A Dizzy Affair
Was the phone ringing?? May be I was dreaming! No, it was indeed ringing. This sounds like intercom. I picked up the phone my eyes still shut, heard someone saying "Doctor please come immediately my father is not waking up" I was blank and I finally said flat number??
It was 2.30 am Monday morning or I still prefer to call it Sunday night, barely slept 2 hours ago with guests sleeping in the guest room. I slowly tiptoed my way out trying my best not waking up anyone at home. As I walking the empty hallway and lift lobby, in a flurry all the memories came hitting me. I recollected my training, all the hundreds of nights when I ran to ER for an emergency. How we had to triage the patient in few seconds, act swift and appropriate. Time indeed costs life in an emergency.
I am in the lift and suddenly realise, I don't have any resources, I am the resource! The best I can do is tell the family call an ambulance. I was replaying every word the guy on the phone spoke, it didn't seem to give any information.
I rang the bell, terrified looking family members started to blabber lot of things at a time. I went to the patient's room, he was lying down. I observed he was breathing normally but not responding to the call. Wife said he has been sweating profusely and has been trying to vomit. He had said he is going to die. As I went near him to examine he got up suddenly and was about to vomit again. He looked at me briefly and had a brief look of relief. I realised he was comprehending to the surroundings or at least briefly. I tried to ask if he had chest pain? headache? shortness of breath? Well, in the ER ideally we would have an ECG, all his vital parameters by now. He looked at his wife and showed his ear, she understood and said he wanted his hearing aid. I thought that was a good sign.
He fell back again with his eyes completely shut. I was still asking him questions while checking on his vitals. He was pale, sweaty and tachycardic. Then he got up again to vomit, I looked into his eyes and I had all the answers I wanted.
No wonder the poets, lyricists, artists and students of art love the eyes. They found love, joy, sadness and multitude of expressions when they look into eyes. I believe ophthalmologists make their living just by looking into people's beautiful eyes.
For me, this moment of gaze into his eyes gave me all the relief and the answers. Medicine is fascinating, every time there is a difficult situation, clinical acumen definitely helps. When I looked into his eyes, I saw his eyeballs darting to and fro involuntarily, aimlessly like "Dancing eyes" may be dancing out of rhythm. This is called Nystagmus. I asked the family if he ever had vertigo.
There comes the answer, the daughter said he had an episode of vertigo a year ago, but he only had dizziness. I told the family this looks like an episode of severe vertigo. Will need admission to hospital for observation and to give medications to decrease the symptoms.
3.00 am walking back home, I was relieved that it was probably a benign condition. Vertigo is a symptom of underlying inner ear/ vestibular problem. It looks terrifying for the person experiencing it and the family around but in nature a benign condition medically.
He was discharged from the hospital the second day after a battery of investigations including MRI scans of the brain with diagnosis of " Acute Severe Vertigo" probably "Benign paroxysmal positional vertigo".
The family was grateful for my reassurance in the ungodly hours. I was grateful to the beauty of clinical medicine.
PS: Information in the blog is not equivalent to medical advice.If you have any of these symptoms you need consult the doctor immediately. Sometimes, it may not be just benign condition.
For those of you interested in vertigo and related disorders, kindly refer http://www.vestibularseminars.com/
It was 2.30 am Monday morning or I still prefer to call it Sunday night, barely slept 2 hours ago with guests sleeping in the guest room. I slowly tiptoed my way out trying my best not waking up anyone at home. As I walking the empty hallway and lift lobby, in a flurry all the memories came hitting me. I recollected my training, all the hundreds of nights when I ran to ER for an emergency. How we had to triage the patient in few seconds, act swift and appropriate. Time indeed costs life in an emergency.
I am in the lift and suddenly realise, I don't have any resources, I am the resource! The best I can do is tell the family call an ambulance. I was replaying every word the guy on the phone spoke, it didn't seem to give any information.
I rang the bell, terrified looking family members started to blabber lot of things at a time. I went to the patient's room, he was lying down. I observed he was breathing normally but not responding to the call. Wife said he has been sweating profusely and has been trying to vomit. He had said he is going to die. As I went near him to examine he got up suddenly and was about to vomit again. He looked at me briefly and had a brief look of relief. I realised he was comprehending to the surroundings or at least briefly. I tried to ask if he had chest pain? headache? shortness of breath? Well, in the ER ideally we would have an ECG, all his vital parameters by now. He looked at his wife and showed his ear, she understood and said he wanted his hearing aid. I thought that was a good sign.
He fell back again with his eyes completely shut. I was still asking him questions while checking on his vitals. He was pale, sweaty and tachycardic. Then he got up again to vomit, I looked into his eyes and I had all the answers I wanted.
No wonder the poets, lyricists, artists and students of art love the eyes. They found love, joy, sadness and multitude of expressions when they look into eyes. I believe ophthalmologists make their living just by looking into people's beautiful eyes.
For me, this moment of gaze into his eyes gave me all the relief and the answers. Medicine is fascinating, every time there is a difficult situation, clinical acumen definitely helps. When I looked into his eyes, I saw his eyeballs darting to and fro involuntarily, aimlessly like "Dancing eyes" may be dancing out of rhythm. This is called Nystagmus. I asked the family if he ever had vertigo.
There comes the answer, the daughter said he had an episode of vertigo a year ago, but he only had dizziness. I told the family this looks like an episode of severe vertigo. Will need admission to hospital for observation and to give medications to decrease the symptoms.
3.00 am walking back home, I was relieved that it was probably a benign condition. Vertigo is a symptom of underlying inner ear/ vestibular problem. It looks terrifying for the person experiencing it and the family around but in nature a benign condition medically.
He was discharged from the hospital the second day after a battery of investigations including MRI scans of the brain with diagnosis of " Acute Severe Vertigo" probably "Benign paroxysmal positional vertigo".
The family was grateful for my reassurance in the ungodly hours. I was grateful to the beauty of clinical medicine.
PS: Information in the blog is not equivalent to medical advice.If you have any of these symptoms you need consult the doctor immediately. Sometimes, it may not be just benign condition.
For those of you interested in vertigo and related disorders, kindly refer http://www.vestibularseminars.com/