Blood pressure emergency

I had been treated for hypertension for almost 2 years with losartan. However one day I felt a little dizzy and was ‘seeing stars’ and flashing lights. I sat down and felt better. I checked my blood pressure and found it was low: 85/46! I relaxed and lay down. A bit later I moved around and did some chores, feeling better. My blood pressure was now 110/54. I cut the medicine in half. Checking the bp frequently, I found the bp never went over 130/60, so I switched to half a pill. I had incidents of low bp twice a month. I would stop the meds for a day or two to make sure I did not get too high or low. After almost 2 years I had the hypotension, again, & stopped the pill, and the bp recovered. However, despite my restarting the medication the bp kept rising until it went to 200/90.

I went to the emergency room and told the receptionist I had a bp of 200. Her eyebrows raised, and she said, “That’s way too high!” I registered; I had been a patient at the hospital five times so that was easy. I waited for only 15 minutes and was called in to tee the triage RN. I gave him my history. He took my vital signs confirming the blood pressure at 210 and he led me to another waiting area. I was next seen by the ER physician. I had typed out my long medical history, emphasizing that I had no symptoms. Everyone is always asked about chest pain, headaches, palpitations, stroke symptoms, urine problems. I had none at all. He asked about my exercise. I told him I swam 2200 yards that morning. He ordered lab tests: blood and urine. A nurse started an IV heparin lock. The IV is in the arm but not attached to anything. After an hour I was led to a room. Nurse has me take off all my clothes and don a hospital gown, get on a gurney. This did not look good. When she returned, she said I was admitted to the cardiac care unit. She takes off my socks and replaces them with special hospital socks with rubber dots so I will not slip while walking. A clerk came with more forms. The doctor came to see me again. He said that when the heart is stressed or damaged, some enzymes are leaking into the blood stream. My Troponin level was 415, normal 54.

No one wants to be admitted to the hospital. However, as one of my fetishes is being naked in front of clothed women (clothed female, naked male-CFNM) I was sure to encounter situations where I would be exposed.

The wheelchair ride: Transport chair has all small wheels and arm rests that go up and down, so I slid in from the side. Aide had large cotton blanket on the chair. I sat down on the chair, swung over straight and put feet on the rests. I got another blanket on top for warmth and modesty. We go through the halls, public areas and finally to the Cardiac Care Unit, about 10:30. Five hours in ER.

The CCU has thirty single rooms. Bed, sitting area, shower and toilet, and sink in the back. I get into bed. The nurse introduced herself and wrote down team members on a board in front of me. In the meantime, the aide took my vital signs, hooking up the blood pressure cuff and sticking a thermometer in my mouth. They wired me up with leads on the chest and a stick-on oximeter. The latter is inconvenient as it is on my right middle finger; the 7-foot cable is always in the way. The RN interviews me. These days everything is on computer. There is a rolling stand with monitor and keyboard. My history from primary care & ER is online, but lots of social questions: married? Someone at home to care for you? Alcohol? Falls? Oh, oh. I stumbled and fell hard on the pavement a week ago. I still have the scrape on one knee, healing scrapes on elbow and the toe is still sore. I told her I have sleep apnea.

A second RN arrived. “Protocol is we must have 2 RNs to your skin exam; it is needed especially because you have open cuts. Do you have anything else we need to know about?” I point out a couple of rashes, one in the groin crease & left leg next to my scrotum.” I had skin exams on other admissions. This time they started by untying the gown and taking it off, leaving me naked except for the socks, which they took off right away. My toe had no skin damage but was tender when they pressed on it. They checked the scabs on my right knee, then rolled me over to check my butt and hips for damage. I hadn’t noticed a hip scrape. “Spread your knees apart and put the soles of your feet together, please.” This position exposed my groin. Rosa, my RN pulled my penis & scrotum over and looked at the reddened slightly damp skin on the leg.

