Friday, March 21, 2008


Guess who came back yesterday? Mrs .420. She called the ambulance for "pain everywhere." Paramedic Pete responded and rolled her through my ER doors at about 10 in the morning.

"Paula, have you been drinking again? 'Cuz you know I can't give you any pain medicine if you've been drinking," I told her.

"No I haven't Julie. I've been puking all morning. I promise I haven't drank anything. My belly hurts so bad - can I just have something for the pain?" she asked.

We transferred her to the ER stretcher and I quickly disrobed her and changed her to a gown. Her abdomen was twice the size as it was during her previous visit. Oh Lord.

"I just don't feel right," she said.

"I bet," I replied.

I finished a rapid assessment, started and IV, drew some labs, got a quick catheter urine sample, and notified my doc of her arrival.

30 minutes later we saw that her liver was shutting down. Her liver enzymes had quadrupled since her last visit, and I noticed she was a bit yellow when I got her out of the exam room and into radiology. Let me just say here that lighting makes all the difference on a skin assessment.

2 hours later we got her admitted to the floor. Dr. Q set her up on the alcohol withdrawal protocol and I reported off to the accepting nurse.

I went back to the ER and started talking about addiction with another nurse. It seems so foreign to me that something could have so much power over you as a human that it can make you crave it while simultaneously destroying your life. I see it every day and yet I don't really think about it all that often.

But here was a lady in her early 50's who could have been anything in the world when she was younger. She could have been a teacher, a lawyer, a politician, a nurse, a mom - anything.

Yet her biggest accomplishment in life was to become a die hard alcoholic and drug user.

So sad.


Tex said...

You reap what you sow...
Amazingly, everybody has the choice and power to become anything, even an ETOH/drug abuser

Lucid said...

Love your blog.

I can't believe she had a .420... that's just amazing. I can't imagine the shape she was in.

I don't know whether to feel sorry for these people or not.

By the way, I'm going to keep in mind what you said about lighting and skin assessment. That's a very good point.

Braden said...

I had a guy found down on the side of the road the other day. He came in by EMS, and 20 minutes later as he wandered haltingly around the ER spewing blood from his recently "removed" IV catheter, I was trying to mentally gage his BAC. When the cops got there to help settle him down we got a breathalyzer - .105

.105? The cop who was standing there said it best: "that's me on a good fishing trip."

Another guy came in a few days later for mid-epigastric pain. I never even suspected alcohol until he admitted a drinking problem. BAC? .23

I'm officially hanging up my guessing shoes.

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