Bill's Emergency

 

Bill at the Emergency Room visit last night waiting for me to pick him up

This time yesterday we began another emergency room visit for Bill.

All day Bill was complaining about "something" being caught in his throat. I reviewed in my mind what I gave him to eat the previous day. Bill has had esophageal swallowing problems for years. Several years ago he even had an endoscopy to address this problem he has.

Reviewing what I fed Bill, the only different food I fed to him in addition to his daily oatmeal (which I grind up to a powder, Ensure and instant banana pudding which is his usual daily diet) was a pineapple fruit popsicle. I noticed when I took a bite of that popsicle there were small bits of pineapple in the popsicle. I thought that was a nice touch but I failed to realize that that pineapple would cause a swallowing problem for Bill. Sometime ago I had to stopped feeding him instant oatmeal with bits of apple because that caused a swallowing problem for Bill.

I thought this problem would go away yesterday but Bill was complaining about it all day. What to do? I decided to take him to the local walk-in clinic. That requires checking with the VA first for the protocol so they cover the cost. Phone calls. That I did and had my forms ready for the personnel at the walk-in clinic. 

The closest walk-in clinic is about five miles from here in a medical complex. The same complex where I get all my "stuff" done, including my recent cataract surgery, which is coming along fine by the way. As I was navigating the complex (they had recent construction adding a new wing to the local main hospital, lot of us old folks down here) I remembered that they moved the walk-in clinic location. Oh goodie! Now to figure out where it was. I found it, it was on the side ground level of the new four story hospital. Getting there was "fun." I went out on the highway (Rt. 24) and traversed a couple of traffic circles. Of course when I got in I realized I could of went in the back way. Oh well, now I know for the next time.

We hobble in the clinic. It wasn't too crowded. We didn't have to wait too long (we never do, I've used the clinic several times myself, I'm old and falling apart too) before a health care provider saw us. He was jolly and happy which seemed out of place but be that as it may. I explained Bill's situation to him and he told me that the food particle (that pineapple bit) would dissolve itself within twenty-four hours. Bill wasn't having it. He wanted something done NOW!

Bill at the walk-in clinic having his vitals checked

The doctor who was seeing him said "I don't have a camera here to stick down your throat. You will have to go to the emergency room. Want me to call an ambulance?" Call an ambulance? What was THAT? I told him I would take (drive) Bill to the emergency room. It was only a few miles away. Through a LOT of traffic (this still is Rehoboth Beach in season after all) but nearby. 

We hobble our Old Man Way out to my red Subaru Forester, looking lonely out in the almost empty parking lot, and I navigate my way out of the traffic maze that is the newly enlarged medical center complex. 

To get to the emergency room I have to go to the main hospital in Lewes which was across the notorious Route One (Coastal Highway), very busy at that time of day with all the day time workers in the Route One Outlet Malls (Delaware is a sales tax free state) and other dayshift service workers of restaurants, hotels, medical offices and all the other support businesses for the area of the country where we live which doesn't make anything, we only have the Atlantic Ocean and low taxes, attracting many from nearby high tax states for their retirement (that's why we're here). 

I missed my turn off of Route One but lucky for me I knew the back way in from New Road from my now long ago days when I worked at the hotel in Lewes. 

I arrive at the hospital and fortunately found a parking spot open in the almost full parking lot. We had to Old Man Hobble our way up the sloping hill that is the entrance to the emergency room. 

At the entrance a hospital employee offered Bill a wheelchair, obviously seeing that he was having trouble walking (as I have trouble walking) on the uphill sloop. Bill turned him down, three times. Yes, THREE TIMES. He looked at us with what I saw as saddened pity. Here are these two obviously ancient old men, hanging on for a few more days. 

The room was almost full of waiting folks. I thought to myself "Well, we're going to be here for a while." I've been to this rodeo before, the Emergency Room Wait. Last time we were there all day. Literally ALL DAY. And nothing was resolved. As a result of that visit was why I put Bill on hospice care, so the health care worker wouldn't send Bill to the emergency room every time his blood pressure was below 90, which was often back then.

