Car Accident

New experiences for Isaac last night. We were in a car accident and I was taken to the hospital by ambulance. The EMT at the scene told me that the officers would "take care of my dog" and I said, "No, he's a service dog, he will come with me" and I was prepared to argue. I would have refused to be transported if they refused to take my service dog with me. But as soon as I said that, the EMT said, "Oh, that's good" and they were happy to bring him with me. There was plenty of room in the ambulance and the EMT told me they had transported other service dogs before. Isaac jumped up in the ambulance with no problem and I told him to lay down and he did.

Isaac has been in the ER before so that was no big deal for him. They took me to get a CT scan and the nurse asked me if my service dog had to go with me. I said "He can't stay here by himself" because of course I was not going to leave him unattended in the ER. She said an aide would take care of him for me while I was gone if that was OK with me and assured me I would not be gone long. I would not have asked staff to watch him but it was their idea. I agreed and the aide said he would take Isaac outside to go potty if that was OK with me. I said it was. He mentioned that there wasn't much grass outside (this was a hospital in a city area) and I told him Isaac would pee on concrete or other surfaces and told him to just show Isaac where to go and tell him to go potty and he would. When they were bringing me back from the CT scan, Isaac was lying on the floor by the nursing desk with three employees gathered around petting him.

I was really glad Isaac is perfectly fine being handled by other people and is not stressed by being separated from me. He seems OK after the accident, but I might take him to the vet today or tomorrow just to get checked out just to be sure. An EMT looked him over for me at the scene of the accident and then a friend checked him over carefully for me at the hospital later. It was a while before I could check for myself because I had a cervical collar on and stuff for a while. I am OK now, just really sore, and Isaac and I are at home.

The hospital and the EMTs were really great and I was relieved not to have to argue about taking Isaac in the ambulance with me.

That's a Well-Trained Dog!

I had to go to the ER today for a cut that I thought needed stitches (ended up with just steri-strips instead). Isaac was lying on the floor beside the gurney when the doctor came in.

The ER doctor said hello to Isaac and held out his hand for Isaac to sniff him. Isaac just looked at him.

The doctor said "Are you shy?" and of course Isaac did not respond.

So then the doctor said to me "Is he a little leery of strangers?"

I said "No, he's just not supposed to say hi unless I tell him he can." And then I told Isaac "You can say hi" and Isaac jumped up, tail wagging, and sniffed the doctor good.

The doctor was like "Oh, that's a well-trained dog!"

I'm like, well, yeah, he's a service dog. It always makes me wonder what kind of service dogs they are used to seeing.

X-Rays

Today I had to go get my knee x-rayed. I was planning to put Isaac in a downstay behind the little divider thing where they x-ray tech stands but there was another x-ray tech that volunteered to hold the leash for me in an adjoining room. They left the connecting door open so I could hear what was going on in there.

They had to take several x-rays and partway through I heard Isaac's tags jingle and heard the tech tell him, "They will be done in a minute."

I called out, "Isaac, stay" and didn't hear anything else. 

As soon as I was done, I called him and he came trotting, but not running, into the room where I was. 

Then when I started to walk out of the room, Isaac turned back to the tech that had watched him for me and said goodbye by nuzzling her hand for a second. It was cute. 

And he behaved very well. 

And no one asked me why I had a service dog.

Muscle Spasm in my Toes

Can you see how my second toe is pressed against my big toe? And separated from the other three toes?

Muscle spasm. I don't have those as much as I used to since seeing the podiatrist and getting the shoe inserts and and increasing my potassium and stuff, but occasionally they are still bad. It was hard to take this pic because I was so busy cursing.

Where Have I Been?

I haven't blogged much lately.  I'm not really sure why.  I've been busy and I've had a sinus infection that just won't go away.  And I've had some stress.  Really, being sick is almost always stressful for me, but I've had other stress, too.  Like, Isaac was bitten by another dog at a dog park.  That's a whole separate post, but it was really stressful for me.  More stressful for me than for him, I'm pretty sure.

