Triple Whammy?

Jobs can sometimes be like the number 68 bus; you don't see one for ages then two or three come along together.

A little while after my call to the young girl (see previous post) I was assigned to another fitting.This time it was to a middle aged woman; a known 'fitter', her husband had come home and found her on the floor. She was semi-conscious when I arrived. In a similar way to the last job, the husband seemed emotionally detached. He explained that his wife was an alcoholic and had subsequently developed epilepsy as a result.(There's a good article here about epilepsy and its causes, which include alcohol abuse).

As the seizures (if she'd even had any) had stopped by the time I arrived, we made the lady as comfortable as we could on the floor and gave her some oxygen to see if she'd 'come round'. Often, with EP patients it's simply a matter of letting them complete their normal postictal recovery and then they can stay at home in the care of their family. I was trying to elicit from husband what her normal recovery time and symptoms where but he was on a different tack entirely. I got the impression that'd he'd pretty much given up with his wife. He kept repeating that she "hasn't had a drink in six day and now this!". He hadn't actually seen his wife 'fitting', he'd just found her lying on the floor, incoherent and with a glazed look; a state he'd witnessed countless times as a result of her 'binging'. He'd have been happy to leave her where she was except that he couldn't smell any alcohol on her breath so he concluded it must have been a fit. "But is this how she usually is after a fit?" I persisted. He wasn't really listening. He was still focused on the fact that she 'supposedly' hadn't had a drink for six days and now she was'out of it' again. His despair was palpable. He was convinced she'd fallen off the wagon (again) and he'd had enough. His only grain of comfort was that he couldn't smell alcohol on her breath so perhaps she'd had a seizure after all (they're common in recovering alcoholics).

My backup crew arrived while we were talking, I'd not met them before but one was sporting one of our new, fancy 'stab vests' (more on that another time). We noticed that the patient's legs were extremely swollen.
" Get's that from the alcohol," the husband said.
" Is she on any water tablets for it?" (diuretics are often used to reduce excess fluid on the legs, in the lungs, etc. Essentially they work by removing excess water from the blood and making you piss more, so patients often refer to them as 'water tablets')." No she wasn't and she didn't have any known cardiac condition that could have caused the swelling."

The oxygen seemed to be helping. The lady was able to converse to a limited extent though she did sound a little intoxicated and confused. Her speech was slurred and she kept looking over her left shoulder all the time. Sometimes symptoms can get you thinking along another track and I could almost hear the cogs whirring around in our brains. "I wonder, has she had a stroke?". We took her blood pressure. It was high, too high. We tested the strength in her hands and feet. Hands were fine, she practically crushed mine when I asked her to "squeeze my hands", but her legs were 'all at sea'. One of my colleagues kept looking at her face, her mouth definitely had a 'droop' to one side.

We decided it would be prudent to let her be assessed at the hospital. I can't do referrals to the medics at the hospital for this particular area so it was going to be a trip to A&E. We 'loaded' the patient on the carry chair which was a feat in itself. For such a small lady she was extraordinarily heavy, almost bizarrely so, it took all three of us to get here onboard. By the time we got her on the bus she was becoming quite agitated; grabbing at us, at the kit, at imaginary things passing by. A classic case of cerebral irritation. We took another blood pressure reading, still very high. She really wasn't coming round and we all began to suspect the worst. The crew strapped her in and off they went.

As I loaded my kit back in the car I couldn't help but feel sorry for the couple. He'd stayed with her through the alcoholism and the subsequent epilepsy and now may be looking at caring for a wife who could be disabled through a stroke. For her part I wondered how much more punishment her body, and particularly her brain, could stand. It probably all started from that 'one little drink' and now she was potentially hit by a triple whammy of alcoholism, epilepsy and cva.

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6 Responses to Triple Whammy?

  1. Happystance says:

    Naively, it just never occurred to me how many times ECPs and similar come into contact with desperate or despondent carers. I know that there are mental health response units in the US that go out with the police to calls where it is suspected that one of the people involved has a mental illness. It’s sounding pretty much as if EMPs need access to a similar service: but with psychiatry and psychology being in the disarray that is portrayed in NHS Blog Doc, I doubt the NHS will have the funds for this any time soon. And it’s not as if Social Workers don’t have much of a caseload.

    If it’s not too inquisitive…What would you like to be available for the carers/family in similar circumstances? What do you think could practically be offered to them?

  2. UnLtd Blogs says:

    They’re Not The Priority But What Would You Do For The Carers?

    There’s another new medical blog, Diagnosis NFI. Magwitch is the author, and an Emergency Care Practitioner. The blog hasn’t been up for long but has already provoked some interesting questions about policies that affect the lives of carers.

    Magwitc…

  3. magwitch says:

    As I mentioned in an earlier reply, the Ambulance Service has traditionally avoided the social care/support issue by passing the buck to the GPs. Now, with ECPs attempting to direct patients to more appropriate primary services, rather than A&E, it behoves us to be more involved. Sadly it varies between PCTs as to what services are available on the NHS and, even within my own county, there is no central agency or database that we can turn to. In addition, as an earlier correspondent noted, many, if not most, of the local support services that are available for carers are run by charities. To my knowledge there is, again, no central agency that can be contacted to find out what is available in the local area. If anyone knows different then I’d love to hear from them.

    Thanks Happystance, for your recent blog relating to articles I’ve written. There are at least two more in the ‘Sad and Lonely’ series coming up which might provoke further discussion.

  4. Gimlet says:

    A really good Blog! Showing all the signs of being essential daily reading. Thank you! Also, if I ever (or when I?) need the services of “one of you lot” I hope it is either you or someone else with a similar attitude/outlook. Thank goodness there are still “good uns” around in this seemingly increasingly uncaring world.

  5. jamie says:

    Came across your site while searching on goole.
    Just reading some of your post\’s, let you know what i think
    jamie

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