Still holding my penis and scrotum aside she said, “Probably from dampness between the leg and scrotum. Wash it at least twice a day. Dry the area and use talcum powder. For a couple of days, we will use an antibiotic cream on the rash.” The right elbow scabs were almost falling off. They concluded the exam, covering my lower body. Next they attached sticky pads on my chest for monitoring leads. There were six wires. They taped the oximeter to my right middle finger. They tied up my gown and pulled the wires through a pocket on the chest. They showed me how to adjust the bed up and down, then allowed me to relax. A few minutes later a nurse attached the IV med for the blood pressure. They pulled up the rails, asking me not to try to get up without help; they did not want me to fall.

The respiratory therapist came with a CPAP (constant positive airway pressure) machine and a mask for me to wear. I told her the setting was seven.

I had peed three times in the ER but had to go again. I got the urinal, peeled back the covers to pee. I’m a ‘grower’ short soft but when hard, about 4.5 inches. I the urinal in place, and the aide enters as I’m pulling it longer. She’s the slim Filipina helping earlier. Her name tag said, ‘since 2009.’ So, she is very experienced. “Need help with that?”

“I am not used to peeing lying down, in a urinal. I…uh, think I have to stretch it to get it into the urinal. Sorry about this. I…um.”

“No need to be ashamed or embarrassed. We’re here to help you. Would you like some help?” I nodded OK. She donned purple nitrile gloves. She pulled back the covers and slid a fresh paper under my hips. “Just relax. I must touch you now.” She positioned the urinal. She grasped my penis behind the head and pulled, stretching it enough to get into the lip of the urinal and two” in. Holding my penis in one hand and the urinal in the other, she said, “Okay. You can urinate now.” I peed; when I was finished, she took tissues and held it over the end of my penis to catch any leftover pee. She pulled the gown over and replaced the covers. She squinted at the amount of pee. “Almost 300 ml. You had a full bladder.” The rest of the evening I peed twice more, dumping more body water.

Early the lab drew blood, and about 7:30 the x-ray tech took a chest x-ray. The echo cardiogram was more involved. I had to lie on the right side. The tech, a young woman, set met me up, and her ‘supervisor’ arrived. I noted she was a ‘student’ according to her badge. They took a long time, pressing the probe over my chest front and back. Eventually the experienced person took over.

The aide entered with several towels. She wet several washcloths giving me one to wash my face while she washed my back. I peeled the gown off my chest; she detached all the wires off the stickies on my chest. She allowed me to wipe down my arms and chest. She had me stand, holding up the fresh gown. However, I told her I wanted to do my legs. I took off the gown & was now naked. I washed my upper legs, and butt. I asked for a fresh cloth and washed my penis carefully, pulling it out and dabbing at it. “Be sure to wash the rash on top of your leg,” she said. I reached between my legs and wiped my anus, “May I have some tissue?” She gave me some Kleenex, and I dried off my anus. I reached down to wash my lower legs, but she offered to help me. I sat on the bed while she took off my socks, washed & dried my feet and lower legs. The aide donned fresh gloves, then put some ointment on her hand. “Spread your legs please. I am going to put the medication on your rash. She pulled aside my scrotum and smeared the ointment on my leg and some on the scrotum. She re-attached the wires to my chest, then pulled them through the hole in the chest before putting the gown on. I had several nice minutes of CFNM. Of course as she was a veteran 40 years as an aide, and done thousands of baths & showers, a patient briefly naked during a bath & changing is routine.

I was still NPO, not allowed to eat or drink. I was next to a large dark room for a urinary tract examination. The tech was a slim young Hispanic woman. I lay on first the left, then right sides while she pressed the probe back and forth over my back. I told her I had a cyst on the right kidney. She confirmed I still had it. She gave me a urinal. “Can you empty your bladder?” I casually peeled off the blanket to the right and the gown, exposing myself. She watched impassively. I had peed not long ago and could not go. “Can I stand up?” I could only make 50 ml or so. Back on the table, she re-draped me, and she told me she was going to scan the bladder. I pulled up the gown & pushed the blanket down, a little too far. She pulled back up to the pubis. This part of the scan took more time. She was waiting for the ureter to squirt urine. There never was any. “There’s a request for a prostate scan,” she said. “How do you do that?” I asked. I found out soon. I lay on my right side with my knees pulled up, anus exposed. She explained she would insert a probe in my rectum. I felt her pry up one cheek. “Let me know if there’s any discomfort.” She gently inserted the probe. All I felt was pushing and stirring around. After she removed it, she gave me tissues to clean off the jelly.

