I promised awhile ago that I would write about my medical hospitalization. This happened after I’d already had 3 psychiatric hospitalizations, so it’s interesting to me the similarities and differences that occurred between the two types.
I experienced a couple of symptoms that came on suddenly, one which was very worrysome and one which I wasn’t too worried about, but was uncomfortable.
The less worrysome symptom started while I was at a place I volunteer at. I’m not very good at listening to when my body tells me to stop something. I kept telling myself I would push through, I didn’t have much longer before I was scheduled to leave. Then the more worrysome symptom appeared and I told the supervisor I wasn’t feeling well. I rested in the break room for a bit hoping I’d feel up to going back to working. A supervisor offered to drive me home, I turned her down. Instead I took public transport.
I called my primary care doctor for an urgent appointment. My doctor wasn’t available, but there was someone else who could see me almost immediately. I saw this doctor and she told me what she strongly suspected the problem was. It was something unpleasant, but at the level I was experiencing it, not life threatening and she expected the symptoms would pass. She told me she’d make a referral for me to see someone the next day to confirm the diagnosis.
I was supposed to get a phone call soon about the exact time and location of the referral.
I went to class. I have to be doing pretty poorly to miss class. The professor noticed before the class that I wasn’t looking great and she kept commenting on how pale I looked. I was very insistent that I wanted to stay even though I wasn’t feeling well (there was no evidence that any of my symptoms were anything contagious). It was a long class though, a lecture followed by a lab. I made it through everything but the final hour. My poor lab parter was pulling most of the weight. I gave up though, I was too miserable to stay, so I left to go home. The professor was understanding.
This is very different from how things are with my psychological problems. I also went to class the day of my first psych hospitalization. There was nothing visibly wrong with me other than that maybe I was possibly quieter than normal. I’d not have been able to excuse myself from the class explaining to the professor that I was experiencing a lot of suicidal ideation, like I explained to my other professor this time about my worrysome symptom.
I hadn’t gotten any call about the so-called urgent referral for the next day. This is pretty similar to how primary care doctors have also treated my psych referrals
I went home and tried to sleep. It didn’t work very well.
I was feeling a lot worse than I had when I’d seen the doctor earlier. I was very stressed, because I had work the next day and no information about a referral (My work that day was flexible enough that if I’d ducked out for an hour to see a doctor no one would have objected) and felt worse.
I called my parents, crying. I feel like I do that too often for someone my age. They kept telling me to go to the emergency room.
I really didn’t want to go. Even though I felt horrible I felt that since I had already seen a doctor that day, who felt my situation was not an emergency, it didn’t make sense for me to go to the emergency room.
I worried that I wasn’t ill enough to go there.
This is pretty similar to how I’ve felt about seeking help for psych emergencys. I go back and forth between, ‘things are pretty bad’ to ‘but I don’t want to bother anyone’.
I agreed to go to the emergency room. The closest emergency room to me is the hospital where my 3rd psych hospitalization was. Nothing went right in that hospitalization There was not a chance I was going there, so instead I took a cab to one a little bit further, but arguably more prestigious.
I told the triage nurse, what was going on. I told her about the diagnosis that the doctor I’d seen had mentioned and how the referral hadn’t come through. I also mentioned how much worse I felt since I’d seen that doctor. On the pain scale I said I was an 8.
I’m a little unclear about the pain scale (and it’s supposed to be so simple!) I had thought that it was based on 10 being the worst pain I can imagine. I’ve since been told by some that 10 is the worst pain you’ve experienced. If I’d answered saying it was the worst I’d experienced then it would have been a 10.
This step was pretty similar to how things worked with triage at a psych hospitalization.
Then I was sent to a little room with a lot of other patients. I’ve been to the emergency room a number of times in my life for things like broken fingers, a broken foot etc. This room reminded me of the types of rooms I’d waited in for those situations. It was the group of people who could theoretically wait forever in the room without dying. I waited for about 3 hours in there. I called my parents again, crying. I told them I was going to leave, because based on how I’d been triaged they didn’t seem to think my problem was that serious. I was in a lot of pain and I figured that if I was in a lot of pain and the doctors didn’t feel it was an emergency then I may as well be in that pain at home in my comfortable bed.
I sat around for a little bit and finally asked the nurse if maybe there was a cot somewhere I could lay down on because, my pain was so much worse when sitting upright.
This is very different from my psych emergency room experiences. I’ve gotten a bed right away. Sometimes that bed was just a bed in a hallway, but it’s still a bed. Still a ton of waiting to be seen by a doctor, but they’d never put a psych patient in a room with a lot of other medical patients and only one nurse. In the psych emergency room I’ve always had a “sitter” watching me too. Here I don’t think the nurse even noticed my sobbing phone call. If I’d walked out I doubt anyone would have noticed. At a psych emergency room though you can’t just change your mind. You’re stuck there at least until you see a doctor.
I was seen shortly after the nurse found me a cot set up in the hallway. I’m not sure if this was because I’d made her more aware of how awful I felt or if it was just because I’d already waited 3 hours.
I was wheeled into another room and saw a lot of doctors and had a lot of tests. The original diagnosis the doctor told me at my primary care office was wrong and sent the ER docs on a bit of a wild goose chase while they ruled it out.
This period of time was very scary, because I didn’t know what was wrong with me. As soon as I saw a doctor I was given pain medication, so at least I was more comfortable physically, but I still didn’t know what was wrong. Many diagnoses were thrown at me as possibilities. Some of these were very serious chronic illnesses.
This is very different from a psychiatric hospitalization, where differential diagnoses are rarely discussed and it’s hard enough to even get the doctors to admit the diagnosis they’ve selected for you until maybe the end of the hospitalization. Here, diagnoses were discussed right off the bat and I was informed of reasons why they considered them.
