Epistaxis, nose bleeding is common in about 20% population,
more common in children. A condition that’s considered harmless, easy to treat
and simple can turn critical. There is a need for good clinician to understand
the problem and then to handle accordingly. Wrong diagnosis or treatment or
surgical procedures can be detrimental and patients condition can turn
critical. Given below is account of my recent experience. There might be some
dramatization due to selection of certain words. Those who do not like to read
about medical conditions should not read further. In this first part I am
giving the preoperative situation that was experienced. Next part will offer
some description of operative procedure, post operative complications, and
recovery. The write up on hospital stay and the services offered can be a good
material for management students to understand gap analysis. Those in service
industry can have some value addition. If you are comfortable then read
further, the first part of Epistaxis.
For the third time in my life on April 10th 2013,
I was admitted to the hospital for an emergency. The first admission was on Oct
18th 1955, when I had a fall from tree resulting in multiple
fractures. Second one was on April 9th 1984, when the scooter that I
was riding was knocked down by a speeding car resulting in injuries and
multiple fractures. These events were cyclic and took place in cycle of 29
years. I know the astrological reasons and planetary positions of those days,
but it’s not the scope of this article. It all started on April 3rd
2013. I shut down the desktop by 10 in the night and decided to retire. As I
was changing I noticed trickle of blood through my nostril. I dismissed it as
minor incidence and attributed the same to hot climatic conditions. In few
minutes the trickle turned into a gush and there was blood everywhere from bed
to bathroom. I packed my nose with cotton gauze, placed crushed ice over the
nose and waited for a while for bleeding to stop. My wife in the meantime checked
my blood pressure and it was absolutely normal. I called my cardiologist
brother and a surgeon friend but no one could figure out the cause. The common
cause at my age can be high blood pressure, but I always had normal blood
pressure and there were no issues, physical or emotional that would surge the
blood pressure. Bleeding stopped in short while. My throat was experiencing
irritation due to trickling down of clotted blood. I involuntarily coughed and
this time gush of blood started. When looked at myself in the mirror over the
wash basin, I couldn’t believe, I was looking like a vampire without protruding
canines. I repacked the nostrils and
decided to held the head straight above the level of heart to reduce the blood
supply towards the nose. It worked and the bleeding stopped. I spent a restless
night. Next noon I had an appointment with the ENT surgeon. I explained to him
what all had happened. He was shocked. He suggested not to remove the pack and
prescribed vitamin K injections, some coagulants and nasal drops. He thought it was posterior bleeding, I thought it was anterior. I volunteered
to remove the pack so that he could examine. He was unwilling, yet I removed
and asked him examine the septum and internal parts of the nose. Everything
looked normal except the raw areas which were bleeding last night. I also got
my bleeding time, clotting time and prothrombin time tests done. They all were
normal. No injury to nose, no high blood pressure, no headache or dizziness, no
infection, no alcohol consumption yet nose was bleeding.
A day went by with
sporadic bleeding. The medications were on. Next day I decided to have second opinion and
went to another ENT surgeon. She was more bold than earlier doctor. She
prescribed me an antibiotic and for some unknown reasons asked to stop the
medications prescribed by first ENT surgeon. I followed her advice. Due to the blood that had gone down the throat, I had dark tarry stools. This was on April 5th 2013. Next twenty four hours were ok, but from subsequent
day my nose started bleeding again. I was confined to indoors as the bleeding
would start anytime without any forewarning. I was feeling weak with loss of
blood. Each episode would result in minimum half a cup of blood loss. It was
frightening for family members. My wife being bold handled every episode with
care and utmost courage. The female ENT surgeon was repeatedly assuring that
the bleeding will stop and we need not worry. On 9th night I again
had a profuse bleeding, just like the one I had on 3rd. There was
blood everywhere, the pillows, the bed sheets, the floor. I packed the nose and
kept crushed ice over the face. It stopped in while, but I had a premonition. I
could not sleep, I was very restless. There was a constant feeling that
something serious is on the cards. Midnight passed by, I was tossing in the
bed. By 3.30 early morning I could sense the bleeding and before I could act
there was a gush as if tap has been opened. I woke up my wife, she was aghast
to see the way blood was pouring out of my nose. I struggled to pack my
nostrils, kept my head under the cold shower. It took about 10 to 15 minutes to
get the situation under control. I asked my daughter in law to call my
cardiologist brother, surgeon friend and the ENT surgeon. They were explained
the gravity of situation and we decided to get admitted in hospital. My surgeon
friend drove me to the hospital, my brother was already waiting there for me
and the ENT surgeon had given instructions to the casualty staff. It was about
4.30 in the morning of April 10th, the Amavasya day, I was admitted. The procedure was scheduled for 10 am
same day. Operation theater was booked; it was available as there were no
planned surgeries being Amavasya on
that day. From casualty I was moved to the room and the preoperative check up
were initiated.
Reading it was quite a nerve wrecking experience! I am quite amazed by the minute details of the entire proceedings that you were able to put here. Its so lively and while reading I could actually visualize the series of incidents just happening in front of eyes. Although, I rarely see things in the light of astrology but seeing the striking details of your past accidents and its resemblence with the present one, have actually made me to question my belief on these things.
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