The other night I had the most wonderful night’s sleep. I didn’t wake until almost 6 a.m. and when I did of course I headed straight for the bathroom. As I walked across the carpeted dressing area I noticed the floor felt squishy. Oh no, I thought, this old plumbing has finally started to leak and we’ve got a major problem. The floor in the closet was wet also. I turned on the light to take a look. The bathroom floor mat was gone, but other than that and the wet floor everything looked normal. The areas closest to the faucets were actually dry, just the middle of the floor was wet. I didn’t smell anything, and there were no stains on the carpet. I couldn’t figure out what was going on. I made a mental note to tell my husband about it later so he could investigate.
When we talked later that day, he said, “That was no leak, that was a major nosebleed.” He said he’d woken in the middle of the night feeling his nose running and figured it was allergies. He went to the bathroom, and turned on the light. That’s when he saw blood everywhere, leaving a massive trail from the bed to the toilet area. He told me that after he finally managed to get the bleeding stopped he used lots of cold water and towels to clean up the mess and they were soaking in the washer filled with cold water. I couldn’t decide what was more incredulous to me, the fact that he had his first nosebleed ever AND cleaned up the mess so well that I couldn’t tell what had happened, or the fact that I slept through the whole thing! The one night I get a really good night’s sleep and I wasn’t there to help my husband when he could have used it. Darn. We both agreed it was really strange that he had a nosebleed. He’d never had one before, and didn’t have any pain or any other symptoms and he was feeling fine. We chalked it up to a random occurrence.
That afternoon about 2 pm it happened again. This time he was sitting at his desk, checking voice messages and writing them down when he saw big drops of blood covering the legal pad. He called to me and as soon as I saw what was happening I ran to get a roll of paper towels. As a veteran of nosebleeds, I advised him to pinch his nose right above where the nostrils flared and lean slightly forward. Slowly, the bleeding subsided. I looked at the desk, his shirt, the floor and thought good grief, this looks like a homicide scene! What in the world was going on? We got him and the area cleaned up and a fresh shirt so that he could go to his meeting without looking like “You should see the other guy…” I called the doctor and requested a call back; this was not normal and something was going on. The nurse called back shortly and asked about history of nosebleeds, other symptoms, medicines he was on, and advised him to take his blood pressure. She said it was probably not anything serious, but due to the amount of bleeding combined with his history the doctor advised that if it happened again that night and we couldn’t stop the bleeding quickly we were to get to the ER. I felt somewhat better, at least now I had a plan from a doctor.
That evening at home I told Paul that I was not going to go to sleep until after he was well asleep and there was no blood. He waved everything off and said he was fine. We had planned to go to the hardware store for a bulk lumber purchase in preparation of a work weekend at the family ranch, so we decided to head to Lowes. He said he felt fine but I insisted on driving. I was still worried about the sudden onset of these incidents and how much blood he had lost.
We arrived at Lowes a little before 8 p.m. – which by the way is a great time to go to the hardware store. There was hardly anyone around and we had the contractor section practically to ourselves. We looked at bathroom hardware and vanities to get an idea of what we might like once the ranch bathrooms were remodeled, then headed over to the lumber section to get the 2 x 4 x 8’s for framing the new shower. Paul showed me how to make sure each board was straight and how to discern the ones that shouldn’t ‘make the cut’. He started pulling boards off the giant shelves and handing them to me to true up, where I’d either hand them back if they were a discard or place them on the lumber dolly if they measured up. We had our own little assembly line going and I had just selected board # 8 out of 32 when I noticed a large pool of blood on the concrete floor. I looked up as Paul was turning around to hand me another 2 x 4. Blood was flowing freely from his nose onto his white Tshirt, which was quickly being covered by large bright red circles. “Honey, sit down, you are bleeding again,” I exclaimed. I dug in my purse for tissue and came up with one slightly used Kleenex. “Here, hold this to your nose and clamp your nostrils where I showed you. I’m going to go get some towels.”
