Sunday, 8 January 2012

2216 An unexpected visit to Casualty

During the past three maybe four years I have made three unplanned visit to the General Hospital emergency department here in South Shields. Two of these arose from using the NHS Internet and telephone service. The other was when I tripped up over a step when visiting a newly opened corner store and split my nose after hitting a metal rack. I was kept at the hospital for a good couple of hours before being released in order to ensure there was no delayed reaction in case I had hit my head harder than I had. I did not enjoy the experience in part because of anxiety that I had left my front door unlocked and that I had planned to go out that day.

On the previous occasion of contacting the NHS service I had spoken to a receptionist, a nurse and then a doctor who arranged for me to see a doctor at casualty which I did in the early hours and where he was able to diagnose a urinary tract infection. I had a cold at the same time and in addition to a surge in temperature which quickly fell back I had trouble breathing and in sleeping.

A shortness of breath and in sleeping at some during a simple head cold and cough is something I had experienced over recent years and where I have come to dread getting and assumed the problem was part of old age just as the need to go to the toilet several times a might upon waking.

On at least two previous occasions of a cold I experienced an in ability to sleep because of shortness of breadth. I remember seeking some fresh air but the situation only lasting 24 to 36 hours.

On this occasion I had developed a ticklish coffee after a visit away at Christmas. I had made the mistake of leaving the warm car twice without a coat on the returning journey home first for milk at the Tesco supermarket and then to check if Morison’s had sprats which I fancied for my tea. They did not and I kicked myself for not putting on the coat because of cold that had cut through to the chest.

The first response on getting the throat tickle was to take a finger of whisky which is usually effective but in this instance the tickle persisted and it appeared that I was about to lose my voice. This was a new experience and startling. For some reason I did not immediately turn to the usual paracetemol cold condition hot lemon or blackcurrant drink from a sachet, a supply I also keep on hand. I also had in the fridge two half full bottles of cough mixture which I commenced to use. I did not lose my voice. Several days later I read “Tickly cough- The irritated area in the throat produces a tickly sensation causing you to cough, even though there’s no mucus to cough up. Dry cough- Dry coughs are caused by an inflammation of the upper airways caused by dust, foreign bodies or a throat infection. There is no mucus or phlegm produced.

I read only later “Gargling with salt and warm water can also help relieve sore throat symptoms and nasal congestion. Dissolve 1 teaspoon of salt in 1 cup (240ml) of warm water. Gargle four times daily – but don’t swallow

I also later read later “Drink plenty of water and avoid caffeine and alcohol. Orange juice is great for vitamin C but don’t drink too much if your stomach is upset from the cold you’ve got. Avoid caffeine at night. If you choose a product that contains caffeine, avoid taking it before bed time. When you’re under the weather, it’s important to drink water. “

I keep a supply of bottled water in my home. I keep one bottle in the bathroom so when I rise at night I can rinse out a very dry mouth. More recently I have kept a single hard boiled sweet on the bedside chair which I suck on waking just to get the mouth clear before rising for the toilet. However I did not commence to drink water until later. After the chest had become congested. It was only when without a head cold or temperature developing my chest became congested and the cough remained dry, going into my lower abdomen, so it seemed, and gagging, and gulping for air that I commenced to read up on the internet.

“Chesty cough: Chesty coughs are caused by a build-up of phlegm or mucus in the lungs. The cough mechanism kicks in to try and get rid of it. A chesty cough can also be referred to as a mucus cough. Mucus cough: When mucus builds up in the chest, it can be hard to get rid of by coughing, so it’s helpful to have something that helps to loosen the mucus and relieve the feeling of tightness on your chest. A mucus cough can also be referred to as a chesty cough. “

For the rest of Tuesday and throughout Wednesday I supped ice cold water in a glass filled with ice and this was effective in easing the throat. However as Wednesday progressed I started to burp even with the smallest of sips. Burping was also a problem. I worked out that the problem was not the water or the coughing so much but the shortness of breath so I was taking air in in gulps.

On The Tuesday I had also read that Garlic is famous for its ability to fight infection, so try munching a clove every 4-5 hours. Young cloves are milder, so maybe start off with them.” “Pepper and chilli are natural remedies for clearing blocked nasal passages and can help to warm your body naturally“. “As we said, garlic can help fight infection – but if you can’t face munching cloves, try making a stock soup with extra garlic. Chicken soup with barley was also recommended and avoiding dairy products which includes chocolate.

