An Emergency Room Visit: A Patient’s View

Emergency DepartmentNothing is more frustrating that sitting in the emergency room feeling terrible and watching someone who looks perfectly fine walk in and walk straight through to triage and be taken back. Right?

I recently got to be that person skipping the waiting room, moving straight past go to immediate help.

I felt fine, well except for the piercing headache behind my left ear that had been there for three days, but that hadn’t brought me into the emergency room. What brought me in was when one side of my face began to droop.

It was quite odd. At first it was just that my eyes didn’t look the same as usual. One seemed bigger than the other and then my face started to seem flat on one side.

Signs of a stroke

I recognized the drooping face as a possible symptom of a stroke and after I called my husband and dropped off the kids with some friends, I had a friend take me to the emergency room. Not my brightest moment. After all, if this was a stroke I was wasting precious brain time, but at least I didn’t drive myself! I couldn’t possibly be having a stroke – could I? After all my mum was 70 when she had her stroke. I was just 48 years old – a spring chicken. While I am definitely overweight, I didn’t have other risk factors.

I raced up to the front desk in the emergency room and began to explain my concerns. By this point my mouth was beginning to droop, too. The nurse took one look at me and whisked me back.

I’m sure to those left in the waiting room this seemed massively unfair. After all, there I was, able to walk, apparently in not significant distress, no bleeding or obvious trauma (they couldn’t see my face) and I was going to be seen before everyone else waiting.

Within a couple of minutes members of the rapid response stroke team were evaluating me for a stroke, bloodwork was being taken, and my situation was being evaluated. After the initial evaluation they were pretty sure I wasn’t having a stroke, but it wasn’t clear what was going on and something was definitely going on. Most of the possible scenarios and options were pretty awful. Center for Neurosciences nurse practitioner Frances West and neurologist Dr. David Teeple kept me calm and informed and made the decision to keep me at the hospital for observation.

The following day, after ruling out a possible reemergence of an earlier melanoma, the pieces began to fall into place. I had Bell’s palsy.

Bell’s Palsy

Bell’s palsy affects about 30,000 to 40,000 people every year in the United States. It results in the paralysis or weakness of one side of the face as a result of damage to the facial nerve. The cause of Bell’s palsy isn’t known, but generally the weakness or paralysis is thought to be due to swelling of the nerve in the area where it travels through the bones of the skull. For many, symptoms often begin to improve right away, but it may take weeks or even months for the muscles to get stronger. For some people symptoms may never completely disappear.

Six months out, my face is still lopsided. I can’t drink straight from a bottle, and talking at length can be tiring and embarrassing as I drool when my mouth tires. However, I can blink and smile. My facial paralysis isn’t quite as obvious as it was previously.

Bell’s palsy is not pleasant, but as my ability to parent, work, live and be an active member of my community is not impacted by my looks, I’ll take this slightly lopsided smile over the other possibilities like stroke or brain tumor.

I am grateful to know that if it had been a stroke, the TMC Rapid Response Stroke Team was ready to act, and the front desk staff prepared to recognize and move on a possible stroke case. And next time I’m in the waiting room of an emergency room … I’ll be a tad more patient as a new arrival is whisked back before me even if they don’t look sick.

While Tucson boasts a half-dozen stroke centers, TMC is the city’s only primary stroke center that has 24/7 coverage by board certified interventional neuroradiologists along with a neurology and neurosurgery stroke team.

Rachel Miller is a Communications Specialist at TMC.  She has decided since developing Bell’s palsy that everyday should be pirate day. (Individuals affected by Bell’s palsy are often unable to close or blink the eye on the affected side. A patch protects the eye from the everyday dust. Here Rachel takes advantage to play pirate.)

Comments

  1. I know exactly how this feels, but of course you never really know for sure what the deal is and maybe that person really is sick. I try to tell people all the time, if you’re really sick and miserable and can’t–or just don’t want to–wait for an appointment, that’s why the healthcare industry invented urgent care.

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