, as to what happened to me.

See, I still occasionally suffer from a bunch of conditions so graciously bequeathed me by 19 kamikaze Muslims who couldn't get a date unless they committed suicide first, or something. Back in the day, the words and concepts PTSD, Agoraphobia, Anxiety Disorder, Clinical Depression were things that I hardly knew about. I know far too much about them now, I can promise you, and it took me years to finally manage them so that I could at least go about the business of life.

In fact, I have managed them very well, indeed. Until I started doing some really stupid things recently.

Like trying to quit smoking.

And removing the caffeine from my diet.

Trying to lose some weight.

Moving in with a girlfriend who has Muscular Dystrophy, and subsequently requires a lot of attention.

If you ever thought you had a raging anxiety complex under control, and wanted to test that notion, then make some significant life changes like that, and see how long it'll be before you're in full-blown panic mode.I'm betting it won't be very long at all.

Now, for those of you who aren't familiar with the physiology of a panic attack, I'll fill you in on all the sordid details because it's good information to have in case you're ever stuck in an elevator with a panicky person, and also because I'm getting sick and tired of people who pooh-pooh the entire experience away as someone being a pussy. Frankly, I used to think this way too, until it actually happened to me. It's no joke.

A Panic Attack basically involves a "tick" in the body's Fight or Flight response, a natural, defensive instinct that either creates the most craven of cowards, or legions of Medal of Honor Winners. It is a reflexive reaction to an imminent threat. The unfortunate part of an Anxiety Disorder, however, is that this reflex often kicks in for no reason at all -- there is no imminent threat, often only a vague feeling of unease -- and then your conscious mind takes over and fucks you up, but good. The run-up to a panic attack is often occupied by what's called anticipatory anxiety, in which the victim works him/herself up into a frenzy trying to anticipate all the ramifications of the event that has upset them, or contemplating the potential embarrassment of being wheeled out on a stretcher, fainting or vomiting in public, shitting your own pants, or generally, of not being able to get help in a what has now become a dangerous situation (in your own mind) should you need it.

The Fight or Flight instinct gets caught up in a mishmash of neuroses, and then fails to work. You can't figure out what to do, run or stand and fight, and in the meantime, your body is doing things to itself that should be illegal in 49 states (sorry, West Virginia).

It is, of course, patently ridiculous, often, to think this way. You may rationally know that you're overreacting to something, but completely unable to turn off your runaway thought process. And this is the truly dangerous thing, because often even though the original stimulus has long passed, the effects linger for hours, sometimes days. You simply cannot take your mind off whatever stray thought it was that sent you careening into a tizzy in the first place. This sort of concept is difficult for people who have never experienced such a thing to grasp.

Believe me, you would not wish it upon your worst enemy, if you'd ever experienced it for yourself.

Physically, because the panic attack always has physical results, the process becomes easier for other people to understand. Your heart starts racing. Your breathing becomes rapid and shallow. Your muscles tense, and blood vessels constrict. As your blood pressure rises, you become dizzy, nauseous, and often numb.You seem to be walking through some sort of alternate reality that is external to you. Things slow down. You become hyper-alert, and every sound, every muscle spasm, every change of light or temperature alarms you.

If you're lucky, and have had the training necessary to deal with these circumstances, you won't pass out. Indeed, if you know how to handle these sorts of things, you'll be just fine in 10-15 minutes, so long as you manage to control your breathing and calm yourself down, or can manage to avoid the thing that set you off for a spell. Unfortunately for you, though, this probably means two to three days of annoying after-effects, like muscle cramps, muscle pain and spasms, and slight, lingering headaches.

In the extreme, a panic attack often mimics some of the symptoms of a heart attack, and this is where it all becomes very serious, indeed.

I hadn't had a full-blown panic attack in some seven years or so before Tuesday. Only this time, the symptoms began about a week prior, and although I kept telling myself it was only anxiety, and going through my coping routine continuously, it wasn't getting any better. Ultimately, the pain in the chest, the numbness in the left arm and shoulder. the twitchy spams in my head, neck, legs and face, were too much to bear and I thought, if only as a precaution, I should go and see a physician. As I am currently without health insurance, this meant a visit to the local Urgent Care Center, where services are rendered for cash on the barrel head.