I left him sitting on a wooden pallet in the aisle, in his blood-soaked Tshirt holding a pitiful used tissue. I was worried he would pass out from so much loss of blood. Running up to the checkout counter I asked, “Do you have a roll of shop towels? My husband has a severe nosebleed and I need something.” The guy at the counter pulled out a roll of dusty, dingy towels that looked like they belonged in a bathroom dispenser. “Here, you can have these but they aren’t the cleanest,” he replied. “Neither is your floor back in the lumber section,” I smiled. I grabbed the roll and ran back down the aisle. Paul’s nose was still bleeding. A young couple wandering by eyed him curiously, then turned to stare at me. I guess we did make quite the spectacle – me in my loudly colored house-dress which I rarely wore outside the house, my hair loosely put up in a butterfly clip and my most comfortable flip-flops, and Paul in his formerly white Tshirt and red plaid shorts, wad of shop towels mashed against his face, standing next to a dinner plate-sized pool of blood on the floor.
A different store clerk came over and asked, “Sir, are you ok?” I showed him the roll of towels and said, “Just a nosebleed, sorry about the mess, I’ll try to get it cleaned up.” Seeing our partially filled lumber dolly, the clerk said, “Can I help you get what you need?” Paul told him what we were looking for and he headed off with the dolly to get help loading the lumber.
Paul looked up at me, disgusted with having to talk to people with a wad of towels shoved in front of his nose. “Let them load up the 2 x 4’s and take my wallet up to the counter. Pay for everything and keep the receipt, we’ll let them pick out the studs. I’ve got to get out to the truck and lean back, I feel kind of weak.”
At this point I started to panic in earnest, and told him we were headed straight to the ER. He didn’t say anything but he didn’t argue with me either. I hurried him as much as I dared, not wanting the movement to escalate the flow of blood. When we got to the counter a different clerk was there. He looked at Paul and back at me. “Can I help you?” Paul nodded. “We’re getting some lumber that needs loading into my truck outside. My wife is going to settle up with you while I go move the truck.” I told the guy what we were purchasing and he rang it up. Swiping the credit card through the machine, I looked outside while I waited for the signature screen to appear. I could see that Paul had managed to move the truck to the loading area and was now sitting in the passenger side. Couldn’t this guy move any faster? “Ready for you to sign, ma’am,” he said. I scribbled with the plastic pen and took the receipt. “Can I have a few more towels, please? My husband has a bad nosebleed and we can’t seem to get it stopped.” He tore off a few more towels and handed them to me. I grabbed them and ran out to the truck.
Two young guys were loading 2 x 4 x 8’s into the back of the truck. I walked around to the passenger side to check on Paul. He was slightly reclining, repositioning the shop towels under his nose. I saw several wads of bloody paper on the floorboard. This was getting ridiculous, and I was getting scared. Was my husband going to bleed to death here in the loading bay of Lowes? At that moment the young clerk who had helped us in the lumber aisle ran up to the truck and said, “Here, I brought you this ice pack. Just break it open and it’ll get cold. Can I get you anything else?” We thanked him and assured him the situation was contained. He looked doubtful but turned around to go back inside. I handed the ice pack to Paul who placed it on top of the wad of towels on his face. Obviously I would be driving from here on out, so I thanked the loading guys as they put the last piece of lumber in the truck bed and walked around to the driver’s door.
I adjusted the seat and mirrors and turned to look at Paul. “We are heading straight to the ER. That’s what the doctor said to do, if this happened again tonight and we couldn’t get the bleeding stopped quickly we were to go to the ER.” Here’s how the rest of the conversation went:
Paul: I don’t need to go to the stinkin’ ER.
Me: I don’t care, we are going to do want the doctor said.
Paul: Look, the bleeding is almost stopped. I just want to go home.
Me: It stopped for a while both times before too, only to start again in a few hours. You have lost a lot of blood, and this is starting to scare me. We’re driving to the ER. Do you have a preference which one we go to?
