Lainey's First ER Visit

I managed to make it 32 years before landing myself in the ER, and I don't even have an epic story. It boils down to this, basically: I sat on a bug.

The end.

Just kidding! It's me, and it's Italy, so of course there's more to it than that. Allora. Tuesday morning I went to the volunteer office, sat down at the table, and put my purse in my lap. Almost immediately, I felt a stinging on the inside of my left leg. My initial thought was that something in my purse must have poked through and scratch me, but that lasted only about half a second before I thought maybe my purse had ants on it and they were biting me. I also quickly moved on from that thought, because I felt a very distinct stinging, not anything itchy. So I stood up and shook out my skirt, but dangit, that stinging was not fun. I decided to excuse myself to the bathroom so I could pull up my skirt and take a look. It wasn't very exciting up there (ha!), just a very tiny red spot. I thought, "Oh, I guess something did bite me."

I went back to the same spot at the table and immediately noticed a yellow jacket crawling on the edge of the chair. Ah, so that explains it. One of the other ladies in the office fetched her fly swatter and promptly decapitated said yellow jacket. Take THAT.

I got stung once by a yellow jacket when I was a kid, helping move or re-stack some firewood. It got me on the hand and I remember it sucked, but that's about all I remember because it was so long ago and probably very minor. Naturally, I was a little concerned about an allergic reaction, since some of my family are allergic and I don't know about myself. Google to the rescue! All of the information I read said to first remove yourself from the situation. Check. Then to remove the stinger. Uh, okay, back to the bathroom. No stinger, but a quarter-sized welt by this point in time, and lots of stinging and itchiness. Then ye olde internet doctors said take some Benadryl or something similar, and perhaps ibuprofen or something for the pain and swelling, and ice the area. Someone in the office kindly gave me a Zyrtec tab and I continued business as usual.

For the next two days, I experienced lots of itching and swelling, which I continued to counteract with OTC allergy medication and topical gel, and ibuprofen and ice packs. I even drew a little circle around the inflammation before bedtime on night two to see if it was continuing to swell or spread. By the third morning, it stopped swelling, hooray! I had some volunteer business tp attend to that day (Thursday) and everything seemed fine up until lunch time. I went home around 2pm and noticed that not only had my leg started swelling again, but it distinctly looked like a bulls-eye where the yellow jacket stung me.

There was a small white welt, a very dark pink (almost purple) welt that was starting to get red streaks through it, and a lighter pink circle about the size of a dinner plate on my leg. Whoa. At that point, I started to get a little nervous and think that perhaps this was not a normal reaction, especially since I'd been religiously following all the assvice about ice and medication. But not wanting to resort to more internet research, I decided to call the 24-hour nurse hotline. I described what was going on and the intake person said "Based on what you are telling me, I think we need to get you seen in the next four hours. Let me call your local area and see if we can get you set up with an appointment." After a very short wait, someone else came on the line and she identified herself as a nurse. She said, "Based on what you are telling me, and the fact that it is already 3pm in your area and your clinic closes soon, we are actually going to refer you to the ER." She gave me the location of the nearest hospital (there's only one) and we hung up.

That freaked me out a wee bit, but I decided there was no need to rush because other than the stupid swelling and itching, I felt otherwise fine. I figured if it was an allergic reaction I would have had it already, and that my sting was starting to get infected. Better safe than sorry though, right? I packed a little running bag with a change of clothes, toothbrush, deodorant, my medicine, a bottle of water, and a book. Having my bases covered, I drove myself to the hospital, which took about 15 minutes. I spent another 25 minutes circling various parking lots and growing ever-more frustrated, before I finally decided to exit the hospital lot and just park in a paid lot next door. I walked myself half a mile to the ER and stood in line. There were thirteen people in line ahead of me (including two nuns) and another 35 or so in the waiting room. I joked to myself, "Oh, there are nuns here? That means God is here. He will look out for me, too. As long as He doesn't give them ALL His grace."

It took a good 20-30 minutes for me to even get to the front desk, during which I read a few chapters of my book. I came well-prepared. I showed the nurse/admin/intake person my ID and he promptly got a translator on the phone. I explained I was stung by a yellow jacket more than 48 hours ago and had been referred to the ER when I called the nurse hotline. I think as soon as I said insect sting, they fast-tracked me for fear of allergic reaction, because I was immediately ushered into the adjacent exam room and they started taking my vitals.

