Doctor as Patient

So, I'm having a somewhat interesting experience right now. I ended up in the hospital. This was only partially my fault.

So, I've posted elsewhere about my ulcerative colitis. Mostly not a problem, except I've gained 40-50lbs on the prednisone I take for it. Or... took for it. So, given the weight gain, and the fact that every time I've gained a few pounds on it, I've been completely unsuccessful at loosing it, and because of the acne, I tapered and stopped my prednisone. 6 weeks ago. It went perfectly fine until 4 weeks ago. And although I'd started to get sick 4 weeks ago, I sort of figured that it might just get better (this really has never happened to me... but hope springs eternal!). And then, Monday, after having slept 40 of 48 hours this weekend, I realized something was really wrong. So I restarted my prednisone and made a gastroenterology appointment. They could get me in in 6 weeks. Um.. yay? So, I tried to keep on keeping on. Then tuesday night, I started having more abdominal pain and vomitting. Not tolerating even fluids orally is probably unsustainable in someone who has copious bloody diarrhea. I'm a doctor, there are some things I know. So after 6 hours of playing the rest for a few minutes, then try to drink, then vomitt, then rest gaime, I decided I'd go to the Emergency Department.

I figured I'd be in for some iv fluids, labs, some iv antiemetics, and then gone in time enough to make it to work on Wednesday morning. In fact, I came in saying, "I don't want to be admitted, I'm here so that I will be able to make it to work tomorrow morning. " I did get some labs, some iv antiemetics, a ct scan which I don't think I needed, and a couple of liters of normal saline (iv fluids) and some potassium. They admitted me, but only after giving me iv dilaudid and then convincing me to let them admit me. I do believe the ED doc, the hospitalist, and the gi on call were plotting against me this way. I feel as though tolerating the oral ct scan contrast was an adequate test of my ability to tolerate po. They say they will let me go tomorrow.

Some interesting observations:
1) the woman next to me in the ED was there for a chf exacerbation and had just eaten a ribeye steak, and had a blood sugar of ~500.
2) Lidocaine really does help when people are putting in IV's, especially those that are 18 gage or larger.
3) I wasn't super sick, but I was the sickest person (not counting the kids waiting for the children's hospital ED) in the waiting room. There were many drunk people and some with complaints that should have been taken care of as an outpatient.
4) I can't get a doctors appt as a new patient for 6+ weeks with a PCP. Faster if I torture myself by using my physician status to sneak in, which I refuse to do. So, maybe if some of the people who use the ED as their PCP could get an appointment with someone they wouldn't be in the ED. Of course, if they had established care when they should have, they would have a PCP by now.
5) Screaming, "You F&*king c*&t" is not a good way to get more pain medicine faster.
5) The hospitalist docs are nice. So are the nurses. So are the gi guys. They seem competent.
6) I think that dietary depts across the country are not designed to work well. I'm ordered for a low residue diet, but still, every day they offer me all sorts of salad and non-low residue things. If I didn't know what I shouldn't be eating (no salads, desserts ad lib, veggies and fruits should be cooked except bananas which are fair game), I would have a hard time.
7) My patients who complain about once or twice daily fragmin can suck it up. It's not that bad, and it's a damn site better than a dvt.
8) Although it feels like a disaster to call in sick to work, it really isn't, esp if you're really sick.
9) Good friends will feed the cats and bring pajamas and computers and movies
10) My siblings are more helpful than I have any right to expect.



More soon....