But now I'm ahead of myself. Let's start at the very beginning - a very good place to start.
I had a bad night of sleep on Thursday. I'd been a little off-kilter that evening, but worst of all was my restless leg syndrome ("RLS"), which was abnormally difficult, much as I'd expect if I'd had several cocktails, even though I hadn't. As a result, I didn't sleep well.
[06:30] When I finally arose in preparation for my work day, I was tired and light-headed. The world wasn't spinning, but my equilibrium was amiss. Much as I'm usually a bit nauseated until breakfast, I assumed I needed to get food in my belly. Food didn't necessarily settle the unease, though. Again, I expected it was due to poor sleep and simply working through the morning would put me to right. I judged the lightheadedness as non-lethal and drove to work without incident.
At work, I was still lightheaded, and starting to wonder how much more would trigger a faint. I felt able to continue with my projects, but alerted my co-workers in the event I suddenly became worse. They helpfully suggested I phone the consulting nurse, which I did.
[08:32] The nurse had a lovely bedside (phone-side?) manner. She walked me through a progression of of questions about my symptoms and habits. She helped me define my lightheadedness, and discerned that, because the objects in the room weren't seemingly swimming, that I was merely light-headed, as opposed to experiencing vertigo. Among the things I mentioned as out-of-ordinary were the poor sleep, the act-up of my RLS, and that, due to my lapse in refilling, I hadn't taken my daily sertraline (an ongoing anti-anxiety medication) in four nights. She dismissed the latter two experiences as irrelevant to my lightheadedness and strongly suggested that I have someone drive me to be seen by a medical professional. She attempted to make an appointment with the clinic, but due to overbooking she recommended I visit the urgent care associated with my medical plan. I thanked the nurse and decided to proceed with a meeting already in progress.
While the meeting was nearby and I sat for the bulk of it, I found I was continuing to feel dizzy, and distracted from the conversations as I sought a comfortable and effect way to keep my head from moving (which, by the way, makes it very difficult to nod my head in agreement). Apparently my distraction was noticed and I was encouraged to go home (my husband was later told that I was looking "glassy-eyed").
[10:00] I packed up my belongings, phoned my husband for a ride, and went to the break room to await him. I was pleased to be able to lie down, though frustrated that it was not easy to read through my symptoms.
[10:45] My husband arrived and listened to my timeline of symptoms as we drove to urgent care, wondering if my difficulty with anxiety (and depression) was a culprit.
[11:19] Check-in at urgent care seemed to go smoothly - there were few people in the waiting area and my husband was told I was third in line for triage. I was actually triaged (a nurse took my vitals and asked me to list my symptoms) about 15 minutes after check-in. I was hopeful, as this seemed to happen with remarkable speed (everybody can remember an emergency room visit with long waits and ill feelings).
[12:21] An hour later I was called into an exam room. While one nurse directed me to the room, another offered me a gown. They left and, as best as I could guess, I was supposed to change to some degree and wait until someone came back. I complied and sat to read my book.
[12:45] Awhile later a nurse introduced himself, confirmed that I was feeling dizzy, asked if I'd already had my vitals read, and explained that he was going to hold off on putting me on a IV drip until after I'd been seen by a provider. Um, OK. By this time I had given up trying to sit in a chair and managed to adjust the levers on the exam table to allow me to lie on my side to wait.
[13:40] A physician assistant arrived an hour later to confirm my symptoms and walk me through some brief field tests. She determined that I was suffering from benign paroxysmal positional vertigo, caused by a small "crystal" deposit in my ear. She advised me that she would order meclizine and see if that helped.
[14:12] Half an hour later, the nurse returned and asked me how I was doing with the meclizine. Upon my informing him that I was still waiting for it to arrive, he expressed surprised and apologized by way of explaining that he thought another nurse was going to take care of it while he was at lunch.
Wait? What?! At this point, feeling forgotten and vulnerable (I was still lying down), I phoned a friend and asked her to wait with me. And, if possible, bring me some lunch. Thank goodness for available, generous, and patient friends!
[14:18] I was given two pills and a glass of water, shortly after which another nurse ushered in my friend.
[14:22] I was feeling better and, while not feeling 100%, responded as such when the nurse came with my discharge papers. He briefed me on my aftercare - that I should go to the clinic pharmacy to pick up meclizine, what signs I should watch for in case I needed further PCP, UCC, or ER care, and exercises I could do at home that might help decrease the vertigo. I was given my after-visit summary and allowed to disrobe to leave.
[15:11] I went to the pharmacy window and gave them my ID number. The attendant didn't find any prescriptions on file, so I pulled back out my paperwork to repeat what I had been told. What my nurse failed to tell me was that meclizine is OTC. (Thankfully they stock it in the clinic's pharmacy.)
While at the window, I asked if I could speak to a pharmacist on an unrelated matter - that I wanted to determine if I needed to moderate my dosage of sertraline, as I had lapsed in its refill. As she pulled up my record, she asked if I'd experienced any difficulties since my last dosage. I told her that I'd just finished a visit to UCC for lightheadedness (refer to 08:32, above).
"Yes, dizziness is normal for missing as many doses. You should resume your usual dosage as soon as possible and you'll likely feel better soon after."
[15:23] Arrive home, resume sertraline, lose vertigo, and feel back to normal the following day.