Some days I really feel like I am out of warranty. Short version. I've been sick for days with what I think is just a flare-up of colitis with pain in the same area that was damaged by a clot a couple of years ago. As much as possible I like to stay away from the health care system until I have done what I know to do first. The last couple of months I have reason to believe I've had an increase of brief periods of AF. Yesterday AM I was more aware of it and not sure if I was getting dehydrated or possibly my K+ (potassium) level had dropped which would surely put me into atrial fib. I finally gave in and went to my PCP. My PCP has an urgent care that runs out of his office and if you don't have an appointment you go to urgent care and if needed he comes and sees you on that side of the building. What I was after was finding out what my electrolytes were and WBC to know whether I needed to start antibiotics.
Well, I went and signed in and within a few minutes went into a more sustained rapid AF. I still waited my turn and kept in mind that, unless I was really symptomatic, the agreed upon time frame before having to call my cardiologist was 4 hours. A great deal of that was eaten up while I sat there really second guessing my decision to come in the first place. When I finally got in I told the nurse of what I really was after and she took my vitals. 120/100 (I don't think so!) pulse 72(absolutely wrong!). I told her so and she brushed off my concerns and suggestion that she take an apical pulse. I waited for the PA and nicely let him know that his nurse recorded totally erroneous information. He listened to my heart and got a stat EKG. Atrial fib with rate over 140. My potassium came back at the very high end normal and the CBC wasn't run for some reason. He kept bringing up that my gallbladder was probably causing the pain and I strongly disagreed with him and said wrong place, wrong symptoms, wrong history. Still he said it needed to be ruled out but it would have to be though ER or wait until things were open again on Monday. I had arrived there before noon and by now my 4 hours had long since expired. My PCP had left for the day before I was seen. He asked me what my choice was and I told him I was going to go to the ER and hoped to get back into sinus rhythm. I got copies of all my stuff and drove to the ER. I was still in rapid atrial fib but the rate was averaging a little higher...150-160 and I was starting to feel a little short of breath. I am not an easy IV stick. Several nurses tried multiple times without success(although they were able to draw more blood for labs). While they were waiting for someone else to be available to try I converted back to sinus rhythm on my own. I was so ready to go home and be back in my own bed. ER doc, (nice guy actually) said we may as well check the GB (gallbladder) with US (ultrasound) while I was there. I ended up with an US of everything in my abdomen above my waist and a complete work-up for an MI (Myocardial infarction), liver and pancreatic studies. All came back normal except WBC but even that wasn't really very high. No antibiotics prescribed. Of course my cardiologist was consulted and I have to see him in a few days but need a doppler study first. My flecainide dose is again at the maximum limit and basically still feel like c**p ....but poorer. Today I'm trying to decide how I could have handled it better. I'm glad I didn't opt to just take another potassium tablet since it can be every bit as dangerous to have a high level as a low one. ER doc thought WBC (white blood count) was elevated from the sustained rapid atrial fib. I doubt that also.
There just seems like there has to be a better way to do this. I'm considering changing my PCP because I really am starting to have a distaste for the atmosphere in his office. What do you all do when something comes up and you really want to see your doctor? I'm still wondering if I should be on an antibiotic....
Actually this IS the short version. It was one of those days that leaves one just shaking one's head in disbelief.
Well, I went and signed in and within a few minutes went into a more sustained rapid AF. I still waited my turn and kept in mind that, unless I was really symptomatic, the agreed upon time frame before having to call my cardiologist was 4 hours. A great deal of that was eaten up while I sat there really second guessing my decision to come in the first place. When I finally got in I told the nurse of what I really was after and she took my vitals. 120/100 (I don't think so!) pulse 72(absolutely wrong!). I told her so and she brushed off my concerns and suggestion that she take an apical pulse. I waited for the PA and nicely let him know that his nurse recorded totally erroneous information. He listened to my heart and got a stat EKG. Atrial fib with rate over 140. My potassium came back at the very high end normal and the CBC wasn't run for some reason. He kept bringing up that my gallbladder was probably causing the pain and I strongly disagreed with him and said wrong place, wrong symptoms, wrong history. Still he said it needed to be ruled out but it would have to be though ER or wait until things were open again on Monday. I had arrived there before noon and by now my 4 hours had long since expired. My PCP had left for the day before I was seen. He asked me what my choice was and I told him I was going to go to the ER and hoped to get back into sinus rhythm. I got copies of all my stuff and drove to the ER. I was still in rapid atrial fib but the rate was averaging a little higher...150-160 and I was starting to feel a little short of breath. I am not an easy IV stick. Several nurses tried multiple times without success(although they were able to draw more blood for labs). While they were waiting for someone else to be available to try I converted back to sinus rhythm on my own. I was so ready to go home and be back in my own bed. ER doc, (nice guy actually) said we may as well check the GB (gallbladder) with US (ultrasound) while I was there. I ended up with an US of everything in my abdomen above my waist and a complete work-up for an MI (Myocardial infarction), liver and pancreatic studies. All came back normal except WBC but even that wasn't really very high. No antibiotics prescribed. Of course my cardiologist was consulted and I have to see him in a few days but need a doppler study first. My flecainide dose is again at the maximum limit and basically still feel like c**p ....but poorer. Today I'm trying to decide how I could have handled it better. I'm glad I didn't opt to just take another potassium tablet since it can be every bit as dangerous to have a high level as a low one. ER doc thought WBC (white blood count) was elevated from the sustained rapid atrial fib. I doubt that also.
There just seems like there has to be a better way to do this. I'm considering changing my PCP because I really am starting to have a distaste for the atmosphere in his office. What do you all do when something comes up and you really want to see your doctor? I'm still wondering if I should be on an antibiotic....
Actually this IS the short version. It was one of those days that leaves one just shaking one's head in disbelief.
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