This sinus infection has been going on for a good month now and I'm just beginning to feel better.  It really triggered my PTSD and I ended up very emotional and not sleeping much.  At one point I was prescribed prednisone for the inflammation and it was higher dose than I've been on in the past and I had horrible side effects from it.  After only two doses, I was crying frequently and having flashbacks and nightmares and my anxiety was through the roof.  After the third dose, it finally occurred to me that what was happening might possible be related to the meds I was on for the sinus infection.  So the prednisone was discontinued and I'm feeling less emotional but still not quite back to normal.

Also, when I saw my rheumatologist back in March, she increased my gabapentin.  I think it is just now finally starting to decrease my pain, but it is causing a lot of blurred vision and that is really driving me nuts.  I am thinking I am not going to be able to stay on the higher dose.  I just don't think I can tolerate this blurriness. 

But I do want to get back to blogging and I have things I want to blog about, so hopefully I'm back now.

Can You See at All?

A couple days ago, I went to urgent care for a sinus infection.

After I explained why I thought I had a sinus infection and described my symptoms, the doctor asked, "Can you see at all?"

I was confused because I hadn't said anything about my eyesight.

I said, "My eyes are fine. I think I have a sinus infection." I was thinking, problems seeing are not common with sinus infections, right?

The doctor said again, "You can see?"

Then he gestured towards Isaac.

Mind you, I was sitting there reading a book (print, not Braille) when he entered the exam room.

My friend Peggy says she is glad to hear that sinus infections do not in fact cause blindness.

At the Podiatrist

Isaac was super good at the podiatrist today. I had him in a down stay on one side of the examining table and while the medical assistant was taking my vital signs and stuff, he stretched out and went to sleep. He was snoring, which the MA thought was hilarious.

Then, while I was waiting for the doctor to come in, I was reading a book and I had the leash in one hand but accidentally dropped it. So I woke Isaac up and asked him to get it for me. Which he did.

There was another patient across the hall, and she could see into the room where I was, and she called across the hall, "Your dog is so pretty!" I said thank you and she added "Smart, too."

Later, I had Isaac pick up my shoes and socks for me and she was super impressed with that.

 Also. None of the staff asked why I had a SD. Apparently they figured it was nothing to do with my feet and they didn't need to know.

The reason I was seeing the podiatrist was because I have been having muscle spasms in my feet for the past two months or so.  I saw my primary care doctor and he ordered some labs but couldn't figure out what was causing them.  

I saw my rheumatologist for a regularly scheduled appointment and asked her about it while I was there and she kind of blew me off, just said, "Oh, fibro can cause that."  But she didn't look at my feet or ask any questions and so I don't know how she could know if it was fibro or something else causing the muscle spasms in my case.  I mean, just because fibro can cause that doesn't mean that is what's causing it.  There are about a million things that can cause muscle spasms in feet.

So the podiatrist looked at my lab report and pointed out that my potassium is at the bottom of the reference range and told me that it can sometimes cause muscle spasms in feet when it's at that level. Something it seems like my primary care doc ought to have known, though I realize doctors usually know little about nutritional deficiencies. But since that's one of those electrolytes, it seems like he probably should have known that.

The podiatrist asked if I was having any muscle twitches around my eyes, which I do have but had thought was a side effect of my gabapentin, and he told me no, low potassium can cause that too. My primary doc didn't ask me about that and I didn't mention it to him because I thought it was just a side effect of the gabapentin.

The podiatrist said he does not think my muscle spasms are related to my fibromyalgia despite what my rheumatologist said, because while fibro can cause muscle spasms they are usually in the large muscles, not the small muscles. Um, shouldn't she have known that? Except she didn't ask me any questions or pay much attention to what I was describing to her.

She also told me that exercising more would help with the muscle spasms, which I thought was an odd thing to say since she didn't bother asking how much I already exercise first. In fact, I am exercising (walking) more now than I was six months ago and the podiatrist said the increase in exercise might be causing or contributing to the muscle spasms because it causes more lactic acid to build up in the muscles. Which does not mean I should stop exercising (how awesome would it be to be told I exercise too much? but no) but it also means exercising more is not the answer, at least not by itself.

I am not at all impressed with the rheumatologist.

So the podiatrist told me to eat more potassium in my diet and he gave me these temporary arch things for my feet. I go back in a couple weeks and if the arches seem to help, he is going to try to figure out how to get my insurance to pay for some inserts for my shoes that they usually won't cover.

I think I love my podiatrist. I think I might need a new rheumatologist, though.

