Work-related: The Emergency Room, Again (in which I am rescued by Helen Hunt)

So now Tuesday. The ER, on Monday, set up an appointment for me to see the Occupational Health department. "Occupational Health" is apparently mostly a euphemism for work-related drug-testing (the husband's theory), but they do some actual medicine, occasionally, as well. Or at least so I'm told. I never saw any actual medicine, but they had posters up in the exam room that looked sort of mediciney, and there were gloves and stuff. I mean, you would have thought that medicine was practiced there, or at least had been at one time, to look at the place.

It sure looks like a doctor's office.
The appointment was set for 8:30 AM. It took until 9 AM to get and fill out the paperwork, at which point a nurse took me back to an exam room and took my blood pressure, which seemed alarmingly high (something over 100), considering what it had been in the emergency room on Monday. Then she left, and I didn't see another soul until 9:30ish, and that was just a doctor popping his head in, saying, whoops, wrong patient, and leaving again.

Actual further medical care had to wait until about 9:45 AM, at which point a second nurse came in to take my blood pressure. Again. She explained that the doctor wanted to get a reading standing up vs. a reading laying down. So far so good. She also got some really high numbers, which by 9:45 AM I would have expected my blood pressure to be high, just from rage over having to sit around for an hour fifteen minutes, but she didn't ask me for an explanation, she just went and got a different blood pressure cuff and tried that one, and the numbers were better then. Then they got a urine sample and I waited some more.

At about 10 AM, one and a half hours after my "appointment," I finally saw a doctor, who said, basically, well, looks like you were dehydrated, and had heat exhaustion, but it looks like you're not and you don't now, so I'm clearing you to go to work. Drink lots of water -- you should be aiming for having to pee about every hour or so -- and keep away from alcohol and caffeine and heat as much as you can.

That's it? That's what I waited all morning for? I knew all this already! So I pushed him:

Look, I said, that's all that anybody's told me all along, drink lots of water, drink lots of water. I've been drinking lots of water. It doesn't help. I'm not dehydrated, I never was, my urine's as pale coming out as it is going in, drinking lots of water is not cutting it. And anyway I already knew all of that, that's what they told me last night, that's what they told me at work, that's what I knew on my own since I looked this up last summer on Wikigoddamnpedia.

And he got visibly annoyed with me, and said, well, maybe this just isn't a job you can do. I don't have a magic pill to give you. Maybe the Wellbutrin you're on is doing weird things to your blood pressure; it can do that, sometimes. (I wasn't thinking clearly, or I would have pointed out that neither the stand-up nor the lie-down reading she'd gotten was out of the ordinary: if it was the Wellbutrin, it obviously wasn't misbehaving then, nor was there any evidence that it ever had.) And then he said to wait for a bit and the nurse would get me and take me back out to the waiting room, where I could collect discharge papers and be on my way.

At some point in here, the combination of rage over having to wait that long to be seen, the pre-existing stress over what this meant for my employment situation, and complete uselessness of wasting my whole morning to be told nothing I didn't already know (and it's not like the follow-up visit had been my idea, please note: the ER scheduled it for me), all kind of got to me at once and I came about as close to crying as you can without actually, you know, crying.

And then I was rescued by Helen Hunt.

(Insert your own angelic-choir noises here. I would also accept Handel's "Hallelujah Chorus," as performed by the Mormon Tabernacle Choir, if you want to get all fancy about it.)
No, seriously. Helen Hunt, smiling her angelic photoshopped smile from a magazine in a rack on the wall.

And I thought, okay, let's get some perspective here. This sort of thing happens to people all the time. Let's pretend it's not real, and that this is just a Lifetime movie where Helen Hunt is a tough-but-loveable greenhouse worker who's having some heat issues and maybe also solving a murder. What would normally happen next in this plot? What would Helen Hunt do at this point?

I concluded, after some thought, that if it were Helen Hunt, she'd have the big emotional breakdown scene like I had just had, and then she'd pull herself together in some kind of big pulling-oneself-together montage and be all feisty and dignified and go out there and be victorious over whatever it was anyway. And then she'd catch the killer and learn the true meaning of family or Christmas or puppies or something, 'cause, you know, Lifetime. And, well, if Helen Hunt can do it, then so can I, right?

(Note to self: I totally need to make some WWHHD? bracelets.)

