Friday, 24 April 2015

Autonomic Dysreflexia

This post is an example of " everything went wrong that could have gone wrong".
Yesterday, I recalled the story of Sue a patient who needed and received some excellent nursing care from a curly haired, potty mouthed and naturally funny staff nurse called Ruth, who I have been dear friends with for over 25 years.
The story, had a somewhat sad ending for after four months or so on the rehab ward, Sue suddenly suffered a major physical complication and died unexpectedly on intensive care . She was only 26 years old.
We had become very close with Sue during her admission, and so it was natural for us to want to attend her funeral, which was across the Pennines in her home city of Manchester, and so early on the morning of the service three spinal injury nurses and three spinal injury patients left Sheffield in two cars to show their support.
Now Ruth and I travelled in one car and with us was a young man called Nick who had been paralysed from the waist down in a car accident and Marie, a young woman injured from the neck down following a fall. Both were wheelchair bound and both had developed a special bond with Sue during their admission.
The other car was driven by a nurse called Paula and with her was another patient called Pete, who was able to walk very shakily on two sticks.
Things didn't bode well after we stopped at traffic lights in rural Derbyshire  for as Ruth muttered her signature oath of " Hell's Teeth!"  her car stalled and refused to start. It was only then when I realised that we were totally responsible for three patients, each one with their own individual care needs.
It was a sobering thought.
Anyhow we eventually arrived at Sue's family home in a back street of Manchester just as the hearse left for the Church, then everything went tits up.
  • Ruth's car finally died, leaving us stranded with no knowledge of where we were going
  • Ruth started to flag down passing cars in a desperate effort to elicit help as Paula and I managed to lift Nick and Marie into her car so that at least we could get them to the service
  • Ruth then incredibly stopped a cheerful plumber called Mick who agreed to transport me, her and the patients' wheelchairs across the city as a favour. Never was a stranger so helpful
  • After getting to the Church we unloaded both van and car, set the patients up in their chairs then bolted to the service which was just finishing. By this time Ruth was literally inconsolable 
  • The " wake" we were then told was located in a working men's club back across the city and Sue's family insisted that we all attend, so after organising more spaces in more stranger's cars we eventually arrived fraught, sweaty, and extremely stressed at one of the grottiest  council estate clubs I have ever seen.
  • Then everything REALLY took a turn for the worse. 
  • As we were setting up the wheelchairs ( brought for us by a couple of pensioners driving a nissan micra), Marie suddenly complained of a pounding headache. She looked flushed and unwell and couldn't quite focus  and we all suddenly knew that she was suffering from autonomic dysreflexia, a condition that is a medical emergency in high spinal cord injury patients. The condition can occur when a urinary catheter is blocked and if the cause is not rectified patients can have a pathological rise in blood pressure which can effectively kill them. The only treatment is to immediately change the patient's catheter.
  • " Get her into the club" Ruth yelled and between three of us , we lifted Marie out of the car and raced THROUGH the wake where a few hundred people were drinking beer  and eating sandwiches) 
  • Luckily a white faced club official saw us coming and pointed to the " ladies snug" which was deserted and on a polished table top , Ruth and Paula managed to change the blocked catheter which immediately reversed Marie's symptoms. 
  • While we were busy, several red faced drinkers had helped Nick and Pete into the club and were plying them with bottles of beer. This was just after 1pm
  • By seven pm, the AA had got Ruth's car started and we were on our way home. Nick and Pete were much the worse for wear and Ruth was beside herself with the stress. " I'm going to get sooo drunk tonight " she promised as we eventually got back to the spinal injury unit and after having to explain ourselves to the matron for our late return, she did exactly that, after talking a bottle of rum from another friendly rehabing patient!
The last thing I remembered of the evening was when I opened the taxi door  outside Ruth's house in
the wee small hours and she fell out onto the road drunk as a skunk. " HELL's TEETH" she slurred cheerfully "'I think I've just broken me finger.........hey ho" ......and I am afraid to say that she indeed had...but it wasn't diagnosed until the following afternoon....
Now you all know where " hey ho" comes from!
Me, Ruth's husband Allan, their kids and Ruth on a visit to Wales
Several years ago!


51 comments:

  1. I'm glad you told us the rest of the story John. It was v sad that Sue died. Your outing to the funeral was eventful to say the least (and stressful) but I was smiling mostly all the way through as I read it just now. Thanks..... and hey ho from Norwich

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    1. The nice ending concerned marie and nick
      Last time I heard nick was running a sucessful international buisness and marie had got married and had had her first child

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  2. "Hey Ho" is so versatile and may become part of my vocabulary!

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    1. I covers a multitude if sins

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  3. A tale of woe that ended in spasms of laughter. Hell;'s Teeth. I may save that one for myself. I believe that was a prime example of Murphy's Law.

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  4. What an outing! I've always mentally translated your hey ho as a combination of c'est la vie and shit happens.

