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Bloody Monday In Vienna

November 14, 2007

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This post could save your life or that of someone you know! It may not be a pretty sight, but I am all well now, had as good an experience that one could have under such circumstances and we learned a lot through it all. I had to learn the hard way, but I hope this warning will help save someone else. 

Even as healthy people, we knew that part of the experience of long term travel would very likely involve some medical or dental services in a foreign land, which is a little bit of a scary prospect. One hears some horror stories and the mind can imagine all kinds of bad scenarios with an illness or injury in a “bad” place. It gets even scarier when you have a child and imagine the worst possibilities.

So far, we have been very lucky and have been grateful for the wonderful care and treatment that we have gotten in several countries in Europe for medical and dental issues. We have been very impressed with the high quality of care, the greater intimacy that is involved where doctors and dentists are more like friends, the fact that family can be with you in a much less formal atmosphere and the incredible low costs (much of it  has been free).

Now back to the specific information that can save your life. First, know that if you are over fifty and happen to get a bloody nose, TAKE IT VERY SERIOUSLY. We mostly think of children who frequently get bloody noses from injuries and those types of bloody noses are almost always not very serious. On the other hand, a bloody nose after fifty is almost always serious and should be taken  VERY SERIOUSLY. I was surprised to learn that DEATH is a possibility with a bloody nose after fifty, so getting good care is essential.

A child's nose bleed is usually a vein, so even though it can look like a lot of blood, it is easily stopped. Conversely an over fifty, older adult's nosebleed is usually from an artery (that fast spurting blood coming from the heart) and usually much harder to stop completely. We also learned that the best way to stop or slow down a nose bleed is not by putting the head back as we were taught long ago. The best way in both cases is to lean forward and put something cold on the back of the neck to slow the blood coming to the nose area.

That was our first mistake, not recognizing that this was a serious problem. I had never had a bloody nose before, but like most people we had seen other kids have them all through our childhoods and lives (DaVinci had a few as a kid through bumping it when playing around). We “knew” from that experience that bloody noses were not a serious thing. Sadly, the people who were helping me, also did not know about the difference between adult and children's nose bleeds. I had already lost a lot of blood and was feeling very dizzy when she reassured me that her children always got them and that they always stop. Meanwhile, mine bled and bled all day long.

Somehow we got lucky in Prague as it stopped on its own that night, my first nose bleed of my life. Had we known that nose bleeds in the fifty and over crowd was such a serious thing, we would have paid much more attention. I did think it was odd, but I was not sure what to do, after the fact and I felt fine.

The other key to nose bleeds, in those over fifty, is that medication almost always  plays a part and exacerbates the problem. I almost never take any medication what so ever and if I do, I take it very cautiously. I would have guessed that I was exempt from this connection. I was stunned when the first doctor called me a “bleeder” and wondered if I was on Cumadin (a blood thinner that makes people bleed very easily, so is closely monitored).

Mistake number two, I had cautiously taken a small amount of Advil which is an ibrupropin (like Motril etc) to help me walk a little more in Prague because we were doing lots of walking which irritates my arthritic knee, from a former injury. Had I known that it could cause bleeding this seriously, I don't think I ever would have taken it. Long ago, I had an acting teacher who almost bled to death from an ulcer he got from taking  this type of medicine. He warned us as he had not been cautious and did not follow the guidelines of taking it on a full stomach.

I heeded that warning and was very careful that I always took it on a full stomach (usually after lunch if I need it). I also rarely take it, although I have taken it more on this trip than I ever have in my life. I am the type that never wants to take even an aspirin and have taken none in years, but because we do lots of walking which hurts my knee so (sometimes every step is very painful), I have used it to help me walk a little more.

I am still not talking about very much though, so I was astonished when both doctors I saw, told me that it was causing part of my problem. I had not taken any ibrupropen for over a month before Prague. Even in Prague, I had only taken FOUR tablets in a weeks time and never every day. I had no wine or anything alcoholic to drink in over a month and rarely drink (alcohol can add to the problems with ibrupropen).

It had been  two days without any when my bad nose bleed began in Vienna . Nevertheless, the nosebleed in Prague happened on the first day that I took advil and had I known there was a connection, I certainly would not have taken any more. It did flash through my mind that morning, since it was the only thing that I could think of that I had done differently, but I ignored that intuited deduction.

This actual incident in Vienna happened on a beautiful sunny Monday morning.  I had a slight cold but seemed to be almost over it, and was looking forward to a great first day in Vienna, after just arriving the night before from Prague. I woke up earlier than DaVinci and Mozart, which is often typical and was starting to get breakfast when I happened to barely touch my nose in passing.