She Bit Me!

Hobbes, my visiting foster kitty, is here.  I have lots to write about but I haven't been able to post much lately.  First I was driving to Florida and back, and had little time to write, and very spotty internet access on the road.  Then, yesterday, Hobbes bit me.

She bit me good.  I don't blame her, she was mad and scared and did not want to be touched.  And I was insisting on touching her.  She had on a harness and leash and I wanted to take them off.  It was easy to take off the leash, but the harness involved handling her to figure out where the straps unbuckled and stuff.  And she did not want to be handled.

She is still wearing the harness.  And I have three puncture wounds in my left hand.

Cat bites, it turns out, are notoriously nasty.  Cats have long, sharp, skinny teeth, so they cause deep puncture wounds.  Dog bites are often less deep, even if it is a big dog with really big, long teeth, because the tooth is wider and less needle-like.  Cats also have a type of bacteria in their mouth that is normal in animals but harmful to humans.  When they bite, they essentially inject this harmful bacteria deep into your tissue.

Because of that, antibiotics are typically prescribed for cat bites right away, instead of waiting for an infection to develop.  And even with antibiotics, serious infections can develop.  Something like one third of people bitten by cats require hospitalization for treatment! How bizarre is that?

So off to the urgent care I went, to get some antibiotics.  I just finished a course of antibiotics for an ear infection.  I take probiotics daily and I eat yogurt but I think I also need to pick up some kefir.  I am going to get a yeast infection or something from all these antibiotics.

I like the nurse practitioner at the urgent care at my county hospital.  The urgent care there is only open Monday through Friday in the evenings, something like 3 pm to 10 pm.  So I can't always go there due to the limited hours, but I like the NP there and I've gotten good care there.

The NP gave me antibiotics and told me if my hand got any worse, if I had increased redness or pain or swelling, to come back to the ER.  Note that while my hand felt a bit tender, like it was going to have a big bruise the next day, the pain was not bad.  It was slightly red and slightly swollen right around the puncture wounds.  But it was not bad.  Maybe a two or three on a scale of one to 10.

A few hours later, my hand was swollen and red and it hurt a lot worse.  And the pain was not just right around the puncture wounds but my whole hand hurt.  It was hard to move my fingers.

I felt silly going to the ER about a cat bite, especially when I'd just been to urgent care a few hours earlier.  But my hand was getting more and more painful by the minute, and the NP had said to go to the ER if it got any worse, so I went.

It was not a great experience.  The ER doctor looked at my hand and immediately said something like, "that's not so bad."  I explained why I was there, what the NP had told me at urgent care, and he said, "Well, this is what I would expect from a cat bite.  They are red, they hurt.  This doesn't look bad."

It bothered me.  It upset me a ridiculous amount.  It was late by then, I was tired, I was in pain.  I felt like he was saying I shouldn't have gone to the ER.  I felt bad about being there.  Guilty or something.  I cried.

However, the ER doc wrote me a script for some pain meds.  I have had good luck getting pain meds lately!  I got some after having a tooth pulled recently and I got muscle relaxers when I had the muscle spasms in my neck and went to urgent care for that.  I'm not sure why I am suddenly able to get pain meds when for a couple of years I suffered in pretty severe pain, unable to get any meds, but I'm glad for it.

The ER doc also gave me a splint to help limit the movement of my wrist and hand, which helps limit the amount of pain.  It is hard to type with the splint on, though.

Urgent Care, Take Two

I went back to urgent care today.

Isaac is getting really used to that place.  Ugh.

I just wasn't feeling any better.  Actually, I was feeling worse.  When I went to urgent care on Thursday, I had a sore throat and my ears hurt.  I felt achy all over, which is typical for me because of the fibromyalgia, but it is a slightly different kind of achy along with chills when I am sick.  I was also coughing just a little.

I should have gone back yesterday, Saturday.  By Saturday  night, after six doses of oral antibiotic plus the ear drops, my ears and throat still hurt, plus I was coughing, a nasty, rattling cough, complete with icky phlegm coming up much of the time.  And when I blew my  nose, it was bloody.

Why didn't I go?  Well, being sick really triggers a lot of my anxiety and PTSD.  I talked briefly to a friend, who said he thought they probably wouldn't change the antibiotic because I hadn't been on it that long and it sounded like he thought I shouldn't go back. 