I went to the supermarket around 8 am on Wednesday. I did not fancy munching the cloves and having read that adding them to some chicken stock I went in search of stock but not sure of there was difference between gravy stock in cubes and that to be used in soups. I tried to look for chicken soup and chicken soup with barley without the addition of cream as I had read it was best to avoid dairy products. I made chicken soup on return adding a smashed clove of garlic and some ginger ands then strained the result which I drank in the morning and then later in the day.

“If you’re feeling blocked up, try pouring steaming hot water into a bowl and inhale the vapour. Add the essential oil, eucalyptus, to boost the decongestant effect.” As a child I had be made to inhale Friars Balsam but could not find the item at he supermarket as it has been a struggle to make the trip I was up to remaining out and going in search of health store, if one had one in South Shields. So I made do with a bowl of hot water later in the day but this did not deal help with the growing problem I experienced and found difficult to cope with.

I was delighted to also read that liquorice can be used as an expectorant. It loosens mucus and lubricates the respiratory tract. It is an ingredient in almost all cough medicines. I eat liquorice to help to keep my bowels regular.

I also read that “A dab of mentholated ointment under your nose can relieve congestion and help restore the skin made red from blowing your nose. A humidifier can also help relieve congestion and help you breathe easier

I found several references to eucalyptus. “Eucalyptus has long been used as a decongestant and is still regularly used today, as it is found in many over-the-counter cold medicines. In "1000 Cures for 200 Ailments," Dr. David Kiefer explains that you can get the eucalyptus directly into your congested respiratory system by adding a few drops of its oil to water in a vaporizer and breathing the steam in through your nose. He warns to keep your eyes closed, though, as eucalyptus oil can irritate them, and not to consume eucalyptus oil. In "Healing Without Medication," Dr. Robert Rister advises sucking on eucalyptus lozenges to help with congestion“.” Get rid of phlegm with eucalyptus remedies. Eucalyptus is an effective expectorant that is distilled from the twigs and leaves of the eucalyptus tree. The primary component of eucalyptus oil is the volatile substance cineol, which has an irritant action on tissues and induces coughing. “

I noted all this for future reference deciding that I did need a humidifier or some form of air freshener in the bedroom in winter. In summer I slept with side windows opened at the top and this appeared to help my sleeping and breathing

So having read and made start I had hoped to see progress during Wednesday but in fact felt more uncomfortable as the day progressed. I had attempted to sleep in bed as dawn approach but the attempt was short lives. Feeling tired during the day I sat in the settee but just when I thought I was drooping off I woke immediately with a start gulping for air. I have had a breathing problem at times when in bed and for several years I have slept on my side rather than on my back and need a couple of pillows.

“When you’re ill,” I had read” it’s normal to experience broken sleep – so you need more of it during the day to catch up on lost sleep. Pushing yourself when you are tired causes more stress on the body – so give your body a chance to fight back and rest more.”

“If you’re suffering from a cold, try sleeping with an extra pillow. Being slightly elevated can help drain the congestion so you sleep better.”

The combination of lack of sleep, difficulty in breathing and burping did create a stressful situation as the night progressed and there was no respite.

To be exhausted and unable to sleep or relax was a new condition so around 1.30 am. Having been up from 2.30 am the previous morning and then only having had two hours of sleep in bed, I decided to check out what the NHS Direct site had to say and commenced their question and answer system but there was nothing about breathing or burping so I decided to ring the number. Because of the previous experience I was ready to be asked a series of questions with the only difficulty in making the point that that I could not remember precisely when the breathing difficulty has become prolonged but at least six possible eight hours and that it was prolonged rather than intensifying. I was then passed to a nurse who went through everything as before. On the previous occasion I then went through the position with a doctor who arranged for me to be examined by a doctor at the general hospital in the early hours of the morning, driving myself by car.

This time the nurse said she was calling an ambulance and I should stay on line. There was no time to speculate about what this meant so I got myself ready to go out, collected my phone, credit cards, cash and diary that included key telephone numbers and then got a pair of pyjamas. I needed the toilet and before I got hold of something to contain the pyjamas, and for washing, shaving and teeth cleaning there was a hullo at the front door which I had been asked to keep open.

It struck me later that if such a situation could happen again and I found myself in a more debilitated condition it might be wise to have a going into hospital emergency bag always on hand.

I did not immediately recognise the paramedic but it was the same individual who had taken me from the corner shop fall and she remembered that I had spoken about cricket. I was attached to a machine and my blood pressure and temperature was taken. I had not felt that I had a temperature but for the original question and answer session I had stopped to take my temperature and as anticipated this was normal.