I also saw a lot more doctors here than at any of my psychiatric hospitalizations. The most I’ve ever seen at a psychiatric emergency visit is 2 doctors and that’s only because there was a shift change.
Here I saw 4 or 5. There wasn’t a lot of waiting time in between either. Once I was past that initial 3 hour wait I had a steady stream of events, from doctors, to nurses to tests.
In my psychiatric emergency visits I’ve sat in a room by myself for nearly 24 hours with no form of entertainment, because they take your possessions, and maybe 20 minutes total of conversation with anyone working at the hospital. And this was at a supposed top tier hospital.
Here I had come prepared and brought my laptop. I was able to use the hospital’s wireless during the chunks of time where nothing was happening.
For medication they put an IV in, which is different from my psychiatric hospitalizations where my medication was taken orally.
For one of the tests I needed to drink contrast fluid. I have a bit of an oversensitive gag reflex and tend to vomit a bit too easily.
I vomited right as a doctor was walking in, because I was trying to drink the fluid. The vomiting wasn’t a symptom of the immediate problem. This is something I deal with regularly when trying to take medications. Nonetheless a nurse rushed over and gave me a medication through the IV that she said would help with the nausea.
It’s a scary thing for a person to so easily put a drug into my body, before I can even realize what is happening. I didn’t have a huge objection to it, but if she’d asked me first I’d have told her it was not necessary.
In a psych hospitalization this would be a lot harder to do. Worst case they could give someone a shot (this has never happened to me), but it would be a bigger deal to do and there are more safeties in place when giving something like this without explicit permission from the patient. It’s not done so casually.
During the course of this hospitalization I received all sorts of medications and I have no clue what any of them are, except for the morphine. In a psychiatric hospitalization I know everything I take and refuse anything without significant research ahead of time.
I contacted my work to let them know I was in the hospital. I don’t know what I would do if this had been a psychiatric hospitalization. I’d have probably had to lie. I wouldn’t feel comfortable telling them about that even though my work is in the mental health field. Actually, especially since my work is in the mental health field.
No one was going to judge me for this transient medical problem, but a long term mental health problem is not safe from judgment.
Eventually a diagnosis was found and treatment was planned. I was admitted to the hospital and moved from the ER. I felt a lot better knowing what was wrong.
The problem was something that was life threatening if left untreated, but not a big deal at all with access to modern medical care.
There is a part of me that mourns an opprotunity wasted here. I always have some level of suicidality and have at times wished I’d come down with something life threatening so I could die passively by just avoiding treatment. At the time of this illness, I was doing very well psychologically, but I wonder if I’d have stayed home instead of going to the ER if I’d been more depressed.
The uncertainty though is what drove me to the ER. Not knowing what was wrong freaked me out.
If I’d been more depressed and at home and known with high certainty the diagnosis (If I’d even glanced at Doctor Google I’d probably have come up with this diagnosis) I can’t say for sure that I’d have sought treatment.
Several years ago I once saw a primary care doctor at this hospital. I needed a psychiatrist referral (Don’t I always?) and could only see one at her hospital by going through a primary care doctor first.
I can’t remember exactly what I said, but I believe I gave a fairly thorough psychiatric history to her.
All through this medical hospitalization they had access to those records. I was really pleased with how that knowledge was handled. It probably helped that the records were old, but I don’t feel like I was treated at all like a person with a psych history.
I was asked 1 time how my mood was and once it was clear that I was fine, it was never asked again.
They also knew my current medications, both of which are psych medications. I was asked a number of times if I needed either of them while I was there, but I think that was more due to confusion because it’s unusual for someone to take Ritalin only some days like I do.
I was relieved that my self-injury wasn’t discovered/discussed in the medical hospitalization (It’s probably in the record from the primary care doctor). It helped that I had no fresh injuries. If anyone noticed the scars no one said anything. I was terrified of having a psych consult sent to me.
Everyone was so much more accessible than when I’ve had psychiatric hospitalizations. I had a button to call the nurse. In psychiatric hospitalizations I might walk around looking for a nurse and knock on the nurses station door to be told someone would get to me eventually. Unless it was a huge emergency, anything could wait. With the medical hospitalization, getting help when I needed it was easy.
In my hospital room I had a roommate. Unlike in a psych hospitalization, I have not a clue what she looked like. There was a curtain between us. All I know is that she was an elderly woman and that she had been there for awhile.
She was very disoriented and spent the night talking to herself.
While that might seem like it would be similar to a psychiatric hospitalization, it really wasn’t. In my hospitalizations someone that disoriented was usually given a single room instead of a double.
The largest difference between the two types of hospitalizations was length of stay. For the medical hospitalization I was there two days, counting my time in the ER. That’s shorter than the time you can be held involuntarily without a court order for a psychiatric hospitalization!
My shortest psychiatric hospitalization was one week long. They wanted to keep me longer, but I signed one of the forms requesting they either release me or get a court order. They realized they couldn’t pull off the court order so they backed down and released me.
After two days of the medical hospitalization I was very ready to get out of there and they were very ready to kick me out, so we were all on the same page.
I did spend a week at home recovering more, but at that point the worst was over. I just slept a lot.
Follow-up was also different. I’ve never had a psychiatric hospital discharge plan that didn’t fall apart within a couple of days of leaving. Then I’m left with no one to call and zero follow-up.
With the medical hospitalization they gave me an appointment at the hospital the following week and I could have continued to go to follow-up weekly as long as I felt necessary. Personally, the one follow up was all I needed. I was even able to call a number they gave me for when I had a question or ran into an issue about the treatment plan.
I’m all better now. It was an interesting experience to have a medical hospitalization after all of the psych ones.
