11:00pm (Monday night) - received 2 patients for my night shift but was told to take only bed 8 and wait for another staff to come take bed 7. Lucky enough, she came 30minutes after endorsement time.
11:45pm - asked a Filipino nurse (one that I trusted) to extract blood for my CBC to check on my hemoglobin. Previous Hgb was 6.3g/dl. Normal value is 12-14.
12:40 am (Tuesday) - got my CBC result at the laboratory and 2 lab technicians assisted me to take my result and was stunned to see my hemoglobin at a WARNING LEVEL of 5.78!
1250 am - shown the result to the charge nurse and with the supervisor around, immediately provided me with sick leave paper. Endorsed my patient to the nurse at bed 7.
0145am- I was brought to the emergency room ambulatory by Precious Medina and Mary Gallentes.
0200am- The same doctor who checked on me 5 days ago remembered me and was smiling when she said, "you escaped the last time! And today we will put you in restraint!" Again, she advised blood transfusion! But later told to me to wait for a second opinion from the medical resident doctor. While we waited for the MROD, blood extraction was taken for my chemistry, and chest x-ray and urinalysis were done to complete my laboratory investigations. Precious was with me the whole time. I stayed at the ER sitting at the female waiting section til almost 4 am when the MROD came and finally decided to have me go back to ICU and advised to take my iron supplement and improve my diet. She didn't give me sick leave "because it's already Tuesday!", instead was told to go to the Employee's Clinic at 8am "so you can get more than 1 day sick leave!" ER doctors aren't allowed to give employees more than 1 day sick leave.
Vehemently, I refused blood transfusion because I am not comfortable with the thought that the blood to be transfused isn't safe or that I might encounter fatal mistakes usually committed in the ward for simple procedures like blood transfusion.
0415- ER pharmacy gave me only 10 pieces of 190mg of Iron tablets and 10 1mg Folic Acid tab good for 3 days!
0430am- I was back at ICU but didn't continue on with my duty. Had my first Iron tab taken per orem. The iron tab tasted so bad, I was nauseated the whole time. Stayed at the Respiratory Therapists Room til endorsement time.
0700am- Aizza and I had breakfast at McDonald's. Apparently, I don't have much appetite to devour my pancake meal. I had the hash brown and sipped on my orange juice and brought home my 3-piece pancake. Dropped by the nearest pharmacy to purchase iron tabs, ironically, same brand as that from our hospital!
0815am- At the Employee's clinic and was seen by a doctor who questioned the ER doctors decision on me going to the employees clinic for a sick leave. She made a referral back to the ER, talked to the ER doctor in charge over the phone and instructed me to go directly to this doctor for an IV infusion of iron.
0830am- ER doctor saw me and referred me to another ER doctor for assessment. The Pakistani doctor who attended to me said to take another blood sample for her to check on my hemoglobin. Again? I refused another extraction! I told her I completed lab investigations earlier. She asked me bunch of questions that seem to prolong my agony of waiting whether or not they will infuse IV iron NOW instead of a blood transfusion later. Aizza was so pissed off, she tried to convince the doctor that the "patient has the right to refuse" and if there'll be alternative, then we'll go for it! The doctor was undecided, she took her phone and referred me to a medical resident doctor. I was struck by what I heard: "MAYBE IT'S LEUKEMIA!" But I didn't panic knowing that this is just but a severe iron deficiency anemia. She then told me to wait for the MROD.
0900am-Aizza and I sat down at one of the ER beds and while waiting for the MROD, she can't help but to take a nap and me, chatting on my iPad. In between, this Pakistani ER doctor will come see me and have asked: "You want your anemia to be treated, right?" And me answering with a bit of sarcasm, "but of course !", and she would tell me: "If the medical doctor will tell you to go blood transfusion, you will say yes?" And I'd say, "no! I want a sick leave!" Now this is what I call MANIPULATION!
0945am- No MROD came! We decided to go back to the Employees Clinic to get a sick leave for tonight's duty. At the clinic, the doctor refused to give me sick leave, I was again told to go back to ER so that "an Internal Medicine will see you!" The distance between the Employees Clinic and the Emergency Room is more than a hundred meter and walking to and from each department with a hemoglobin of less than 6 made me realize I will die of fainting due to shortness of breath before I could get the necessary treatment.
1015am- Back to ER. A female MROD was at the nurse's station waiting for us. I was, honestly disappointed to see a very young resident doctor, maybe at 26, inexperienced as I thought, to have her assess me. She let us sit down and asked few questions before she said: DO YOU HAVE ENOUGH STAFF AT ICU? What does she mean by that? Then made mention of a blood transfusion! Aizza, having lack of sleep and tried to keep calm butted in and clearly explained of the patient's right to refuse treatment besides the safety of bloods being transfused to patients, and if she would advice for a one time infusion of Iron intravenously as per the Employee's clinic doctor's instruction, then we'll go for it! The doctor was nodding her head, then took my papers, reviewed it a bit, had me auscultated and wrote 1 DAY SICK LEAVE! I contested her decision. But she said, per protocol, ER doctors can't give more than 1 day sick leave for employees! Disgusted, we returned to the employees clinic.
11:15am- The doctor at the Employees clinic didn't say anything but have written 1 day sick leave on my SL paper. Again, with much disappointment and a simple rage, I said, "one day sick leave only doctor? And i am still here at the hospital? I waited for less than 12 hours and I got only one day sick leave?" She took her whitener and erased the one she've written and put on 2 instead. So I get 2 days sick leave, 10 Iron tabs and 10 folic acid with no return appointment, no medical advice except to "improve on my diet" and dizzy spells!
1130am- Aizza and I decided to go home. Her and Precious advice: go to the dispensary to have an IV infusion!
11:45 am- Back to my room purely exhausted, hungry and sleepy. Had a lil chat with Rico before I finally hit the sack, him having contacts with his former colleagues at the Dammam Medical Dispensary and hoping to get me at least 2 vials of Iron IV this day.
0800pm- Two good looking guys personally delivered my adobong liver with 2 vials of Ferrosac complete with paraphernalia on hand, ready for intravenous iron infusion. Well, dinner today was something "real" even if I had it alone as usual!
11:50pm- Donna, my roommate arrived and immediately inserted gauge 22 IV cannula at my left basilic vein and started with 0.9% NaCl 500 ml plus 1 vial Ferrosac.
0315 am Wednesday- above IVF consumed and discontinued. Me feeling better, without the usual dizziness and headache! After 3 days, another vial!
As the saying goes, “To be stupid, and selfish, and to have good health are the three requirements for happiness - though if stupidity is lacking, the others are useless.”
― Julian Barnes
Thank you, Precious, Mikmik, Aizza, Bing, Rico, Dennis, Donna, Nema and Shine!