Remember, I had my first nose bleed about a week before this which I slept through, so it was a very odd sensation to suddenly have a gush of warm blood  pour down my throat and out my nose. Still, it only took me a flash to realize what was happening. I was not fearful, just surprised and worried about the mess. Soon DaVinci was up and helping me as nothing goes unhidden in a living space that is so small.

We tried the head back method that DaVinci had used in childhood and we had always seen, but it continued to gush and the bad news with this method is it forces you to swallow some which makes one feel ill. We could not get it to stop gushing and I had seen a first aid station sign near the reception building, so we went there hoping they might know how to get it to stop. I was beginning to feel quite dizzy and light headed, but she pooh-poohed it and told about how her children always had them and they always stop. She put a cold cloth on the back of my neck and said to lean forward and let the blood pour into a waste basket that she gave me.

Finally, it did seem to slow down, after several cold cloths were repeatedly put on. Meanwhile, she went about her business helping campers check in or giving directions to places in Vienna and such, as she was the only person in reception. When it slowed down to a trickle we decided to go back to the RV where I could rest more comfortably and privately, as we assumed it would stop soon.

It never did stop, but it was not draining very fast either, so not a problem as I quietly worked on the blog as I waited. I felt fine and thought we were out of the woods, so DaVinci and Mozart decided to do an errand and check out the park while I waited for it to stop. Everything was fine for about an hour, until I had to get up to urinate.

Then the nose started to gush blood like there was no tomorrow, the act of standing had opened the floodgates. My main concern again was the mess as I already ruined one shirt with the blood stain from Prague which never came out. We have few things, my size is most likely hard to find here and a stain on the furniture would be a disaster. Yet it was cascading all over the place at a faster pace than I could keep up with and felt like I was drowning in my own warm blood.

I left my mac open (which I had been writing on) and decided I better get back to the reception for some help with all this blood as it was too much for me to handle on my own. She looked a little surprised to see me back again and the intensity of the blood now. There was another couple who just happened to be there checking in or out and she also helped. The blood just kept surging and surging and everyone looked a little stunned and confused and I kept feeling weaker and nauseous, but hoping DaVinci and Mozart would get back soon.

They put some more cold cloths on and tried to get back to business. It is a little surreal to be bleeding like this over a bucket with people lined up handling reception business and normal conversations. This time the cold cloths did not seem to have any effect what so ever for all the blood flooding out of my nose. I began to think I might pass out, so asked if she had any ice as maybe that would do it. She eventually got a chance to try the ice, but that did not help either. Finally she realized that she better call the ambulance. I was really nervous then that I might have to go to some unknown hospital without ever connecting with DaVinci and Mozart. Yet I knew I had to get this blood to stop as I was starting to feel really, really bad.

Later DaVinci and Mozart arrived at our RV home with groceries and found blood all over the camper when they opened the door, like some horrible murder mystery. I guess actually, most of it was in the sink as I tried to lean in that direction, with drips on the floor and a trail of blood all the way to the reception.  They were surprised to see that I was no where in sight and the laptop was still on, something I would normally never do. They quickly unpacked the food that needed to be refrigerated and ran to reception to see if I was there.

Luckily they made it just after the ambulance did. I was so relieved to see them.  Actually, I did not see anyone much during this time, as my head was bent over and my focus was just on stopping the blood and not passing out, but there was a swirl of activity around me. I felt better just knowing they were there and was very happy to know that they could come along with me in the ambulance. They watched as the ambulance people got me into a wheelchair thing.

The people who run the ambulances are very nice. I ended up taking two different ambulances and both times there were young people who spoke good English which is such a relief. When you are feeling this bad, you really don’t want to deal with the language barrier on top of everything else. Luckily,
English is the second language choice of most countries in Europe.

They have an interesting system in Austria where all youths have to serve after University, and they can do it in the military or through doing the service of what we would call paramedical and ambulance drivers. Some of the ambulance attendants were older, permanent job holders and the younger University grads had shorter term training and tenure. I was quite surprised (and a little worried) when there was no ramp and the skinny young pretty blond girl who looked like a high school student and her male partner had to lift me up in a wheel chair to get in the ambulance. I had visions of a busted noggin to match my red streaming nose, but they managed to get me safely in with no problems and off we went to the hospital after Mozart and DaVinci were also strapped into seats in the back.

At the small  hospital nearby they cleaned me up and gave me a fresh ice pack which was finally slowing things down some, along with a gauze bandage. I was stunned when the doctor thought I was a bleeder and wondered if I was on coumadin, a heart medicine that thins the blood which can be very dangerous for something like this. I said the only thing I had taken was advil and that had been a couple of days and only four pills during a weeks time, taken very carefully. He said he thought that was part of the problem in making me bleed so much, but he could not do anything as he was not a nose specialist and did not have the equipment to help me.

