Framing the Dialogue

Stat Not

I had a recent experience dealing with the healthcare industry when my mother became ill. She went in with a condition that for those of us younger would take some antibiotics and be done, but when you’re elderly a simple illness can be fatal. It was interesting that when my wife heard her symptoms she made a diagnosis and the EMTs did the same. They ended up being correct as confirmed by the tests or so I thought.

It is frustrating trying to pin down a doctor regarding diagnosis. A doctor in the ER noted the diagnosis, and ordered treatment for the infection, but said that she could not confirm until the cultures were back in 24-48 hours. That’s a long time. I talked to the floor nurse and she was more affirmative about my mother’s condition. It is a sad state that a doctor can diagnose and treat, but is unable to confirm w/o tests. Why have all of the education if they only rely on test results?

So they bring my eighty-something year old mother to her first room. Did you note the “first” room? At this point my mom is wiped out and barely awake. My sister and I are in the room with her until she gets settled. She has a rather loud roommate who was on the telephone a lot. In addition to her volume, she was very emotional. I didn’t want to eavesdrop, but she made it hard not to hear and I am nebby-by-nature. At one point she mentioned that she was in “detox.” We were not happy campers and I mentioned it to one of the doctors and simply “hoped that she was safe” in that room. About 15 minutes later they were disconnection my mom’s IV and moving her to another room. She even got the window view in the new room.

The treatment worked wonders and my mom was back to her old self so we anticipated a release in the next day or so. She has had trouble with arthritis and her posture and walking are a problem. We suggested that she be evaluated since she was there and therapists thought she would do well with some rehabilitation. We started the dual task of convincing her and finding a good place nearby. Again with the idea that she’d be getting out the second day. The case workers had already printed a list for us of potential rehab sites.

I never could sync with her primary care doctor, but was able to get updates from a resident. The day I thought she would be discharged I had a startling conversation with him. It seemed that her blood levels were quite low and she needed a transfusion and the quote that is burned in my brain “with blood levels that low she could be fine one minute and crash the next.” She got the blood and the added odyssey of the testing to see why she was anemic.

If you have ever watched a hospital show, and I know that it is just television, you see doctors ordering tests and getting back results and speeding around healing patients. That is about as far from the truth as it can get. My experience was that they ordered a test, had the test the next day, and possibly got the results that night and then decided what to do…oh another test. This one we only waited about 48 hours for. We actually had one of the doctors tell us in response to our questions that he “could only answer general questions” about my mother’s condition. WTF?

Since it was a colonoscopy the test was preceded by a liquid diet, a bottle of laxative and a few laxative pills and “nothing by mouth” after midnight followed by a night sitting as close to the pot as possible. As of ten when I arrived the next day there was no test. Then they came and had her walk to the hallway to get on the gurney and was quickly NOT sped away to the test. Having laid in the cold hallway for an hour the doctor called and said that they had an “emergency” and couldn’t do her test that day. They got my mother back in bed and one of the nurses was nice enough to get her a cup of chicken broth since she had no food for over 24 hours. She had no sooner finished her broth when another nurse came in and told her that the test was back on…except that she had the broth and when she told the nurse he said he’d have to check, but didn’t think it was a problem.

It was a problem! They didn’t admit it, but all of a sudden they were not able to do the test for some reason. Not the broth mind you. I really couldn’t be upset that a caring nurse gave my hungry mother some nourishment. I was frustrated that the freakin lab seemed in such disarray. We couldn’t even get a firm time for her test the next day. These doctors are like a cable company. I’ll stick a camera up your butt between 7:30 and 2:30…just be ready when we arrive. Fortunately she only had to drink another bottle of the laxative and could skip the pills and enema for the second go around.

When I got to the hospital the next day it was after her fifth night there and she had her test and was resting uncomfortably. “Unofficial” indications were that the test was fine and that her blood work continued to improve, but no one would send her home. We wanted to get her on her way as the next day was the Pittsburgh Marathon with 25,000 runners and hundreds of detours. Not a good time to move between hospitals. The hospital was very gracious and kept her until well after the marathon was over so she didn’t get to the rehab center until later in the afternoon at which time they decided to inquire about how she would get to the new facility.

I had been out in my yard catching up on some landscaping. When I got back in I noticed several calls and one from the hospital. Not a call you want. There was a big kerfuffle about transportation. Calls being made, questions unanswered. Now that she could be discharged the machine went into action to get her out. When my mom didn’t know the answer they all of a sudden found a way to communicate better.

This is not meant as a hit piece on the healthcare system. I just found the delays mind-numbing. I also cannot speak to why tests cannot be run more efficiently. By my reckoning her stay should have been at least two days shorter. She would have been in rehab sooner and closer to coming home where she belongs.

By the way I am still waiting to her what her last blood count was.

Leave a comment

Use basic HTML (<a href="">, <strong>, <blockquote>)