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Related: Culture Forums, Support ForumsI lost a patient today.
She was a sweet lady that I had been visiting with for about a year and a half. She had poorly-controlled asthma, and Chronic Obstructive Pulmonary Disease. The thing is, she had never smoked in her life. At least, not directly. Both of her parents were heavy smokers (and if you're reading this and you smoke, STOP SMOKING AROUND YOUR KIDS! )
The last couple of visits were difficult for her. She was always having difficulty breathing. In addition to her pulmonary problems, she also had severe anxiety, which didn't help her much when it came time to try and take a deep breath.
Anyway, she came in last week very dyspneic, sweating, and on-edge. I listened to her lungs, and instead of the usual wheezing, I heard a coarse rale in her left lower lobe. Her oxygen saturation was within normal limits, but between her respiratory distress, and that rale, I sent her to the ED for an emergency chest x-ray.
I found out this morning that they had admitted her, and then she coded: pulmonary embolism. They weren't able to get her back.
I'm going through the usual "What-more-could-I-have-done-for-her?" phase. She was only 60.
CaliforniaPeggy
(149,754 posts)I am so very sorry to hear this...
And you know you did everything you could. But it's horrible, so horrible.
Please don't blame yourself...I know it's a natural thing, to do that...
Sometimes we can't help those patients.
panader0
(25,816 posts)Wounded Bear
(58,758 posts)I feel for you bro. Hang tough and keep up the good work. Try to hold what you learned from treating and interacting with her as lessons for how to work with future patients. You are a good person indeed. Hang on to that.
pinboy3niner
(53,339 posts)I had a friend who smoked, but it was a hereditary lung disease that got him, not smoking. I drove him to the hospital for all his appointments to prep for a lung transplant. His single lung transplant gave him another 8 years.
R.I.P Rod Kane.
Archae
(46,364 posts)I asked her once who were the hardest to see die, in the ER she worked in for a number of years.
She said babies.
You tried, but all that second-hand smoke killed her.
pinboy3niner
(53,339 posts)He was there for 8 days and he pulled through. His doctor's name was Huckaby, but we called him Dr. Hugababy.
ailsagirl
(22,901 posts)You may find this link helpful, Aristus:
http://blog.beaumont.edu/2015/03/photo-captures-er-doctors-grieving-moment/
blue neen
(12,335 posts)Pulmonary embolism. I live in fear of that. I have 2 inherited blood clotting factors.
The poor lady---she must have been so frightened. So sorry, Aristus.
steve2470
(37,457 posts)I'm sure you did all you could. To be fair, it's up to we patients to take proactive measures to take care of ourselves before our health deteriorates too much. Once you get past a certain point, there's not much doctors can do.
to you and keep doing what you do! RIP to her, also.
sarge43
(28,946 posts)pinboy3niner
(53,339 posts)And some of the hardest cases were the medics, who blamed themselves for the deaths of those they couldn't save. There were stories about former medics who'd go to a bar and pick a fight with the biggest guy there, just to punish themselves and get what they thought they deserved.
When I got hit there wasn't much my medic could do for me besides slap on a battle dressing. Eventually, from back in a stateside hospital, I wrote to my medic to let him know I'd survived. Which turned out to be a good thing, because he and the whole platoon had been told I died.
When my medic found me 20 years later, he still had my letter. He also got a kick out of my P.S.: "Your bedside manner sucks."
He told me that my letter literally saved his life. And I knew exactly what he meant.
magical thyme
(14,881 posts)You did everything you could. 60 seems too young, but since I turned 60 I've started thinking every day now is a gift, an extra day.
livetohike
(22,165 posts)In_The_Wind
(72,300 posts)femmocrat
(28,394 posts)malthaussen
(17,219 posts)We do what we can, my friend.
-- Mal
mnhtnbb
(31,410 posts)You did everything you could for her...but it still sucks that it wasn't enough because
60 is way too young to go.
My first husband's mom was a very heavy smoker. Guess who ended up dying of lung cancer?
Her husband--who didn't smoke. All that secondhand smoke really takes a toll.
Hugs for you, my friend.
hedgehog
(36,286 posts)redwitch
(14,952 posts)I have no doubt at all that you did the best you could. I have been reading your posts for years and you are obviously a caring and competent health care provider. I am sure it hurts to lose a patient.
MrMickeysMom
(20,453 posts)I think you know I'm an RRT. I think you're a primary care physician, yes? Outside of her having started some time back controller meds for chronic asthma, I'm not sure you could have done much. Had you seen a complete PFT, you or the pulmonologist may have seen more to indicate air trapping and/or COPD, but not necessarily PE. The DLCO is not always an indicator.
It's preventative care that is still such a problem with chronic airway disease. I wonder if most can even afford the very expensive pharmaceuticals - for long acting beta agonists and levels of inhaled steroids.
I'm sorry. I've seen too many wonderful people with uncontrolled asthma, but for the cost of care, could have gotten to this sooner in their plan of care.
Regards,
MMM
discntnt_irny_srcsm
(18,483 posts)While it's always a thought that maybe if you were something more or something different... better... that you'd have been able to save that one life, but it is what are that has enabled the saving and bettering of so many other lives.
One day the heroes like you won't lose any more patients. Science, skills and training will be perfected.
A toast to that day.
For now be both the human and the hero and be okay with that.
It may sound absurd but don't be naïve
Even heroes have the right to bleed
I may be disturbed but wont you concede
Even heroes have the right to dream
And it's not easy to be me
tawadi
(2,110 posts)Don't blame yourself. May she RIP.
libodem
(19,288 posts)That you caught the rales. You knew your patient well enough to note her change in condition. The hospital concurred with your assessment per the admission. You were on top of it. I think you did what any competent health care professional would do in your place. I believe that is the criteria by which to measure yourself.
She was too young to go. Sorry for your loss. Goddess bless you for your compassion and love. Sometimes it's easier not to care.