And somehow I fixated on that and started thinking I shouldn't go.  It would be a waste of money.  It would be a waste of time.  I would just be bothering the people there.  I should quit being such a baby.  I was just being lazy.  I had stuff to do.  It would be bad to go back.  I would be bad if I went back.

I knew I was sick and that the  antibiotic wasn't working.  But I felt like I had to choose between continuing to feel very ill or going to urgent care and feeling very guilty and angry at myself for doing something wrong.  I know that doesn't make sense.  I know that's not rational. But that's my disability.

And I know that's not what my friend meant.  I also know he isn't a very medical kind of person and he had no clue whether or not they would switch antibiotics.

But sometimes my mind just grabs onto something and it spirals like this and won't let go.  I used to do that a lot.  It's much better now.  I mean, it happens less often now.  Much less often.  But it's still bad when it does happen.

So I didn't go back to urgent care yesterday.

This morning, I went.  When I woke up, in addition to all the things that were wrong yesterday, I also felt like my head was going to explode.  The sinus pressure around my eyes was tremendous.  My chest also felt  heavy when I tried to take a deep breath.  I got worried.  So I went.

There was a different doctor there today.  He said I had a sinus infection but that my lungs sounded OK.  He changed the antibiotic and told me to get an OTC decongestant.

I should have gone yesterday. 

Sick with a Service Dog

I am sick. Ugh, I am so sick.

It started three days ago.  I felt fine when I woke up but by mid afternoon, I was cold and achy all over and my throat hurt.  My ears also hurt when I swallowed.

The next day I felt worse.  I tried to ignore it, to do what I needed to do even though I felt bad.

Yesterday I woke up at 4:30 am and my ears hurt terribly, especially my left ear.  I decided to go to urgent care.  Isaac and I got there about two minutes after they opened.  I was the first patient of the day.

The nurse practitioner looked in my left ear and said, "Eww."  She ended up prescribing oral antibiotics and ear drops that contain both oral antibiotics and steroids for the inflammation.

Whiskers is a wonderfully cuddly kitty and is great company while I am sick. Isaac, not so much.  He is helpful, he is doing all his tasks.  But he is not so cuddly and he needs exercise.  This morning it was cold, about 27 degrees, but bright and sunny so we went for a walk.  Well, I walked.  Isaac ran and burned off some energy.  But I would have preferred to be home in bed, to be honest.

I love Isaac.  And he's helpful.  I took the ornaments of my Christmas tree today, the ones that were left on the tree.  Whiskers had already removed all the ornaments from the lower branches.  Isaac picked them up off the floor for me. 

He's helpful, but taking care of an active dog is hard work, especially when I'm sick.

I've had three doses of antibiotics and six doses of ear drops (I am supposed to do those four times a day).  I don't feel like the antibiotics are kicking in yet. I'm glad I went to urgent care yesterday, though.  Glad I didn't wait until Monday to see my regular doctor. Although I am going to be calling him first thing Monday morning if I am not feeling better by then.

Had a Tooth Pulled Today

I had a tooth pulled today and I got the dentist to prescribe me some Tylenol with codeine. I'm not sure why I have been having such good luck with doctors lately. Usually around here it is extremely difficult to get any type of pain meds. But a few days ago I got a muscle relaxer and now I have Tylenol 3.

And it is working wonderfully. Unlike last time I had a tooth pulled, I am having no pain at all. I'm sleepy and getting ready to lie down for another nap. Whiskers is pleased with all day napping. But my mouth does not hurt one bit.

Isaac was great during the appointment.  I had to have an x-ray taken and he did a perfect down stay in the hall outside the door (which was left open), even though there were people walking around in the hallway.

It was a lovely day today and I am sure Isaac would have enjoyed a walk.  But I gave him a new beef knuckle bone to entertain him.  Whiskers finds napping on the couch with me entertainment enough.

I Wish I Had a Picture

When I saw the audiologist about my dizziness, I had a hearing test.  I was informed my hearing is excellent, no hearing loss at all in either ear.  I didn't realize I was worried about my hearing until I got that news and discovered I was re. lieved.

