A Trip to the ER

On November 29th I removed a Mirena IUD that I've had in for almost a year.  Two days later, I started my period, and few days later, it started getting really heavy.  So heavy I could barely keep up with the flow.  I worked from home for couple of days because of this.  I called the doctor on the 8th day after the removal and they said heavy bleeding was normal.  Two days later, I called again and got the same response, but was told I could come in to get blood pressure checked if I would like.  This was Friday.  By end of the day, I could barely vaccuum a whole room without having to sit back down again.  I was told the bleeding would last 7-10 days.  It was the 9th day of bleeding so I thought I'd give it another day to see how it goes, so I didn't go in.

On the 10th day, a Saturday, I could barely stay standing for a minute.  I couldn't possibly fathom how it was 'normal' to lose so much blood.  I got hold of the on-call doctor at my practice who urged me to go to the ER given how much blood I had lost, and the fact that I feel faint.  My dad is still here with me, so he took me to the ER at Bartlett Regional Hospital, the only ER in Juneau.  He drove me to the doors, got a wheelchair and wheeled me in.  I thought I'd be there a while so I grabbed couple of books before going... but I couldn't be bothered to change so I went in my PJ's.  I could also barely manage to brush my teeth.  I had to sit while brushing. 

By the time the nurses wheeled me into the ER I was scared and emotional.  I started crying, but sent my dad home since Millie needed to be walked and looked after.  Once in ER, the docs checked my heart rate, which was high.  Apparently this is the first sign of significant blood loss since your heart has to pump harder to get the blood around.  The next sign is low blood pressure, but mine was still normal.  Then death... yikes.

The ER nurses hooked me up to an IV to thicken my blood and lower my heart rate.  They then took my blood to measure my hematocrit, or percentage of actual red blood cells in my blood.  This number generally hovers around 40% for women, and mine was 18!  I lost over half of my red blood cells.  I was then told by the ER doctor that a transfusion was absolutely necessary.  If I don't, it would take months to recover that much red blood cells naturally, and I would remain ill until then and remain at risk of dying.  I initialy resisted the idea based of fears of complications with transfusions that existed in the past.  However, after some reassurance of the improved screening process these days, I consented to the treatment. 

Although the doctor was able to treat the symptom, no one knew why I bled out so abnormally.  An x-ray and pelvic exam showed everything was normal.  I am also relatively healthy.  Their best guess was that somehow my hormones got seriously out of whack so they gave me a small dose of progesterone, the same hormones that were in the Mirena IUD.

I got my first pack of blood in the ER.  As I sat in the ER getting treated, all I could do was cry.  I blame it on the whacked hormones, but I could not stop.  The slightest thing, such as worrying about whether my dog was happy, would set me into tears.  I did not want my dad to see me this way so I asked the nurse to let him know how I was doing.  However, my boss at work did come to visit me, and she was very supportive and understanding.  She stayed until I was admitted to the hospital, where I got a proper room with a comfy bed, window, TV, and private bath. 

By the time I was admitted, I'd finished receiving my first pack of blood and felt slightly better.  It was dinner time by now so I got a nice meal of fried chicken and mash.  Then two more packets of blood, which took until 1am or so to go through.  Dad stopped by a bit later on, and I spent the evening watching TV or reading.  I tried to sleep, but the nurses kept coming in every hour to check my vitals.  I finally got uninterrupted sleep at 2, but was woken around 5. 

It seems the progersterone I received finally kicked in and slowed the bleeding on the second day.  Another set of blood tests showed I was still anemic, so the doc ordered another round of transfusion.  I spent the morning watching men's figure skating, and rest of the day watching Law & Order reruns.  Despite the circumstances, it was kind of nice being in the hospital.  There was no way I could relax at home with Millie running around.  The nurses were also at my beck and call at the push of a button.  Since I was hooked up to the IV and needed help with every little thing, I kept pushng the button.  They would come on the speaker and ask what they could do for me.  Often it was one of, "I need to go to the bathroom", "my IV is beeping", "can you close the door please?" 

I was released from the hospital about 4:30 on Sunday.  I felt pretty good, as I was told I would be.  The effect of a transfusion is immediate.  I was given a prescription of progesterone to stop the bleeding, but by Monday the bleeding had nearly stopped so I never took any of it.

That night I took a much needed shower.  Once out though, my lips started itching and swelling.  I called the doc, who suggested taking benadryl.  The itching subsided by swelling didn't.  I slept fine that night, but soon as I woke up the next day I broke out into hives all over and my mouth area swelled.  I felt a bit of swelling in my throat that scared me.  A dose of benadryl helped.  I went in to see my usual doc later that day and found out a reaction to transfusion can happen up to 48 hours after.  They were naturally concerned about the swelling I experienced in my throat, so they prescribed some steroids to keep handy just in case.  They urged me to take one that day, and to take the rest as needed.  I took couple more benadryls before going to bed.

By Tuesday my bleeding had stopped and I was no longer reacting to anything.  I felt fine.  Fortunately I was working from home this week to do an online training course.  I got out a little early this week, and by Wednesday, I was out taking Millie for a walk.  Today I did my usual four mile walk with her and dad, and did just fine.  I feel as fine as ever. 

It's hard to believe just a week ago I was nearly on my death bed.  If it weren't for all of those people who donate blood, I may not be here right now.  To all of you who donate, thank you for saving my life and of others like me who may not have survived without it.