I freely admit that this was a pretty dumb train of thought. But it worked. I think I basically just needed the distraction, something else to think about for a second. (Like Cesar Milan does with dogs sometimes on "The Dog Whisperer," or like Jo does with kids on "Supernanny." And yes, "Dog Whisperer" and "Supernanny" are both shows I've been known to watch. Having a couple drinks with Jo in a nice neighborhood bar somewhere is totally on my life's to-do list. And yes, "Dog Whisperer" and "Supernanny" are essentially the same show. But it's a show I like. Shut up.) So I managed to pull myself together, in Helen Hunt fashion,¹ and back out to the waiting room, where I did eventually get to leave.

Never again with [hospital name], I said to the husband as we drove to my job. Never ever ever. What incredible, useless dicks. I'd previously used [other hospital], which, they weren't, like, jumping to attention as soon as I came into view, but they never inspired me to homicide, either. Not like this. Grumble grumble. Bitch bitch.

So I was seething when I got to work, but eventually I did settle down (after ranting briefly at one of the nursery lot guys). And actual work got done.

We have two greenhouses that are attached to the store: a north one, which was built first and has better ventilation and tends to be cooler, and then a south one, which was added on at some point and has comparatively little ventilation.² The south house is normally only open in the spring (maybe February to June), for annuals, and then the fall (October to December), for poinsettias. When the flood happened, all kinds of stuff from the store got moved to the tables in the south greenhouse, because that was slightly higher ground than where they were, and since then, everybody's been really busy trying to get stuff back where it needs to be, and the stuff in the south house is really only a priority to me because it really only affects me. So that was what I did. It was cloudy out, and not unbearably hot, so I figured Tuesday, what was left of it, was my best shot at accomplishing something in the south house (when am I going to have another reasonable-temperature cloudy day, after all?), and maybe accomplishing something would make me feel better.

So I finished moving stuff out of the south greenhouse, and I started spraying down the capillary mats on the tables. Capillary mats, for those of you who don't know, are just big black mats that are supposed to hold water -- the theory is that you can put plants on a mat, spray the mat with water, and then the plants will soak up the water from the mat, and it's all very neat and tidy. In actual practice, it's never that simple, because sometimes the soil has dried up and contracted and isn't touching the capillary mat anymore, or the mat isn't exactly perfectly level, so water pools in some spots and never reaches others, etc., but on paper it sounds like something that should work. Anyway. So during the course of the season, dirt gets spilled on the mats, and dead leaves fall on the mats and get absorbed into them and turned into algae and scum, and roots grow out of the pots into the mats and then get left behind when the plants are moved, and so on and so forth. So I elected to spray the capillary mats clean for the rest of the day.

The "before" picture.
And that was really slow work, but I was still, you know, able to do it. Went and drank a bunch of water about every ten to fifteen minutes, the greenhouse wasn't unbearably hot, everything seemed to be going okay.

And then the rain hit.

Outside rain, of course. But there was so much of it. I mean, seriously, you would have thought the place was getting sprayed by fifteen fire hoses at once.

Unfortunately, we hadn't gotten all the sandbags moved away yet, from the flood preparations, partly because the boss wasn't sure she trusted that the flood was over, and partly because not enough people had had enough time to get to them all yet. Like I said, we've been busy pretty much across the board, trying to get things put back where they're supposed to be. So long as the sandbags were behaving themselves, other things were the priority.

So but you see the problem. Huge quantities of rain falling, gutter attachments that had been removed or had flopped into the wrong spots and were pouring water into the space between the building and the sandbags -- we had water coming into the building, fast, in at least three spots. I mean, the actual rain was maybe only really intense for about ten or fifteen minutes, and we still managed to have water an inch deep in one room inside.

So it was a problem. But still - doesn't sound like an obvious heat problem, right?

But. Then everybody opened all the doors for maximum air circulation (they'd been closed previously to keep in the air conditioning: the store and flower shop are air-conditioned). Which meant that there was nowhere air-conditioned I could go to, to cool off, except the flower cooler, which was cold enough to be, possibly, dangerous (as explained in footnote 5) for me. Plus everybody was running around crazily trying to mop up, or squeegie away, the water that had come in, which meant there wasn't anywhere I could actually stand that was out of the way. And then the humidity went to basically 99% in the whole building, the whole outside, everywhere, and the air also got really still.

Oh shit.

