Doug to the ER

Doug has not been feeling well for about a week. He's had a rapid heart-rate along with being shaky, extremely fatigued and weak. We were in Iowa for a funeral and he experienced a few bad moments, where we considered taking him to the local E.R.

He toughed it out and attributed the symptoms to all the medication he is on for his hearing loss, combined with the anxiety of traveling and dealing with the loss of a close relative ... someone near his own age.

Well we returned from Iowa on Friday evening and I thought he might "perk" up a little bit on being home in his own surroundings. That did not happen. Saturday morning we debated about going to the local ER, and the symptoms finally got the better of him so off we went to Centennial Medical Center in Frisco,TX.

We arrived in the Emergency Dept around 3pm.
They admitted him to the hospital around 6pm. Doug's symptoms on arrival at the hospital were: rapid heartrate of about 124, fatigue, weakness. On triage, they noted a slightly low pulse oximetry of 89%. He was quickly taken back and put on a monitor. They started an IV and took blood, performed and EKG and chest xray.
He was put on oxygen and his pulse oximetry improved to about 98%-99% on 2 liters. He was somewhat agitated during the whole process and they gave him Ativan intravenously and that seemed to calm him. The cardiac enzymes were fine. The only blood test that was abnormal was blood sugar...only slightly high. The chest xray showed an enlarged heart.

At 7:30pm, he was admitted to the 3rd floor. The hospitalist (on call - staff internal medicine physician) admitted Doug for telemetry(continuous monitoring of his heart). He was not oriented to the floor until 10pm, as the nurse was dealing with some other patient who was not doing well and trying to discharge another patient. Anyways. She ordered his meds at 10pm. He got his first food around 11pm. Meds arrived around 11:30pm. Some confusion with all that process...but that's another story in itself! The meds were held, because he was due to have labwork at midnight for cardiac enzyme testing that needed to be repeated every 8 hours. The labs were drawn at midnight. He got his sleeping pill and other necessary meds about 12:30am. I stayed until he fell asleep. I was home about 1:30 am.

Sunday morning, I called the kids and the parents to explain the hospitalization and then proceeded to the hospital. On my arrival, Doug was agitated...more confusion on meds...Wrong strengths of medicine, wrong doses...the errors just seem to keep piling on Doug. He's a little worried about this system but I assured him I'm here to be his advocate and haven't left his side. More labs and another EKG were done in the morning and the heart ultrasound was done around lunch time. We would have to wait until almost 8pm though, to see the cardiologist. In seems the computers were down on our floor and he never got the notation that he was to see Doug for a consult.

Anyways... The cardiologist states, Doug's heart is just fine. The enlarged heart on the ER dept chest xray was probably an ER anomaly. He states those xrays are taken with the patient sitting in bed and they don't sit up as straight as they are supposed to and can't take as deep a breath. The heart ultrasound was done to check that finding. He states the heart ultrasound was good. No enlargement of the heart noted and all the valves, etc are working properly. EKG and cardiac enzymes were negative.

His diagnosis is sinus tachycardia..which means fast heart-rate. Yeah!!! We knew that!

Well, he said that sinus tachycardia is not a cardiac problem. It is a symptom of something else going on: infection, stress, anxiety, dehydration, thyroid disorders, etc... The trick is to find out what the trigger of that symptom is might be a little tricky. He did change one of Doug's medication. He stopped his Benicar for blood pressure and started him on a betablocker: Metoprolol Tartrate (Lopressor). Doug will stay in the hospital for another night, so that they can monitor his response to this new medication. I think he will probably go home tomorrow regardless of how this medication works. Stay tuned for more updates on that!