insomnomaniac

Hip Hip Hooray!

OK, Dad is out of the woods. He was moved on Monday to the "Transitional Care Unit" (rehab floor), and they are taking MUCH better care of him there.

Of course it probably didn't hurt that:

• My sister and I camped out (taking turns of course) in his room 24/7 monitoring everything everyone did to him or for him from Friday through Sunday


• We DEMANDED to speak with the head of all nursing for the entire hospital. We lit her up big time, and from that point on she has personally checked in on my Dad to make sure he's OK


• When Dad finally regained his ability to communicate with us, he demanded to see his surgeon for a little "chat"


• He told the surgeon that his PA was a dolt with a God complex who ought to ditch the chip on his shoulder and actually go to medical school if he wants to be respected like a real doctor would be. Prescribing blood transfusions (unnecessary ones at that) just because the state allows you to is a bad habit to get into


• He started stepping up and asking a LOT of questions. This was key because prior to his surgery, he took the "I don't want to know" approach. He'd never been in the hospital for more than a few hours before, never had surgery, and is very squeamish. He learned that information is power, especialy when you're in the hands of incompetent people

So we're all hoping this will be an "all's well that ends well" situation. But you know what's scary? When we thought he was deficient in the mental status department, he was merely incapable of communicating with us. He now says he remembers a lot of what was going on, he just couldn't communicate with us--couldn't get the words out, he was so out of it, so dehydrated, tired, confused--and he now says there were moments when he truly thought he'd die in that hospital. That breaks my heart. I can understand how he felt that way though.

Lessons learned?

• "Shop" your hospital, not just your surgeon. Find the "best" of both worlds, and make sure it's a "best" you can certify. Don't rely on the say-so of your physician, your best friend, or US News and World Report!


• When seeking the "best" surgeon and hospital, ask people who have had complications if you can find them. People who had nothing go wrong before, during or after a procedure (especially seniors) will likely report that everything was just FAB, but people who had a complication (like my Dad who's spinal block wore off, meaning he had to be put under in a hurry because he could actually FEEL them cutting him) are the ones you want. They will be able to tell you how the staff handled their situation, whether they solved the problems quickly and with a minimum of pain and confusion, or whether they flubbed, caused lasting damage or induced pain or anxiety in the patient or family members.


• Don't schedule surgery in such a way that you will be in the hospital over a weekend, if you can possibly avoid it that is. The "best" nurses and techs get hours during the week. Weekends, especially nights, are staffed by the most inexperienced or least skilled nurses. Often the staff on those days are freelancers looking to make some extra money, not seasoned pros familiar with the facility, its doctors, protocols or patient types.


• If you are conscious, ask each and every person who enters your room who they are, why there are there, who ordered what they are doing, if they have read your chart (often they do not), if they have double checked your wrist band--last names can be similar--and what their qualifications are. You may be surprised to hear some of their answers! Do NOT worry about offending them, and if you are worried, simply tack a "I don't mean to offend, but I've had a bad experience and I just have to ask (insert vitally important question here)?"


• If you are not conscious, or will not be for any period of time, or if you have to have surgery or an overnight stay in the hospital on a weekend, do your level best to have a close family member or friend there with you 24/7 to act as advocate for you, asking questions, representing your wishes, etc...Don't refuse medical treatment or care outright because of paranoia, just ask a few questions and make sure you're satisfied with the answers or the people giving them.


• If things start to go wrong, go straight to the top. This isn't your office, these aren't your bosses. No need to worry about how it will be perceived if you do an end-run around someone or go up the food chain too fast.


• Listen to your gut. Even if you aren't a medical expert, you are an expert at what's normal for YOU. If something doesn't feel right, or you're in pain or not feeling yourself, ASK WHY! Same goes for your loved one if you are the person camping out in the hospital to be an advocate for him or her.


• Do your homework. If you or someone you love is going in for a surgery or treatment, poke around the Internet a bit. Make sure you visit reputable sources like the CDC, American Heart Association or other professional association web sites for links and resources, don't just google a condition, you might freak yourself out unnecessarily or hit upon links to blogs and other sites that dish out plenty of anecdotal or misinformation. When you find good sites, read as much as you can about your surgery, and do it well enough in advance so you can ask your surgeon any questions sparked by your reading. Do not let fear of gory details keep you from learning something that could save your life later.


• Remember, doctors and nurses are people too. They put their pants on one leg at a time, they make mistakes. Don't be so awed by their confidence in the face of blood that you forget they work long hours, are often constrained by (or motivated by) time and money, not your good care or outcome, and despite what you might have heard or read, are pretty good at covering their butts if they fear a lawsuit coming on--they'll even LIE if they have to. This is not to impugn all of them, it's just a warning that some are bad apples, and only you can protect yourself from them. A lawsuit won't help you much if you're dead or maimed or otherwise impacted for life.


• If you're on medicare, expect to be treated like a number, because to most healthcare workers, unless you're a Senior Citizen whose famous or uber-wealthy (i.e., Dick Cheney), the treatment you get will be doled out according to the guidelines and restrictions of a massive and very cold bureaucracy. Even if you can pay cash for whatever extra you might want or need, expect your care-givers and doctors to look at you like you're speaking Greek and not saying "I'll write a check! Just do it!" Expect to repeat yourself s-l-o-w-l-y, again and again until they get it that you don't want paperwork or cost depriving you of vital care. If you can't pay for it, then consider buying supplemental insurance, seriously, whatever it costs it might be better than the alternative. Failing that, follow all the other advice here and you should be OK, just bear in mind you will be a number and find ways to mitigate the negative results of that if you can.


• If all else fails, or if you ignore these lessons and wing it, PRAY. I'm not being sarcastic, it can happen. You go a long time without illness or need for hospitalization, or you've never needed it, and you figure "Hey, it's no biggie, they do this every day, right?" Well yes, they do, but they sometimes let that make them cocky or complacent. If you forget they're human--you the vulnerable patient--imagine how easy it is for them to forget! If you forget that you are in charge of your destiny to a larger degree than you think, and if that thought comes back to bite you, then pray to the Lord who made you for help or guidance. He is listening. Ask your friends and relatives to pray too. We managed to think of some of the things on this list (those that were still possible) before it was too late, but I think the prayers we uttered put those things in mind in the first place.

And now I would like to thank all of you who prayed with us. I mean it, it really helped! He's doing so much better, and he'll go home this Saturday if things continue to go well. He's 'back' in the sense that he's with it again. How do I know? Well, instead of mumbling incoherently, he was yelling at me today about how INANE Dingy Harry Reid is trying to bring up the President's policy on stem cell research this week with all the other more important issues there are to consider! When my Dad starts one of his "welcome to the handbasket that is our world" speeches, you know he's ALL there in the head that's for sure.

So now perhaps I can start to get back to my life, clean my house, fill my fridge, pay attention to my kids, my husband and the world in general (and you know when that happens I'll be back to blogging for sure). But first I must get some sleep. Even we insomnomaniacs need some from time to time, especially after a week of dealing with idiots.

Posted by insomnomaniac at May 4, 2006 11:43 PM | TrackBack