An Epistaxis Retirement……#269 (2009)

Colony Park/Country Villa - Gary's Building for the past 9 years

Colony Park/Country Villa the 99 bed skilled nursing facility – Gary’s Building for the past 9 years

      It was a warm March friday afternoon,  Gary participating in his routine of breaking down the accumulated empty cardboard boxes deposited by Rosa Guzman.  Rosa responsible for ordering and stocking the palates of  weekly truck delivered patient care supplies, Gary responsible for depositing the unsightly remnants in the 10 yard compactor.  The sun giving notice, the sweat on Gary’s brow bearing witness, a brief handkerchief swipe of the forehead and face remedying the moisture only the white cloth kerchief bore the red stains of blood,  Gary thinking a runny nose, only it was blood that was exiting.  Going inside the maintenance shop he followed the prescribed procedure from his EMT days, sitting, head slightly forward, pinching the cartilage on the nose but after several minutes the blood flow continued.  With handkerchief in hand he decided to see who was at the nurses station, discovering that Carolyn Hauser the director of nursing and another nurse was in her office.  Entering, Carolyn immediately recognized his predicament, listening as he related how he had tried to stop the flow,  telling a passing  CNA to go to the kitchen and get some ice in a plastic bag as she reached for a blood pressure cuff.   Gary noticing Carolyn expression changed as she murmured “that can’t be right” retaking his pressure a second time, Gary asking what the reading was,  Carolyn not immediately answering as she reached for her purse saying that we need to go to the hospital,  she would drive, then adding your blood pressure is 221/128.

Carolyn Hauser Director of Nursing

Carolyn Hauser Director of Nursing

Doctors Medical Center being only four blocks from Country Villa, in her haste Carolyn pulled into the employee parking instead of the ER, realizing her mistake but leading Gary and the other accompanying nurse through the main entrance asking an office employee how to get to ER from the office annex side.  In ER his nose bleed remained but his blood pressure began to come down Gary telling Carolyn that he could take it from here but would appreciate it if she would call Fran and tell her he would be late getting home.  After what seemed like an eternity a physician entered the treatment room, the doctor swabbing the inside of his nose with silver nitrate stopping the flow.   He was about to leave when to his surprise Fran entered the treatment room having taken a cab to the hospital, it was a comfort,  the two walking back to Country Villa to retrieve the car.

  The 6:30 a.m. Monday morning ritual was normal Gary was about to step out of the shower discovering his nose bleed from the previous Friday had returned, only this time flowing with vengeance.  He found it difficult to hold a towel over his nose with one hand and dry himself off with the other and get dressed,  then soon discovering that you can’t tie shoes with one hand.  Once dressed he placed a call to Country Villa to give noticed he wouldn’t be in and by chance Brad happen to answer the phone,  Gary explaining the situation but after hanging up the situation turned for the worse, the blood not only was exiting thru his nose but now down his throat causing him to gag.  His condition wasn’t life threatening, he didn’t need to call an ambulance, what he needed was a ride to the hospital  deciding to call Brad back and see if he could come by, Brad answering,  he was on his way.  Gary finally waking Fran making her aware of the situation.

Doctors Medical Center

Doctors Medical Center

Doctors Medical Center ER,   Gary signing in, told to be seated, the blood continuing its flow, his towels almost totally soaked, enough was enough, approaching the reception counter area once more only this time removing the towel letting the blood drip all over the counter, getting the attention of the person behind the glass, it worked he was immediately taken to a treatment room.  For the second time in three days his nose bleed was stopped, the noon hour having arrived deciding to walk the four blocks to Country Villa for a ride home, but no sooner had he exited the building his nose bleed resumed.  Returning inside, the process of waiting for his name to be called returned, a second doctor repeating the same process as the first halting the bleeding,  being told to remain in the treatment room. Gary thought they had forgotten about him as the evening hour approached, when the bleeding once again resumed, only this time requiring suction to prevent the blood from entering the throat.  A third doctor performing a brief examination informing him that he would be transferred by ambulance to the Kaiser Hospital in Fremont, a distance of 75 miles,  Kaiser Permanente his HMO.  When moved to the ambulance entrance surprised to find Fran standing there having just arrived after being notified of his impending transfer, looking very concerned..