If you've never had a hearing test (this was my first), it is usually done with the patient in a little booth, about the size of a phone booth (remember those?), which is soundproof.  The audiologist sits right outside the booth and there is a window so you can see out and you wear headphones and can hear the audiologist and she can hear you.  Without the window, it would have felt claustrophobic to me but since there was the window, it felt OK.

I planned to have Isaac in a down stay in the exam room near the audiologist while I was in the soundproof booth.  When I sat down in the booth, however, Isaac got up and walked over to the door of the booth and looked in at me.  He looked worried.  I told him it was OK and to go lie down. 

Instead, he came into the booth with me.  I don't know why he didn't want me in the booth without him.  He does not have separation anxiety.  Once recently he was happy to have my acupuncturist take him outside to go potty (because he waited until she was almost done putting needles in me to announce that he had to poop right away and she generously offered to take him out).  He was also happy to lie in the hallway outside the little x-ray room at the dentist office recently.  The door was open but he was not in the room and couldn't easily see me.  He was fine with that.

So I don't know what it was about the booth for the hearing test that worried him.  But he looked worried.

The audiologist said it would be all right for him to be in the booth with me so I had him lie down at my feet.  It was crowded.  He didn't care and neither did I.

I wish I had a picture of him in that booth with me, though.

And, even with a snoring dog in the booth, my hearing still tested excellent.

Been a Rough Few Days

I don't think I ever posted about the outcome of my visit to the ENT and the audiologist, but I was diagnosed with something call benign paroxysmal positional vertigo, or BPPV, which is apparently a very common cause of dizziness and usually very easy to treat.  And sure enough, the treatment seemed to help.  For a couple of weeks, I was dizziness-free and loving it.

Friday evening I had a severe episode of dizziness, but thought it was probably due to low blood sugar because I ate a bunch of crackers, which tends to make my sugar crash.  Luckily a friend was here and he got me something to drink and something to eat and eventually it went away.

Also, Friday I had a horrible muscle spasm in my neck.  There was this giant knot on the right side of my neck and I could hardly turn my head.  I tried heat, my TENS unit, stretches, everything I could think of, and nothing helped.  Saturday morning, I was miserable and desperate.  I decided to go to urgent care.  The physician's assistant touched the knot, said "Wow!" and seemed most impressed, and prescribed 20 tablets of a muscle relaxer. 

I was amazed she gave me that many.  Apparently she thought my knot was really, really something.

It was huge.  I mean, you could feel it.  Maybe even see it.  Like having an egg-shaped lump on the side of my neck, made of muscle.

I took one tablet and by the next morning, the knot was almost gone.  It was a normal muscle knot, anyway.  The kind I get in my neck and shoulders all the time.  My neck hurt, but it was a normal pain for me, not something I felt I needed urgent care or prescription medication for.

I am guarding the rest of those muscle relaxers like they are gold, let me tell you.

Isaac was great at urgent care, by the way.  Snoozed the whole time.

Then Sunday night, I had another really bad dizziness episode.  Couldn't stand up.  I took my blood pressure and it was 79/49.  Tried it again a bit later and it was 78/48.  I debated going to the ER.  Finally decided not to, partly because I thought they would just give me IV fluids and I didn't think I was dehydrated and just didn't think they would be able to do anything to really help, and partly because going to the ER would have meant walking out to the car, driving to the hospital, walking from the car to the ER, etc.  And I couldn't really stand up.  Definitely not long enough to do all that walking, and I wasn't sure it was a good idea to drive when I felt like that.

And then I had an anxiety attack.  I think the anxiety was about feeling anxious and guilty and stuff I needed to get done, including some articles I was already late finishing, and feeling anxious and scared about how dizzy and sick I was feeling, and feeling depressed and alone about not being able to go to the ER because I was too sick to drive myself there. 

And yeah, I could have called 911 and gone by ambulance.  I didn't want to.  How would I get home if I did that?

Anyway.  I ended up crying, and Isaac brought me my medication, and I took some, and then I got down on the floor with him and lay down with him and he rolled over for me to rub his belly.  And then Whiskers came over and licked tears off my face and curled up next to me and purred for a while.  And after a while, I felt better.

So it's been a rough few days.

I need to call the audiologist back because I probably need another treatment for the BPPV (I'll have to explain what that is later).   Wednesday I have to have tooth pulled and I'm trying to get prepared for that.  So it's also been busy.

