Friday, December 30, 2011

Continuing that day...

So I left Dr. K's office around 9:30 to go see the neuro-opthamologist. This guy had a weird system in his office and I saw 4 different people for 4 different tests over the course of 2 hours before I actually saw the doctor. One of the tests I did, that kind of freaked me out, was the color-blind test we always do at work physicals, except I did one eye at a time and my right eye couldn't distinguish some of the colors, even though I knew the numbers were there, I couldn't see them. Finally I saw the doctor but only saw him for about 5 minutes, didn't get the results of the other tests I'd done but was again told I had severe swelling of my optic nerves & discs...which I already knew. So he sent me off to get my MRI.

I left his office around 12:30 and my MRI wasn't until 2. At this point I was exhausted, hungry, probably dirty looking since I was still in my scrubs from the night before, had a decent headache setting in and I had massive, dilated eyes. So I probably looked like a druggie off the streets wandering around the hospital, but I got some lunch and headed off to the MRI area to check in. Also, the MRI "suite" at WHC is down in the tunnel that connects it to Children's so I kept seeing all the signs with directions to Children's...I wasn't aware that people actually used the tunnel for anything other than transports but thought it would be funny if I ran into the transport team down there.

The MRI waiting room was packed, it was almost 3:30 by the time I was called and 4 by the time I got in the scanner. I've taken plenty of kiddos down for MRI's but never had one myself. Now let me tell you, how we expect these infants to have a full belly and then sleep peacefully through the MRI is beyond me! Those things are loud! Like a jackhammer on your eardrum (great when you already have a headache!) and the whole table shakes and vibrates at times. Actually the tech had to tell me several times to stop moving! (I kept yawning haha). But I definitely wasn't about to sleep through it, as tired as I was. I also had a contrast MRI done and I was not impressed with how this tech did it. Rather than putting an actual IV in my arm he just put a large needle in my arm and injected the contrast and then took the needle out...the bruise from that lasted about 2 weeks and I've never bruised any time I donated blood or had blood drawn. My MRI lasted about 2 1/2 hours...that's a LONG MRI.

When it was finished the tech told me a radiologist had been looking at the images and was suggesting that I go to the ER to be admitted...but didn't tell me why. He also told me that my neurologist had been in contact with them and wanted me to call him first. Well first, I had to call work, because clearly I wasn't going to be there at 7. 6:30 is pretty late for a call out but they were nice about it thankfully! I then called Dr. K back who asked if I would go back to his office and talk with him...this man stayed in his office, after hours, to check up on how I was doing, he is a great guy.

The man who saved my life.

FINALLY! November 28th I had my appointment with the neurologist. We'll call him Dr. K. My appointment was for 8am and I had worked the night before so I figured I would go straight there from work, have maybe a 30-45 minute appointment, be home by 10 at the latest to sleep and be back at work that night. Boy was I wrong.

Prior to going to see this neurologist, I had done as any nurse would and completed extensive research on his background (about as extensive as you can get on google and yelp I guess). He specialized in migraines and epilepsy, had been a professor and won numerous awards for not only his work but for being in general a great doctor. Awards given to him by both peers and patient reviews. He also worked on an inpatient ethics committee which very few doctors do so that added points in my book.

He started my exam with the general interview, going through each neurological system and the associated symptoms I was having. When I started talking about my vision problems, and in particular, vision loss he became very alert and immediately stopped the questioning to exam me. He took my blood pressure MANUALLY which impressed me immensely...a doctor, who knows how to take a manual blood pressure? Almost unheard of! (MAYBE a cardiologist, but a neurologist? Definitely not!) Anyways my blood pressure was fine :-) and he proceeded to do an eye exam. At this point he became very "poker-faceish" while asking me if I could take my contacts out so he could see better. I did and he continued looking in my eyes for what seemed like a very long time. Eventually he finished and told me he needed to go make a quick phone call...umm, ok then.

When he returned he sat back at his desk and seemed pretty somber. He told me he had seen papilledema behind my eyes which is swelling of the optic nerves and/or optic discs. Thanks to my knowledge of "Retinopathy of Prematurity" (ROP) I knew that any swelling in that area was not usually a good thing and could lead to blindness. He told me the most common cause of this swelling is something called a pseudotumor which is when the pressure inside your head increases for no obvious reason...aka the patient has symptoms of a tumor but no actual tumor is present, however he also told me that this is more common in obese women and I was not considered obese (oh good).