Anyway, I settle Bill down in a seat far away from the plexiglass checkin location.  I approach the check in and tell her our sad story. I give her Bill's identification and she looks him up in their system. We're both in the system, we've both been in that emergency room more than a few times since we moved in Delaware in 2006. I finish with her and return to my seat next to Bill, preparing myself for the Big Wait.

In less than five minutes a woman comes out and asked "William?" I looked up and thought "No, that couldn't be us."  She called again "William?" Most of the other twenty-five or so folks waiting look up and around. Again, the third time she says "William Kelly?" It is us! We struggle up and when I get to her I said I didn't expect to be called so soon. She said "Oh we're just taking your vitals." Oh, that makes more sense. Of course we're still in for the Big Wait In The Emergency Room. 

Well guess what? We were next? She took Bill's vitals and then settled in in a curtained location. I guess the explanation she said when she first called Bill in the emergency room waiting room was to avoid bad/hurt feelings among the horde of people that were there before we were. 

Bill waiting for medical care in the emergency room bay

She had Bill sit down on one of those hospital beds (oh how many times have both Bill and I put our posterior on one of those expensive adjustable beds that area always too short for both of us who are over six feet tall). By the way, as we walk the hallways I'm doing side glances in the other occupied curtained bus, wondering why those poor people are in the emergency room this day. Later I overhead them explaining to one woman she had a silent heart attack. But I digress.

After Bill's vitals were taken again a physician's assistance saw us. I explained Bill's situation again with the lodged pineapple bit in his esophagus. He entered all this information in on his medical iPad (notice how they don't write anymore? Medical personnel all use iPads now. So cool). 

He left to consult with the doctor on duty. We never did see the doctor on duty but the PA did get direction from him. He had Bill drink two full eight ounce glasses of water and eat a pudding. Bill loves pudding. He said "If he can drink the water and eat the pudding the doctor isn't going to perform an endoscopy surgery on you tonight." Well, Bill wasn't happy with that and started to get irascible. Bill wanted that particle of food OUT NOW! 

I apologized to the PA for Bill's irascibility and he left giving me a chance to talk to Bill. I reminded Bill of the "rules" posted on the wall about "aggressive behavior" not being tolerated. I saw the same sign at the walk-in clinic earlier. Bill calmed down. I am a calming influence. He better calm down.

Even though Bill said he couldn't drink the two full glasses of water, he did. And he ate the pudding. The PA came back and we were discharged after being given our discharge papers, which stated that if Bill continued to have a problem we could arrange to have an outpatient endoscopy. Thus instructed we made our Old Man Hobble out of the emergency room curtained bays. I guess we must have looked pretty pitiful, two old gay men navigating our way out of the "right turn here, left turn there" to the EXIT. We only made one wrong turn which was quickly corrected by a sympathetic hospital worker. 

Bill was so cold. He only had his short sleeved shirt on. I was wearing short but I thought to take my shirt jacket. I should have taken Bill' sweater but I didn't think we were going to do the Emergency Room Visit thing yesterday.

When I got home I called the VA Emergency Number to report Bill's emergency room visit. This is something I have 72 hours to do, in order to have the cost covered by the VA. They've been very good about covering all of Bill's medical costs but you have to get VA authorization. I answered all her questions and got the NINETEEN DIGIT authorization. We shouldn't be getting any bills from yesterdays adventure but occasionally some of those expensive bills make their ways to the patient even though these medical facilities are informed NOT TO SEND BILLS TO THE PATIENT. But they do, I have receipts. But I digress again.

So here we are twenty-four hours later and Bill's pineapple bit that was lodged in his esophagus HAS dissolved just like the doctors said yesterday. 

Just another day of caregiving folks, but thankfully Bill's condition resolved itself. We're very lucky and thankful.