I feel like someone is stabbing me in the back of my head.
If you can get here by 10, the doctor can see you then.
Have you ever had an EKG before?
This isn’t nothing. You need to go to the hospital right now.
You aren’t having a heart attack.
Stick out your tongue for me.
Meet the Stroke Assessment Team.
I’m going to have you stay here for observation at least overnight.
Welcome to the Neurosciences floor.
None of your tests showed anything abnormal.
Migraines can be caused by all sorts of things.
Your doctor signed your discharge papers. You can go home.
I guess you could say I’ve had a pretty eventful 48 hours.
I was sitting on the couch after dinner and trying to figure out what recipes we should make for dinner next week using the laptop. Matt was on the floor playing with Elizabeth.
Suddenly, I had a shooting pain, starting from the back of my head and burning towards my teeth. Intense pain that brought with it severe dizziness.
I put the laptop on the coffee table, laid down and started to describe to Matt what was happening: “I feel like someone is stabbing me in the back of my head.”
Every few beats of my heart, the same thing: an intense burning from the same place on the back of my head.
Then, after 10 or 15 minutes, it was gone as suddenly as it started. Matt told me to be sure I went to see a doctor the next day. Just in case something was wrong. I agreed though was hesitant – it was probably nothing.
Driving to work yesterday, I felt it again. Another 10 or 15 minutes of the same sort of coming and going, dizziness-ridden pain. Then it was gone.
I called and made an appointment with an office for Monday morning but I was starting to feel dizzy again. After a call to Matt’s normal doctor, I had an appointment for 20 minutes later. (“If you can get here by 10, the doctor can see you today.”) I grabbed my things, told a coworker I may or may not be back, and we headed to the doctor.
We had the usual wait for a few minutes to see the doctor. I was a new patient so I diligently did my new patient paperwork. My name was called so I went back and told the nurse my complaint. And was honest that I also had some tightness in my chest.
“Have you ever had an EKG before?” she asked, like this was a normal thing for 30 year-olds to have experienced.
(I had – back in high school when I kept fainting and no one could figure out why. Nothing ever came of that.)
She grabbed the machine, stuck me with the small green electrodes, and printed a report for the doctor.
We talked for a few minutes about me in general – what I do, my medical history, that I have an adorable 10 month-old. Then I told him what was going on and he looked over the EKG.
“This isn’t nothing. You need to go to the hospital right now”
He grabbed Matt from the waiting room. Of course, I had managed to lose it completely in the five minutes it took to grab him so I was crying when he came in, not at all sure what the doctor was grabbing him for. The doctor confirmed that he was OK to drive me – he’d call an ambulance, otherwise – and sent us on the way with brief written notes about what was going on.
The drive took an eternity. I had another episode and was getting dizzier and now my heart was racing, not sure what this could possibly mean. Something scary. Something dangerous.
We arrived in the ER and the triage nurse immediately gave me another, more precise EKG then took it over to the attending to check over. “You’re not having a heart attack.” Well, that was one thing off the list. My heart rate wasn’t quite right, but not so messed up that a heart attack was in process. I was sent back out to the lobby to wait for a room to be made available.
[In that few minutes, we got a call from daycare. Squirms had a fever and needed to be picked up. No way Matt was going to leave me and we didn’t want to pawn off getting her picked up to our friend who isn’t used to handling a sick kid. So Matt went and called his parents to come down the two plus (wound up being three due to traffic) to get her. He also gave them a quick rundown of what was happening with me and why we couldn’t’ get her ourselves. Her fever broke overnight between time and a dose of Tylenol given to her by my mother-in-law. She’s back to her happy, smiley self. Not sure what was going on, though we suspect teething.]
Back to a room where we met the second nurse who would be taking care of me. She explained that the doctor would be in shortly, but that they were putting me on a heart and pulse-ox monitor in the meantime (thankfully, she reused the same electrodes as the triage nurse).
The ER doctor came by a short time later and talked to me about everything that had happened in the last 16 or so hours. She did a basic battery of neurological tests that would be repeated in various ways the whole time I was in the hospital: hold out my arms with palms up and close my eyes, walk heel-to-toe in a straight line, raise each leg against pressure. And my favorite “stick out your tongue.” (Apparently, stroke victims often can’t stick their tongues out straight.)
Maybe at this point she started asking about history of blood clots or seizures or the like. Talked about how being on the pill means your blood coagulates faster which can cause blood clots. Then she went away for a bit. She returned with two nurses.
“Meet the stroke assessment team.”
