My Emergency Experience at the VA

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The VA's new TeleStroke Program at work
The VA’s new TeleStroke Program at work

Thank you Orlando VAMC at Lake Nona

My emergency experience at the VA in Lake Nona on Friday, 9 August 2019 can be defined by the following memorable words: scary, innovative, fast, quality, stroke, clot-busting, no-stroke, headache, oxygen. It was an experience, but a good one.

I was sitting on my couch on Friday watching the news. My dad called to see how we were doing. I live with my 17-year old granddaughter who helps take care of me. She really is a winner! About 2 pm, I decided to work on my blog; however, my WordPress account was being stubborn. The darn thing would not let me in; the password was not working. It was the same with all my other apps. Frustration overwhelmed me.

What was I doing wrong

I tried my password in WordPress over and over to no avail. My granddaughter suggested that I try the password in another program. She wanted to check if I was “in my right mind.” She likes teasing me. I could not get any of my programs to “let me in”. I even prayed to myself, “Oh God, make this program let me in, please! Okay that was a little selfish, but I was desperate. Better to be asking to Him for help with my frustration or my inability to deal with the computer issue, or whatever else was happening with me. I determined I was “going out of my mind.”

My granddaughter came over and got my password to work in MS Word first try. She has the same password on her computer as mine. I started crying — nervous breakdown! I didn’t understand what I was doing wrong. When I looked up at her and tried to talk, my speech was very slow. I gave up and put the computer aside. So much for the blog!

My granddaughter said, “Grandma you aren’t talking right.” I ask her what she meant. She repeated what I told her in a slow voice. You have to love her. I told her I felt frustrated and very tired. My head hurt. She started my oxygen (10L) for about 15 minutes which is the treatment I have at home for headaches. When we stopped the oxygen I still spoke slow, even more than before. Not a good sign. I decided to lay down.

Calling VA Nurse Triage

When I woke up about a half hour later, I did not feel well. My speech sounded “all messed up,” and confused. We decided to call the VA Nurse Triage Call Center . The nurse was extremely professional. She asked a few questions upfront, then immediately went to the stroke questionnaire. Yikes! After going through the questionnaire, her recommendation was call 911.

My granddaughter told the Triage Nurse that we did not want call 911 because they will insist on taking me to Orlando Regional Hospital, not Orlando VAMC at Lake Nona. This did happen once before when we called them. We requested the Ambulance take us to the VA; however, they refused. The paramedics said they had to take all patients with certain criteria to Orlando Regional. The Triage Nurse told us to “go right now to the VA in Lake Nona as quickly as you can get there.” We took Uber; they arrived in 6 minutes, probably faster than an ambulance.

The Emergency Department

In the Emergency Department, it started out as a sort of comedy according to my granddaughter. Once we arrived in the room, I insisted my wheelchair rolled backwards with me in it. I was begging quite loudly for anyone to stop it. After four nurses put their arms around me from all sides, they convinced me the chair wasn’t going anywhere. Whew! It really wasn’t moving. Darn Vertigo again.

Next, came getting onto the bed. The staff decided to use a lift. Big mistake! The lift terrified me apparently. Sure do wish there were photos of that fiasco. As they tried to get the lift to go up, I was telling them to go down. They could not figure out why it would not move until finally a doctor came in and pointed out it was caught on my wheelchair. My granddaughter said she knew it was but was afraid to get involved. Too many cooks in a kitchen and all. Once the lift seat was dislodged, everything moved smoothly and I was moved onto the bed.

VA TeleStroke at Emergency at VA Lake Nona

I experienced VA TeleStroke. The VA Emergency physician and the neurologist were concerned I was having a stroke. They engaged a VA Stroke expert through VA TeleStroke. Within minutes the Neurology Stroke expert connected through a teleprompter in my private ED room. She examined me by asking questions, and had the physician make specific physical examinations where she could see the responses.

The neurology expert told my granddaughter she was not convinced that I had a stroke. Even so, if I did have a stroke, it was likely a small one or TIA. Plus, it was too late to give me the “clot-busting” medication, Alteplase, which is the new medication that can prevent stroke or reduce effects. “The fact is you waited too long to come to the Emergency Department” she said. “When symptoms occur, you must come to the Emergency Department immediately.”

My granddaughter first noticed symptoms at 3 pm and we didn’t get to the hospital until 6 pm (my fault). The Emergency Department admitted me at 6:30 pm. VA TeleStroke evaluated me at about 7:00 pm. The Neurology Specialist through VA TeleStroke said the window for alteplase is 4 hours and I exceeded the window. Since there was no stroke evident on my CT scan, I need an MRI to be sure.

One important thought

My fear of calling an ambulance and being hauled to Orlando Regional Hospital is not reasonable. Concerns about Orlando Regional are based on a prior bad experience which probably will not ever occur again. However, not calling an ambulance puts my health at risk. Never resist calling 911 for any reason. False beliefs are can really hurt you. Something I am learning from I trauma therapist.

Orlando VAMC Quick Review

The care that I received at the Orlando VAMC at Lake Nona was exemplary. From my emergency experience at the VA through inpatient, an awesome team of Nurses, Nursing Assistants, IV Specialty Team, Physical Therapist, Neurology Team, and Primary Care Team cared for me. I wish I could call them out by name; however, I am confident all the VA teams work just as hard. I was very pleased with the commitment as the team they provided my care. When I was discharged I was told if I had further issues to immediately call the VA Nurse Triage Line or call an ambulance.