So if you are reading this, hopefully you have already read Hospital Admission – Part 1 – Xolair Injections if not it may make more sense to read that first.
So after a 6 hour wait on the diagnostics ward and the bed manager over ruling my consultant I was denied a bed on the respiratory ward and instead I was on my way to hell, sorry I mean AMU.
I was taken in a wheelchair to the ward even though I was more than capable of walk, but apparently it is procedure and so a nurse pushed me round in the chair and we were accompanied by my wife.
We arrived at AMU and was directed to Bay 5, Bed 5. I jumped out of the chair and was relieved to find plenty of sockets on the wall, all of the gadgets that I had brought in would be able to be charged.
With the hope of only a 1 night stay I decided to not really bother unpacking my bag too much and instead just grabbed out the essentials, i.e. my iPad and my earphones. Since I had not eaten my wife had brought me in a sandwich which I quickly demolished. The bay was full and just for a change (not) I was the youngest by far, the next youngest was probably 20 or 30 years older than me. A couple of them introduced themselves to me while another had visitors, meanwhile 2 of the patients were asleep.
After about 30 minutes a nurse came and introduced herself and we filled in a few forms which took about 10 minutes, she then attempted to do my obs which proved a lit more difficult than expected. According to the machine my oxygen levels were 100, which they have never been, even on oxygen, this was all the more surprising considering that all day they had struggled to reach the low 90s. My pulse was said to be racing along at 130 which seemed unlikely and despite the cuff inflating on numerous occasions it was unable to take my blood pressure. The nurse then took my blood sugar levels which were quite high but no more than was expected due to the steroids. I explained to the nurse that my chest felt very tight but not particularly any worse following my injections. I got the feeling that she wasn’t all that interested as her shift was due to end shortly.
Never mind I thought, I know my condition pretty well and didn’t worry too much. Visiting time ended and my wife went home and so I decided to try and make myself comfortable and started to watch a video on my iPad. At around 21:00hrs a young looking male doctor introduced himself to me and asked what had brought me in to hospital, I was slightly surprised at this considering it is the hospital who wanted me to come in for observation and had been sorted over 3 weeks previously. The doctor seemed a nice enough guy but it was blatantly obvious that he did not understand what I was telling him. I explained to him about my Xolair injections which is a treatment that he had never heard of, I explained the side effects and why my consultant had wanted me admitting. It was all very strange, they had no information on me or why I was there, they had no record of my Xolair injections of anything, basically all they had was what I was telling them. This was one of the problems of being on the wrong ward, I know all of the doctors on the respiratory ward and they know me, they know my condition and they would’ve known what I was in for. The doctor told me that he would get somebody from respiratory to come and see me the following morning, in the meantime if I felt unwell I had to report it to the nurse. I then gave him a list of my medication for him to write up.
The rest of the evening was a complete waste of time, nobody bother with my obs, the doctor hadn’t got round to writing my meds up and so I was asked if I had what I needed and if so just take them. I did that and then the nurse locked them away, something that I hate but understand why it is done. The next couple of hours were chaotic with numerous patients coming and going, moving beds etc. Then at 01:00hrs on Tuesday morning a carer came to tell me that they were moving me to the next bay. I quickly packed before I was wheeled round on my bed. Fortunately I hadn’t managed any sleep by this stage anyway and so it was hardly a problem. Another hour passed and I suddenly began sweating badly and feeling very dizzy and lightheaded. I knew straight away that I was suffering a hypo (low blood sugar). I grabbed my blood glucose meter which was in my overnight bag and wasn’t surprised to see a reading of less than 3. My Gluco juice was locked in a cupboard with the rest of my meds and so I had to ring the buzzer for assistance. After about 15 minutes (by which time I was feeling quite unwell and out of it) a carer came, I explained to her that I was having a hypo and she went to grab a nurse. After another 5 minutes a nurse returned with a couple of bottles of Gluco juice and told me take one and give it a few minutes and if I was still low to take the other. Nobody actually bothered checking my bloods, they just took my word for it!
I took the juice and also I found some sweets in my bag which I took as well and within a few minutes I began to feel slightly better. Due to the hypo and the noise I knew that I wouldn’t get any sleep and decided to give up trying. I put my earphones on a listened to some music and just tried to relax. Nobody came back to see how I was doing following the hypo, nobody came to check how my tight chest was or to do my obs. By this time I was beginning to get a little wound up, basically for what the hospital were (or weren’t) doing for me, I may as well have gone home, where I could have checked my own sats and looked after myself much better, who knows in my own bed I might even have eventually even managed some sleep.