Paul: I just want to go home.
Me: Fine, we’ll go to that new ER close to our house. Please put your seat belt on, and keep pinching your nose so the bleeding doesn’t get going again. We’re out of towels.
I’m a native Texan so I can drive, park and navigate traffic with a pickup truck. But it’s a little more interesting when the bed is loaded with lumber. Not only was my rear view blocked but about 3 dozen 2 x 4s were overhanging the back end by several feet and I was nervous about tailgaters on the road. As I pulled cautiously out of the parking lot I heard some of the studs shift in the back. Suddenly I remembered we also had dozens of boxes of ceramic tile and several sheets of glass tiles in the truck bed, right under the lumber overhang. I didn’t want that expensive stuff to get broken to pieces on my watch. All I had to do was get my bleeding husband to the ER without losing a single stud or trashing the tile. No pressure.
As we merged onto the freeway I noticed Paul feeling around for some more towels. The nose was on the flow again, not too heavy yet but definitely not stopped. I didn’t know how much more blood he could stand to lose and he had stopped arguing with me about going to the ER. Tailgaters, studs and tile be damned – I pressed the accelerator.
About 12 minutes later I turned into the medical center parking lot and looked for signs to the ER. This was a smaller, new hospital in our neighborhood and we’d only been once to visit a friend. But at the time a staffer told us the ER was open and ready for business. I figured any ER should be able to handle a nosebleed situation…..
To my relief the parking lot wasn’t crowded. I wheeled the Z71 diagonally into a horizontal parking space – well, two spaces actually but I wasn’t going for accuracy. Besides, given our overhang we needed at least two spaces. I yanked the keys out of the ignition, jumped out and ran around to Paul’s door. I opened it and helped him out – for a guy who was “fine” he sure seemed in a weakened state to me. We walked up to the emergency entrance and through the automatic doors. A very efficient nurse greeted us and led us into an examination room. Paul laid down on the table in all his blood-stained-shirt-plaid-shorts glory while I did the paperwork. The admitting nurse left the room and we waited for the doctor. Paul was starting to feel better because he sat up, saying “This is ridiculous. I don’t need a doctor, just need to go home and lie down. It’ll probably cost us $2000 and all I needed was more towels for my nose.” We had an abbreviated version of our by now routine “I want to go home / We are going to the ER” conversation. Since we were already at the ER I won this round.
About that time the doctor walked in. At least that’s who he said he was. I didn’t believe it though, he couldn’t have been more than 13 ½ and he seemed nervous. He also didn’t know his way around the room very well. Great, we chose the ER where Doogie Howser was doing his residency. Too late now. He rummaged around in a cabinet for a pair of gloves, then turned back to Paul as Nurse Ratchett appeared in the doorway. Unlike Dr. Howser, she was extremely confident and very familiar with her surroundings. She surveyed the situation and just stood there. Doc asked Nurse if she knew where a scope light was, and she said, “There should be one in the cabinet.” Didn’t move, didn’t offer to get it for him much less help him find it, just stood there. He turned back to the cabinet and rummaged some more. Ratch finally ambled over to the cabinet, opened the far right door, pulled out the scope and handed it to him without a word. Her contempt for the young doctor was almost tangible. Great, I thought – my husband is going to bleed to death while these two act out their power play.
It became clear to me that what we had here was a very experienced RN of probably 30+ years teamed with an inexperienced doctor who had been practicing approximately 17 minutes. I could not believe she wasn’t even trying to help him. Doogie bent over Paul with the scope, intently peering into his nasal cavity. He asked some questions about the frequency and severity of the nosebleeds and took another look. When he straightened up he said that we really needed to get to an ENT as this sort of thing wasn’t his specialty. However, he went on to say that it appeared it was not the type of nosebleed that was life threatening. Life threatening??? A nosebleed can kill you?? Geez, what were we dealing with here?!
