(Almost) 24 Hours in A&E – by Andy Broomhead

I bought this book as a tongue-in-cheek gift for my wife.  I may have commented that it’d take her a long time to fill it.  In the last two weeks, I’ve probably done enough to warrant buying her a second copy…

          “My list of things I was right about”

It’s Thursday and I’m in London for work.  My elbow had felt sore the night before but I didn’t think much of it.  “Don’t scratch it!” I’d been told that Wednesday night about the dry skin on my elbow.  “It’s fine” I thought to myself.  It’s one of the things I do absent-mindedly (along with biting my nails).  I know it’s gross but here we are.  (Score 1 for my wife at this point).

I get home Thursday night and get changed.  Actually, my arm’s looking a bit red and swollen so I have a quick chat with Dr Google and decide (correctly as it happens) that I have bursitis.  I follow that up with a quick call to NHS Choices to make sure I don’t need to do anything urgently.  I’m told that the existing GP appointment I have for the following day is fine – no need to do anything else unless it gets a lot worse.

“It looks better”

I spend that evening and half the weekend attending various out of hours services in Sheffield and Rotherham (not to mention a midnight visit to the only open pharmacy in Sheffield) as the swelling gets worse.  Eventually I end up on a decent dose of oral antibiotics which I decide are working perfectly.  “It looks a lot better” I declare brightly on Sunday afternoon.  My wife frowns and murmurs something.  “You’re not going to London tomorrow are you?” she asks, almost incredulously.  “Probably” I answer confidently.  “I mean, it looks better today so if it’s getting better tomorrow morning then yeah why not?  I mean, I feel fine.”  (Score 2 for my wife at this point).

                 My elbow, “looking better”

Predictably, I decide this is all fine at 5am on Monday morning and get on a train to London.  By lunchtime I’m waiting to be triaged at the Royal London Hospital (score 3).

Maybe not

“It’s cellulitis” the nurse tells me.  “We’ll just need to take some bloods and give you some IV antibiotics” (score 4 – probably).  Suddenly this is utter chaos.  I’m 150 miles away from home, needing an indeterminate about of intravenous medication.  After much discussion, deliberation and distraction (I hate IV needles), we agree I’ll have the first dose of antibiotics in where I am, then head across London and back home to Sheffield (all whilst the cannula is in *shudder*).  So that’s what we do.  I get off a train back home at 21:20 and go straight to my second A&E department of the day.

            Maybe it’s not entirely better…

The A&E doctor back home pulls some strings and after giving me my second IV dose, manages to get me set up with the OPAT team the next morning where they’ll treat me as an outpatient with daily IV antibiotics (score 5).  “It’s typically 5 – 14 days, depending on how well you react to the treatment”.  I get home at about 1am (score 6).

Over the next three days I’m back in hospital every day before they mercifully discharge me.  This time it finally is better.  So what does this all have to do with diabetes?  That’s what this is supposed to be about right?  Well this whole fiasco got me thinking…

  • Firstly, listen to your significant other – they’re right, you’re wrong.
  • Secondly, if you’re turning up to an out of hours service with a suspected infection, tell them you have diabetes.  I didn’t (because it wasn’t on the form) and it meant I was sat for a few hours when I could have been talking to a doctor.  Having diabetes means your body may not handle an infection as well as others.  If that infection goes untreated you be in a lot of trouble and the healing process could take a lot longer
  • Thirdly, managing my diabetes when I’m ill feels like having a second job.  Extra finger-prick tests, temporary basal rates, persistent high blood glucose readings.  It’s a lot to manage physically, but mentally it gets on top of you quite quickly too and that can be doubly hard to manage when you’re already unwell.
  • Finally, it made me think again about how much responsibility is given over to us as people with diabetes.  In the last 10 days, I’ve probably spent more time in various healthcare establishments (15 hours) for one  reasonably routine issue, than I have in the past 4 years for an incredibly complex condition.

When I got diagnosed, I carried on like I was bulletproof.  I was fairly ignorant about how serious this condition was and just carried on for a long time believing I could do what I wanted without consequence.  I’m a little ashamed to think that’s how I started dealing with this infection.  I decided that because I’m (luckily) fit and well most of the time, there was no need to do anything urgently and that as long as my bloods were OK, I was fine.

Looking back, I was obviously wrong (score 7).  It’s OK to feel fragile, to need that extra help and support, and to slow down and rest when required.  I’m definitely not bulletproof and hopefully I’ll actually remember that in future.

I owe a great deal of thanks to the Emergency Department staff at the Royal London Hospital, the A&E team at Sheffield’s Northern General, everyone on the OPAT ward who patiently put up with my needle-phobia, and my wife, who never actually once said “I told you so”.

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