After quick intros from the senior nurse and a stroke-specific nurse-in-training, I went through most of the same tests again. I stuck out my tongue for a second stranger. Apparently, they found nothing worrying as they said goodbye after it was over.
Eventually, I was told that I would be doing a bunch of tests: lots of blood tests (CBC, heart enzymes, thyroid, liver function), a CAT scan of my head, a chest x-ray. They were checking for blockages or blood clots that may be causing my weird headache or the dizziness or the chest pains. An MRI later was added later.
I tried to remain calm as I was taken to do each test, getting shuffled back and forth on stretchers because I couldn’t be trusted to not fall over walking and this hospital seemed to only rarely use wheelchairs.
Before my MRI and after the others, the ER doctor came by to tell me the crushing news: she’d been in consultation with the staff neurologist: “I’m going to have you stay here for observation at least overnight.” Then an internist checked me out and confirmed that overnight and the need for an MRI.
I was terrified at the concept of the MRI. Giant, metal tube where you can’t see out and it makes loud noises. I knew I was getting a bunch of different “studies” done – studies, not tests, for some reason – but had no idea how long it would take – it took an hour. But, I didn’t freak out except for maybe three minutes when I couldn’t hear if the tech said “You’re done” or “You’re almost done.” I assumed I was actually done but still had ten minutes left, the sudden clicking of the machine starling me into disappointment. When done, my neck and shoulders were killing me from having laid perfectly still that entire time. (Matt gave my parents a call to tell them what was going on while I was in the tube. They were, obviously, worried, but we kept them updated until I was released.)
There was some confusion over where I was to return to – my ER spot had already been re-assigned but the radiology tech wasn’t given my upstairs room number. After a few phone calls, I had my room number and was moved upstairs.
The nurse came in, a slender guy our age or younger with a good smile: “Welcome to the Neurosciences floor.”
We settled into the huge, corner room in an obviously newly renovated wing. Matt played on my phone, I tried to watch TV despite the poor satellite reception (stupid rain showers). And they kept taking my vitals and hooked me up to a portable heart telemetry unit. A nice gentlemen who goes by Uncle (his nephew worked there, too, and always just called him Uncle – others heard this and the nickname stuck) brought me some dinner – my first food other than a banana at breakfast and some crackers and a ginger ale a nurse begged my doctor to be allowed to give me.
I met my fifth (sixth?) doctor around 8 when he came in. He didn’t ask me to retell the entire story – thank goodness – but he did spit out my results quickly.
“All of your tests showed nothing abnormal.” (You could see my first upstairs nurse – already there an hour past the end of his shift – visible relax at the news. I was probably the youngest on the floor by 20 years.)
Other nurses and techs came. They checked my vitals. They shined a flashlight in my eyes and did more neurological tests. They put me on an IV drip of saline because I was so dehydrated at that point. They convinced me to take some Pepsid and a headache-targeting pain killer. I wore the funny machine-inflated calf pads for a few hours because it was protocol and I didn’t want to get a nurse in trouble (they let me take them off around Midnight when I was, finally, ready to go to bed). I was awoke every few hours for vitals checks but I did sleep, getting up a bit before 8.
In the morning, it was lots of waiting. A PA from the neurology practice came by – more sticking out my tongue and bright lights in my eyes – and told me that this was just an atypical migraine.
“Migraines can be caused by all sorts of things.”
Usually these type are caused by an inflammation to muscles nearby or irritation of the occipital nerve which runs right where my pain was starting from. Sometimes they do regularly prescribed meds – like the ones I had overnight – but they could also do a nerve block which she didn’t go into but I later Googled (yeah, I know, don’t ever do that for medical stuff).
Eventually, the neurologist herself showed up (about 2 pm) and told me the same things, but that I could just go see someone in her practice outpatient to discuss future treatment.
All I heard was that I was done and could get out of the hospital as soon as my internist signed me off to go home. Another hour of waiting and my doctor was found.
“Your doctor put in your discharge notice.”
Finally – finally! – I could go home. I removed my electrodes myself and my nurse the IV (man, did that hurt). I signed my discharge orders and went with Matt to the car.
And we’re home now. I haven’t had any more dizziness or more of the stabbing headache. I’ve got a bit of a headache now, of the too-long-of-a-day-that’s-stressful type. So I will go and take an Advil and go to bed early. And, on Monday, I get to explain a whole different group of people why exactly I went to a doctor’s appointment just to get a little thing checked out but never came back. But that’s a problem for Monday.