I’m not sure I’ve made the timeline of events with my Dad clear, so let me present it here. In terms of symptoms and presentation, I’ll be quoting heavily from the Merck Manual (http://www.merck.com/mrkshared/mmanual/section3/chapter26/26b.jsp) since Dad’s case is for the most part textbook.
On Tuesday morning, Dad went for his regular daily 5-mile walk at Minto Brown Park. Afterward, he stopped by and took Jonah down to our park for an hour. Later, when Jonah, Elisha, and I headed over to Brama and Poppers house around 5:30 PM for dinner, Dad was feeling unwell. The initial thought was that he’d eaten bad meat for lunch and was suffering from food poisoning. After an hour or so of terrible nausea and vomiting, he emerged from the bedroom and announced that he needed to go to the hospital. The kids stayed with Brama, she called Erin (who was still at school for parent-teacher conferences), and I took Dad to the ER.
He was in a lot of pain on our ride. How much? Nine on a 10 scale according to him. The Merck Manual says this:
Most patients suffer severe abdominal pain, which radiates straight through to the back in about 50%; rarely, pain is first felt in the lower abdomen. Pain usually develops suddenly in gallstone pancreatitis versus over a few weeks in alcoholic pancreatitis. Pain is severe, often requiring large doses of parenteral narcotics. The pain is steady and boring and persists without relief for many hours and usually for several days. Sitting up and leaning forward may reduce pain, but coughing, vigorous movement, and deep breathing may accentuate it. Most patients experience nausea and vomiting, at times to the point of dry heaves.
When we arrived at the ER, I wheelchaired him in and they immediately got him into triage. His presentation was somewhat similar to that of a heart attack, and the doctors and nurses attempted to rule that out first since he’s over 55, is overweight, and has a family history of heart disease. It was clear relatively quickly, I think, that it was not a heart attack. Again, the Merck Manual which describes his condition almost perfectly:
The patient appears acutely ill and is sweating. Pulse rate is usually 100 to 140 beats/min. Respirations are shallow and rapid. BP may be transiently high or low, with significant postural hypotension. Temperature may be normal or even subnormal at first but may increase to 37.7 to 38.3° C (100 to 101° F) within a few hours. Sensorium may be blunted to the point of semicoma….Examination of the lungs may reveal limited diaphragmatic excursion and evidence of atelectasis.
He had a hard time that night. By the time he was admitted, they’d given him a fair amount of pain medication, but he was still miserable. He’d sit up in bed, want to move his pillow to the other side of the bed (from the head to the foot), and attempt to get comfortable there. Then three minutes later, he’d reverse the process, because no amount of jostling or movement made the pain go away and the pain meds were making him less than lucid. The effect of all this back and forth was to frequently tear off the EKG leads, which nurses would then dutifully try to reattach. Mom and I finally left after midnight, once he’d more or less settled in. (Though in our absence it turned out to be a very restless night for him.)
…I will write more to update this timeline as I get the chance…right now (Saturday night), I’m too exhausted to continue. Thank you all for your support. We appreciate it.