How any bad things can wonky breathing indicate?

Last Sunday I was watching some of my taped programs when I felt a tightness in my upper chest and a shortness of breath. Sometimes I can ignore my asthma and it goes away, so I kept watching "Criminal Minds" and "CSI: NY." After the shows were over, I was still feeling off, so I took my inhaler. Nothing. When my attendant Sarah got here, I starting thinking about going to an ER to get my blood pH checked (remembering my metabolic acidosis of a year and a half ago). Sarah checked to see if Charity Hospital had reopened after the storm, but it hadn't. University Hospital has somewhat taken its place in that the poor, uninsured, and under-insured go there. My Medicaid only covers me in Kansas, and I don't want to lose my suite of amazing doctors by transferring it to Louisiana -- therefore I fall into the uninsured category while I live here. So University it was.

My friend Erika drove me, and we got there at about 1830. Normally the staff only allows family back in the rooms with a patient, but I pleaded. I had the sense things were going to be strange there, and I wanted moral support as well as someone I knew would add her voice to mine if need be.

So here is 14 hours, yes, 14 hours of ER time in a short summary to determine if I had a pulmonary embolism (blood clot in my lung):

-- seven IV attempts (with bruises to show for every one)
-- six different med students/interns/residents/full-blown doctors
-- chest x-ray
-- attempted contrast CT scan (my IV blew when they were administering the dye, puffing my arm to nearly twice its size)
-- full blood work up
-- urine analysis
-- blood gas
-- ultrasound of both legs

The ultimate diagnosis -- I had a blood clot behind my left knee. This is more than likely due to my sedentary nature (i.e., being in a wheelchair), but the part that irks me is that I have been taking an aspirin a day for years now to prevent this. ::sigh::

So I was admitted and started on anti-coagulants, but not before I lost my cool with a nurse at about 0600. This particular nurse, we'll call her Nurse Ratchett, was helping me get on the bedpan for the second time, and she put me on crooked (again). I told her as much and nicely asked her and the other nurse who was also helping to please adjust me. Nurse Ratchett quite unceramoniously jerked apart my legs (like she did the first bedpan round), looked at my crotch somewhat over the bedpan opening, and declared that I was fine (as she had previously). OK, I had had no sleep, had experienced this with her before, and was stressed (I still hadn't been diagnosed). I looked up at the ceiling, and said, "You know, I'm really getting tired of people telling me what's fine with my body."

Ratchett: No one's doing that.
Me: You just did. I said I was crooked, and you said I was fine.
Ratchett: Well, you're on the bedpan.
Me: Yes, I'm on it, but I'm crooked. I won't be able to pee if you don't adjust me.
Ratchett (with an exaggerated sigh): If you go off the side, we can change the sheets.
Me: I'm not going to pee off the side. I'm not going to pee at all.
Ratchett: You're fine.
Me: Lady, I've been living in this body for 36 years, and I know how I need to be situated on a bedpan to pee.
Ratchett (with a bigger put-upon sigh and an eye roll): Ma'am, I don't know why you're so upset. We're just trying to help you.
Me: No, you're not. You're trying to get by with what's easiest for you and not listening to me when I tell you what I need.
Ratchett (with yet another sigh): Well, what do you want?

Contast that with a couple of days later when I got to be the one who helped a nursing instructor teach five students how to change sheets with the patient still occupying the bed. I was instructing two students on how to support my bad knee and on the easiest way to roll me when the instructor called everyone's attention to what I was doing. "Always always ALWAYS listen to the patient, especially one with a disability," she said. "They know their bodies better than anyone. If you listen to them and do exactly as they tell you, you won't hurt them."

The only other incident of note was on my last night in (I was there four days). My friends who were babysitting Reba brought her to see me to help me with my stress, and security refused her access. I had anticipated this, so I had instructed my friends on what to say (she's an assistance dog, ADA allows her access, yadda yadda). The fellows working the door, who I have lovingly dubbed Einstein and Galileo for their amazing intelligence and forward-thinking, rather than just admitting they'd never experienced this before and calling for help, started making up reasons why they wouldn't let her in. My friend Kim's favorites were:

-- if she'd had the dog with her when she was admitted, we'd let the dog in
-- if the dog were yours [Kim's or William's], we'd let it in
-- if she were getting discharged, we'd let you take it up

William called to tell me what was going on, and I told him to put Einstein and Galileo on the phone. Naturally, they did not want to talk to me, but the threat of irate gimp finally kicked their shared brain into motion, and they called the nursing administrator on duty to enlist her help. She came to my room (with Galileo practically clutching her skirt) to tell me she was attempting to locate the hospital's policy on assistance animals as a CYA measure. In the meantime, I called Naomi for my own CYA measure, making sure I knew what to do to handle this properly and efficiently -- I was tired, hungry, sore, and stressed, and I needed someone calm to remind me of what I already knew. When Ms. N came back, she told me she had been unable to locate the written policy and could not let me bring my dog in without the policy in hand or a hospital administrator's permission. She apologized profusely and asked me many detailed and excellent questions about my disability and what my dog does for me. Like many people in this part of the country, she was only vaguely familiar with assistance dogs, but she knew enough to realize Reba will not be the last assistance animal the hospital sees. She told me she was going right back to her office to email her supervisor, the patient advocate, and the hospital administrator. I gave her my cell number and asked her to include it in the email along with my offer to help the administrators determine if their policy was in accordance with ADA law or to help them write a policy if the hospital did not have one.

The next morning, the patient advocate, Ms. C., called and also asked many excellent questions about assistance animals in general and Reba in particular. While she was searching for the policy, she offered to try to find some way of accomodating me seeing Reba if I did not get out that day as anticipated. That afternoon, she called me again to say she had found the ADA law. She had also found the hospital policy and it exactly matched the federal law to allow an assistance animal access to a patient's room. She thanked me for being patient and for helping educate her and others about assistance animals. She told me they would implement an education program for their staff so this wouldn't happen again, and afterwards she would send me a letter to tell me what they had done. I thanked her for her swift attention and help. I'm going to call her this week and offer to help with their staff education.

This weekend has been spent recuperatng from a lousy bed and lack of sleep. I have to take an anti-coagulant for six months with clotting time monitored every week for the first month and once a month for every month after that. The up-side is that my dad will not be allowed to "teeny pinch" me when I go home for Christmas.