Celebrate Excellent Care: Beebe Emergency Department

This is a 2-Part Series: In these articles, Wes and Michelle Rumble of Lewes share their story about the excellent care they received over the past couple of years in the Emergency Department at Beebe Healthcare.

Wes and Michelle Rumble met 22 years ago in Lewes, while taking lifelong learning classes. Prior to settling in Lewes, each had been busy enjoying life - living and traveling both domestically and abroad. Wes is originally from California, while Michelle is a Beebe Baby (someone born at Beebe) and former Rehoboth Beach summer worker who decided to return to her roots.

Neither had experienced any monumental health issues. Their emergency room visits had been few, peppered over the years, and all relatively minor. That all changed April 18, 2015. That evening, after many hours of serious abdominal discomfort, Wes had his wife call 911. After he arrived at Beebe's Emergency Department via ambulance, the doctors initially diagnosed Wes with diverticulitis. However, the physician ordered a CT scan to confirm. The results revealed something different, and the doctor promptly switched his opinion to acute appendicitis, informing Wes that a surgeon had already been called.

Wes was taken to surgery immediately, and stayed in the hospital for several days before he was discharged. Wes describes both his ED stay and his inpatient care as top notch; his needs were constantly attended to by staff who were attentive, caring and compassionate.

While Wes was still recovering from appendicitis, Michelle began having episodes of atrial fibrillation that led to a series of ED visits. Then on Oct. 3, 2015, Michelle suffered a stroke. As Wes tells the story, "I was looking over Michelle's shoulder as we were discussing something on her computer screen. She said something I didn't understand."

Wes asked, 'What did you say?' And, again, he could not understand - she was speaking gibberish. "Almost immediately I suspected a stroke," Wes said. Michelle knew something was wrong and got up, talking, but not making any sense. Wes brought her back to a chair to sit down. He then checked her face and arms for stroke signs as he called 911.

"Upon hearing me say 'stroke,' the 911 operator immediately transferred me to a medical specialist who guided me through diagnostic tests for the few minutes until the EMTs arrived. All of a sudden, there were three more people in the room with me - one continuing diagnostic tests with Michelle, one observing while preparing to transport her, and the third one asking me questions. Before I knew it, Michelle was on a stretcher and out the door, looking back at me with fear in her eyes," Wes said.

Wes quickly followed the ambulance to the hospital, but he had to wait to see her after her tests were completed. Wes was worried because he wanted to be with her to help her communicate. He was brought into the ED area and saw Michelle being propelled along the corridor by the EMT crew and then into a room. He soon discovered that the EMTs had taken Michelle to two imaging locations within Beebe. There would have been a long wait at the primary one, and the EMTs were unwilling to leave her, so they had taken her to the secondary location. Their decision not to leave Michelle waiting for imaging was critical. They knew she needed a diagnosis immediately.

While the routine ED tasks were being done, Wes called their children and noticed that Michelle's fear had subsided a bit.

However, as she struggled to communicate, she became tense and angry, frustrated with her inability to speak. Attempts by the ED doctor, the nurse and others to calm her had little effect. "I remember seeing the doctor and nurse talking briefly off to the side," Wes says, "then the nurse disappeared. When she returned, she had her arms full of little stuffed animals with Beebe T-shirts on them. She gently handed them to Michelle. Michelle immediately relaxed and a smile appeared on her face."

By the next morning, after working with her son and other family members, Michelle was able to name the frog and a few others!

"It was a brilliant idea by the ED nurse, Amanda Ragland," Wes said. "I will forever be thankful to her for thinking to use the stuffed animals, not only to dissipate the anger and frustration, but to help Michelle begin her speech therapy."

Wes was extremely grateful for the treatment Michelle got at Beebe's ED. "I cannot say enough about the care my wife received. All matters of consequence were carefully considered. Nothing was done automatically, yet what needed doing was done efficiently."

After a consultation with a neurologist, Dr. Christopher Kim, a hospital medicine physician who was stationed in the Emergency Department that day, decided that Michelle did not need the “clot-buster.”

"I remember talking to people afterwards who were surprised that the clot-buster was not prescribed. But I am glad it was not necessary and not used out of habit or blind procedure," Wes said.

Michelle agreed, saying that it was Dr. Kim's presence that kept her positive throughout her stay. "He was wonderful. He knew that I was making progress, he was involved but wasn't in the forefront, and I could tell he was keeping a good eye on me," Michelle said.

Two days later Michelle was working with therapists in her room when she mentioned some small, fleeting vision problems. Within minutes, she was on a stretcher and on her way to diagnostics because in some cases, vision problems could indicate continued or renewed bleeding. Her tests were negative and soon afterward, she was able to leave the hospital and return home under the care of Beebe Home Care Services. From there she was discharged to begin her outpatient speech therapy. However, more ED visits followed as Michelle's atrial fibrillation continued to occur.