Eventually at 06:30hrs the nurse came round to start doing obs and doing them bed by bed I was down to be the last on the bay. She finally got to me and decided to check my blood sugar first which was surprisingly low considering the glucose that I had during the night, I felt ok though and it wasn’t quite hypo low so I wasn’t overly concerned. The nurse then got called away before returning at 07:00hrs, finally for the fist time for 12 hours my obs were done, my blood pressure was slightly high, my pulse something like normal and my oxygen was back at 91 which didn’t seem to bother the nurse too much. I told the nurse that my chest was still tight and she suggested taking a neb if it got any worse. With that her shift was over. The morning staff arrived and it was time for meds. I explained to the nurse that I was self medicating and so she unlocked my meds and read out what I had to take and as I took each tablet she marked it off. When she finished I realised that she had not mentioned 2 lots of tablets, she hadn’t mentioned Slo-phyllin or Prednisolone. I queried this with her but she said that the doctor had not prescribed them! I took them anyway, the nurse didn’t seem too impressed and made a note.
Then the famous NHS breakfast arrived of cold toast and jam, weak tea (not I like it) and cornflakes, what more can anybody want for breakfast (apart from a full English).
After breakfast I flagged down a passing nurse and told her that my chest seemed to be getting tighter and my breathing seemed shallower than usual, she told me to take my neb if I needed one, on this occasion I decided to take the neb which did help a little. The rest of the morning dragged while I was waiting to see if I could go home. No more obs were carried out and to be honest I was getting more and more wound up. I am on a phased return to work and I had to take 2 days off without pay for this yet nobody was checking my sats, it all seemed like a waste of time.
Finally just before lunch a doctor came and introduced himself, he asked how I felt, I was honest and told him that I felt crap but no worse than before the Xolair injection. He asked about the injections and then asked to listen to my chest, I explained to him that I never wheeze and if anything my chest would sound almost silent due to low air movement. He listened away and then told he there was no wheeze, he said that because I wasn’t wheezing I could go home and did not need to be in hospital, he added that should I start wheezing I should report back to A&E. I was stunned, he had not listened to a word that I had said or even appreciated why I was there. I asked whether I would be seeing anybody from Respiratory to which he replied he stated “it wasn’t necessary” again I was stunned. Saying that there wasn’t much point in arguing, I wanted to go home, he was sending me home, even though I didn’t feel great I knew that it was more of a result of how I had felt in the days leading upto the injections, I also knew that I wasn’t bad enough to be in hospital. I was just angry at how it had all seemed a waste of time. Anyway I was going home, all I had to do was wait for the discharge letter.
While I was waiting, one of the respiratory nurses came to see me, she had come searching after discovering that I was not on the Respiratory ward. She asked what me peakflows were, I told her that I didn’t know because nobody had asked me to do one and I couldn’t use my own because it was locked up in the cupboard with my meds. We did a peakflow and found that it was still low but not critically so. She then asked about my tight chest and had a listen, she told he that I had very little air movement (there’s a surprise). She then told me that the Respiratory doctor would come to see me after lunch to discuss whether or not we thought the Xolair injections had gone to plan and to discuss whether I should go home or stay another night in hospital. At this stage the ward nurse handed me my discharge form and meds and told me that I could go home. My respiratory nurse looked shocked and asked me if I felt well enough to go home, I told get that I was. After a chat and the usual stuff spoken about such as taking it easy and if I felt unwell I should ring them or go straight to A&E. I then went home!!!!
Since returning home my chest has still caused concern but I am well enough to stay out of hospital, I did take an extra day off work to rest.
This story may just sound as though I am criticising the doctors and nurses who I encountered and even though I was not massively impressed by them, it was not really their fault.
I was sent to the wrong ward, they were not trained to do what needed doing, I needed respiratory care, not general.
Once again they were short staffed, as I was leaving I was told that there were over 40 patients on AMU yet there were only 3 nurses and 2 carers!
All in all I am just relieved that I have had no side effects to the Xolair this time,which is terrific news and also that my stay was only one night.