Thursday, March 11, 2004

You should see the other guy

Ready for a long one? My adventure for yesterday:

I left work at a reasonable time yesterday to quite the uneventful commute, I must say. I had not managed an afternoon snack (bad mommy!), so I was rather hungry. I decided I would have a bowl of cereal when I got home to tide me over to dinner. Problem #1 with this plan: got the cereal poured, only to discover no milk. Why? Because we hadn't gone to the grocery store! I was just trying to decide whether to put the cereal back in the box or just eat it dry when the phone rang. Hmmm.... that's odd, it's only 5:30. No way that's DH, unless he's pulled his groin again playing basketball. (He sat out the past two weeks for that.)

Well, I was half right. It was my husband, but he hadn't pulled anything. Instead, he had taken an elbow to the face while playing defense. He now had a self-described "gash" on his forehead that has only just decided to stop gushing blood. Is it going to need stitches, I ask. "Well, yeah, probably. I'll let you take a look at it when I get home." Oh yeah, because I'm a nurse? Call my mom, the registered nurse. How can I tell if a "gash" (that I have not yet seen) needs stitches? "If it looks like more than a scratch, or if it is still oozing blood a couple of hours later." I explained the situation, and given that this is not the first injury of this type he's had, she figures that if even *he* admits that it probably needs stitches, then it probably does. Great, just great.

Naturally, he left at the height of rush hour, so it took him *forever* to get home. At 6:15, he walks in, at least having the decency to look sheepish, and says "I'm going to go take a shower." Um, no. Show me. And he was right, gash is really the best word for it. To his credit, he clots well. I'd still be gushing if it was me. Let me see if I can describe its position. Put your finger at the top of your nose, just where it meets your forehead. Now slide it over to the space between that flat spot and just under your right eyebrow. From there, trace a 1 inch line upwards, tilting towards the center of your forehead. It was probably open an 1/8 of an inch at it's widest point, just above the level of your eyebrow, and narrowing towards both ends. Even this layperson could tell it needed some kind of closure. No shower for you, just change, and let's go.

He does drive us there, holding a napkin to the wound the whole way. It wasn't gushing, or even dripping, but it was oozing enough that it would run down his face from time to time. We parked and walked in. The receptionist starts before she looks up. "What seems to be the.... oh, I see. (That can't be a good sign.) Fill out this form please, then have a seat." Only waited there about 20 minutes (they sure seemed to be hopping) before getting to see a triage nurse. Again, without looking up at first, "So why are you here? (looks up) Oh, I guess I should say how did it happen?" Explain the story, answer some questions. "We're going to send you down the hall to the Fast Track station." Fine with me, as my tummy was already grumbling. It was about 7 pm at this point. I was supposed to be finishing up dinner by now.

Get to the station, turn in our paperwork, and sit down. After 15 minutes, I was *dying* of starvation, so off to the vending machines I go. A bottle of water and a pack of crackers later, I'm doing okay, but not great, but it shouldn't be long, right? And we wait. And we wait. And we wait. No one has gone in our out of the two rooms they have. There is no television, no magazines, no nothing. I guess they figure it's supposed to be fast, so why have all that stuff. An hour later (8:20 or so), there has yet to be any movement. The most entertainment we've had is hearing the story of the guy who literally shot himself in the foot (with a nail gun).

Finally they start calling names. Everyone starts getting excited. We are third to be called, but we pass the other two, headed back to the waiting room. "Okay, let's get you registered." Um, didn't we do that already in the ER? "Yes, that was ER registration, this is triage registration." And you couldn't transfer the registration info because.....? (I think they desperately need to hire an IE to work on idiotic process problems like that, but that's really beside the point.) "Okay, you're all registered. Take a seat back in the waiting room." Hey, starving pregnant lady here! How much longer will it be? "I'm not sure. We got really backed up because we needed a spanish interpreter and a sign language interpreter, and we couldn't do anything with the patients ahead of you until they arrived. They both got here about 5 minutes ago." Great, just great.

Back to the waiting room we go. I had thankfully had some change left, so back to the vending machine I went. Baby decided the pretzels sounded good; glad I listened. They were actually more filling than the crackers. More waiting, and more waiting, but at least some patients were finally being seen. I had just checked the time at 9 when they called us back. A female nurse comes in to check the wound to see if it does need treatment (would we really be here if it didn't, and is there a reason you couldn't do that 2 hours ago when we got here so that we wouldn't have waited 2 hours just to be told it doesn't need treatment? >: ). Yes, closure is needed, though he may be able to do without stitches. You would have thought he had just been told he was the new color commentator for the Atlanta Braves! No needles!! "But you will need a tetnus shot, since it's been so long since your last one." And he comes crashing back to earth. Why, was the elbow rusty? Doesn't matter, just standard procedure for any open wound when the subject has not had a tetnus shot in the last 5 years. And she hastily leaves the room.

We wait another 5 minutes, and the male nurse comes in. "Let's do the shot first." If Steve could have willed himself to disapparate out of the room, I think he would have, but he did very well. I told him he could pick where we ate dinner for being so brave (I had already requested McDonalds as pennance for making me miss a meal.) "Okay, we're going to clean the wound now." Betadine, and since it was going to be around his eyes, he had to hold gauze up against his nose and eyes to keep all the gunk out. "How did it happen?" Took an elbow playing defense in basketball. "Cool." Through gritted teeth: not so cool now! Poor baby. I know it hurt, really I do, but they did have to get it clean before they sealed it up. Don't want to seal in any germs if we can help it. And he really handled it all very well.

The PA comes in and says yes, it will either take stitches after numbing the skin with "several" shots, or he can go with the Derma-Bond. Gee, hmm, tough choice. Well, they left out a few facts. First, since they were having to do this around his eyes, they had to put ointment in his eyes "Just in case some Derma-Bond runs in there. Never happened before, but we like to be careful." You know, we don't want his eyes to seal themselves shut! Have I mentioned how much DH hates ANYTHING near his eyes? You should see them trying to dialate them at the eye doctor. He simply can't tolerate it. He couldn't even watch me put in my contacts when I wore them because it creeped him out. Thankfully, they just put it in the corners and rubbed it on the lids, but still, I know it was not at all pleasant for him.

Then they start applying the Derma-Bond. I had it on my belly incision for my gall bladder, so I just figured it was no big deal. What I forgot was that I was asleep when they applied it. All of the sudden, I hear this extremely sharp intake of breath from the stretcher. More teeth grinding. Is it supposed to burn? "Oh, yeah, it does burn quite a bit." Ya know, it would have been nice if you had mentioned that beforehand. Not that he wouldn't have gone that route anyway (anything to avoid needles), but a little warning would have been good. They managed to keep it out of his eyes, though it did run up his forehead a bit, and some into his eyebrow. "Okay, we'll let that dry, and then you're all set." They walked out and closed the door. He starts breathing very heavily through his nose. "It just burns really really bad." Some hand holding, some head rubbing, and he at least starts to relax a little. "I'm getting used to the pain."

It finally starts easing off about the time they come back in to check on him. They help him clean the ointment out of his eyes, but tell him not to wear his glasses until in the morning (don't want it bonding to the frames or nose pads). Give him care instructions and two perscriptions: Tylenol3 and perscription Motrin (800 mg). *Regular* Tylenol makes him sleepy, so there was no way I was letting him take something with codine in it unless he really needed it. He'd be unconscious! And I was not going to fill a perscription for Motrin when he could just go home and take 4 Advil. No perscriptions for us, just pay our $50 copay and leave. His face should be lovely shades of blue, green, and yellow, just in time for the inevidable family pictures at Disney next week.

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