So we waited another half an hour or hour for another ambulance to arrive to take us to another hospital as my nose continued to drip blood, albeit at a slower pace with the ice on my neck. Soon a young blond girl in the Austrian red ambulance outfit, leaned over and talked to me in English with a completely American accent. She had gone to the University here, but was raised in Texas and South America with an Austrian father and mother from South America. She was fluent in German, Spanish and English and she said she honed a lot of her English by watching the Disney channel in South America.

This was a very special crew and it was a longer ride into the city to Vienna's top hospital which is the biggest in Austria, so we got to know them a little bit since we ended up spending a big part of our day with them. I am so sorry, but I have forgotten their names. One sweet young man just crouched down in the back with us as Mozart and DaVinci were sitting in the seats that were for him. He spoke English as well since his mother was English and his father is Austrian. He enjoyed Mozart talking about her travels as he was looking forward to going off to Dubai soon when his service ended.

Much to our surprise they gave us a present of a few jars of honey that was from their region of Austria near the campsite. The hospital was huge and I felt a little bit bad being wheeled ahead of all the people waiting in line. One lady did not like it and was arguing something in German to the nurse while I was getting my blood pressure and such checked. She was pointing to her loved one nearby, so one did not have to speak the language to get the gist of what was going on. I guess I was considered high priority since they needed to get the bleeding to stop.

The hospital appeared exactly the same as a good, large hospital in the United States and as a former nurse, that fact  gave me feelings that were a mixture of comfort and anxiousness. Frankly, I do not care for hospitals period, (especially when I am the patient) and the chaos, fear and negativity that seems to embody them. But, when they are the only game in town for a given problem, I hope to be in a good one.

After a little wait, we were whisked in to see the nose specialist doctor. He agreed with the other doctor that the advil was adding to the problem and he could see that it was still spurting blood in a pulsating action from a large nose artery. He was young, soft-spoken, and seemed to know his stuff. I was happy that he also spoke English well.

It is a pretty painful procedure and consists of basically putting some instruments way up your nose and burning the artery, five or six times, to close it. I did not find it as painful as Mozart's 48 hour birth, which is my personal measurement on severe pain thresholds, but it could probably be used as a torture procedure as no anesthesia is used. I was sorry that Mozart had to watch it as it seemed to disturb her, but after the fact she was fine. Nobody wants to see their mom whimpering in pain, but once I was feeling better we all had a good laugh about it. I suppose it is good to know that sometimes life hurts, but then it hopefully passes. DaVinci decided a few shots of the procedure might interest somebody on the blog. 

I was relieved that it finally stopped bleeding and hoped this odd nightmare was over with. The doctor packed my nose (which is another uncomfortable feeling) and we got a few medicines that he prescribed at the hospital pharmacy. Our ambulance friends helped us with that and they had bought Mozart a little birthday treat because she had told them that she recently had a birthday in Salzburg in our conversation coming to the hospital. Such sweet people!

They took us home and we picked up another patient on the way (a young girl from India, but her family had to meet her there as we were already full with my two passengers). They dropped us off right in front of our campsite and even though I felt weak, I wanted to get a picture of them. They were going off shift so the girl had been dropped off first, but at least I got one picture of the two guys who helped us. I had given one, our URL for the blog, so if they are reading this, I send them a warm hug from Spain and big thanks!

It was not what we expected on our first day in Vienna, but then you never know what life will hand you on the road or else where. If this same thing happened at home, it would have cost a young fortune. The hospital would not take any money and the ambulance (for both rides and bringing us home) was about ninety dollars. There could have been much worse places that this could have happened, so if it had to happen, I am glad that it was Vienna.

Needless to say, I haven’t touch advil or any other medicine since then and do not plan to. It did take me longer to recover than I ever would have imagined and I still flinch slightly when I find myself touching my nose, hoping a new flood never returns. Mozart thought it was a pretty thrilling day and not too many kids get to experience three ambulance rides and two hospitals in a foreign land!


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Cristina

WOW that's scary. Grandma had a nosebleed sever years ago and it turned out to be b/c of high blood pressure. Fast forward cpl of years and not taking medication...she had a mild stroke. So yeah, adult nosebleeds are dangerous.
Sorry your first day in Vienna was like that :( I love love love that city . And yes, many ppl speak perfect English, even in the farmer's market!

Judy

Wow what a story, that must have been so scary for everyone. I am so happy that you are better now. I never would of thought that a nose bleed in adults would be so serious.

Dana

Wow! I'm glad you are OK!

I wrote a long reply, but it got deleted. Ugh! Anyway, I had a scary traveling health problem... I had blood clots in both lungs! I posted about it here: http://love2travel411.blogspot.com/2008/04/long-trip-home_27.html

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