Doogie turned to Ratch and bravely said, “I need a nasal tampon please.” I almost burst out laughing - they were going to fix my husband’s nosebleed with a tampon!! Nurse sauntered over and leaned on the counter. “There should be one in the cabinet.” Apparently they had their own version of the “I want to go home / We are going to the ER” conversation. This time however Doc was prepared. “I already looked, and I didn’t see any.” Obviously put out, Nurse Ratchett turned and left the room, heading down the hall and out of sight. Score one for the doc. He looked up at us and smiled. “I’ll be right back and we’ll get this nose packed for you.”
This time when the room emptied of all medical personnel, Paul sat up and rolled his eyes at me. “This is ridiculous. These people don’t know what they are doing and they aren’t even fully stocked with supplies! Get me out of here.” Secretly I was inclined to agree with him, but we were already admitted and besides, I was committed to following through with what our doctor – a real physician – had instructed us to do. I was thinking of an intelligent comeback when the doc can back in, closely followed. He immediately noticed that Paul’s nose had started bleeding again just by sitting up, and he seemed to take a more serious interest. He even sounded more like a doctor. “Lay back down, we’ve got to get this bleeding stopped and appropriate packing put in place to get you stabilized.” He donned a fresh pair of plastic gloves. Nurse Ratchet came in carrying two plastic packets. “This is all we have – two sizes only, small and large.” She caught a glimpse of my freshly bleeding husband and for some reason it had the effect of softening her. Possibly she also noticed the panicked look on my face. I was beginning to thing he wouldn’t make it through the night without bleeding to death and I surely couldn’t leave him here.
Ratch began to talk reassuringly to us while Doogie determined which packing material he would use. She asked Paul about his blood pressure, exercise habits and whether he thought he was overweight. He glared at her. “What do you think?” he asked. She smiled sweetly. “I was just trying to be nice.” After that she was even nicer – I think she liked having a patient spar with her, especially a handsome one, even if he was being a crankypants.
Doc decided to try the small nasal tampon. He carefully inserted it into the nasal cavity as far as it would go. He instructed Paul to keep lying down and he’d be back in a few minutes to see if the bleeding was stopped. Of course, when someone is messing around in your nose it tends to tickle all those little sensors and it makes you want to sneeze. Which Paul did. Out comes the packing, out comes a new flow of blood, and basically I felt like we were back at square one.
Nurse came running in, the Doctor on her heels. “You should have used the large nasal tampon,” she said accusingly to Doogie. He just ignored her – finally, he was getting a backbone. This time he approached the cabinet confidently, extracted the tool he had used previously - which he had found with no help from Ratchett - and opened the packaging for the large tampon. Same song, second verse, except this time he also instructed the patient not to sneeze. Amazingly, he did not.
After another 15 minutes or so of waiting, Doc pronounced that he would release us. He told Paul to keep the packing in all night and until he saw the ENT if possible. We thanked him, and he toddled off down the hall having performed his emergency doctor duties for the night. Ratch came to the door and asked me if I’d like her to wait with Paul while I went to pull the car around. Not only did I not want my husband alone with Nurse I’ve-Got-A-Crush-On-You, but no way was I going to drive our Jed Clampett truck with all the lumber sticking out of the back, piles of tiles askew in the bed and plumbing parts everywhere right up to the emergency entrance of a new, fancy looking hospital. “No thanks, we’ll walk,” I said as I grabbed Paul’s hand and practically yanked him out of her grasp. Geez, these older women love to throw themselves at my husband even when he’s literally a bloody mess.
Doc had suggested I get some neosenephrine to spray in the nostrils to keep the blood vessels constricted and hinder bleeding. By now it was 11 pm and I wasn’t sure we had a pharmacy open in our neighborhood. On the way home I spotted a CVS and turn into the parking lot. The cashier was outside, cleaning the glass of the front door, obviously preparing to close for the night. I jumped out and ran up to her. “We just came from the ER, the doc said I need to get one over the counter item, do I have time?” “We close in 5 minutes,” she said. I raced back to the cold and allergy section and scanned the rows of boxes for neosenephrine. They had one box - I snagged it.