"It is unusual to be cared for by the same ED personnel on repeated visits," Wes says, "however, no matter who was on duty, they were indistinguishable in their obvious concern for the patient and for the patient's well-being."

Dr. Georges Dahr, cardiologist, was instrumental in Michelle's treatment; he had treated Michelle for a heart attack in 2010 and now again in 2015 for her stroke.

"He was so patient and spent an extraordinary amount of time with us and with our daughter who is a physical therapist and had at least a million questions," Wes said. "Dr. Dahr answered them all. He never made us feel like we were bothering him. He makes you feel very special. On several occasions, we had to call him in the evening and there was never a problem with that. He would respond quickly to our calls. He just makes you feel so cared for."

Eventually, Dr. Dahr recommended that Michelle consider an ablation for the atrial fibrillation. She decided to do that, and following a cryo-ablation in January of 2016, her AFib, and ED visits, stopped.

With numerous visits to the Emergency Department in 2015, and with the resolution of Michelle's AFib in early 2016, Michelle and Wes thought their serious ED visits were all behind them, however in December 2016, Wes found himself back in the ED three more times.

PART 2

After numerous visits to the Emergency Department in 2015, and with the resolution of Michelle’s atrial fibrillation in early 2016, Michelle and Wes Rumble thought their serious ED visits were all behind them. However, during the month of December 2016, Wes blitzed the ED with three more trips!

Trip one: “On the evening of December 15, 2016, I was taking my pills as I usually do,” Wes says, “but this time, I choked on them and could not breathe.” As his wife, Michelle, was calling 911, Wes was able to cough the pills loose and breathe a little before they again blocked his breathing. This sequence happened several times. “By now I had a severe burning sensation in my upper chest and a lot of congestion,” Wes describes. The EMTs arrived quickly and took Wes to the ED where the doctor prescribed a breathing treatment. “The physician listened carefully to my description of the experience and agreed with me that the sensations and congestion were likely due to one of the capsules dissolving and spreading herbs and fish oil into my lungs; the congestion and coughing felt much like bronchitis.” After a brief stay in the ED, Wes was sent home feeling somewhat more comfortable.

Trip two: Wes’ symptoms eased for a few days but then worsened; definitely a bad case of bronchitis he thought. “My primary care doctor prescribed medications; however, by Christmas Day I was feeling so bad and experiencing so much pain from coughing that I could not completely suppress, that I asked Michelle to take me back to the ED.”

In the ED, Wes was given a shot of morphine but had a reaction. He remembers opening his eyes to see a room full of people; Dr. Joydeep Haldar peering at him from only two feet away, and other Beebe staff working with the equipment attached to him. “I could hear one of them asking questions of Michelle, so for some unknown reason I said, ‘Whatever my wife says is probably correct;’ everyone around me laughed, which surprised me as I didn’t think it was that funny.”

What Wes didn’t know at the time was that he had passed out, his vital signs had dropped and he had been administered naloxone to reverse the effects of the morphine. “Later,” Wes said, “it occurred to me that the laughter I’d heard sounded more like a relief of tension rather than a response to humor, which made sense in the circumstances. But I was, and still am surprised at how rapidly that room had filled with people. After some observation time, I was released with prescriptions to fill and orders to rest.”

Trip three: The next evening, Wes’ coughing had begun to generate pain in the front of his rib cage to the point that he couldn’t stand on his feet at times and could not bend enough to sit. Again 911 was called – pain in the chest is not to be ignored. So back to the ED and into a cardiac room for testing and observation. The doctor on duty was again Dr. Haldar, who was extremely cautious with further medications. They tried different drugs but made him stay until they were sure he was not reacting negatively to the medication. Eventually, Dr. Haldar settled on a hydrocodone combination and sent Wes home after a period of observation.

“Over the course of the three ED visits,” Wes said, “what impressed me the most was the time and consideration given to me and my situation. I never felt that what was being done was just procedure. Of course it was, but it felt personal, from EMTs to nurses to imaging specialists to doctors, everyone made me feel so special.”

Michelle and Wes agree, saying, “All of our experiences with the ED and the staff were excellent. We are impressed about how the ED staff followed their procedures, but at the same time the care we received was very personalized.”

“The entire staff was extremely responsive, and understanding,” Wes adds. The Rumbles’ experiences in Beebe’s ED were all top notch. “The staff listens, they respond quickly and effectively, they do their job, and they make you feel like you’re part of their family. They truly care about you as a person and how you feel.”