Geriatric Nurse Practitioner – February 2009
As I prepared for bed, I began to shiver followed by nausea and vomiting. I put my cell phone in my pocket in case I fainted like last winter. I unlocked the kitchen door so the ambulance paramedics could enter without breaking the door down in case I had to call them. I felt like when I had the norovirus a few years ago and ended up in the hospital with low blood pressure. I prayed for the Lord to have mercy upon me and help me not to faint. My concussion after I fainted last year and missed three months of work was still fresh in my mind. The vomiting continued and I began to black out so I called 911 and lay down in my recliner.
I thanked God when two paramedics walked through the door and asked me what was going on? I briefly told them my symptoms and history of low blood pressure. He checked my blood pressure and said, “It’s too low at 70/40. We have to get you to the hospital.” They helped me to the breezeway where I collapsed on their waiting stretcher. The uncontrollable vomiting continued, so I asked them to grab a plastic bag from my kitchen. They wheeled me down my dark driveway through the biting snow storm and loaded me into the ambulance. I never felt so cold in my life. My shivering continued until my muscles painfully spasmed. The kind paramedic put a dissolvable Zofran tablet under my tongue to stop the vomiting.
After fifteen minutes, we arrived at the emergency department and they rolled my stretcher into a private room since I was contagious. The nurse quickly put me on the heart monitor and began checking my blood pressure and pulse frequently. My fever registered 100 degrees Fahrenheit. The doctor entered, introduced herself, did a quick exam after obtaining my history, and ordered lab tests and intravenous fluids. The nurse then tried to get an intravenous needle into my veins so she could draw blood for lab work and quickly replace my lost fluids. I asked God to help her get the needle in. After a few unsuccessful punctures, I asked her to wrap my arms in hot wet towels covered by plastic bags. This worked in the past to help dilate my veins when my blood pressure was low. She agreed and fifteen minutes later, we both breathed a sigh of relief as we saw my blood fill the glass lab tubes. She then began dripping the fluids into me as fast as possible to raise my blood pressure.
The doctor reentered my room an hour later and gave me my lab results.
“Your tests are negative for flu, but you are dehydrated and we can’t get your blood pressure above 80/40. You likely have the norovirus which is running rampant right now in the community and is highly contagious. Health care workers like you and me are especially susceptible because we are exposed to it at work. I’ve already had it twice myself this winter, so I know how miserable you feel. Most people can ride it out at home, but you can’t because your baseline blood pressure is so low. Since you live alone, it’s not safe to send you home, so I’m admitting you to the hospital.” I thanked her for her compassionate concern and thanked God for giving me a doctor like her.
The next afternoon, the nonstop diarrhea started – phase two of the virus. After the aide cleaned me up a few times, I asked her to give me some disposable diapers. Since I didn’t have my Bible with me, I asked God to bring verses to my memory and to comfort me in my weakness. God wrapped me in His wonderful peace as I recalled Deuteronomy 33:25, 27 (KJV)
“…as thy days, so shall thy strength be. The eternal God is thy refuge, and underneath are the everlasting arms.”
After two nights in the hospital, my blood pressure returned to baseline and the vomiting and diarrhea stopped. I tolerated clear liquids and a soft diet and maintained my blood pressure when I stood. They discharged me home to continue my recovery. It took me six more days before I was strong enough to return to my job as a geriatric nurse practitioner at the nursing home. I didn’t dare return too early because I didn’t want to risk infecting my frail elderly patients or catch the norovirus again. I used all my sick time, but God graciously provided once again.
The norovirus is also called the cruise ship virus because it commonly occurs in crowded places such as ships, resorts, hotels, daycare, preschool, and nursing homes. It is transmitted by eating contaminated food or water, touching your hand to your mouth after touching a contaminated object, or having close contact with an infected person. According to the Center for Disease Control, over 20 million people are infected with it annually. It is the most common foodborne illness and mainly occurs from November through April in the northern hemisphere.
The best way to prevent it is to wash your hands thoroughly after using the toilet and before eating, avoid contaminated food and water, and wash fruits and vegetables before eating. Using gloves and paper towels, clean up vomit and feces with a bleach solution, and then disinfect surfaces with bleach. Dispose of the paper towels and gloves in a sealed plastic bag. Stay home and don’t travel for at least three days after the symptoms stop. For more detailed information, go to http://www.mayoclinic.org or http://www.webmd.com.
I thank God for His healing hand upon me and the comfort He gave me through the compassionate healthcare workers during my time of illness.