The Medical Incident:
In early December I flew back east to spend time with my older daughter, Hannah who was 32 weeks pregnant with twins. She has had a tough pregnancy.
I spent the week caring for my daughter as well as lending a hand with my granddaughter, Ellie. I told my husband how grateful I was for this time. It’s rare that I get to spend a few days just focusing on Hannah and I enjoyed every second.
Unfortunately, Hannah began to feel ill again. One day, she was just very tired, the next day she was vomiting bile because of high liver values, cholestatis. Her OB wanted her to be observed in the antenatal unit and so that is where we spent the day.
I was worried and remained with her in the hospital until her husband got there and the decision was made to perform a C section because Hannah was in labor.
My job was to head back to their house and pick my granddaughter up from school.
Before I picked up Ellie, I downed my water and ate a small amount of chicken salad. I hadn’t eaten more than an apple, and had barely had any water all day.
Once upon a time, I could have gotten away with that.
Not anymore. Unknown to me, I was dehydrated, my blood sugar was low and my already naturally low blood pressure had nowhere to go. First I felt nausea. I texted my other daughter, Julia that I wasn’t feeling well. She was already on the way and I figured I’d just go lie down when she arrived.
But just before she got there I felt dizzy and began to make my way to the floor, passing out on the way down.
I woke up to hear my granddaughter crying; with no idea what had happened or why there was so much blood and vomit on the floor. My chin had split wide open when I hit the floor. My granddaughter was so frightened. She was sobbing. It will take some time for me to get over letting her down like that.
I called her other grandparents who rushed right over to care for her.
But this story wasn’t over.
I went to the ER just to get stitches and while there passed out two more times. Vasovagal syncope is what the hospital called it. They admitted me for the night for observation.
I had a full cardio workup, head CT, echocardiogram, blood work, chest X-ray, images taken of my hand to rule out a break and four stitches in my chin.
Apparently women in the midst of heart attack can present as I did.
I had almost refused going to the hospital because I began to feel better once Ellie was taken care of by Hannah’s in-laws. Thank goodness they thought otherwise because I needed care.
There have been other times I’ve almost passed out, but none of them involved complete loss of consciousness. This was something new.
Everything happened so fast.
In the meantime, twins were born, healthy and beautiful. And Hannah and I spent the night in the same hospital, just one floor apart. Everyone was worried I had done too much.
The truth is, I hadn’t done too much. What I had done was ignored quite a few symptoms from the past year.
After returning home, and a bunch of blood tests later, I’ve begun to get a glimpse of why I passed out. Dehydration likely pushed me over the edge, along with the stress of the day. Especially if, like me, you have low blood pressure and heart rate. And we discovered I have hypoglycemia along with anemia. As my primary care physician said, “this was a perfect storm.”
Women especially downplay symptoms. We don’t want to be a bother. I’ve been annoyed with getting sweaty and shaky shortly after I eat and disturbed by visual disturbances (another sign of low blood sugar and dehydration) for quite some time. I didn’t think any of this was a big deal, just my biology.
I’ve learned I need roughly 65 ounces of water daily. I’ve been drinking that amount for over a week and am blown away by how improved my skin color is (I had been pale for a long time). I also need more salt and fat in my diet and to eat every 2-3 hours (to avoid blood sugar crashes). I’m working with a fabulous nutritionist now.
Many of these symptoms were subtle and didn’t interfere with my daily life, but perhaps I could have paid better attention.
Sometimes I forget that I am a bit older. This experience was humbling and disturbing. I didn’t like feeling so vulnerable and not in control of my own body.
The Hospital Experience:
I’m hoping most of you have not had a recent hospital experience. If, like me, this is the case, it is important to learn how to advocate for yourself. Health care is in a crisis and that won’t be improving anytime soon. My daughter is already on her third primary care physician in just a few years because of doctors leaving their practice. Nurses are stretched thin.
Specialists are scheduling months out for the most part.
I received good care in the ER and once I was admitted, but I had to speak up for many things. My IV remained unattached for hours despite a diagnosis of dehydration. I had landed on my hand when I fell and that began to throb just as I was admitted but getting pain medicine and a bandage to compress my hand took a few reminders. My nausea wasn’t treated until I vomited again at 2:30 in the morning (likely due to the pain in my hand). Every time I was moved to another test, the caregiver forgot to put the call button within reach. I was freezing in the ER and sitting on a vomit covered sheet until I went for a CT scan and they gave me two heated blankets and clean bedding. They also propped my lower legs up.
I want to emphasize that I don’t fault the nurses. They were working their asses off and I know I was lower priority once it was clear I was not having a heart attack. There just aren’t enough nurses to go around, never mind beds. I was one of the lucky ones, many patients remained lying in the halls for hours.
One thing I found myself doing over and over again was sharing with my care team that I am athletic, fit and take good care of myself. Despite my daughter also being my advocate, I was worried they would just see an older woman looking like a hot mess, and not receive the same care as a younger person.
And to be honest–I do think that reminder is important especially when we feel vulnerable. Unfortunately ageism in health care does exist.
What I learned:
For what it’s worth, here are some thoughts should you find yourself in a similar situation:
- Pay attention to your body and learn to push to be heard when something is off. You are the one who knows your body best. Doctors are not infallible. Look, this past year I’ve had a plethora of minor changes in my health and was becoming worried my doctor thought I was a hypochondriac. In some ways this incident was a blessing because suddenly everyone listened.
- Don’t ignore unusual symptoms or chalk something up to menopause or getting older. That could be the difference between life and death.
- Don’t downplay your symptoms. This is a tough one for me and many women I know. I tend to focus first on being polite and agreeable when I’m the subject. While waiting in the ER, I began to feel dizzy again but just lowered myself to the floor. My daughter ran to the triage nurse and demanded attention. I’m so glad I didn’t take a header to the floor, but it was only because of Julia’s quick thinking that I didn’t.
- It’s okay to request a test that your doctor wasn’t thinking of. I recommend doing some research too–not to diagnose yourself, but to familiarize yourself with questions you might want to ask. Think you have an issue but your doctor says you are fine? Have a conversation–don’t give up on communication. If they don’t listen, find a new doctor.
- Put yourself first. Damn, this one might be the hardest one of all. I flew home after the babies were born because they were going to be in the NICU for the foreseeable future but also because I needed rest to recover as well as to see my familiar doctors. But I’d be lying if I didn’t say I felt guilty that I wasn’t remaining to take care of my daughter. I had to remind myself that she has a very capable husband and a generous sister along with amazing in-laws. I’m not her only support person.
- Make sure you have an advocate with you. My daughter, Julia, was my angel, demanding help, asking questions and generally making sure I was getting the attention I needed and the care I deserved.
I’ve learned that I’m not superwoman. My body can’t handle some of the things it once could, or at least needs a bit more gentle care in some areas, like diet. I might be healthy and fit, but that doesn’t mean I’m protected from having medical incidents.