Kaiser Permenente Fremont

Kaiser Permanente Fremont

   It became evident that the AMR ambulance crew hadn’t made very many trips to Fremont as Gary heard one of the EMT’s tell the other he was at the wrong hospital,  apparently the driver pulled into Fremont’s 269 bed Washington Hospital instead of Kaiser,  he was relieved that the hour and twenty-minute ride was over.  In a treatment room introduced to a young lady doctor,  it was approaching midnight the nosebleed had subsided to a trickle but he was beginning to feel the stress of his long day.  He questioned the doctor about the procedure relating that the previous two doctors had used silver nitrate to no avail.   She said she would be using something different this time, it was medicinal cocaine, that it had vasoconstrictor properties, in essence, the cocaine puts a chemical tourniquet on the blood supply to the septum.  With the  procedure completed, the bleeding stopped, Gary relegated to a wheelchair, the hospital unseemly quiet at that time of the morning, thoughts about how and when he could return home beginning and just when he thought all was well, his nose once again gave forth another notice as the blood once again commenced.  He was beginning to have a concern that he might have to have surgery,  the lady doctor informing him that there was another non surgical procedure and that an ENT from the Bay Area was on his way to administer it.

     Once again relegated to waiting only this time in a tranquil secluded area seated in a wheelchair,  a night shift nurse breaking the solitude wheeling him into a treatment room. The door opened, stepping into the room was a short elderly Chinese man wearing a traditional white lab coat who spoke up gingerly about the upcoming procedure that would halt the bleeding.  Laid out on the treatment table Gary had his doubts until the doctor unwound  two 24 inch long strips of packing while saying this might be somewhat painful as he proceeded to insert a whole 24 inch strip into each side of his nostrils forcing them up into his sinus cavities.  The procedure completed,  his tensing up a reaction to the pressure felt with the insertion of the packing leaving him somewhat exhausted plus  the biting reality of the past 20 hours setting in.   The doctor relating that he would have to live with the packing in place for the next ten days but at that moment it was of little concern,  a means of returning to home was foremost on his mind.  He was relieved after being told that the hospital had notified his wife and that she was making arrangements, concluding that admittance was out of the question he asked if there was some place he could possible lay down while waiting and to his surprise his request was answered, a nurse moving him into what appeared to be a darken unoccupied ward room, the bed a welcoming sight.  The doctor was right when telling him of the discomfort that would come with  the sinus packing, sleep finally settled in.  He was aroused by nurse with a food tray informing him it was afternoon, surprised at the hour and the food tray as he wasn’t an admittance.  The hospital having called Fran and he suspected she had called his mother who in turn contacted his sister Katherine in Groveland, the two finally arriving that afternoon.   Awaiting at home was a concerned Val Galindo and his wife Kay from Country Villa,  apparently Gary’s two-day absence and word of Brad taking him to the hospital must have gotten around.

March 26th having arrived, the ten-days of staying home waiting for removal of the packing had elapsed, Gary having an afternoon appointment with Dr. Vijay Bais M.D. ENT.   Still somewhat puzzled at the parade of events, a simple epistaxis, better know as a nose bleed requiring attempts by 5 doctors and two hospitals to halt the flow from a cartilaginous nasal septum.  On his way to the doctors deciding he would stop at work as quip so they could see his swollen disfiguration from the packing and what he had endured for the past ten days, the expression on the business office manager Joanie Peels face was priceless.  Dr. Bais a very congeal elderly man, removing the gaze and flushing the sinus cavity, Gary recognizing a familiar  odor as the packing was removed, it reminded him of the smell of human decomposition, the doctor smiling, nodding when informed.

Joanie at her desk

Joanie at her desk

       Once again returning to work,  a renewed effort being made to retire,  an interview for a replacement was at hand , this time one with applicable experience.   Scott Hensley having worked at Manteca Nursing and Rehabilitation Center also possessing a Contractor License.  Gary took an immediate liking to his replacement but when questioned about the plant systems and appliances he enumerated the Manteca facility contracted the service.  Over six weeks having passed, Gary satisfied with Scott’s progress approached Rashmi giving her notice that his last day would be Friday, May 29, 2009,  having attained  68 years resiliency it was time.   His final day was much like most keeping busy,   approaching 4:30 he entered the business office to cede a farewell to Joanie Peel the business office manager.   After nine years, Joanie was almost like family, Gary having employed her son Michael and daughter Karen in the past.  Saying goodbye and about to leave,  Joanie stopped him,  imparting that he shouldn’t leave just yet,  grabbing his arm,  leading him to the closed-door of the conference room.  Seated inside was Rashmi and all the department supervisors and many others, a large cake and refreshments adorning the long conference room table.   Gary was taken aback,  caught without words, the reception unexpected, but the real unexpected gift was not just their presence but an acknowledgement he would be missed.

Advertisements

One Response to “An Epistaxis Retirement……#269 (2009)”

  1. 4baby24.pl Says:

    Wonderful, what a web site it is! This webpage presents valuable information to us, keep it up.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s


%d bloggers like this: