Lost a patient today

[bivenator]

I performed a nuclear stress test on this gentleman in late April. The test indicated a small area of ischemia. A heart cath was performed and a stent was placed in the RCA. A follow up visit post heart cath showed positive signs of improvement, normal BP and EKG.
Today he came to the office with some swelling in the ankles and complained of fatigue. We drew blood, ran an EKG (normal) and adjusted his BP meds thinking that they may be the cause of his fatigue. He was a little dehydrated and his BP was 130/60 in the office. We sent him home and waited for the lab results.
When he arrived home, he did not make it inside, collapsing in the front yard and died en route to the hospital.
An autopsy will be performed to determine the cause of death. I am guessing an electrical problem possibly related to the dehydration.
As he left the office I patted him on the back and told him it was good to see him and to take care.
Tough.

[masraum]

Yeah, rough job. Great highs when you can help someone, but those are there to offset the lows when things don't go well.

[bivenator]

You are right about the highs, earlier this week a patient approached me in the office, shook my hand and thanked me for helping save his life. I couldn't remember who he was and certainly don't believe that my role in his care was lifesaving. But, I felt great afterwards thinking that I had made a difference at least in the patients perception.

[Rikao4]

remember telling Livi after something like this..
someone is laughing,
being held close..
is loved & shares same..
because of what you did yesterday or long ago...
you can only try to do the same tomm..
today is but a lesson on how quick it can change..

hang in there..

Rika

[HardDrive]

Sorry to hear that. My wife works in a Childrens hospital. She's a tough cookie, but some of the losses are very hard.

You can only do what you can do. Much of what happens is out of your control.

[Tobra]

Sucks to lose one, but it happens, even Ted Williams did not bat a thousand.

I get people giving me the you saved my life thing when all I did was tell them to get their ass to the hospital, do not pass go, do not collect $200. It is sort of trippy when they do that and you have no memory of who they are.

[BernieP]

I thank my cardiologist every time I visit him. He was on call the night I had my MI. Great guy.

Bernie

Sorry to hear that, bivenator. I know a number of doctors, and they all take it very hard when they lose one. It's more than a job, it's a calling. I'm sure you have helped saved many over the years and many more--like their families--owe you huge debts of gratitude.

Chin up.

[m21sniper]

Originally Posted by bivenator

I performed a nuclear stress test on this gentleman in late April. The test indicated a small area of ischemia. A heart cath was performed and a stent was placed in the RCA. A follow up visit post heart cath showed positive signs of improvement, normal BP and EKG.
Today he came to the office with some swelling in the ankles and complained of fatigue. We drew blood, ran an EKG (normal) and adjusted his BP meds thinking that they may be the cause of his fatigue. He was a little dehydrated and his BP was 130/60 in the office. We sent him home and waited for the lab results.
When he arrived home, he did not make it inside, collapsing in the front yard and died en route to the hospital.
An autopsy will be performed to determine the cause of death. I am guessing an electrical problem possibly related to the dehydration.
As he left the office I patted him on the back and told him it was good to see him and to take care.
Tough.

Sorry to hear it doc.

[bivenator]

I'm not the doc, run the stress lab for him. He is a good guy and was pretty bummed. I apologize if this was not clear.

[aap1966]

P. E.?

[wdfifteen]

I'm sorry to hear this. You can't know and do everything. You did your best. Sleep well.

[livi]

Some things is just impossible to get used to. Sorry it happened to you. I know how it feels.

[Tobra]

Markus, I would say if you could get used to it, your empathy bone is broken

[Nathans_Dad]

Sorry man, that sucks. Try not to beat yourself up too much over the next few weeks, been there done that.

Unfortunately this job is one that is marked by lots of stress, lots of ups and downs. I have come close to hanging up the stethoscope a couple times myself. I guess I just try to remember the good patients and the great saves I have been a part of and learn from the poor outcomes. Sounds like arrhythmia but who knows. It was just his time. Remember, you did not give him the disease, you were just trying to help him through it. Most of the time, the disease eventually wins.

I ran into a patient at the gym yesterday, he was admitted to me over an entire month with the worst case of alcohol withdrawal I have ever seen. The guy couldn't even walk for two weeks. He was very confused and I was pessimistic he would ever regain normal mentation. He finally went to an inpatient rehab hospital and 6 months later he is sober, running on a treadmill three times a week and enjoying life. Those are the ones that keep you coming back. Every time he sees me he comes up and shakes my hand.

Remember those.

[dentist90]

To alll you physicians out there... respect, man!
Part of the reason I went into dentistry instead of medicine was to avoid dealing with the life and death stuff. I may lose the tooth, but I don't lose the whole patient. I have diagnosed and referred a few oral cancers and serious facial infections, but I got to refer these people into the medical system. Props to y'all.

[bivenator]

Thanks for the encouraging words. We got the blood work back and there was nothing that would indicate the cause of the sudden death.
When its time, its time.

[Danimal16]

Bivnator,

Sorry for your loss and that of your team. I COULD never do what you guys do everyday. One thing I can say, is I truly love my doctor and his staff. If anything bad happened to me I have full confidence that they would do their best and if it meant I died, it would not be for a lack of something I value, . . . caring. I am sure that quality has a tough side to it, as per your post. Don't doubt that your patients know that. Hang tough and keep doing what you do.

[Hugh R]

The best, and most honorable, professions in the World have to be Medical, Police and Fire. None of which I'm worthy, or capable of doing.

[Buckterrier]

Well said Hugh.