Tuesday, April 24, 2007

Slightly Bumpy Day

I slept for twelve hours last night -- which I'm sure I needed after the flight fiasco -- and woke up only because a cousin called to see how Mom was. I had a pleasant workout at my mother and sister's gym and then went to the hospital.

Mom had been transferred from the ICU to a regular medical/surgical bed, which was the good news. The bad news was that her hemoglobin was so low that she needed a blood transfusion. Furthermore, they had to use her "bad" arm, the one that's so prone to cellulitis that she has a standing order for antibiotics if the skin gets broken. Medical folks never use her bad arm for anything, and there's a special armband on it alerting medical folks not to do anything to it, but they couldn't get a vein in her good arm -- so the bad arm it was.

My sister and I hope they're also giving her antibiotics, but we haven't been able to get a clear answer about this. We're pretty nervous about it; she's been hospitalized twice for infections in that arm, and it's easy to pick up an infection after surgery even if you're otherwise healthy.

We left pretty soon after the tranfusion, and the latest labwork hadn't come back yet, so we didn't know if her hemoglobin was back where it was supposed to be. The nurse said Mom wouldn't need another transfusion, but also left the IV in the bad arm -- I guess so they'll have an available vein if they have to do anything else. (And how can she know that Mom won't need it if the numbers aren't back?)

Mom was very tired today and had a bad headache, but, especially once the transfusion kicked in, she did seem more herself than she did yesterday. We cajoled her into eating a reasonable portion of a cottage-cheese and fruit-salad plate by feeding her forkfuls, turning it into a game where each forkful was for a different family pet (we went through generations of cats, including some I'd never heard of before, like Mom's grandmother's favorite cat, Big Kitty).

It was odd to be in the hospital as a family member; I haven't done that for a while, and I'd forgotten what it felt like to be treated like someone who doesn't know anything. All of the nurses were nice, but quite often they wouldn't finish listening to our questions, or wouldn't listen carefully enough to understand what we were actually asking. They'd answer some simpler question they thought we were asking, and we'd try to ask the more complicated one again, and they'd repeat the answer to the simpler one -- only more slowly, with dumbed-down vocabulary. *Sigh*

At one point, a strange man in a suit walked into the room. I said to Mom, "Here's your doctor." He said, "I'm not her doctor," and proceeded to remove her chart from a drawer and walk out of the room with it -- before I could ask, "Well, who are you, then, and what are you doing with my mother's chart?" A few minutes later, I looked for him to ask those questions, but couldn't find him. About forty-five minutes later, he walked back into the room, plunked the chart on a countertop, and left, again too quickly for me to ask any questions.

The CNA who was in the room, and who was the most informative person we dealt with today, told me that he was indeed a doctor, but she didn't know why he needed the chart. She did tell us not to be shy about asking questions. Well, I'm not usually shy about asking questions, but it sure helps when people a) bother to introduce themselves and b) hang around long enough for other people to formulate sentences.

I was supposed to drive into central Philly to visit my father after seeing Mom today, but I stayed so long at the hospital that I decided just to go back to my sister's. I did okay driving my brother-in-law's car on local roads, but I didn't want to attempt it on a new, complicated highway system when I was fighting jet lag and when I'd also have to find my way back after dark.

I think my father was disappointed by this, although he understood; he's now pressuring me, though, to get there tomorrow. The problem is that tomorrow's my only day to see my nephew, and I can't do that and go to two other places (in opposite directions from my sister's house) to see my parents. So I told Dad that if Mom seemed to be having a good day tomorrow, I'd go to his house instead of the hospital, but that if she didn't seem to be having a good day, I'd be at the hospital. That made him cranky. He cares about her, even though they've been divorced for forty years, and has called her in the hospital, and I'm glad he wants to see me, and I want to see him too -- but I can't bilocate. If their positions were reversed, I'd be spending more time with him.

From Thursday on, I should be able to divide my time more easily; especially since we're still hoping that Mom will be home by then. Having her home will be good news on many fronts!


  1. Glad your Mom is doing well, Susan. I'm sorry that you are having difficulty in getting questions answered. You might try this: ask to speak with her nurse case manager - that person should know who all the team members are - consulting physicians, therapists, etc. She should also be able to answer complex questions OR to get the right person in to speak with you so that you do get your questions answered. The other person to ask for is the nurse manager. Either one of these people is obligated to making this right. The other point is that ALL personnel by law must have photo ID's on and they must identify themselves by title and function. If an anonymous person comes in again, I wouldn't hesitate to follow him or her out the door and confront them about their identity. If you're uncomfortable, ask the unit secretary to contact your Mom's nurse or hospital security. What you experienced is not acceptable and it's not safe.

    Hope all goes well on the parental fronts today!

  2. I second n=1's recommendation, and since I haven't said it before, I'm sending you good thoughts, and I'm glad things are working out.

    My sister-in-law had a kidney transplant two months ago, and in the three years of being on the waiting list, we learned how hard it is to get all the information you need. This, in spite of the fact that I'm a medical student and my partner's a molecular biologist and the staff all know this (and many of them know me). Between time contraints, communication constraints, and the "culture of medicine," it can be a mess, and I completely sympathize. It's exhausting to be an advocate!

    I would definitely make your opinions known to the nurse case manager or nurse manager, as well as the attending physician. Something like "We know you're really busy, but we have been trying to get a few questions answered for several days now, and if someone could take a few minutes to sit down and answer them, it would be really helpful."

    And good luck!

  3. My good thoughts go out to you, your family and your mom! I know how hard it is to go from a hospital worker to a patient (or family member) having done the patient thing myself recently....

    By the way, I have tagged you for a "thinking blogger's award" as a blogger that always makes me think. I know you are busy now, but feel free to read up and join in when you have the time...


  4. martyn taylor2:22 PM

    Good news about your Mum, and all best wishes for still more.

    I know all the excuses, but there's never an excuse for rudeness, even if you are a doctor and, therefore, GCMG.

  5. Thanks, everybody! See my next post for the follow-up to this.

    And John, thanks for the tag! N=1 also tagged me for this one -- gosh! -- way back when we were in Hawaii, and I haven't had a chance to think about it yet. But I'm certainly very flattered!


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