Muck’s Minute and a Half #10

 

Let me tell you a tale of incompetence, hubris, anger and a near total failure of the medical system.

My sweetie of 58 years has several physical problems including spinal degeneration (a failed lumbar fusion included) and atrial fibrillation.  She wears a continuous feed morphine pain pump (embedded in her abdomen) to at least partially  manage the severe lower/middle back pain from the spinal degeneration and a pace maker to offset the lowered heart rate brought on by her a-fib medication.  i.e. one takes medicine to solve a problem which in itself causes two more problems which requires the implant of various devices to offset the side effects of the medication!)  Medical science has a long way to go, believe me!  (and this is NOT to denigrate the marvelous advances in medicine we have seen and enjoyed during our all too short life spans!!)

To put it mildly, my sweetie and I have had a few not so fun days of ring-around-the-doctor(s) and nurse(s) with merry-go-round-music playing (a lot of “duh’s” to provide the rhythem) and clown performances in the hall, not to mention yours truly coming with in inch – FIVE TIMEs – of being put into handcuffs and tossed in the local hoosegow.

Sound like an interesting story?  You judge for yourself.

Four days ago, Annette slipped into a-fib and for 24 hours, using the medication available to us, we tried to bring it under control.  Using the maximum allowable of meds suddenly drove her B.P. up into the high 170’s, old Dad rang the alarm bell and as it was 6 AM in the morning, I tucked her into the car and ferried her the three miles to the hospital rather than call an ambulance and wait-wait-wait for it.

(Gold Star here!) She was received at the ambulance entry with very fast care of the appropriate kind by very competent nurses and a retired male fireman who was converting to be a nurse for a second career!  Really nice people.  Except one.

As you all know, one of the first things they do at an ER (after making sure you’re alive) is inset an IV needle through which various saline solutions and medications may be administered.  A little twit of a tech (not a nurse) came in and , taking the wrong, easy and simple way out, started to insert the IV in Annette’s right (dominant arm) elbow joint.  I asked, very politely for her to locate it elsewhere so when, as would inevitably happen, she bent the elbow, the IV entry point would not come under stress.  I was informed by the twit that she knew far more than I did on how and where to put it and would I butt out (no please).  The only way I could have kept her from taking the easy (and wrong) way out was to physically restrain her (this is the #1 incident where I could have found myself, at minimum) ejected from the hospital.  MORE on this later).

Immediate room availability, Annette wired for sound, monitor pinging in the background and paper work done we then waited and waited and waited. And waited and waited.  I went to the nurses station and asked what was going on and was informed that they were waiting (too) for the Boston Scientific Rep. (Boston Sci. manufactures Annette’s pace maker) to drive down from Ocala which small city is 40 miles North of us down a very traffic full highway) to “interrogate her pacemaker”.  No, our very large hospital had no equipment, capability or knowledge to interrogate the pacemaker to see if it; A. was working; or B. needed adjustment.  I’m glad we were not in the middle of the desert somewhere.

Three hours later (now almost noon), her medical readout showing continuous a-fib and hysterical efforts by her pace maker to keep her hearts’ ventricle chamber beats up with the atrial chamber of her heart as it fluttered and thrashed about (now going on 30 hours plus), the very nice gentleman from Boston Sci. showed up, coupled his machine (externally) to her pace maker; made one small tweak which changed absolutely nothing and then provided me with a 20 minute concentrated seminar on pace makers, how to read hospital CRT readouts to be able to tell what a-fib looked like and normal pacing looked like (she was doing both), when to panic and when to watch and wait.  Super instructional period and I had a lot of my studying on the subject both confirmed and expanded.

He left.  Time passed. More time passed. My sweetie began to hurt in both shoulder (she has had rotator cuff surgery and inactivity intensifies discomfort therein) and back.  I went to the nurses station (As an important BY-NOTE, when she checked in to the ER, I filed both a Living Will and Health Surrogate forms with them to go in her records (The THIRD time as they keep loosing the ones I had filed in the past)..

The ER Doctor (unfortunately a young lady- maybe low-30’s max) who was already absorbing a God Complex from her limited M.D. pedigree  and ER rotation was not cooperative.  I requested a mid- powered analgesic  such as hydrocodone to provide my sweetie with some relief from her discomfort. After a five minute lecture on how little I must know about pain meds (Ha!) she grumped and said she’d take care of it.  (My wife and I have been dealing with pain medication in varying strengths and formats for the past 35 years and know exactly what works, how and how much, have studied the subject extensively, holding great interest in our own health, the medications we put into our bodies and to insure our maximum quality of life – what’s left of it!).

Twenty minutes later, in waltzed the minimal-ER Doc accompanied by a nurse who was waving around a syringe containing 2 ml. of liquid morphine.  (Don’t forget, Annette is already on a continuous morphine feed pump!).

