Last week, I had the most amazing experience in Emergency Care at the Toronto Western Hospital. About 7:45 that evening, after getting up from my couch at home, I felt a sudden onset of dizziness, chest pain, and a continuing compression in my chest which made me feel “winded.” It was like nothing I had ever felt before. When the condition continued, I called to my husband to drive me to the nearby hospital. I feared a heart attack and knew from the experience of several colleagues that it was imperative to get to the hospital ASAP. We were there within minutes.
Fifteen minutes after I signed into the emergency ward, I was called to the triage nurse. He heard my story, found my blood pressure to be high and noted that I had an abnormally fast heart rate, and immediately sent me for an ECG. That showed an arrhythmia in my heart and I was taken right away to what I later learned was the “Resuscitation Room.” I totally bypassed the normal Registration process which was done by the staff on their own while I was seeing the doctor.
The resident physician gave me a once-over and concluded that I had Atrial Fibrillation (AFib) which can cause a stroke or a heart attack. He gave me two aspirins and ordered immediate blood tests. To slow down and correct the rhythm of my heart rate, I had two choices. I could take a drip treatment which takes some time and which may or may not work, or they could do an immediate Electrical Cardioversion. He explained that an Electrical Cardioversion was a brief electrical “shock” to the heart using a machine (later I learned called a defibrillator) which uses two sticky pads that are put on the chest and back. During the procedure, I would be given meds to make me feel comfortable. Since my nephew on the west coast is an electrocardiologist and works with these procedures, I was more than willing to consent to the “shock” treatment.
Within an hour of my arrival, a senior doctor on the ward was doing the procedure in consultation with another doctor, and in the presence of two residents and two nurses. I was left in the Resuscitation Room for a while and then moved to the back of the ward for another three hours. They then took more blood tests and did another ECG. Although I later learned that my systolic blood pressure at one point had been over 200 and my heart was stressed for about an hour, the blood tests taken on my arrival and again three hours later showed no damage to my heart and, as the nurse said, I (now) had “the ECG of a 16-year-old girl.”
I was discharged with a prescription for blood thinners, a referral to the Atrial Fibrillation Quality Care Program (AFQCP) at Women’s College Hospital for the next Wednesday, and a recommendation that I see my family doctor within two days. I was able to see her at 7:00 p.m. later the same day.
I was blown away by the quality of the care. I consider myself most lucky. This AFib Incident identified my current cardiac condition and steered me onto a path of treatment which may avoid a major heart attack or stroke down the road. Although the AFib condition must now be managed, my chances of living a longer life and without stroke-induced disabilities just improved. Because I went to the hospital immediately, the “shock” treatment was an available option to stabilize my condition.
NOTE THAT THE “SHOCK” TREATMENT IS ONLY POSSIBLE FOR A SHORT PERIOD AFTER THE ORIGINAL AFIB INCIDENT. Should you suspect a heart attack, go ASAP TO YOUR LOCAL EMERGENCY DEPARTMENT so that you too might qualify for this treatment.
I have subsequently learned that it may be better to call an ambulance immediately. The paramedics would monitor your condition en route to the hospital and you would be given a priority in triage on arrival. On the other hand, the ambulance may not take you to the nearest hospital; they decide where you go depending on how busy the different emergency wards are.
The incident taught me even more.
First, I saw that emergency care nurses have the most demanding of jobs. They work twelve-hour shifts. How they do it I do not know. They are constantly on the run, working in crisis situations, and responsive to many people who are difficult, impaired or addicted, and who make unreasonable demands like shouting that they want to go home when they clearly cannot.
One of my nurses is 62 years of age, has two grandchildren and a constitution which allows her to sleep only five hours a night. She “loves her work” and would miss it if she were to retire. She told me her name, and showed me pictures of her grandchildren. The other nurse is 30 years old. He came from Gander, Newfoundland, and spent the first two years of his career as a Flight Nurse working in Nunavut. He also told me his name and we talked about my forthcoming trip to Newfoundland in October. Both were extremely pleasant and resilient, with incredible patience and warm compassion. That they shared so much of themselves made me most comfortable. I very much appreciated that they kept me informed about my condition and what was happening as we went along. When I was discharged, one took me to the lobby and showed me how to call a cab.
Secondly, I learned that it is still common practice among medical professionals to refer to women patients as “my dear.” When the attending resident referred to me as “my dear,” I asked him not to call me that and to call me by my first name. I told him that I was surprised that young doctors are using that term in this day and age, that the only other doctor who had ever called me that before was an older cardiologist I consulted years ago, and that the term was well-recognized even then as being demeaning. The two very wonderful nurses admitted that they too used the term; one never thought anything of it, the other used it when she was looking for deep veins and thought she might be hurting me. The doctor concluded our interaction by saying that he learns something new every day. How is it that medical schools and institutions are not addressing the issue?
Thirdly, going home alone from the hospital in a cab at 5:00 a.m. is not to be feared. As we talked en route, the cab driver showed that he knew quite a bit about medical procedures in emergency wards. When I got out of the car, he added, “Marion, don’t forget to drink lots of water.” He was absolutely right to know that I might be dehydrated, and I was happy to take his advice. He waited at my doorstep until I was in the house.