Isaac and I did get to go for not one but two walks Sunday, one in the morning and another in the afternoon, before the dizziness hit me.

It was very  nice.  We both enjoyed it.

So, Like I Said, I Saw the ENT Today

And when he finished telling me about his affinity for labs, he did examine me.  It was a pretty quick appointment.  He wanted to schedule some testing, which is what I expected to happen.  He asked some questions, seemed to be making sure my dizziness and other symptoms were not likely to be caused by something like a stroke or a brain tumor (I already know they were not), and then said he thought the best thing to do was to do some tests to see if there is something wrong with my inner ear(s).  Which made sense to me. 

So still no answers and no treatment, but they were able to schedule the testing for next week, which seemed really quick to me.  And I will see the doctor that same day, right after the tests, so I will get the results and hopefully we will have some answers then.

Why Do You Have a Service Dog?

A couple weeks ago, I went to have my biannual eye exam (yes, I know it is recommended annually but Medicaid will only pay for it every other year and since my prescription barely changes these days and I have no problems with my eyes, I only do it every other year).

While I was sitting in the waiting area, you know, waiting, the office manager came over to me and asked, "May I ask why you have a service dog?'

I gave him my standard answer.  "I don't share that information with people I don't know."

Yes, the ADA allows businesses to ask two questions for the purposes of "gate-keeping," making sure a dog is really a service dog, but that's not what he was doing.  And he wasn't asking one of those two questions, either.

He said he understood and left.

As soon as I got back into the exam room, the doctor asked me, "And why do you have a service dog?"

I sighed and said, "You know you aren't really supposed to ask that, right?  Under the Americans with Disabilities Act, you are only allowed to ask two questions.  You can ask if it is a service dog and -"

She cut me off.  "You don't have to answer if you don't want to."

Well, I knew that.  Which is why I didn't answer.  But apparently she was in need of some education, so I wanted to offer that to her.  She was not interested in being educated, though.

"It's just that, in a medical setting, you know," she went on, making excuses that I wasn't buying.  "I wondered if there was some medical condition we should know about."

If that was true, then why not just ask that?  And why not ask it of all clients?  Why assume only clients with service dogs might have medical conditions?

"For instance," she went on, "if you have seizures, some of the tests we do, they could maybe trigger a seizure.  So it would be important to know about that."

If that was true, shouldn't they ask all clients if they have a history of seizures?  Not all people with seizure disorders have service dogs.  In fact, probably most don't.  Two years ago, though, when I was there without Isaac, no one asked me about seizures.

And if what you really want or need to know about is seizures, why not just ask about seizures?

I don't think she was really asking in order to get medical information.  If she was, well, there is a better, more appropriate, more respectful way to collect medical information.  And a way that doesn't violate the ADA.

Note that when I went to the ER recently, the day after my eye exam, in fact, no one there felt the need to ask why I have a service dog in order to gather the necessary medical information.  They just took a medical history, the same as they do for all patients.  My primary care physician has never asked why I have a service dog.  My rheumatologist has never asked.  They just took careful medical histories, like doctors should do with all patients.  If none of those medical professionals need to violate the ADA, and therefore violate my civil rights, by asking why I have a service dog, why should an eye doctor need to do so?

Edited to add: And yes, I am going to address this with them.  I called the next day to find out who was in charge, who I should speak to.  Turns out to be the office manager, the one that first asked me the inappropriate question.  Great.  But he was not in when I called.  I've tried calling two other times, plus I stopped by once, and have yet to catch him in the office.  He must not work very much.  But I will catch up to him.  I have printed out some educational material to give him and I plan to offer to speak to the entire staff at a staff meeting or training session.

Update on the Dental and Health Stuff

The dental work went well.  The most painful part of the procedure was injecting the novacaine.  A couple places where the needle had to go, it hurt.  But then I didn't feel anything during the procedure.  And it didn't take that long.

There were a couple moments where my PTSD was triggered a bit.  My jaw was starting to ache from having my mouth open so wide and the feel of the dentist's hand on my face was triggering.  I was able to push it away, to force myself back to the present.

I slept much of the afternoon.  Nothing about the procedure should have made me tired, yet I felt wrung out.  Whiskers curled up beside me and we slept off and on most of the rest of the day.