I politely request that they (even said “please”) do not administer that large a dose of morphine and instead please give her a milder form of pain med such as hydrocodone which would help her discomfort without putting her into la-la land.  I was given a “sniff” and an ugly look by the ER Doc, completely ignored thereafter and the morphine was administered. (NOTE: This is #2 on my “damn near” getting cuffed, ejected from the hospital and tossed in the local klink).

Predictably, within 10 minutes she was floating about two inches off the bed and couldn’t remember her own name.

Time passes.  More time passes.  Yet more time passes.

Ah Ha!  Mid-afternoon comes along and in comes a physician (I use the term conditionally) who was a member of our Cardiac Group and who had installed Annette’s pace maker two years before (never heard from since).

He proceeded (after completely ignoring my presence) to explain to her in highly technical terms a procedure that was going to be performed on her the following morning called a “cardiac electroversion” which, essentially, was a procedure where they put a paddle on each side of her chest and shock the bejesus out of her in hope that it will cause the heart to drop out of a-fib and back into normal rhythm.

Three minutes into this explanation, I got up and left the room, knowing full well that Annette was wearing a 1,000 yard stare, was nodding and smiling at inappropriate times, not asking any questions and two minutes after the “doctor” left, wouldn’t remember he had even been there.  (She asked me, not five minutes later, who was that guy who came in an talked to her because she didn’t remember any of it!)

At any rate, I waited by the Nurses Station until he came out of the room and politely asked him is I might have a minute or two of his time.  Please note: This variety of “doctor” is far down the path of “Godhood”, way too self-important for his own good, too busy to be bothered with anything requiring even a slight deviation from his appointed (or is it anointed?) path.

He whirled in his chair (having sat down by then), scowled at me and very gruffly said, “What?”..  I (very gently and calmly) started to explain to him that, in my opinion , my wife never understood his explanation of the procedure due to being excessively sedated 20 minutes earlier.

He actually yelled at me, “The attending physician determines the any medication given to the patient!” Bang..

I then started (key word “started”) to ask his permission to finish what I had started to say.  Never got past started because he had spun around in his chair (his back to me), picked up a telephone and started dialing.  Note: This was #3 in the series of anger control exercises to keep me out of jail – but the Senior Partner of the Cardiac practice will hear about this in SPADES!!).

Time Passes.  And Passes. Night Falls.  I determine to sleep (Ha!) in the “recliner” in the room and stay with Annette all night. (Why, you ask?  Need you ask???)  The recliner is designed to drive even the most caring and dedicated caregiver out of the room in less than an hour.

At 4AM one of the floor nurses came into the room and administered a medication to Annette via her IV (don’t forget the IV, now). Since he didn’t deem it necessary to let me know what it was, I got up from my recliner of pain, went out to the Nurses Station and asked.  The medication was Digoxin. That’s a really powerful medication that is capable of slowing the heart down unto death.  It is also to be used VERY carefully in those of advanced years (say 70 plus) as the results of using it on an aged heart can be both abrupt and fatal.

I have been unable to find out (yet) who ordered the medication but it wasn’t all bad because within 15 minutes, her heart dropped out of a-fib, resuming the normal pacing at about 60 beats per minute.  Annette went into a very deep exhausted sleep. (A-fib causes one chamber of the heart to beat at high rates (115- 160-+) [and can cause fatal blood clots] as if one were jogging along at a high rate of speed for 36 hours without a break and literally wears your heart down until you are -as I said above – exhausted.  It is the equivalent of taking a 76 year old woman and running her through the 24 hour endurance course for Special Forces as far as her heart is concerned.

Time passes.  And passes. A fresh Doctor from our cardio group popped in the door (this one is a “she”), sharp as a tack and with the exception of not being fond of listening to you, is much more to trusted as far as knowing her business.

She informs us that since the heart is no longer in a-fib, as soon as the quagmire of paper is complete and discharge stuff is finished, my wife can now go home.  No procedure was needed (regardless of the option of the first “doctor”) and a follow up appointment was made with her regular cardio-man.

Shortly there after. in gathering her belongings to leave, she  inadvertently flexed her right elbow (remember that damned “easy” IV?),  stressed the IV severely and squirted blood in a stream from her closet cabinet across the floor to the edge of her bed where I brought her a towel and she applied pressure to slow down the flow.  I summoned her nurse (stat) and she, with an extremely ugly pile of cotton and tape managed to stem the flow of blood (more pressure required).

The nurse grabbed a towel from the bathroom and wiped up the blood (sorta).

The housekeeping staffer was summoned and a very pleasant and totally incompetent middle aged lady showed up, took a second rag and smeared the blood around a second time.  Then she took a dirty mop (hadn’t been rinsed in living memory as far as I could see) and mopped the floor, smearing the blood and dirt around and left.