He went on to tell me that the phone call he made was with a neuro-opthamologist at Washington Hospital Center and also to radiology to schedule me for an MRI that afternoon. Now I know how the system works, and to get me an appointment with a specialist, immediately, and an MRI for that afternoon...we can't get inpatients to see specialists and have tests that quickly so I knew he was pulling strings for me because he was worried, and I appreciated it, I really did, and do, but at the time I just wanted to go home to bed.

Wow, these get long fast, I'll get back to Dr. K after my day of appointments.

Thursday, December 29, 2011

How it all started

So for me this "adventure" started back in April of this year. I had worked 4 night shifts in a row which 1. I never work night shift and 2. 4 in a row is a lot. I came home that fourth morning and crashed, hard. When I woke up that evening I had a pretty bad headache and was back in bed not long after getting up. The next morning I had what I could only think at the time was a severe migraine. I stayed in bed for the better part of three days, avoiding bright lights and loud sounds and vomiting anytime I moved too much. Eventually it went away and I didn't think much of it, only that I'd had a pretty bad reaction to those night shifts. I didn't think anything of it again for weeks.

The migraine episodes started occurring more often though that summer. Every couple of weeks and would last anywhere from 1 to 3 days. They mostly happened after I worked consecutive shifts or after working night shifts. That summer was also when I switched units at work and my new unit required rotating, so I was doing more night shifts that I was used to and I assumed my body was having a hard time adjusting.  The migraines were more severe than any kind of pain I had ever experienced...even after four years of rowing, and the more intense they got the more likely I was to throw up without any control over it (ps: huge indicator of increased intracranial pressure aka ICP...had I been my own patient I probably would have been more on top of that symptom). Still though, I brushed it off as migraines, thousands of people have them and have just as severe of symptoms.

I even biked 150 miles the day after one of my bad migraines. I recovered quickly for the most part.

Late August into September was when things started changing. While I still had the bad migraines every few weeks I now started having daily headaches, not as bad as the migraines but severe enough to slow me up, in the mornings I was sluggish to get going, on my days off I slept until the early afternoons, I had little energy and survived on around the clock excedrin and lots of coffee. Still though, I plowed on...nurses always make the worst patients, and didn't think there was anything to be done. On a side note I DID go see both my primary care doc & eye doc over the summer to see if they had any input...my contact prescription was up to date and my primary told me I had tension headaches and that was that.

October was when I finally gave in and believed something else was wrong. I started having vision changes. At first I thought I was being overly concerned and thereby imagining these problems, but they got to a point where I could no longer ignore them. Initially it started with seeing bright spots...kind of like if you looked in the sun too long and looked away and it takes a few seconds for your eyes to adjust back to normal. Then the tunnel vision set in, usually only affecting one eye at a time, again never for longer than 30 seconds or so. Then the most concerning problem started, one that I couldn't ignore. If I stood up too fast, or stood from crouching on the floor (as is done often in an ICU when checking chest tube output or urine catheter output) I would completely lose my vision, everything went dark, not for long 20-30 seconds, but I couldn't see at all. So then I would find myself, for instance after jumping up to silence a monitor alarm, standing still, just staring into space until I could see again. I can't even imagine, if any of my patients parents noticed, what they thought was wrong with me, but no one asked. Of course initially I brushed it off as having "orthostatic hypotension" (a period of low blood pressure when changing positions, common in women in their 20s & 30s)...once again being a bad nurse and diagnosing myself, but at this point I also started looking in to finding a neurologist.

Once I found one it was a month until I could get an appointment, but it was better than nothing and until then I continued my daily regimen of excedrin & alieve, and sleeping whenever I wasn't working. Looking back on it, I don't know how I was functioning so well at work, but I was, it was probably the only place I was functioning really well. I was alert and able to stay on top of my patients, even through the dreaded night shifts. But every day I was looking more and more forward to that appointment.

What am I doing?

So I'm not really sure if this whole blogging thing is really going to fly or not...but I've been doing too much sitting around the last few weeks and need some new hobbies to keep me entertained. For now I can use it to tell my story since everything happened pretty quick the last few weeks and I've kept people updated via facebook and scattered emails. My hope would be that I only need to tell the story of the past few weeks and in a month or so I'll go back to work and there won't be anything exciting to update about after that...well nothing health related anyways. So, stay tuned, and I'll let you know what's been going on.

Hope everyone had a great holiday!