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  5. I know things were very hairy therefor a while but there is so much life and resilience and community in this post. At least this horrific day was experienced together. Ruth's end of day realize was pretty perfect.

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  6. That should be end of day "resolve" not "realize." Damn smartphone.

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    1. She's had worse adventures since......i remember that her camper van burst into flames when she, hubby and dog was in it

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  7. Well, now I love Ruth that much more.
    You and your gang are remarkable people.

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  8. Yet another day to remember which would have been better forgotten. Sorry for you going through all those 'downs' concentrated together - nevertheless, a riveting read for us outside the experience.

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    1. I have more spinal injury tales to tell..... Some cannot be published hey ho

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    2. Oh, hells bells! - but we can hardly wait your relating them with your characteristic verbal sleight-of-hand.

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  9. Great story John. Such a fine looking young chap in the photo you are. Hey ho!

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  10. What a story. And I thought I was stressed.

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    1. It was years ago now.........i dont get myself in such situations now......I cant talk for Ruth though

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  11. This reads like an episode for a medical drama TV show, except much more touching and real.

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  12. Sounds like a typical family day out to me, just minus the argument halfway through.

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  13. Ruth is my new favorite character.
    Hey ho!

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  14. It is just now I am realizing that when things go bad in the Ukrainian Village or with your dogs, that these incidences are 'nothing' compared to what you have encountered in your life and work, John.
    I am tired (and amazed) just thinking about it!

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    1. I think we were all, young and foolish

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  15. I'd have gotten drunk along with her!

    Hey ho!

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  16. You make my life seem very dull.

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    1. It happened twenty years ago
      And im still living off the story
      So who has a dull life?

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  17. You three nurses were brave to take on the care of such compromised patients outside a medical setting!

    And I find it's generally things going wrong that make the best stories. As long as no one dies.

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  18. They don;t make nurses like Ruth any more, do they? Brilliant woman by the sound of it.

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  19. I wish we had more nurses that cared.

    Again, a wonderful story!!!

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    1. I do t think that they are too hard to find

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    2. I agree, John. My dad is currently in hospital with a severe pneumonia and every one of the nurses has been first rate. And I am so thankful for their caring.

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  20. A wonderful tale, one thing's for sure you'll never forget Sue's funeral !!

    Shame about her finger but if anyone deserved to get drunk Ruth did.

    And yes ... you've got me saying 'Hey Ho' too ... in all sorts of situations :-)

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  21. That was a good catch on diagnosing the AD....did you have a BP cuff along?
    Yeah, that was a day that went south in a hurry.
    Take care, pal.
    Mike

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    1. Mike
      Every spinal injury nurse worth their salt would kow about AD
      No equipement needed

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  22. It sounds like one of those anxiety dreams, where you are thwarted
    ( lovely word!) at every turn while attempting to get somewhere!
    It goes to show that there are so many good people in the world, that step up to help, even strangers, when needed. Something to remind ourselves when watching the evening news. All's well that ended well. Hey ho!

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    1. I have just realised i havent spoken to ruth in an age....lits about time,!

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  23. I'm guessing Pete, Nick, and Marie have gotten a lot of mileage from this story, too, and can't help thinking that it helped with their healing, besides the obvious save in the AD situation. What i mean is, you nurses treated your spinal injury patients like real people. So many people who see those who are handicapped tend to forget that; they see only the handicap. Hey ho.

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    1. Handicap is not aword that is used in spinal injury nursing

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  24. It seems that there's never a dull moment in your life, John!!

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  25. Wow, what an eventful funeral and wake John. You and Ruth are certainly very caring...

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  26. Sorry to hear about Sue, but what a crazy day!

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  27. Little Man you had a busy day. I'm glad everyone was ok especially Marie. Sounds like Ruth has the right idea. Sounded a little rough. Nurses and teachers are some of the most hard working caring compassionate people I know, (and I know a few) and I think the most under-appreciated... at least here, across the pond in the State.

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  28. Read this
    http://disasterfilm.blogspot.co.uk/2010/05/ruth.html#comment-form

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  29. Good God. I wish I had a frosted sugar cookie.

    Love,
    Janie

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  30. Sometimes doing the best thing, is not doing the easy thing, you did the best thing by making it possible for everyone to participate, despite the challenges

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  31. Wow, what an incredible story! I've injured my spine several times but have been lucky (so far). It is frightening to hear about those who were less fortunate.

    I'm laughing at "Hell's Teeth" and will have to remember it. I usually say far worse things than that.....

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  32. This should be a film !

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  33. The way you write is such flowing. Keep writing. www.bellofpeace.org

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  34. What a horrible nerve wracking day as you all set out on that important mission. Thank goodness you did get to meet the family, lend your support, but wow. What a day.

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  35. They say what doesn't kill you makes you stronger, but I think that day would have taken a few years off my life. Always wondered what hey ho meant.

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