That was Wednesday.  Thursday I felt a little tired still but got a lot of stuff done.  Then Thursday night, I had nightmares.  I woke up for a while, managed to go back to sleep, had more nightmares.  Finally dragged myself out of bed, still tired, but not wanting to even try to sleep anymore.  And then Friday night was the same.  I'm guessing the nightmares were triggered by the dental procedure.  Hopefully I will be able to sleep better tonight.

The dizziness continues.  It seems to get worse in the evenings for some reason.  That's really the only pattern I've noticed.

I have an appointment later this month with an ENT.  Hopefully he has some ideas about it.

Managing My Meds.

I am currently on a ton of meds.  I've been on a lot for a long time, if you count all my vitamins, which I am counting.  I take a lot of vitamins because I had gastric bypass surgery about six years ago and that affects your ability to absorb vitamins and minerals.  So if you count those, I am on a ton of meds.

Here are all my meds for one day, Mondays to be exact.  There are a few vitamins I only take a few times a week, like vitamin A is only on Mondays, Wednesdays and Fridays.  But vitamin D3 is only on Saturdays and Sundays and zinc is only on Tuesdays and Thursdays, so it works out to about the same number of pills.

This is not counting any PRN meds, like meds for anxiety or migraines.

I used to take my meds in three separate doses, the first at breakfast, the second either at lunch or dinner, and the third at bedtime.  Between the new med for vertigo, which has to be taken every eight hours, and the antibiotic for my UTI (which fortunately I only have to take for one week), I had to change my medication routine.  I now take meds five times a day, on a pretty tight schedule.  I have the alarm on my cell phone set to make sure I don't forget when to take them.

Just one of the things many people with chronic illnesses deal with on a daily basis.

Trip to the ER

Last night I went to the ER.  I didn't intend to.  I intended to go to Urgent  Care.  My local hospital has both an ER and an Urgent Care and I didn't consider my condition life-threatening or emergent, so I drove over there intending to be seen in Urgent Care.  However, they informed me I needed to be seen in Emergency instead.

I was feeling dizzy.  I've been feeling dizzy a lot lately and haven't posted much about it because, well, I figure people get bored hearing me complain about not feeling well, and I just didn't feel like talking about it.  I have seen my primary care doctor twice for it, though, and we still don't know what's causing it.  He is supposed to be referring me to an ENT but I haven't heard from him yet.

Anyway.  I was super dizzy and repeatedly felt like I was close to passing out.  I felt vaguely nauseous and, I don't know, just not right.  Something was wrong, I just didn't know what.

So I went to the hospital, intending to be seen in Urgent Care and ended up in the ER instead.

Isaac went with me, of course.  They wanted to take me from the registration desk back to an ER bed by wheelchair since I was dizzy.  They didn't want me to faint or fall or anything.  Isaac had never walked beside me before while I was in a wheelchair.  It never occurred to me to train him to do that, because it's not something he's ever needed to do before.  He handled it just fine, though.  He kept looking at me like he was not quite sure what he was supposed to do, and I was a little bit worried he'd get too close to the chair and get his toes run over, but I told him to heel and he did great.  It might not seem like a hard thing for a dog to do, but heeling with a wheelchair is different than heeling beside someone that is walking.

They took me back right away.  I didn't have to sit in the waiting room at all.

They seemed pretty concerned and got me hooked up to a heart monitor right away and then did an EKG.  My heart appeared to be just fine.  Although at one point the EKG tech said something like, "Oh, that's not good," and I thought, "Crap, there is something wrong with my heart."  Turns out she was talking about the  machine.  A cord was not working right.

I took a towel for Isaac to lie on.  He was snoozing away on the floor on one side of the gurney and at one point I had two nurses and the EKG tech on the other side of the bed, all doing things to me.  Or trying to.  I kept saying, "If you need to get on the other side of the bed, I can tell Isaac to move."  They kept saying, "Oh, no, we don't want to bother the puppy!  He's fine.  We're fine."

At one point I invited Isaac up on the bed with me.  He thought it was too high and too small and he did not want up there.  He preferred his towel on the floor.

The staff was all really good about Isaac.  No one distracted him, no one questioned my right to have him there.  One of the nurses asked me about what Isaac did for me, and when I told her some of the things he does, she said something like, "It's just amazing what they can do" and that was it.  The doctor didn't ask what Isaac did for me.  I'm honestly not even sure he realized Isaac was there.

