Monday, July 30, 2007

A Sunday to remember

So yesterday I am getting ready for church. My pants were "fluffing" in the dryer and I had just leaned over the sink to fix my hair when I felt something running out of my nose. I looked down and it was blood...bright red blood and it was flowing fairly briskly. I've had nose bleeds before, so I got some toilet paper and put it in my right nostril. I waited for a minute and then noticed that the toilet paper was soaked. When I went to change it, there was a significant amount of blood that came out and I was still bleeding...BRISKLY.

I called Beth into the bathroom and told her that I might need to go to the Emergency Room. She said that she would drive me. Since she was teaching Sunday School and making the announcements during the service, I told her that it was no big deal and that I would drive myself. At this point, blood started flowing out of my LEFT nostril (it was the right one that started first).

This is when I said to Beth, "On second thought, you need to call someone to cover you and we need to go to the ER. Now."

So as to not freak my mother or mother-in-law out, I will not tell you how fast Beth drove to the hospital. You see, we live about 35-40 minutes from the hospital I work in. It was important that they go there, because I know they have ENT residents in-house and my ENT had privileges there.

By this point, I had surmized that I had an arterial bleed. The fact that I was bleeding so much and that the blood was so red, told me that it was arterial.

So we're in the car. Now you may be asking why I didn't call 911. Well, as I mentioned, we live 40 minutes from the hospital and I was convinced that it would take an ambulance 20 minutes to get to the house, not to mention the 40 minutes to the hospital. So we got in the car and drove. I get that from my dad. But that's another story.

In the car, with both nostrils packed AND holding pressure, I started swallowing a fair amount of blood. Now even I'm starting to get a little freaked out. I tell Beth to drive quickly, but safely. That when she came to a red light, she was to slow down, check for traffic, honk the car horn and go. Luckily for us, it was Sunday morning and there was very little traffic on the road.

I pick up my cell phone and called my ENT. His office message says that he is out ouf town and another ENT is covering. They give a name and phone number, but I can't very well hold pressure on my STILL BLEEDING NOSE, hold the cell phone, AND write down the number of the covering ENT.

So I called Hermann. I work there, remember. And asked to speak to ER triage. Then, I asked to speak to the attending physician. Luckily for me, it was one of the attendings that I know, and like. I told her who I was, that I had had surgery one month ago, and that I had an arterial bleed. I asked her to call ENT and told her that I would be there in 10-15 minutes.

We arrived at the hospital, Beth dropped me off at the front door, and then went to park. I walked in and asked for the attending. Again, luckily for me, the ER tends to not be a busy place on Sunday morning. I walk in, tell them I have an arterial bleed and that I've spoken to the attending. They get me in a bed, start an IV, and call ENT.

ENT was there within 10-15 minutes. It was soon determined that an artery in the posterior part of right nose was the artery that was bleeding. It was in a place that I couldn't apply direct pressure. That's why it didn't stop bleeding. And it wouldn't have without professional help. This is also how you can believe me when I say that I didn't cause this bleed because I was picking my nose. Digital trauma (nose picking) is still the number one cause of nose bleeds or epistaxis. But in my case, it was an artery in the posterior part of my nose. But I digress.

The ENTs were able to stop the bleeding there in the ER. They had just placed a surgical seal adhesive gauze thingy (yes, that's the technical medical name) when I started bleeding, AGAIN. They were going to send me home, but when I started bleeding again, and given that we live that far from hospital, we decided that it would be best for me to spend the night in Obs just to make sure everything was ok. We also decided to keep me NPO (nothing per os ((mouth)) in case it started bleeding again.

All of this, before noon. 2 wonderful friends from church brought Beth Whataburger and, yes, they ate it in front of me. They left and Beth and I took a nap and she decided to go home, let the dogs out, and would come back later. I called the ENTs around 5:00 to ask if they were going to let me eat dinner.

About 10 minutes later, one of the residents comes into my room holding a consent form. Guess what, no dinner for me. At least not any time soon. It was then that he told me Dr. Smith, my ENT, was on his way to the hospital, and that they were getting an OR ready for me.