I had already not been doing that great, for reasons I don't completely understand: I elected to take a short break at 2 PM and eat something. WCW always has a Snickers bar at some point during her shift, and WCW has no problem with the heat, so I decided to get a Snickers, on the theory that maybe that was her secret.³ And I got a "Powerade," Coca-Cola's entry in the sports drinks sweepstakes, on the suggestion of the boss's husband,⁴ and also because it was cold and non-caffeinated.

The Snickers bar went fine, but the first drink of the Powerade, when it hit my throat, immediately gave me a weird feeling in my head. Pressure, mostly, like a sudden, bad sinus headache. This was odd, certainly, but I didn't know that it was necessarily bad -- I figured maybe it was a cousin of ice-cream brain-freeze, and it'd go away momentarily. And meanwhile, I had potassium to replenish, so I finished drinking it, just slower.

That weird head pressure feeling stayed with me for the rest of the day, and I never really got an answer as to what it might have signified or whether it was necessarily a problem.⁵ But so anyway, back to the rain. After about half an hour of trying to figure out whether I might be useful, or trying to find a place to go where I could cool down, I realized that I was kind of deeply fucked up (the weird head-pressure thing, plus I wasn't cooling down, even standing in front of a fan, and I could tell that my brain wasn't really operating normally, though I'm not sure how it was malfunctioning, exactly) and needed to go home. So I punched out, told people what was going on ("Yeah," said one of them, "you do look really pale." There was no need for her to add, again.), and then there was a brief conversation with co-workers about exactly how useless the ER and Occ. Health had been, and then the husband arrived and took me home.

Wasn't feeling any better at home, though it was cooler. Head still felt weird, and I was actually beginning to feel a little dizzy and nauseous, I was able to speak more or less coherently, but I remember being kind of frustrated at how slow it was -- I was having all the same thoughts; they were just taking longer to get to my mouth,⁶ and my arm was cramping up. We discussed whether I wanted to go to [crappy hospital I'd been to already] or [other hospital], and I said [crappy hospital] was probably the better choice, because at the very least they'd just seen me the day before, so maybe the fact that I was coming back would mean something to them, where I'd be starting over from scratch with [other hospital]. Husband argued that [other hospital] was the better choice, by virtue of not being crappy, and because we weren't mad at [other hospital] for the morning. The conversation was long. Eventually we wound up going back to [crappy hospital].

Hey everybody! I'm back!
Got there at just about 5 PM exactly, and didn't leave until just before 8 PM. Much, much, much better doctor this time. He said that the Wellbutrin really probably was not the cause, that if I'd already been on it for a couple years then my body was probably adapted to it just fine, that neither antidepressants as a class nor Wellbutrin specifically were known for causing that sort of problem, and so he didn't see any reason to go off of it. He also said, when I asked about what the Occ. Health doctor had said, that yeah, sure, there are blood pressure issues for some people with Wellbutrin, but if that was my problem, I would have found out when I first started taking it, not two years later.⁷

There was a urinalysis, and a blood workup, neither of which turned up anything terribly unusual or interesting, and I got a liter of saline solution by IV, which was interesting only insofar as getting a liter of room-temperature liquid stuck in you makes you cold,⁸ and so I was shivering during a lot of that. Also, judging by how many times the nurse had to stick me with the needle, I apparently have difficult, crooked veins that pretend to go one way but then go a different way. Which does (sigh) kinda sound like me.

The doctor said that it looked like I may actually have been drinking too much water, that my urine was awfully dilute,⁹ and my blood sodium and potassium were also on the low end of normal, which could also indicate some excessive dilution, though none of it threatened health or anything, just, it was noteworthy, especially for heat exhaustion, since overhydration and heat exhaustion aren't normally problems that go together.

He also said I shouldn't probably go to work on Wednesday, which I hadn't been planning on it anyway (I'm scheduled, but so is WCW, and it seems a bit silly to even try, at this point. One emergency room visit in one day: Oh, you poor dear. Two emergency room visits in two days: Oh my god! What's going on? Are you going to be okay? Is there anything I can do? Three emergency room visits in three days: Oh. So . . . you just really like going to the emergency room, right?). Didn't really address the question of whether to go back to work after that, or how.

Which is something I'm going to try to avoid thinking about today.

Side-note: I appreciate all the comments on yesterday's post. Obviously I would have responded to them, but I was kind of otherwise-occupied all day Tuesday.