The paramedic reassured that she thought the problem was cold related as the tests did not reveal any immediate major other problem but she thought a medical examination and opinion was important.

I became familiar with the General Hospital at South Shields during the six weeks that my mother was resident before her death. I would pass the outpatients and casualty on my way to the admission ward where my mother was first admitted. My own memory was also of what I would term as a standard hospital waiting area. This occasion there was an attractive reception area when the paramedic insisted on wheeling my in a chair through to the adult casualty waiting area. My mouth had become dry with the talking so I obtained a bottle of water from the machine. You gave to type in the number of the item and then insert the money required and then put in the number again before the machine moves into action. I had to get help to do this. There was no information available to explain the procedure.

The water helped but I continued to belch although the coughing had settled down. During the day I had taken two doses of a new decongestant purchased at the supermarket in the morning and which had no immediate effect.
I had to wait a little while before being wheeled to a cubicle where I was prepared for a medical examination. Again the facility appeared different from when I had visited my mother when a couple of years before her final admission where I first saw her on the ward, I had visited her soon after she was taken to casualty and stayed with her half the night before she was declared ready for discharge back to the residential home.

On this occasion I was attached to an assessment monitoring machine by ten connections to my body. The base body connector was stuck tot he skin which had to be removed by hot water when I returned hone, One two each lower leg, two to the sides and four to the chest. And one on each hand. Fortunately none to the back which would have made removal difficult. The paramedic had attached her machine to my back and removed the skin connectors leaving those to my hands. I cannot now remember if the nurse also asked questions but I was told to make myself comfortable sitting up on the high from the floor examination bed.

The doctor was very sympathetic and asked me to explain what had happened and seemed to focus on the gagging and breathing which is what had concerned me from the outset. He asked about changes in shirt neck size which appeared important that my neck has increased in size over recent years. However I explained that I had bought bigger size shirt mainly to ensure they were big enough to cover my tum adn that this retiring a I rarely buttoned at the top to wear a tie therefore my shirt size did not reflect my true neck size as an indicator of whatever.

I also mentioned that it was not uncommon although not a daily occurrence for me to go to sleep on the settee after a meal watching television and finding that half an hour, or less had passed by when I woke. Over the previous 24 hours I had seemed about to drop off on the settee but waking instantly gulping for air. This was the difference. My feeling physically tired during the day had been one reason why I had sopped rising at 5 and going for a my swim of 750 metres for a year, reduced to 500 in the last in the two months of the second year before I decided to stop. I was no longer enjoying the experience as I had; I needed to do more with the rest of the day. I had felt fit and psychologically happier with myself apart from the appearance of my body because I had put on weight. There was also the cost factor which led to decision. It was now some three months into the previous lifestyle where I would sometime sleep until later in the day rather than rise at 5, often because I had stayed up until eleven to midnight, occasionally watching a film until 2 am..

The doctor spoke of a condition which I vaguely remember coming across as he said this could aggravate the breathing problems which arise with a cold, otherwise he and not detected a chest infection, I had mentioned that the phlegm was white rather coloured. So had \I experience a panic distress attack. Certainly I felt better in myself being able to talk about what had happened and in fairness to myself I had not requested medical attention but wanted information.

I was asked to visit my GP and report the situation which I did with an appointment on Friday afternoon. I already attended outpatients for a blood test which I have done several times previously for the annual check up, I had intended to arrive eight for the eight thirty start as the waiting area is usually full if you arrive just before 8.30. However I had slept a full eight hours with the usual getting up on the Thursday. I had felt better during the day although I had again not been to bed. I was dislodging phlegm when coughing a my nose had cleared although as the weekend has progressed I continued to have coughing fits and on Saturday evening I appeared to be back to square one for a while which a blocked nose, coughing and burping but not as congested. I went to bed about a half hour after midnight and could only get comfortable almost upright with four pillows and turning on one side. But I manage to sleep with three waking until well after seven and have felt fresh since.

Although I arrived for the Blood test after 8.30 with 28 individuals waiting I was back in my car in about an hour. There is an appointment for a chest x ray on Monday afternoon and I return to see my General Practitioner in two weeks by which time he should have received the information of my visit from the hospital as well as the additional test results. I feel unexpectedly calm about the prognosis and its implications deciding not to speculate in the meantime but concentrate on preparing of any eventuality. One good aspect is that my appetite has become less losing a couple of pounds over the past week so that a break below 17 stone is now in sight again and with the loss of a full stone since getting my head right about three months ago.

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