Well, the doctor there needed all of about five minutes to make the decision to call the ambulance.

So, I wound up in the Emergency Ward at SIUH.Now, this sort of thing has happened to me before, most notably in 2003 when, before I knew I had an Anxiety Disorder, I had managed to walk into the Emergency Room at SIUH three times in a ten-day period with heart-attack-like symptoms, only to be given the proverbial clean bill and a recommendation to see a psychiatrist. The last visit resulted in a five-day stay in SIUH's beautiful (and at that time, new) cardiac building, after which, the cardiologist on duty told me, bluntly, "get the fuck off my don't need a doctor or a hospital, you need prozac."

She was right. Then again, what else do you say to someone who came in complaining of heart-related issues, and then leaves the ward -- heart monitor still attached -- to go off and smoke cigarettes every hour or so? They did, however, alert me to a massive cholesterol problem that I was totally unaware of, and some changes to diet and a few pills knocked that problem out within a short time.

Well, guess what? This time, the same thing happens. I'm not having a heart attack, but I did have a massive panic attack. I knew it pretty much as soon a I got to the ER and my chest didn't hurt anymore.  I even told the Doctors this. This is a common occurrence with panic attacks: just as soon as you're ensured that you're about to be cared for, the worst of the symptoms almost immediately and mysteriously disappear. Still, they didn't like the family history (lots of early heart-related deaths), my weight (I'm wondering where I put it all, because I sure as hell don't look THAT big!), and my sky-high blood pressure (a result of the panic).

Long story short, while in the hospital for those 27 hours, I got to take a good look around me, just to see what goes on there.

The heroin addict across the floor, wheeled in for the third time this month. injured (also for the third time this month) while trying to break into someones house. You wonder why he isn't in jail, and why he's lying on a hospital gurney eating that disgusting institutional food like there's no tomorrow. The nurses seem to be on a first-name basis with him.

The room next door, in which the unseen man within alternately hoots or howls like an animal, or cries his eyes out. I suspect some sort of unresolved mental health issue there, and I figure he must be strapped to his gurney.

The drunks, seemingly all around, who have injured themselves with power tools, or in minor traffic accidents, who fifteen minutes after arriving unconscious start yelling, wondering where the fuck they are, and who has their fucking pants, and can they go the fuck home now?

The room that I lay directly in front of whilst on the gurney in the ER, which contains a 15 or 16 year old girl. From the conversation, and the fact that she has a nurse actually GUARDING her, it's apparent that this girl is on suicide watch, and it isn't her first time either. The conversation -- mostly involving her pleading to be let go by a grandmother with an iron spine -- is predictable: she's a drug addict. The typical Staten Island drug addict, which means she's addicted to Valium, Percocet, and the all-time fave of the local junkie, Oxycontin (known in these parts as Staten Island Crack). She's been in rehab twice, and relapsed twice, and grandma is going to have her committed and there's no arguments about it. It's sad, but you realize that it's probably for the best.

Wave after wave of one-foot-in-the-grave-already super elderly folks who are, literally, one blink of an eye from taking the dirt nap. All have paper-thin skin beneath which you can see the veins in their faces and skinny arms, looking like someone draped some Saran Wrap over a bag of guts. They come in all day long with a long laundry list of ailments, and you wonder how it is they're still breathing: Who is a stroke victim, who's the heart attack, who is diabetic, who is all three with a raging case of osteoarthritis, kidney failure, and pneumonia on top of it all. These people look gray, spent, and they lie on gurneys surrounded by machines like some sort of vision of Frankenstein's Laboratory. Why is anyone bothering?

Mexicans (or at least Central Americans) everywhere you look. They're coughing up lungs, sneezing without covering up, bleeding all over the place (usually from the lacerations they received after the broken-bottle attack. There were three of those in about a five hour span which coincided with Happy Hour), the odd battered wife or child who came in looking like a losing heavyweight, chattering and wailing in a combination of non-standard-Spanish and great pain.

This is what the hospital is full of. And then I have to come in and make things worse?

Anyways, After a few hours in Emergency, I wound up on an Observation Ward, my doctors having decided to give me a full cardiac workup before letting me leave.Truth to tell, I could have predicted this was what they would do, and what they would find, which was nothing.