Now, if you know me at all, you know that I am a Fainter. I capitalize it because it's just a fact of my life. I get nervous around doctors (we call that "white coat anxiety') and I'm not very good with blood. I get nervous when people tell me about their medical procedures and have been known to pull the car over while driving to put my head between my knees just because someone was trying to tell me about their wisdom teeth being removed. Glaucoma test? Fainted at the air puff in my eye. Dental exam? Fainted in the chair. Procedural consult? Fainted in the waiting room while waiting for a copy of my paperwork. And don't even get me started on blood draws. Just call me the fainting goat.

You see where this is going, right? Well, I didn't faint (at least not yet) but apparently my blood pressure and heart rate were elevated. They took my pulse three or four times in the span of a few minutes. Oh, and they took my temperature using an armpit thermometer! Been a while since I used one of those, but I guess it could have been worse...I told the translator I was just nervous, but they wanted to be sure. Next thing I knew, I was across the hall getting an EKG and giving a blood sample. The EKG was fine, and so was the blood draw. I even joked that it was just as bad as the initial yellow jacket sting. So, no fainting! I guess the nurses were reassured because they sent me back out to the waiting room. This was somewhere between 4:30 and 5:00pm. So I pulled out my book and settled in to read, trying to ignore the cannula on my wrist - that was a first for me. I took a few swigs of my water bottle, and had fun watching people try to figure out the automatic door: it wasn't so very automatic; someone on the other side had to press a button. I was in general good cheer, and made sure to let Tony know what was going on as best I could via FB messages. I also had a good friend (Thanks, Helena!) on standby in case I needed any assistance, ride home, etc. The waiting room kept getting more and more crowded and even though I was right by an open window, it was also quite warm. One of the nurses came out once to take my blood pressure and pulse again, and she smiled and said I seemed to be back to normal. So I kept reading and people-watching. Suddenly I felt myself getting a little woozy. I've fainted enough times to be able to recognize the symptoms, and usually I can head it off. The people across from me started pointing and looking for a nurse, and I grabbed my water bottle and took another swig. Then...I think I fainted?

At least, I got dizzy and I remember the people across from me springing up to help me out. And then I was in a reclining wheelchair in the lobby surrounded by people. So, yeeeah. That happened But all the people around me were so very nice. They fetched nurses and fanned me and offered me more water and kept me company even though none of them spoke English. The nurses took my blood pressure and pulse again, and ushered me in through the "automatic" doors to yet another waiting area. I thought, "Oh, well at least maybe this means I will be seen soon." The nurse told me there were "only" ten people in front of me in the queue. This was around 6pm, and I heard church bells outside playing some version of "Figaro." Hey, it's Italy, there are always church bells ringing, somewhere.

So I sat in THAT waiting room for another few hours. Eventually I gave up my fancy reclining wheelchair when the nurse walked in someone with an IV and there were no seats available. A dad put his 8-year old kid in his lap so I could have that seat. I did a few laps up and down the corridors, continued drinking my water, hit the restroom, took my allergy medicine and ibuprofen, and finished my book.At least three of the people in the waiting room with me were kids with broken arms. There was also one old lady with her arm up in a splint and a bandage on her head, and a teenager with her ankle iced and elevated. The waiting area and hallways just kept getting more and more crowded. I was really eyeballing the vending machine choices when I heard English being spoken. Another one of the patient liaisons was ushering in another military family, so I asked her if she knew how much longer it would be. She told me she had actually just checked on that, since she saw my name still on the list, and said there were eight people in front of me in the queue.  This was at 9:30pm, so we had a conversation about what it would mean if I just left, because I heard the nurse call out at least a dozen names in the last couple hours, so there were definitely people being triaged at the front desk who needed more urgent assistance than I did. Ultimately, I decided to just wait it out. In for a penny, in for a pound, I guess.

Hospital waiting room was not this nice, and the chairs weren't this comfy.