It was overall a really good ER experience, and I'm glad because I have avoided the ER since my bad experience nearly three years ago.  I really like my local hospital.  I felt like they treated me with a lot of respect.  Of course, I wasn't there for anything mental health-related. 

You know how in the ER, you can often kind of hear what's going on with other patients?  Emergency rooms are not always the most private of places.  Well, a little while after I got there, a young woman was brought in by ambulance.  I couldn't see her but I could hear her some.  I could hear nurses talking to her some.  She was in a lot of pain, I think abdominal pain, and was crying and moaning some.  I'm not sure how old she was, not a teenager, but a young woman, I think.

Anyway, I overheard them asking her about her medical history and stuff, and heard that she was on the spectrum.  They were referring to it as Asperger's, although that diagnosis no longer exists, technically.  All forms of autism are now referred to as autistic spectrum disorder, or ASD.  Anyway, even though she had autism, they were treating her the way I image they'd treat someone without a neurological disability.  They were talking to her like an adult, like she was capable of answering questions about her medical condition (and it seemed that she was indeed capable of doing so).  Her boyfriend was there at first and later I think a family member was there, but the ER staff all talked to her, not to the other person.  That may seem obvious or common, but it's really not.  It is common for medical people to ignore a person with a disability and talk to their companion instead, like the disabled person is not capable of peaking for his- or herself.

Back to me.  They did some blood work, and it was all normal except my blood sugar was a teeny bit low.  So I got some orange juice and graham crackers.  My blood pressure was low, so they gave me some IV fluids.  After a full bag of fluids, my blood pressure was even lower than it had been when I arrived there!  So they gave me more fluids.

They also wanted to do a urinalysis.  I didn't think I had a UTI, there was no reason to think I did, but whatever.  They wanted me to pee in a cup so I peed in the cup.  And guess what?  I have a UTI.  Apparently a pretty bad one.  I have no idea how I could have a really bad UIT and not know it.  I have no pain, am not peeing any more than usual, have no fever, my pee seems normal to me... I don't know.  But it was bad enough that they wanted to give me some IV antibiotics while I was there.  And they sent me home with a script.

I don't think the UTI is causing my dizziness, though.  So that has not been resolved.  At least I found out I have a UTI, though.  At least I'm being treated for it.  I just don't get how I didn't know I had one.

More on Service Dogs in Ambulances

I recently wrote about an online discussion with an EMT in which she stated that she didn't care what the law says, she could and would decide whether or not to allow a service dog in an ambulance with their handler.

Here is what the U.S. Department of Justice says about it in their recent document entitled Frequently Asked Questions and Service Animals and the ADA:

Q16. Must a service animal be allowed to ride in an ambulance with its handler?

 

A. Generally, yes.  However, if the space in the ambulance is crowded and the dog's presence would interfere with the emergency medical staff's ability to treat the patient, staff should make other arrangements to have the dog transported to the hospital.

There are two things to note here.  Well, actually, three things.

1.  The federal law says she is generally supposed to allow service dogs to ride an ambulance with their handlers.

2.  If the dog cannot ride in the ambulance, arrangements should be made to have the dog transported to the hospital.  One person joining that online discussion mentioned that when she had to be transported by ambulance, police officers drove her service dog to the hospital.  But the EMT that said she did not have to follow the law made no mention of making such arrangements.

3.  Even though the law says your service dog can ride with you in most cases, and that staff should make arrangements for your dog to be transported if he can't ride with you, some EMT's don't care about the law and will violate your rights anyway.  This is really scary to me.

Doggie at the Doctor's Office

I had an appointment with my primary care physician today. Isaac loves him and he really likes dogs.

We were chatting while he examined me and I mentioned that my rheumatologist is afraid of dogs. I explained how I put Isaac in a down stay behind my chair and keep him there the whole time she is in the room so she feels less anxious about him being there.

He looked surprised and said "Really? If Isaac was any more laid back, I'd want to check his vital signs!"

In other news, he ordered some blood work because I've been feeling dizzy a lot and my blood pressure has been running low.  He also prescribed something for migraines, because I've had three of them in the last month