Five EKG's, continual overnight monitoring with a cardiac halter.

Two Cardiac enzyme tests, both negative.

A full blood work-up which revealed high cholesterol (been there, done that). no diabetes.

A stress EKG on the treadmill (I did almost 12 minutes, got my heart rate up to 160, hardly out of breath, but very sweaty).

Echo cardiogram (negative).

So, the verdict? Probably a panic attack, which is what I told them the day before when they admitted me. Still, they were being cautious, and you can't blame them for it, and I even thank them for it. There's no underlying heart problem, but there will be if I don't knock the weight off and take care of the cholesterol, because I'm pumping Jell-O through my veins.

Now, what did it cost.

Well, all told, for 27 hours in an Emergency Room, and Observation Ward, and a bunch of tests, it's going to be somewhere around $7,000. You read that right, that's SEVEN FUCKING GRAND. It would have been worse: they wanted to run two additional tests that would have verified the results of the two they already ran, and which would have kept me in bed for another day. For this kind of money, I could travel the great capitals of Europe for a month, and gotten laid at least once a day whilst doing it.

I have no insurance, but that's okay: No sooner did I enter the emergency room without an insurance card then the Financial Advisor chick showed up to draw up a payment plan. The hospital takes installments, and is willing to negotiate a price, just for the ability to collect SOMETHING for their services. Which mans me, the guy who is wiling to pay, insured or not because that's the right thing to do, probably got overcharged by a factor of at least five on everything, so that Mexicans who fight with broken bottles, beat their wives, and spread deadly Third-World Shithole diseases can be treated for free.

It probably means that I had to be charged $75 for a baby aspirin because some 101-year-old is lingering on death's door, and refuses to shuffle of this mortal coil, already, and is only being kept alive for no logical reasons by a myriad of apparatus that do nothing but keep everyone else on the floor awake all night with the constant beeping, buzzing and alarms, and waste valuable -- and expensive -- electricity, all only partially paid for by Medicare.

It probably means that perhaps half the tests I was given, and the two I was going to be given before I'd had enough and checked myself out, were being performed not for a medically-necessary reason (after all, the diagnosis Panic Attack, Hypercholesterosis was made within a few hours), but perhaps to keep the hospital and doctors from being sued, and maybe if I were stupid enough to pay for these unnecessary tests, another half-dozen Salvadoran battered wives could get nose jobs, or another thieving heroin addict could have his broken foot set...again.

Giving credit where it's due, I will say this for the democrats and President Odipshit: they're right. The Medical System badly needs to be reformed.

It needs to let drug addicts and drunks die from their mostly-self-inflicted wounds and infections.

It needs to turn the irredeemably ancient away in order to husband resources better use don someone with an expectation of a longer lifespan.

It needs to turn wife beaters into the Police...or the Border Patrol.

It needs to let those who are intent on killing themselves do so. just so that they don't cycle through the wards constantly.

It needs to stop practicing defensive medicine. Perhaps if we started shooting ambulance-chasing attorneys who bring bullshit malpractice cases, this would stop, eventually. Then again, maybe if John Edwards were hung in the public square, it would stop immediately.

In the meantime, I will gladly, if grudgingly, pay my inflated $7k, for the care I received was first rate, and also because I was raised to pay my bills, unlike a good number of people in that Emergency Room who, shall we say, were obviously of low means and lower caliber, who came expecting something for nothing, and largely getting it because someone else was made to pay for it.


Mr Chap said...

I'm sorry you went to the hospital, Mr. M. And I'm really sorry that you had to experience those symptoms associated with the attack. I can't even begin to imagine what a hospital visit in New York is like, with dictator Bloomberg in office.

Granted, I don't understand in the inner workings of a panic attack. I do know that I want you to take care of yourself, and eliminate all things from your life that are unhealthy. Whether it's food, people, cigarettes, whatever. You're too awesome of a dude to leave this place, so get your shit together, and call me when you can.


Matthew said...

Hey, thanks for the well-wishes, Mr. C!

Diogenes Sarcastica™ said...

Sorry to hear you're experiencing problems,Matt.
Hope everthing get better for you soon!

Matthew said...

Thanks much, DS. Need a bit of rest and some better eating habits, and I should be fine.