I passed down the wine aisle as I walked up front to check out. It occurred to me that it had been a long evening, I probably wasn’t going to go to bed anytime soon because I would need to watch my husband for a while, and I ought to buy something for myself too. I grabbed a bottle of pinot noir and plopped my two items on the counter. The cashier, anxious for me to exit so she could close up the store, eyed my purchases. You could almost hear her thinking, “Yeah, right, you just went to the ER and the doctor told you to stop by the drug store and get a bottle of wine!!” She wordlessly rang me up, I paid the bill and exited the building with as much dignity as I could muster.
Within minutes we were home. Finally. I helped Paul walk in and got him settled on the couch. I didn’t want him moving any more than absolutely necessary. “Neosenephrine for you, wine for me!” I cheerfully announced. He scowled as I sprayed in the medicine, careful not to disturb the packing. It had been a long 24 hours, my worry increasing with every nosebleed and the high-anxiety drive in our Jed Clampett truck to the ER staffed with some of Austin’s finest. Now, sitting on the couch watching my husband and sipping a glass of wine, I began to relax a tiny bit. I was scared to go to sleep. What if his tampon fell out and he bled to death during the night? Would I sleep right through it like I had the night before when he bled all over the bed and dressing area? He started to slump over and said he felt very weak. No kidding, with as much blood as he had lost. He laid down on the couch. It was then that I noticed the tampon beginning its slide, out of his nostril and down his face. “Honey, don’t let it fall out!” I said. He just looked at me, then said, “You deal with it, I’m too tired.”
With all the medicine inside his nose, there was no keeping that packing in there. And I sure as heck wasn’t going to sit up all night holding it in. There was wine to drink and sleep to be had. Nasal tampons be damned! I collected the packing with a paper towel - amazingly we still had a few – and tossed it in the garbage. So much for all the doc’s hard work.
Fortunately the night passed uneventfully. I awoke to begin making calls to try and get him into an ENT that morning. We got an appointment for 9:00 am – apparently they take heavy sudden nosebleeds and visits to the ER pretty seriously. I was permitted in the exam room with Paul where we waited to meet a new doctor. This one was no Doogie Howser; he was more of the good old boy variety who looked like a coach. I liked him right away. His common sense style and professional demeanor put us at ease. Paul started by telling him he wished his wife would find another place besides the nose to hit. Ha Ha, very funny. I countered with, “I’m happy to start punching you in the arm if you prefer.” Dr. W just laughed and said, “Tilt your head back, let me take a look.”
Almost immediately after looking with a lighted scope in the now tampon-free nostril, he spotted the problem. “You’ve got a large blood vessel that has dried up and started to crack. Because it’s so large, once it started leaking it let a lot of blood out.” “You’re telling me!” I replied. “We’ve both taken to wearing red all the time so the blood won’t show.” I glanced down, and as it happened we were both actually wearing red shirts. Doc said, “This happens as you get older. And like you most people are on baby aspirin these days so our nosebleed cases have been on the rise. But it’s much better to see the doctor for a nosebleed than for a heart attack.”
He called in the nurse to set up the equipment. She powered up what appeared to be a small soldering iron. Within seconds it was smoking, little wisps of smoke rising in the air as it heated. This was going to be interesting, I decided. The doc came back and told Paul to hold very still, that he was going to inject the site to deaden it for the procedure. Yowsa, nothing like having a long needle stuck up your nose – what a place to get a shot. Paul flinched a bit but followed instructions. Then, after waiting a few minutes to make sure the shot had taken effect, doc picked up the instrument and began his welding.
Fifteen minutes later, we were at the checkout desk. The doc had cauterized the defective vessel, advised him what to expect in the next two weeks, and released him to work. It was such a relief to know that we didn’t have to worry about any more sudden loss of blood or trips to the ER. Out of the nosebleed section at last.
