Get Out of the Car!
Nine.
One.
One.
While starting an intravenous line on a patient in a doctor's office, the doctor came in and told the patient not to come back -- at least not with the kind of heart problems this patient had.
The patient has a recurring problem with his heart. It races really fast -- more than 200 beats per minute. At that speed, the heart doesn't fill with blood between each beat and can't effectively keep blood flowing to the brain or the rest of the body.
The patient can feel his heart racing and usually is able to fix the rapid heart rate by coughing or grunting. On this day that trick didn't work. Worried -- and not wanting to brave the waiting room at the ER -- the patient hopped in his car and drove to the doctor's office. He could have called 911 or gone to the ER. Next to doing nothing at all, going to the doctor's office was his worst option.
The doctor was trying to educate his patient on the proper choice for an emergency, but the doctor got it wrong -- sort of. The doctor's advice to go to the emergency department was fine, as long as someone else drives. With his racing heart, this patient was at risk for losing consciousness and sitting behind the wheel is the worst place to be unconscious.
So, for all you obstinate old men out there who get chest pain in the future (and everyone else, too):
CALL 911! Do not drive yourself anywhere.
Nine. One. One. Period. If you happen to live in the far reaches of the county where ambulances take hours to reach, get someone else to drive you to the ER. If someone drives you, have them take you directly to the emergency department. Do not pass GO; do not collect 200 dollars.
If no one else is available, who you gonna call?
911.
I'm sure I've made my point. Unfortunately, not everyone reads my blog, which means I'm going to respond to another doctor's office -- or fire station, pharmacy, urgent care center, clinic, etc -- for another patient having another heart attack. Hopefully, it won't be too late.
- Don't Take Chest Pain to the Doctor's Office
- Supraventricular Tachycardia
- An Early Thanksgiving (what can happen when we try to drive ourselves to the hospital during a heart attack)
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Comments
Rod, great blog. A few years ago (I was about 42 years old) I was having a persistant burning in my chest. I called my doctor’s office to make an appointment and they refused to see nme! I was like “Say what?” The receptionist said “Ma’am the doctor will not see you for this until you are checked out at the emergency room.” I was so ticked off because, as I explained to the receptionist, my chest was burning, I kept burping, and I felt very “acid-y” and I knew that this was heartburn. All I wanted was to get it checked so that I didn’t end up with an ulcer like I did in High School. “No, I’m sorry ma’am. You really need to go to the ER to get it checked before the doctor will see you.”
Being the busy working mom that I am I put it off and put it off until a few weeks later I reluctantly went to the local ER. It was really burning this particular day and I was very uncomfortable. When I checked in with the triage nurse, he took my info, got some vitals and had me take a seat in the relatively empty waiting room. He kept doing something funny though. He kept looking at me… like a lot. I’d look up and there he’d be looking up from his work at me through the little glass window in the triage office. Now this wasn’t a leering kind of look or a “come hither hoochie momma” kind of look. It was a genuine “Ok, she’s still sitting there… not on the floor. Breathing’s not labored. Color is good.” kind of look. I started to wonder if maybe there really wasn’t something wrong with my heart! After only about 10 minutes the doctor was examining me in the back, giving me some nitro and a baby asprin while the nurse got an IV started. This was starting to freak me out just a tad. They drew blood. They hooked me up the EEG machine and said “Hang tight. We’ll let you know what’s going on in a few minutes.” A little while later, the doctor returned and asked if I felt any better. I told him no because that doggone burning was still there! He came back again with the test results and said “Ok, here’s a prescription for something called Aciphex. It’s for acid reflux. Get this filled and follow-up with a gastroenterologist.” A wave of relief rolled over my face. Seeing this he realized that I had been sitting there this whole time thinking I had a stomach problem but being terrified it might really be a heart problem. He chuckled a bit and said “Didn’t mean to give you a scare there. We just have a certain protocol to follow when someone, especially a woman, comes in complaining of burning in their chest because it’s a symptom of a heart attack.” It took about two seconds for it to dawn on me but when it did “BAM!” I realized that my doctor’s office was AWESOME! (And that I was an ID-10-T for waiting so long to get checked!) I realized in those moments exactly WHY my doctor wouldn’t see me and it’s for the same reasons you discuss in your blog. If I was truly having a cardiac event the best place for me was the ER. I realize now that the only thing the receptionist should have done differently was recommend that I call 911.
Thanks for the great information you provide and for the opportunities it affords us for some great discussions.
Take care!