-

Photo credits: Well, me, kind of obviously, though an argument could be made that Redbook sort of owns the Helen Hunt picture.

¹ This is actually sort of unusual for me. I mean, I don't think of myself as being especially effeminate, and I don't get the impression from other people that they think I am either. But there must be something: I don't imagine many straight guys in that exam room have ever looked to Helen Hunt as a role model.
² (North has a ridge vent, vent fans, a door to the west, and a door to the north which leads into a work area in back; south has only vents along the south wall, and two big industrial fan vents on the west. There's also a door on the west end, but it's broken in such a way that if you ever open it to get air moving, three different people will descend upon you on three separate occasions throughout the day, usually when you're holding something really heavy, whether you were the one who opened it or not, screeching that the door is never to be opened under any circumstances because there's something screwy with the door frame and it's, allegedly, hard to get the door closed again once it's been opened, so don't ever open the door ever, for any reason, ever. Though I've not had that much problem closing the door, when I've had to close it, so I'm a little confused still about what the deal is. In any case, having the vents at person-height along the walls, while better than nothing, also lets the heat build up along the roof. There's no ridge vent, and only two small exhaust fans up high, so the heat just builds and then gets blown down by two ceiling fans, so that there are two spots in that house where the plants dry out every fifteen minutes, and that are really uncomfortable, brain-cooking places to stand. Having a door to open on the west end would be helpful, though it's probably not the whole answer.)
³ (She also smokes. I used to smoke, and I don't recall having any problems with heat back when I was a smoker, so there's a hypothesis, but unfortunately I can't test that to see if smoking is WCW's secret heat-adaptation strategy, because not only would the husband not approve, but I'd likely wind up with asthma again, since developing asthma is why I was eventually forced to quit in the first place.)
⁴ Who is also a boss, but they apparently worked out a separate-spheres kind of arrangement a long time ago: he runs the flower shop and deliveries, and she runs the landscaping, billing, annuals, greenhouse, etc. There's some small overlap in the store and in the greenhouse, but otherwise they're more or less autonomous in their own part of the business.
⁵ My best guess is that the cold, when it hit my throat, caused some set of blood vessels in my throat or head or somewhere to constrict, which then led to feeling pressure in my head. I have no actual idea of this is correct, though I do know that this is the reasoning behind why they say not to take someone with heat stroke and toss them into a bathtub full of ice: the cold hitting their skin makes the blood vessels on the outside of their body constrict, and then the heat at the core of the body has a harder time getting out, so they actually, contrary to what you'd expect, stay hotter longer, in the areas where the damage is actually happening. This, on a smaller scale, could have been responsible for my headache, though if that were all, I'd think it would have gone away sooner than it did.
⁶ Which is kind of one of my very special fears about getting old. If I had a stroke or something, and it left me able to think but not able to communicate . . . .[shudder] I'd kind of rather be dead. In this case, I was really only having to be a little more deliberate about speaking than usual, and it wasn't that big of a deal, but even that much was panicking me a little bit. I want to be able to take communication for granted. In fact, I'm going to insist on it.
⁷ At this point, it occurred to me that the Occ. Health doctor hadn't even asked me how long I'd been taking Wellbutrin, and that information wasn't on the sheet I had had to fill out, and I got mad at him all over again. I really kind of hate him and wish him ill. At the very least he could have reminded me that I might be somewhat weakened by Monday's experience, and that I would be, consequently, more prone than usual to heat exhaustion on Tuesday. But no. Not even that.
⁸ Makes perfect sense, of course. The average body only has about 4 1/2 to 5 liters of blood to begin with: mixing a liter of saline at 72F (22C) with 5 liters of blood at 98F (37C) is going to drop the temperature of the mix down to about 94F (34C). Which I'm assuming is part of why they stretched it out over 30 or 40 minutes.
⁹ Specific gravity of 1.005 g/mL; the lab report said that the normal range was 1.001 to 1.031. Wikipedia gives the normal specific gravity of urine as 1.010 to 1.030, in which case I was outside the normal range, on the too-much-water side. Though we know Wikipedia is not necessarily to be trusted. In any event, I was only following the instructions from Occ. Health, may he burn in hell forever, and trying to drink enough to pee every hour. And I was peeing every hour, even after I left work: I went three times at the ER.