Well that was a fun couple of days. You know this is a fly fishing blog, from the point of view of an average angler, so it's about fly fishing with a little bit about life mixed. And you know if you've been reading for 13 years know it hits on the good, the bad, and the ugly. Well this week it got ugly.
Last year in April I fell in line and got the Moderna vaccine. Shortly after my second shot I went into hypertensive crisis. BP 210/110 with symptoms. Luckily my man and fellow fly fisherman Dr. Brendan Muholland got it under control and my cardiologist Dr Jeff Osofsky saw me through until it normalized. Since then I have holding off on getting the booster as it was scary to have my blood pressure that high which really puts you in the wheelhouse to have a stroke or heart attack.
So with my booster shot, which is required for work, still looming overhead I though the least I could do would be to get the flu shot. No big deal. I've had them before. It'll make me look like a good employee. According to the CDC this years flu shot for Influenza A and H3N2 has an efficacy rate of 34-35%. That means you are 34-35% protected against the flu. 66-67% chance you could get it. I made an appointment at CVS and rolled up my shirt for the flu vaccine. While there I talked with the pharmacist and told him about last year and asked him if I should get the booster, his advice, "Don't get it, wait".
Over last weekend I started to feel a little "off". I returned to work on Monday to introduce my nursing students to taking vital signs, including assessing blood pressures. They caught on quickly, but one was having a little difficulty hearing. I offered myself up as I know my pressure can be heard pretty easily. She very carefully, and slowly, watched as the needle pulsated on its way down to zero. "No Professor, your blood pressure is too high, I got 206/122!". So a few more gave it a shot
and I put the results on the board. On Tuesday I did the same thing and by then I stared to realize over the past few days my head was pulsating, my heart pounding, and my vision wasn't normally as sharp as it usually is. So before work on Wednesday I changed out the batteries on our home blood pressure cuff and gave it a look. 184/113. "Fuck", I thought to myself. So I went to work and called
my man Brendan's offcie to make an appointment, he is only seeing patients these days on Monday and Tuesday, and my cardiologist, who's staff made an appoiintmet for me on January 5th 2023. By the time that appointment rolled around I would have been decomposed. So I decided, finally, as nurses are the worst patients, that it was finally time to go. I drove down to Monmouth Medical where I used to work and where my docs
have privileges, or so I thought, Monmouth Cardiology and Osofsky jumped ship over to Jersey Shore. I walked in and stopped at the front desk where they asked me what I was there for, "My blood pressure is high". "Okay, have a seat". Then I added, "No I'm about to have a stroke". So with a mix of concern and sarcasm they had me come around and took my blood pressure. Before it registered I told the tech and the nurse, you might be calling "Code STROKE". "All right lets see",
with that kind of "I've seen it all before". Well sure as shit when the 230/130 registered, they moved quickly, and I was off to the races. The ER doc hit me with hard core "life saving" meds meant to quickly lower a blood pressure, Labetalol, Hydralazine, twice, Losartan by mouth, all with minimal results. So I got room at the inn and was there from Wednesday to Friday. Had all my peeps
checking in on me and visiting. With things not going well into Thursday afternoon and my blood pressure creeping back up to 180/115 I had to do a little self-advocacy and open my mouth. If you don't know the game, then know it sucks, no matter what hospital you are at. Medicine works this way. An ER doc sees you, a hospitalist covers you, residents (if that hospital has them) check in on you, and attendings get consulted to fix you and then discharge you. Kind of that way. The attendings usually make rounds in the mornings, and then see you the next day. A lot can happen between 10 am one day and 10 am the next. So with things heading back up, the attending and hospitalist not in the house, lets say I had to blow a gasket, to get some treatment plan changes before I really had a stroke.
The treatment plan changed and a good IV blood pressure med was started and after about 6 hours I started to drop. They doubled up on the doses of the oral meds and by Thursday night the pressure and throbbing started to subside and by Friday morning I knew I was going to be discharged with a blood pressure of 138/88. But before I left a few more attendings had to come in for their piece of the pie. One was the "kidney doctor", who walked in and greeted me as I sat in the bedside chair all cleaned up and dressed to get out of there. He looked at me and made a face and a
made a sound or a comment under his breath. Before he could say anything I said to him, 'Hey doc, go f%$k yourself". And then asked, "Are you f%$king kidding me?". You see, he looked at my shirt (above) and judged me before even saying a word. I quickly told him to read my shirt again and asked him if he has ever heard of the Grateful Dead. In his Indian accent he said, "No, I know it was, you know". If I could have I would have throat punched him as he tried to laugh it away. Why would I punch him? Not because I gave a shit what he thought of me, or whatever his bias is, or what or who thinks I believe in or who I voted for, but because it's just wrong as a provider.
One of the things I stress with my nursing students and in my own practice is, and I say it word for word, is, "Check your own shit at the door". We are taking care of our patients, period. Not judging, not engaging about things where a different belief or ideals is different from your own. I was furious, and really pissed off as that is one of the cornerstones of providing care to patients. He thought I was a "Trumper", or whatever they call it. I wasn't going to give him the satisfaction that I wrote in and voted for Tusli Gabbard, a Democrat, during 2020 Presidential election and that I vote on both sides of the aisle. I'm still pissed about that.
Before that drama I looked out my window and really wished I was some where else. I thought of Lief, not in a romantic way, on the beach in Deal, only a few miles away, running his Snake Fly through the waves as the mullet make their first light run down the beach. I'm ready to go fishing and can't wait for the fall run to begin. It felt good to get out of there. First, shout outs to my nursing students who kind of got this party all started. I am always thankful to the nurses who were great, and to the docs who helped me out of this, with some good suggestions and advocacy on my part. I can't imagine patients and their families going through anything medical without a hint of knowledge and experience. Every health care provider should be required to do some time as an inpatient, especially that kidney doc.
So in this PSA (public service announcement), coming from a nurse practitioner who always waits too long, if you see or feel something different, do something about it. Heart attack and stroke can and will kill you, or leave you severely disabled. Get a regular physical, listen to your own body, don't wait to go to the emergency room, which today is really an extension of your doctors office and primary care, and take your meds as prescribed. Health is wealth!