Dr. Smith wanted to take me to the OR to cauterize the artery that had bled. He is going out of town this week, and didn't want me to start bleeding. This way, we would take care of it for good.

I called Beth and told her she might want to come back to the hospital sooner, rather than later. I actually felt bad for her, because I knew I would be in the OR before she could get back to the hospital. I did ask the ENT resident to make sure that Dr. Smith talked to her after the surgery.

The surgery went fine. They cauterized the artery and I went back to my room. More good friends from church brought Chipotle...mmmm, my absolute favorite. I slept on and off for the rest of the night and they let me go home early this morning.

Dr. Smith told Beth that he is concerned that I started bleeding this far post-op. The original surgery was one month ago. I should be well healed. We did go swimming Saturday and I did dive in the pool once, but he said that this shouldn't have made a difference. So, this Friday, I have an appointment to go see him and I guess we're going to talk about it.

I'm a little worn out, but no worse for wear. I am also grateful to my friend Mark who was working in the MICU who came down, said hello, held my cell phone while I was in the OR, and came to sit with Beth once she arrived at the hospital.

I must take a minute to brag IMMENSELY on my wife. She handled her self INCREDIBLY WELL concerning the pressure that she was under. She kept it together on the way to hospital, made phone calls that were necessary, and just did everything that you could ask for from the wife of a doctor who's bleeding profusely from his nose.

Double kudos for her having to hear over the phone that I was going back to surgery and that she wouldn't make it to the hospital before I went under. Again, the epitomy of poise and grace.

I'm a lucky man.

Monday, July 16, 2007

Trying to do better

So I make no promises as to the consistency with which I hope to blog. However, I am going to try to do better.

I am now 16 days into my 3rd year of residency. Which reminds me, I need to update my profile. People ask me how it feels to be a third year and I tell them it's a little scary because now people actually expect me to know something. Huh, the nerve! But then I run across an Intern (whose been a "practicing" physician" for 3 weeks now) or Heaven-forbid a 3rd yr medical student, and I realize that I really DO know something. Because let's face it...they know very little. You might think that July would be a dangerous time to visit a teaching hospital. Actually, I think the opposite is true. In July, EVERYONE is more careful, and the upper level residents (me) are checking EVERYTHING the interns say and do. So feel safe, just keep one eye open when some scared kid that looks twelve and was born around 1981 comes into your room, ask him if he's 100% sure about what he's about to do and then ask him if he asked his upper level (again, me).

I think I've said this is this blog, but my sister is pregnant with #2, so in January, Beth and I will be an Aunt and Uncle x2. We're REALLY excited!


Thursday, July 05, 2007

No more packing!!

Just thought I would post a post packing picture. I didn't realize until now, that I couldn't breathe through my nose. It's SO MUCH EASIER to breathe now! I am SO glad that I had the surgery. Thank you Dr. Smith.

Tuesday, July 03, 2007


So I went back to the ENT's office today and he unpacked my nose! I CAN BREATHE!!! AND I can taste food again! I can TOTALLY tell a difference in my breathing pre-sugery and now post-removal of packing. The true test will be to see if the snoring is any better. How can it not be, right?

I am on call tonight and MD Anderson. I am covering any patient with a solid tumor. They don't even tell us how many patients that is because I'm sure it would scare us silly. Basically, I am here to give medicines to sleep, pee, poop, and pronounce anyone who might die overnight.

Beth and I plan on driving to Palastine, TX in the morning when I get off to see my dad. Kristina and Eric and Tori will also be there. It will be a quick trip as Kristina and fam have to drive home and Dad has to go to work. But any visit is a good one.

Thanks for all the support and making-fun-of-me in my hour of distress (Becky) during the past week. There is chocolate cake leftover from Beth's birthday and homemade cookies from Chelsie that I plan on making out with tomorrow when we get home. Why? Because I can, AND I can taste them!

Peace and Love,