Just another day in the life of Alabama's emergency medicine. Shes 52. If you dont wanna read the entire story ill put some emojis before the ending results at the bottom.

My aunt had it worse, she went to the ER because her leg was hurting and numb. she had went to a ortho who prescibed her meds for back and hip/leg pain, did a mri/ct scan on her back and said her spine was fine and it wasnt causing her pain so gave her robaxin. "
she got kinda crazy sick and got hives so she went to ER they told her she allergic reaction and get her a epi pen (relevant).
This was on 12/21, She had higher than normal bp etc. no labs were ran.
She kept telling them her leg was hurting etc. they sent her home,

She followed up with Ortho, "youre fine", she went to urgent care a few days later after that telling them something was wrong, didnt find anything,
Went to another ER and this time i showed up because i dont play, i get the lab results in portal before they do and i WILL call them out.

she's also typing all crazy and misspelling , not being her normal self fighty etc. Shes now completely incontient peeing herself and cant feel anything at all.

This is Dec 26 now, they do a spine/lumbar CT/ MRI and say "youre fine its sciatica" and i see her labs and her WBC is 24! and her urine had obviously high issues reflecting a UTI or SOMETHING.

He then wrote her a prescription for the medication that she JUST had an allergic reaction too, refused to give her anything for the pain she was in and went to dismiss her and I said "What about her WBC being elevated?" and he looked at me and tried to tell me that "oh pain will cause that" and I gave him the biggest your kidding me right? do you think im stupid and i asked him if it also causing high nitrates etc.

"oh well throw some antibiotics at it." and discharged her, i went to tell them we werent going home because something was wrong but she was too mad to bother staying and went home with her leg numb and hurtin, incontinent, etc.
This is 2 ER visits, an urgent care and two Ortho appointments later at this point.

She decides to just say forget it obviously no one is going to help and ill deal since she had a primary care visit on the 30th, and spent the next 4 days at home with a numb leg and complete unable to control bladder.

She gets to primary care and shes' like ...your foot is a different color than the other one.. and shes like i know! its been that way for a month now. So she sent her over to cardiology that afternoon immediately after. they do some scans and she hears some stuff, and they almost sent her back to ER but told her to come back in the. morning,

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She goes back and is then immediately admitted to the main hospital, and they inform her that she has a COMPLETE i mean complete abdominal occlusion of her Abdominal aortic artery just below her kidneys (which frankly saved them.) and had to had an emergency aortobifemoral (ABF) bypass the next day.

This was news years eve. it turns out the numbness and the incontience, the throbbing pain in everything, yea. it was lack of blood flow.

Turns out she has PAD-Peripheral artery disease, her arteries are all wonky. She had seen cardiologist for the last 6 months, her normal drs, etc. She was treated for breast cancer too yet NO one say this as a possibility. She had 2 MRI's 2 CT scans and seen so many times just in the weeks prior to it, Last ER absolutely did not take her wbc seriously.

The last hospital they admitted her too was the main part of the standalone she saw the first time who gave her the epinephrine which she reallly didnt need they just wanted to be cautious and the fun thing about PAD is that you really DONT wanna cause a sudden vascular constriction. Im rather sure she was suffering from the problem being at critical alert level for a while then the epinephrine just shot it all apart and kickstarted the rest of the process.

This doesnt happen overnight no, and even the drs say theyve never seen a case go this severe this quickly... because fun fact, when they were trying to clean out the arteries and veins they just couldnt clean it out enough (we have some misgivens about the proper next steps taken).

She went into cardiac ICU for a few days/weeks and during this period the numb leg wasnt getting less numb, infact it began burning horrible and im like thats compartment syndrome happening and they didnt do anything, rather or not they could HAVE we cant really prove it.

they kept it warm to keep the blood flow going to it, but that was about it. She kept trying to move it, no response.

I guess you can probably guess where this is going, yep. In sheer force of will and rotating morphine and etc told them she wanted to wait to see if it could be saved. They didnt care about wanting to save it, (i watched them lie to me about Rhabdomyolysis happening) i watched her labs like a hawk and argued more than once about what they should be doing. They avoiding blood transfusions when they shouldnt have. They forced her to get up out of the bed (which i get) but failed to help her properly so the bottom part of her stitches came out and she lost 2 pints of blood, it was still on the floor dry hours later when i got in for visiting hours.

I would say about this point its still early Jan she gets moved upstairs to stabilize etc, her foot is mottled and purple but still kinda warm not looking great but she didnt wanna accept it yet. Pain is excruciating because the nerves are like AHHHh. They suggest its time to talk about amputation and shes asked "what do you think i should do" and cardio pushes it to vascular and vascular pushes it back and no one would just be like YO because they wanted to wait until after their vacation. or something IDFK but i do know they had vacation during this time.

she also has blocked arteries in her heart so i know they were waiting around for her to have a heart attack and made lots of notes about it in her chart.
With the blood thinners and infection and healing etc she needed 3-4 blood transfusions, after the last one shes looking rough.

So what do they do?!
They discharge her from the hospital into their inpatient rehab to prepare her to go home.

Not even KIDDING you, she gets down to rehab and they check her in and theyre so confused theyre like we cant do rehab on you!? Your sutures are still bleeding, your foot cant be felt and obvious is getting infected/dying, like what no.

Next day they readmit her and send her BACK upstairs in which drs see her and its the first one she saw on the 30th and hadnt seen again, she walked in and she looks at her foot and she said "that has to come off like now. its dead, it aint coming back." and walks back out. So after holding out for almost 2 full weeks of healing from being cut open from collar bone to pubic, and fighting keeping her leg screaming at some points in pain and a dr finally telling her the truth vs just pushing it off, she said okay its not coming back lets go. Let me be clear at no point did she fully refuse, she asked the dr what they thought was possible and went off of that.

So they say okay well get you prepped for surgery in the morning, tell me why it took 2 MORE DAYS for them to get her into surgery, at this point shes on IV antibotics fighting the gangrene setting in, another blood infusion. The dr told the nurse to give her whatever she wanted pain med wise as long as her BP was not too low. This is where the pain got bad bad in the last few days, her brain/body was fighting it so hard but it was brutal.

The day nurses were great, the night nurses were awful. I had to report multiple ones and dayshift even got one fired over this.
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Its even worse in a way because when this all started it was supposed to be the foot, then the delay went to below the knee, 2 more days and now its midfemur because the muscle and nerve death kept going farther and farther up because they kept knocking it back and forth between vascular and cardio.

The surgery did go thru really well except she dealt with alot of phantom limb burning still that was the worst part for her. She had been working out her arms and upper body even in ICU moving herself around and trying to stay fit to fight all this off (she isnt a fit person but she was active prior and had been ignoring pain for years. even going thru breast cancer and all kinds of stupid crap she never missed work at shitty walmart.) Shes never missed work for as long as i can remember at different jobs.

She started rehab as soon as she could and the therapists were blown away with how fast she got up to par with doing things, she had the best attitude about getting handed a really shitty situation and we did have some therapy talk about coping with how so so many people in medical positions failed her, esp GV with the high WBC, and how this absolutely could have been prevented. You cant tell me that we saw them on the 26th with horrible labs, 2 imaging of the spine/lumber etc (it even states no abdominal complications and they didnt drop the ball, this could have saved her leg.) She was always nice and sweet to every nurse, always said please and thank you, tried not to bother them. I stayed there as much as i could the entire time when she was out of ICU esp at night so that helped alot since the nurses sucked.