Serene Forest

Showing posts with label Emergency Instruction Chart. Show all posts
Showing posts with label Emergency Instruction Chart. Show all posts

Thursday, December 5, 2013

Avoiding the Pitfalls of the Emergency Room


Hello All,

I have posted two blogs about emergency issues related to Periodic Paralysis. The first was about knowing when to call for an ambulance or when to seek medical help. The second was my story about my experiences with the Emergency Room (ER) and    why most of us who have Periodic Paralysis fear the ER and the doctors we must deal with there. Today’s post is about how we can better prepared and get the care we need if it is necessary to be seen in the ER.

I created the following after my own experiences and knowing that in the future I would probably have to be seen again in an emergency situation.


Avoiding the pitfalls of the emergency room



Since I received my diagnosis, due to the previous mishaps in the ER and the hospital, I have taken a trip to the hospital with all of my records. I had them copy all of my information. This is for four reasons. First, to prove my diagnosis; second, to teach the doctors about Periodic Paralysis; third, to educate the doctors so they will know how to treat me the next time I am in a crisis and fourth; to clarify all the lies and misdiagnoses.

While there, I explained that they have to monitor my breathing; make sure I do not choke and monitor my heart due to the tachycardia, and arrhythmias, watching especially for the long QT interval beat. They are not to hook me to an IV, not to give me glucose or any medications. They are not to use a tourniquet or have me make a fist if they need to take my blood.  They should look through my file and/or folder for any other info they may need. It is also important for them to now listen to your significant other (if you are lucky enough to have one), who will be your voice, if you cannot speak or explain things to them.

Since that conversation, and now having everything in place for the next emergency, I feel better about the possibility of having to ride in an ambulance and being admitted to the hospital if needed in the future.

The following is my outline plan:

1.      Call hospital administration office
a.      Explain your problem
                                                                          i.      Tell them the history of visits and the problems during them
                                                                         ii.      Tell them about your fears due to the previous visits
                                                                        iii.      Explain your diagnosis or possible diagnosis
                                                                         iv.      Explain your plan to bring in all your records for your file
                                                                          v.      Ask how you can speak to the supervisor of the ER
2.      Call the ER supervisor or make an appointment to meet with him/her
a.      Explain your problem
                                                                          i.      Tell them the history of visits and the problems during them
                                                                         ii.      Tell them about your fears due to the previous visits
                                                                        iii.      Explain your diagnosis or possible diagnosis
                                                                         iv.      Explain your plan to bring in all your records for your file
3.      Meet with ER supervisor or representative in person
a.      Bring your significant other or a friend or family member
                                                                          i.      Present your records
1.      Name and numbers of your doctors
2.      Information about Periodic Paralysis
a.      Your personal Emergency Chart
b.      Bring the book: Living With Periodic Paralysis: The Mystery Unraveled
c.      Copied from the internet
                                                                                                                                               i.      The types
                                                                                                                                               ii.      Andersen-Tawil Syndrome?
                                                                                                                                              iii.      Hypokalemic Periodic Paralysis?
                                                                                                                                               iv.      Hyperkalemic Periodic Paralysis?
1.      How to take your labs
2.      How to treat your symptoms
3.      How to diagnose, if not done yet
3.      Your diagnosis reports (from doctors) if you have them
4.      List of medications you can not have
a.      No IVs
b.      No medications that paralyze
c.      No meds that cause long QT (if it applies)
5.      List of medications you take
6.      List of other medical issues
a.      Possibly diabetes, heart problems, etc
7.      Records of previous labs and tests which helped with the diagnosis or ruled other things out to include but not limited to:
a.      EKGs,
b.      Holter monitors results
c.      EMGs
d.      EEGs
e.      Muscle biopsy
f.        Sleep studies
g.      Pulmonary study
h.      Physical therapy
8.      Letter from therapist clearing you of mental issues
a.      Good to be seeing a therapist to help deal with
                                                                                                                                                 i.      Failing health
                                                                                                                                                ii.      Moral support
9.      Possibly a standing prescription from your doctor:
a.      “if muscle weakness or paralysis”
                                                                                                                                                  i.      “Blood serum labs for Potassium”
10. Have hospital records copied by:
a.      Records department or
b.      ER personnel
11.  Explain anything else you believe is important
12.  Always carry a plastic folder with copies of the above   information in case you find yourself out of your local area in an emergency.

A year ago, Calvin and I moved to a new home in another state. I immediately called the nearest fire department and hospital. I explained my medical issues. The fire chief took notes and the hospital asked me to bring in my records to have them be put in the system. I did just that.

About two months ago, this was all put to the test when I had a possible small stroke (TIA). Calvin called 911 and my doctor. She called the hospital ER and told them about my condition (Periodic Paralysis). When the paramedics arrived, Calvin handed each of them my emergency chart with instructions. They read them, asked a few questions and got to work checking my vitals and getting me ready to transport me to the hospital. With Calvin’s coaching, they followed every detail and I was safely taken to the ER. Upon arriving, the same thing happened. More copies were made of my emergency chart and the doctors referred to my medical records already in the system. They were very careful with everything they did or did not do to me or for me.
 
Calvin and I were very happy and relieved. They believed us and followed our instructions. We no longer fear a trip to the ER. However, with the co-pays and expenses related to an ambulance ride and a few hours in the ER and the testing involved, we now fear that we cannot afford to call 911. I am paying nearly half of my social security check towards being covered, but the costs we must still pay, make it nearly impossible to ride in an ambulance, go the ER or see specialists. I believe I have a new idea for another blog?!