My phone had long since died, so I started a new book, standing up for another hour just to get out of the horribly uncomfortable metal chairs in the waiting room. Finally, FINALLY, they called me into another exam room, I think around 12:30am. It took a few minutes for the liaison/translator to come down, but the nurse took all my vitals again and took a look at the sting site. No poker face, that one. We chit-chatted for a few minutes in a mixture of English and Italian, and the doctor and liaison came in a few minutes later. I actually understood most of what the doctor said, but it was still extremely comforting to have the translator there. Thumbs up, Army! The doc examined my leg and then took me to yet another room for an ultrasound. I never thought my first ultrasound would be on my leg! The gel stuff was kind of soothing, but otherwise it was not fun to have that wand pressing around on my sting site. Through the translator, the doctor explained that there was an infected area, about 1cm deep, the size of a baseball on my leg. That would be the dark part of the bulls-eye. And there was a shallower infected area everywhere else. I had no idea you could use an ultrasound machine to discover/diagnose infection, but at least it confirmed what we thought was going on. The doctor wanted me to get started on antibiotics and cortisone right away. I took a dose (of something, I dunno which actually) right there in the exam room, and then left with the liaison to do some paperwork and get counseling on the next steps.

I got a copy of my intake paperwork, EKG, blood draw, and the doctor's notes. The translator told me I could either get my prescription filled at an Italian 24-hour pharmacy and get reimbursed later, or since I already got some medicine at the ER I could just take the prescription in to the pharmacy on post later that day and get it filled there. I asked if I needed to see my primary care physician, and she said no. She assured me that she would email my provider the notes, and that she would put in the prescription in the morning so all I had to do was go in and get it filled. Since it was now 2am, I decided that was my preferred option

Ha.

HA HA HA.

Nope.

I got home and quickly updated both Tony and Helena that everything was okay, and slept in until about 8:30 or so. I cleaned up, ate, touched base with my wonderful, worried husband and assured him I was fine, and headed to post to pick up my prescription. The pharmacy said they didn't have anything in their system for me, so I asked the tech if she could call my primary care provider. They did, but the doctor was probably with a patient, so I was referred to primary care. When I showed up at the intake desk and said it was for an ER follow-up, and asked if they could check on the prescription for me, the very nice ladies said, "Yes, there is a note in your file from the patient liaison. I will have a nurse come talk to you."

After a short-ish wait, a nurse did indeed come talk to me. I explained what happened the night before, and she sort of unloaded about the hospital procedures. "They think we have a magic computer over here and that we can just magically fill prescriptions, sometimes for things we don't even stock, when there's no way to tell what they gave the patient or whether the patient already picked up the identical prescription from an Italian pharmacy." Naturally, I was taken aback by this tirade, and she must have seen it in my face, because she apologized and explained there are frequent issues like this happening. So she took my vitals, examined the site, and told me she'd contact my primary care provider, who had apparently already closed out my case thinking I picked up the medicine from an Italian pharmacy already. I was able to leave the clinic around 1115 and still make my 1130 volunteer luncheon at the Golden Lion, which was a very nice event. I had fun regaling everyone with my adventures, too. When the lunch was over, I checked my phone and saw the clinic called twice, so I started heading that way. En route, the nurse called again, and said the provider wanted to meet with me, and asked if I would be available at 2:30. Sure, what other option did I have at this point??? So I went back to the volunteer office, did some admin, checked my email, and killed an hour before heading back to the clinic. You know the routine: check in, intake, wait, see the doctor. Who was ever so nice and gracious, and commiserated about the nasty Italian bugs. She examined my leg and seemed less convinced that it was infected and thought it was just a bad local reaction, but she still decided to prescribe me an antibiotic, cortisone pill, and topical cream. So BACK to the pharmacy, and I was out of there by 3:30. Twenty-four hours after I called the nurse hotline in the first place, I had a prescription in hand, whew. Take with food, don't drink alcohol, yada yada. I still itch, the topical stuff doesn't do jack, my stomach seems fine with the meds, and ice seems to be the best/most effective treatment at this point. I picked up pizza for dinner yesterday, and fell asleep somewhere around 7 o'clock. I woke up at 11 and put myself to bed, and slept almost straight through to 10:30 this morning. I guess I needed it after all my adventures and back-and-forthing this week.

So that's the tale of my yellow jacket sting. But you should have seen the other guy.

(Wocka wocka!)