OK, 56 year old woman presents with weakness, diaphoresis, nausea, diarrhea, and Dyspnea at rest. BP 140/80, pulse thready 80, RR 28, lungs clear, temp 98. Onset of symptoms 20 minutes ago. History, hypothyroid, arthritis, HTN, depression. Meds zoloft, celebrex, levoxyl, atenolol. Recent history of elevated cholesterol 300's per husband, and just started zocor 2 days ago. Random BS 112.
Am I just a paranoid former cardiac nurse? Because the first thing I thought was MI. Women commonly present with symptoms that are atypical. Coupled w the recent elevated cholesterol. Either that, or she is having that atypical weakness caused by the statin meds. I know of one lady who almost was parlyzed, and developed rhabdo after being on it for 2 weeks.
This just happened to my neighbor, and I just sent her 911. She wanted her hubby to drive her, but she was so weak, she could barely walk. I was a little annoyed that the squad didn't call in MICU, and put her on a monitor. They said her vitals were stable, but just to look at her, my gut screamed MI. They even took the oxygen off b/c she didn't feel any better with it on after 10 minutes!
ER nurses especially, I am interested in your input. I encouraged her to get an ekg at the least, b/c if it is MI, she is a good candidate for thrombolyitcs, being that the onset was only 20 minutes ago. This woman is a strong person and no whiner by any means, to see her so pale and weak, well, it's not just gastroenteritis!
Well, thanks for sharing your bowel problem Renee, usually I tell my friends that is TMI or Too Much Information for me to know about them, but what you have is interesting, I would also have assumed it was from constipation.
Things that make you go Hhhmmmm....
Heard from my neighbor, coronaries are clean. Sent home w/o NTG patch she wore in the hospital. Now they are going to check her carotids. Maybe she did the vagal thing like you Renee?? She doesn't have a bowel obstruction, that was r/o. she doesn't have thyroid issue, that was r/o. But she is going to follow up w doc in 2 weeks, so we'll see where it goes from there. All in all she was glad I made her go to the hospital, she said if I hadn't, she would not have gone. She also said she is greatly relieved to learn that her coronaries are clean, with her family history, she is very very worried about it. Only new med is a baby asa a day. She looks good and is happy to be home.
How silly of me to assume that you are constipated when you are having those vagal stimulations.. What was I thinking? Let me know what the MD says when you go to your next visit. I'd be curious! Take care, Gilda
Peeps and Hoolihan...thanks for the concern. I had to laugh though, Hoolihan, when you said "thanks for sharing your bowel problem....that is TMI for me to know...." :chuckle
Yeah, that would be me...tell it all annie...:chair: :rotfl:
I share because I care...if by sharing my personal drama and or personal health issues with others causes another to learn something they didn't know before, then I have helped another individual to add to their knowledge...for which I am always grateful to learn from others sharing about themselves, too. :kiss
Peeps...the vagal stimuli thing isn't all that clear to me yet...just what the doctor told me about them usually putting people out of the Army who have it, but I am constantly researching information about it so I can learn as much as I can about it. If you come across anything that will help me learn more about it, please share it with me. It's quite scary when it happens because it comes on rather suddenly...it really does make me feel like I want to die when I have one of those attacks with the bowel. I'll find a website that medically addresses this issue, then I will post it, but so far, I haven't come across anything. I'll keep you posted though. :)
Thanks for being the "specimen of the day" Cheerful.
Vagal stimulation is affected by different factors if I remember from Anatomy II. CCK release from the gall bladder, stretch receptors in the intestinal wall, but yours affects a response "upstream". Other systems not associated with digestion?
How interesting.
Much more so than Life-span............and not at all connected with it................that's what makes it the most interesting.
As an ER nurse, we look at the symptoms and rule out the worst case scenario and work down from there. I have seen O2 ordered for a person who wasn't haveing SOB but if they are even suspected of having a cardiac diagnosis, it decreases the load on the heart. Therefore, I don't understand DC'ing the O2. Right off the bat, EKG (even before the Doc peaks in), PULSE OX, considered the 5th vital sign in our ER, CBC, LYTES, Enzymes, Coags, CXR and go from there.
Let me know what the MD says when you go to your next visit. I'd be curious! Take care, Gilda
Peeps Mcarthur
1,018 Posts
So it's just a loss of negative feedback mechanism?