The rest of the day was boring. I sat in a chair. My receptionist brought some books. The doctor said since I had no symptoms, he had let me go tomorrow if the nuclear scan was okay.

It was near midnight. I had to pee, so I took the urinal, peeled back the covers and gown as the RN entered. “Oops. I will come back in a moment.” She took care of the urinal. A couple of hours later I had to go; I slid out of bed to pee in the toilet eight feet away. I was a little dizzy, maybe from the meds. I staggered a little, saying, “ack!” The aide was just outside and rushed in. “I am all right. Just must go to the toilet.” She helped me there holding one arm. I am not sure why, but she had me use the urinal, saying she had to measure the amount. She pulled up the rails, saying I should not get out without help. Six AM I had to go again. She lowered the rails. This time when she gave me the urinal, I just peed at the bedside as she supported me.

I was told I would have a heart test in the morning. No food or drink after midnight. At nursing rounds they noted I had no bowel movements. It was Tuesday. I hadn't had one since Saturday morning. The nuclear scan: I was NPO again and was starving & in need of water. They started and IV and injected a small amount of technetium-99. It was wrapped in a black sleeve, for radiation shielding. The scanner was a 3-foot square box on an arm. I had to lift my left arm while the tech slid it over my chest. The scan took seconds. The stress test: I was hooked up to more leads in another room and then given Lexiscan to raise the pulse rate. I was told there would be some discomfort but felt nothing. I was given a meal. Sandwich, grapes and caffeine—I took coffee. By and by I had a second scan. I was told these would be the most important images. Once again, I was squeezed by the camera. I asked what if a person had a thick fat pad, like a woman with big breasts or someone four hundred pounds. He said the distance from the heart to camera would degrade the images.

Back in my room I ordered more food, a dinner entrée, with sides. I had not had a bath in the morning; They wanted me to be available for instant availability. I got several washcloths and towels, fresh gown from the staff. Aide commented she would check to see how I was doing later, as they were busy with shift change. The sink is in the back of the room. I opened the door of the toilet so I would not be seen when someone entered the room. I was able to shampoo my hair & use a lot more water to wash. I’d got down to my knees. “Knock, Knock. How are you doing?” It was the slim Filipina. The one time it has expected the patient to be naked is at bath time. “I’m afraid to balance on one foot to do my lower legs and feet,” I said. She replied, “Just sit in the chair here.” She washed and dried my feet & put on my socks. I stood to get the gown. Puzzled, I said, “Where’s the sleeves?” She showed me how the snaps went together. Before I could dress, she had to re-attach all the wire, including the pulse oximeter on my finger. She threaded them through the hole in the front, then I could put on the gown. I settled down for just a few minutes when she returned with the ointment and after having me pull up my gown, applied the ointment on my leg and scrotum. She asked if I could try to have a bowel movement. I went to the toilet, sat and pushed. Nothing. After ten minutes she returned, and gave her the bad news. I was still sitiing on the toilet when she returned and asked me to return to bed. She said I needed an enema!! She showed me the 'Fleet's' enema. It was a bottle I rolled over to my left side, pulling up my right leg. She inserted the nozzle of the enema, and I felt the cold fluid. "Hold it as long as you can," she said. Five minutes later I had the strong urge. I dashed to the toilet, just making it. First a lot of fluid, then the backed up poo, and more water. I sat there for a few minutes. The cramping and runs back to the toilet lasted almost an hour.

I was anxious to get out of the hospital. While I was eating the RN said my scan was okay & she only had to get the papers. I called my office. Garnette was still there and could be there is 20 minutes. The nurse went over the instructions. The doctor had given me a summary of what had happened, the test results and medication & activity instruction. “We’ll help you pack up,” said the nurse. The aide was there too. I removed my gown and pulled on my jeans first (I do not wear underwear). I stumbled a little and the RN quickly caught me by the elbow, stabilizing me until I had my pants on. I got a ride downstairs in a transport chair. Garnette was waiting and took me home