Sunday, April 17, 2005

The REAL ER - Update

My mother was released thursday night, so she could see her neurologist Friday. Unfortunately he wasn't available, but over the phone his partner told her to ABSOLUTELY NOT TAKE the medications the idiot at the other hospital had prescribed her.

The pain was actually getting worse, and the nausea was at least as bad, so she asked what she should do. The partner said that she should check herself in to a different hospital, a little farther away, so they could run some tests; and that they would call ahead so they were waiting for her when she got in.

So my mom calls me up at 9:30 last night saying "ok they told me to go to the ER"; I told her, it's 9:30 on a firday night, every er in town is going to have a multihour wait, call the ambulance or at least make sure they called ahead and get the local medical transport company to take you, we don't want a repeat of last time. I also told her to call me when she was admitted with her room number because they wouldnt let me go with her or see her at this time of night if she went in by ambulance.

Well surprise surprise, she didnt call an ambulance. I waited up all night for her to call, and finally passed out around 6am (remember, I havent had more than 2 hours sleep since this started monday night).

I was woken up two hours later by my aunt Allison calling for an update; she had spoken to my mother and grandmother who had told her "oh it's nothing" (you can see where she gets it), and she wanted the real story. After talking with Alli for a while (I should mention, all but one of my aunts and uncles were from 13-19 when I was born, they're more like my older brothers and sisters), I called my mothers cell... no answer. Ok, not exactly surprising, so I called the house... nothing. I'm not exactly worried at this point, just a little put out, but by 11 after calling a couple times I finally fell back to sleep.

1 o'clock rolls around, and I get a call from my moms phone "oh I need to go to the emergency room now" -- "Jeez ma, what happened last night?" "oh well I was hoping it would get better overnight and I wouldnt have to go, and it's jsut getting worse and worse.

I told her to call an ambulance again, but she assured me "They're waiting for me, the Dr. called ahead".

Now remember, it's 30 miles between me and her, 30 minutes with no triffic, over an hour with, and for some reason there was a lot of traffic. By the time I get there she can barely stand up AGAIN.

"You're sure your Dr. claled ahead, and theyre jsut going to take you right in right" "Oh yes", "and you're sure this is the hosptial we're supposed to go to right, we're not supposed to go to St. joes (the nerulogical institute is there" "Nope, this is where they told me to go".

So we went to the hospital, and let me tell you what a HUGE difference it was.

There was still a 4 hour wait for general emergency room care, but the second I described the symptoms she was having, and her history, they took her back right away.

It turns out her Dr. HAD prepared admission for her the nhight before, but when she didnt sho up by change of shift, they through everything out, so they took her in the er, and had a Dr. examine her. From the moment we hit the door, til when she was in the bed was no more than 20 minutes, and they put the line in and monitors on her right away, drawing blood for whatever tests right away as well. The guy doing the stick was honest, and accurate, he said "it's going to be five minutes til this, and another 15 minutes til this", and he did the job professionally and well.

There was something about his manner that just said military to me, so I asked, and yeah he was infantry in Gulf 1, and became a nurse after he got out. We both said a fuck you Clinton together.

Anyway, he said it would be 15 minutes before the Dr. came in, and right on the money he was there. This time th Dr. clearly gave a damn, and actually knew what he was doing. This one WAS young, dedicated, and a trauma doc, not some washed up burnout.

The VERY first thing this guy did was ask her about her pain, and he went right away, and got her meds himself, back within 5 minutes.

Let me say this, the most important difference in this whole experience, is that the staff made an effort to make sure you knew what was going on, and to make it clear they werent ignoring you, and were responding as fast as they could. That makes a HUGE difference.

The NEXT thing he asked was to verify all her dr's names, because he was getting them on the phone right after he finished talking with us (and he did, but it took him a while to get the docs on the phone); meantime he said that unfortunately this facility wasn't equipped to deal with amjor neuro issues, so if they found something,, they would immediately transfer her to St Joes. He left then to get the other docs on the line. Every few minutes the nurse checked in on her, and when she reported her pain control and nausea control were ineffective, he chaged the nausea med, and gave her a much bigger dose of demerol, which brought her down to a 7-8.

She told this to the nurse, and he said plain straight "If you're pain is this bad, we're probably not going to be able to really control it here and now. We're giving you as much as we can without threatening your pressure and your respiration (her BP was 95/55 already), but we're gonna do what we can to at least take the edge off".

Again, nobody wants to hear that, but honesty is a hell of a lot better than lying about it, or just ignoring it.

Anyway the Dr. came back, and said "Ok, I've talked to your neurologists office, the covering doc says she wants us to do another CT, and a lumbar puncture (aka spinal tap), jsut to make sure, and if they're clean we're gonna send you home tonight, and you can see your neursurgeon on monday so he can look at the aneurysm; otherwise we'll transfer you to St. Joes right away. Unfortunately, we really can't figure out what wrong here, and we're not equipped to do anything more diagnostically. We can help your pain a little, but I dont think there's much else we can do".

Again, this is EXACTLY what SHOULD have happened on tuesday after my mother was in the other hospital overnight, rather than them keeping her two more days and doing NOTHING. Then she could have seen her neurologist and neurosurgeon on wednesday, and maybe have figured out what's wrong, instead shes spending the entire week in pain...

It only took 90 minutes from the time we walked in, til he told us this, and he worked the case properly, with a nurse coming in to check on my mother every 15 minutes, and them giving as much pain control as they could without depressing her system too far.

So, they did her CT, which took a while; or rather the CT itself didnt take long, but it didnt get done til after 8 pm because of the queue, and it was clean, so the set up for the spinal, which they did around 9:30, and we waited for the labs.

It was about two hours before they came back clean, and they wrote a DIFFERENT anti nausea scrip (compozine this time, but in pill form, because the fenergen wasnt effective), and sent us home. We walked out the door at a few miunutes past 12.

Now from beginning to end that was about 8 hours, and they got to the same point that it took the other hospital 4 DAYS to get to; providing better care, and more and better information the whole time. Although they weren't able to help , they were responsive, and made their best and msot timely effort, which is all you can really ask of someone. Even though you could see how stretched they were (when we left the charge nurse told me that the low priority people in the ER would be 6-8 hours), they still provided quality care.

Oh and one of the good thingsa about scottsdale, although the ER was definitely over full, very few of the people in it were illegal mexicans. The Scottsdale police are pretty much assholes about rousting people they dont think belong there. Is it racial profiling? You bet it is; but it also keeps the crime way down, and the hospitals have a far lesser problem with illegals and indigents.

Am I an asshole for thinking that? Hell yes, and I'm glad to be. If it means my life, and my mothers lives are better because of it, I don't give a shit. The illegals are jsut that, illegals, and while I don't think they should die in the street, THEY SHOULDN'T BE HERE IN THE FIRST FUCKING PLACE.

NOTE: For anyone in the area, the hell hospital is Paradise Valley Hospital, and the hospital we were at today (well, yesterday) was Scottsdale Shea Medical Center.

All that said, next time I'm just taking her to St. Joes. It's 25 miles from her house (a lot closer to my place than hers actually), but they have all her records there, her neurosurgeon, pain control person, and neurosurgeon are there etc.. I don't know why her doc didnt just send us there in the first place.