Denver Direct: Report from the ER

Monday, July 19, 2010

Report from the ER

Last Monday at 4:00 am I was back in the PSL (Presbyterian-St. Lukes) emergency room with intense abdominal pain. The pain is hard to describe – grinding and insistent. It makes you writhe in agony. It was a repeat of my condition from 18 months earlier.

The doctors immediately went to work, hooking me up to an IV, taking my history, etc. Within a half hour they got to the pain relief, my choice of morphine or Dilaudid (synthetic morphine). I chose Dilaudid, and within seconds of injecting it into my IV tube – relief, ah, blessed relief. The abdominal agony gone.

Next was the CT scan. This requires that you be wheeled on a gurney through the incredible maze that is PSL to the lab. Once there, you get a scan in the big doughnut machine, pause for an injection of contrast dye, and then another pass into the doughnut. Then back to the ER to wait for the results.

While waiting, I couldn’t help notice that the ER booth I was in was dirty. The floor was tracked with gray splotches. The bathroom in the ER was also dirty. Discarded wrappers on the floor, which, near the toilet, was sticky with crud. Maybe it was the end of the shift and the cleaning crew hadn’t been through yet. I’ve been to the PSL ER on a number of occasions and never seen it dirty. I’ve always been pleased with my experiences at PSL, and I hope this was a rare exception.

My images were sent to a lab, probably in California I was told later, and the report comes back to the ER Doc. My report showed diverticulitis, an infection in the colon. And oh, by the way, some possible lesions on my liver. I was given prescriptions for 4 medicines, and approximately four hours later, I was on my way to the pharmacy – Walgreens at Race and Colfax.

Much to my surprise, one of the prescriptions, Levaquin, an antibiotic, was $352.00 for 10 pills, one per day. I was shocked. I asked the pharmacist, who was very helpful, if it was some kind of a new magic bullet. No, she said, and suggested that she could call the ER doctor and see if a substitution was available. Within minutes the answer, yes, Ciprofloxacin, another antibiotic, would do the trick. Cost – $10 for 20 pills, two per day. Why would the ER doctor prescribe a medicine that cost $35 per pill when one was available that cost 50 cents per pill? You be the judge.

I made an appointment for Thursday with my primary physician as I was instructed. The comment that lesions had been discovered on my liver began to sink in. Google, as usual, provided way too much info. Usually benign, sometimes malignant. If malignant, usually indicative of cancer at another location.

Of course I tried to remain calm. Would a biopsy be required? Further tests? Don’t jump to conclusions. Wait. Tick, tock, tick, tock.

Thursday finally rolled around. My doctor, having reviewed the scan and lab reports, said it was the VOMIT Syndrome. What? Yes, VOMIT – Victim of Medical Imaging Technology. There was nothing wrong with my liver, but the ability to see every dot and speck in my gut had led to the over-analysis of the scan by the technician. Happens a lot these days, he said, what with vastly improved imaging technology. Of course I was relieved, but couldn’t help but think of the thousands of days of unnecessary worry endured by those who, like me, waited in limbo between the technician’s reading and the physician’s analysis.

I’ve been on a high-fiber diet for years, and if I continue to have these attacks, will probably have to have a section of my colon removed. No big deal, I’m told. Done laparoscopically. Leaves three dots on your lower abdomen. A friend who had it done said it completely cured him of the attacks, and has had no problems since. Here’s hoping.