Until later…

Tuesday, November 19, 2013

Emergency Instruction Chart




Hello All,
 
The fog and shades of gray lingered through the day yesterday, as well as breathing issues, fatigue and weakness. I did, however, manage to write another blog; translate some conversations in Russian and Spanish; congratulate someone on their genetic diagnosis; work on our survey; pass along information for caregivers; support someone who cannot get a diagnosis; encourage someone, and his caregiver, who is struggling physically while attempting to taper off of harmful medications wrongly prescribed, as he is attempting to get a diagnosis; setting up some technical things for the blog; research more ways to spread the word about Periodic Paralysis; help Calvin make a pot of vegetable soup, from my recliner; researched pure supplements for myself to deal with my exercise intolerance and finally sent a message to Barrack Obama, the President of the US, during a live phone chat session about the Affordable Care Act, seeking help for those of us with Periodic Paralysis. Wow! It is time for me to take a break. Maybe I will begin to feel better if I rest a little more.

The subject for today’s blog is a continuation of the past two days, understanding “episodes”. For those who go into full-body paralysis and are unable to speak, you may find yourself alone when an attack ensues. It is wise to have information, which can be easily seen for your caregivers or first responders. One of our members, who lives alone, shared a list of instructions she has posted on her bedroom door. I used her idea to create one for myself and my particular needs.
 
Although, Calvin is usually with me, the day may come when he may not be able to be with me or he may be unable to speak or just in case he needs reminding during the stress of an emergency situation. The following is my “Emergency Instruction Chart”:

My name is Susan. I am 72 years old and I have a very rare disease called Period Paralysis. The type I have is Andersen-Tawil Syndrome (ATS).

Potassium shifts in my body if I am hypokalemic, hyperkalemic or normokalemic. I become totally paralyzed when the potassium shifts from my organs and goes into my muscles. I am unable to move in any way and am not able to speak or open my eyes. I look like I am asleep, BUT, I can hear everything going on around me. I can hear everything being said.

I may be able to move my index finger on my right hand. If you ask “yes” or “no” questions, I may be able to answer. Up and down is “yes” and sideways is “no”.

My husband, Calvin, knows exactly what to do for me, so listen carefully to what he says and follow his directions. If he is not with me or is unable to speak or help me please follow the outline below:

If I must go to a hospital take me to Valley Medical Center. My doctors are:


  1. Dr          PCP                            541-
  2. Dr.         Neurologist                 541-
  3. Dr.         Cardiologist                541-
  4. Dr.         Renal Specialist         541-
  • Please talk to me and tell me what you are doing to me and for me.
  • Please make sure I am comfortable.
  • Please make sure I am reclining but not lying flat.
  • Please be sure my oxygen is on and working.
  • Please cover me with a light sheet or blanket because I get cold.
  • Please make sure my head and neck are supported. My head will fall to the side and can hurt a great deal.
  • Please do not try to move me when I am paralyzed. Damage can occur to my muscles and joints.
  • Please do not put me on an IV. I cannot have saline or glucose…if one must be used, very diluted mannitol may be okay.
  • Please do not give me any medications of any kind to include antibiotics.
  • Please do not give me any type of anesthesia, to include lidocaine.
  • Please do not use a tourniquet if blood is to be taken to check my potassium levels.
  • Please do not put any food or liquid in my mouth, I will choke because I cannot swallow.
  • Please watch my breathing it may stop or be very shallow.
  • Please watch my swallowing. I may choke.
  • Please monitor my heart. I have a heart loop monitor in my chest. I have long QT interval beats, arrhythmia, tachycardia, bradycardia and my heart may stop beating. I may go into cardiac arrest.
  • Please do not be alarmed if I have myoclonic jerks or fasciculations. It may mean that I am hyperkalemic, and is not a seizure.
  • Please have patience. I will come out of it eventually. It may last 15 minutes to several hours or I may go in and out of it.
  • Please be ready with a bedpan or be ready to help me to the bathroom. I will have to urinate urgently after I come out of it, but will still be too weak to walk by myself to the bathroom.

    Thank you!
 Other conditions: Type 2 Diabetes; Fibromyalgia; severe osteoporosis (bone crush of spine); Heart Arrhhythmias: PVC’s, PAC’s PJC’s, Errants, ST Segment Abnormalities, Long QT interval, Non-conducted PAC’s, Abnormal T waves and Angina; Small Vessel Ischemia of the brain; Degenerative Disk Disease; Diverticulitis; Arthritis of the spine; Acid Reflux; Hiatal Hernia; High Cholesterol/Triglycerides; Restless Leg Syndrome; Muscle Myopathy, Exercise Intolerance, TIA.
  
I have a Medtronic Reveal XT Heart Loop Monitor implanted in my chest…do not give me an MRI

My Medications: Potassium Bicarbonate as needed, Oxygen Therapy 2liters 24/7
       
Address
Phone number
DOB
Emergency Contact 
You can use this as an outline for your specific needs.

 I have this posted on our refrigerator, one in our car visor clearly labeled with “First Responders,” one in my purse, a few copies in the medical file we take with us wherever we go and one made to wear around my neck as necessary. I fold the paper and place it in a plastic name tag holder on a chain or other type of necklace.



 
I hope this has been helpful.

Until later…