Balloon Man

What is it that makes people decide to use the ER?  Some call 911 at the first sign of a mild cough, a handful decide after 10 year of knee pain that they simply can no longer take it, and others with legitimate and obvious medical problems nevertheless avoid medical treatment at all costs.

The other night I was working in our critical care area when a patient arrived via EMS looking like a poorly-drawn cartoon character.  Massive swelling from edema from the neck down to the toes.  Basically, he was a human Michelin Man.  Hypertensive to the tune of 270/140s, CHF, SOB.  Of course, he had prescribed meds for all his underlying conditions, but he hadn't taken them for months because he didn't like doctors.

Unfortunately, it got worse for the poor gentleman.  To get a urine sample, the nurse tried to insert a foley.  After a few tries, the doc attempted.  Then urology.  Turns out he was so swollen, even they couldn't get it in, and left the guy moaning in a blood-soaked gown.  Probably didn't improve his opinion of doctors very much.

For so many of these kinds of patients, I often wonder at what point they realize that they have a problem.  Many times it's family members who call 911, but if I were blown up like a balloon, I might try to do something about it.