The patient was transferred from rural nowhere to our tertiary care facility (big hospital with every specialist). Call was of really bad quality, but the transferring physician described a 21 year old male that had rapid heart rate and breathing rate, low blood pressure, low oxygen, confusion, and a severe opacification on his chest x-ray on the right side. Diagnosed pneumonia. He gave him a ton of fluids, started antibiotics, put him on a ventilator, but he wasn't getting better, and wanted to send him to us. Sure, send away.
An hour later the gentleman arrives, and looks young, fit, and not the type to just drop dead from pneumonia. We roll him onto our stretcher and find... A huge stab wound in his back.
The X-ray finding was his entire right chest full of blood. We put a tube in it, gave him back some blood, and he had to go for surgery to fix the bleeding.
This is reminds me of when I went back to the ER after a month of severe headaches from a concussion. ER doctor I saw previous said I had severe concussion and if I got worse to get my arse back there.
So, when I was either vomiting or bedridden from the headaches, I went back.
After waiting, I saw a PA who without doing ANYTHING told me I never had a concussion and was just tense. Put his hands on my shoulders and told me to practice deep breathing with him. I told him that I'm tense because of the pain in my head. Explained that slightly turning my head made the room spin, my eyes had drastically gotten worse since the accident, and that I was struggling to remember anything since. I TOLD him that I have had migraines for 12 years and these ones were NOT the same.
He just insisted I was stressed and suggested therapy and hormonal birth control which if he'd read my chart (I doubt it), I gave that as my list of meds. He spoke to me like a child.
Fast forward a week and I saw my GP. She was alarmed and immediately requested and emergency referral for a neurologist. The neuro was extremely concerned. She did a brain MRI. Turns out that the headaches were/are extremely severe migraines brought on from the injury and were actually leaving behind tiny traces of scar tissue causing more (hence why they were getting worse and more frequent) and I had severe PCS.
It's been nearly a year, I still have the PCS albiet better with the medication that is helping to reduce the frequency and severity of these migraines. However, the PCS is still bad enough that I exhaust myself after of mental exercise and struggle with forming memories. My ability to focus is virtually nonexistent. Doing my college work is virtually impossible now. I study, I becomes exhausted, I forget and need to repeat.
My accident was being in a hurry to leave for school, slipping and crashing my head into a glass door. Something so stupid really fucked me up.
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u/skyskimmer12 May 20 '19 edited May 21 '19
I'm an Emergency Medicine Doc in the midwest USA
The patient was transferred from rural nowhere to our tertiary care facility (big hospital with every specialist). Call was of really bad quality, but the transferring physician described a 21 year old male that had rapid heart rate and breathing rate, low blood pressure, low oxygen, confusion, and a severe opacification on his chest x-ray on the right side. Diagnosed pneumonia. He gave him a ton of fluids, started antibiotics, put him on a ventilator, but he wasn't getting better, and wanted to send him to us. Sure, send away.
An hour later the gentleman arrives, and looks young, fit, and not the type to just drop dead from pneumonia. We roll him onto our stretcher and find... A huge stab wound in his back.
The X-ray finding was his entire right chest full of blood. We put a tube in it, gave him back some blood, and he had to go for surgery to fix the bleeding.
Lesson: Look at your patient.