I took a small hand full of clean white paper towels, tossed them on the darkest smears and used my foot to wipe them around.  The towels were black when I finished.

I took the hand full of towels and carefully stuffed them into a plastic bag that we had brought along – “just in case” and took the mess out to the nurses station, explained the situation to two nurses and dropped the bag on their large, high priced high-tech, full of monitors desk.  One of them carefully picked it up with two fingers and deposited it in the trash.  No apology.  No “We’ll get it done right!” NO NOTHING. Not a word about HIV and Hep. C or any of the other lovely diseases that lurk in dark corners of hospitals when they aren’t disinfected properly.  It was never cleaned up prior to our departure.

That was #4 in my sequence of holding my temper.

#5 in that sequence came an hour later when the discharge papers came along, listing her medication list (incorrect for the third time since her admission as far as pain meds) and did not even list the Digoxin that the hospital itself had ordered from our local pharmacy for her to take upon release from the hospital to keep he heart out of A-FIB!

I got her home, finally, alive, with 3 errors made by doctors and 4 errors made by nurses and an uncounted number of rude encounters and being ignored all within a 48 hours period.  Two errors of the doctors could have been fatal. Errors made by the nurses were unforgivable and showed a total disregard (with one notable exception) of patient care or condition and NONE OF THEM paid the least bit of attention to the Health Surrogate form in her file – even when I drew their attention to it and demonstrated the fact that my wife was incapable of making informed decisions due to over-medication.

SUMMARY:  I would not admit  a dog to a human hospital without a 24 hour advocate (yourself, a trusted friend or someone hired for the job)  that stays there 24 hours a day to insure more damage is not done than treated or cured.

PS:  This local hospital – large, serving most of the County where I live and several surrounding Counties – has received awards of all sorts for wonderful performance, care above and beyond and gold stars galore.  I wonder how much they paid for them.

Author: MuckAbout

Retired Engineer and Scientist (electronic, optics, mechanical) lives in a pleasant retirement community in Central Florida. He is interested in almost everything and comments on most of it. A pragmatic libertarian at heart he welcomes comments on all that he writes.

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Stucky

“Talk to my preacher El Stucky, he’ll save your mortal soul from hell fire and damnation.”
——– Sensetti

Well … thanks. HOWEVER …. I have NEVER, not once, ever preached AT (or, to) anybody. Not here. I take some pride in that. I just present my views, and let the chips fall where they may.

“God loves the twisted fucker!” ———- Sensetti

Indeed. And He loves you too, and everyone else here ….. except, bb!

“God is love” —— 1 John 4:8

TE
TE

Thank you so much for your kind thoughts about my dad Muck.

Thankfully, for the past 5 years or so, I’ve only been on backup duty for most of the day to day, my sister lives close to him, but I always feel compelled to be at the hospital.

Over the years the hospital and my family haven’t been completely sympatico, and if not for my advocacy and innate bitchiness with smiles, they would have killed my sister, my mother and my father a few times.

All the same hospital, rural life, a grandma that retired from there and people that are more afraid of the unknown demons than the known one.

They have put my dad into diabetic coma three times, once after a hip replacement (that had to be replaced because it was installed wrong), once after hemorrhoid surgery and once after a scope.

They diagnosed my mom with a stroke and were doing NOTHING for her after 4 hours in the ER. I walked in the door, looked at her cracked lips and pinched her arm. The skin stuck together. They had lost complete control of the diuretics and even though they had “promised” us two more years, my mom went from needing a hip replacement to dead in less than two years. The diuretic problems (swelling and weeping legs, to dessicated and unresponsive, multiple times) finally shut down her kidneys and she went. Fourteen years ago this July.

On the Saturday of the big Michigan/Michigan State game, my sister called me and complained of vomiting, fever, pain in her side. I rushed her to the hospital. The doctor would not come in to the ER because it was during the game and he was “having an important party.” We sat in the exam room over 12 hours before they diagnosed ovarian cysts and decided to admit her for observation. Tucked her in and went home.

Four hours later, at 4:30 am, the doctor had finally arrived, found my sister had classic symptoms of a ruptured appendix and called me to tell me to rush to the hospital and possibly tell her goodbye before she was rushed into surgery. She was in the hospital for over three weeks and I was left to run interference for her, and care for her 15 month old son. The staff was awful proud of how they fixed their fuck up. My sister sued and got a little, not near enough for nearly killing her.

Then a couple years ago, my 20 y.o. niece started being treated for bronchitis that turned to pneumonia, problem was she had neither. What she had was a newly developed “side” effect of over the counter allergy medicines that have recently gone off prescription. She was – literally – passing out and drowning in her own phlegm and had been rushed to the ER twice by ambulance. Trust me, a 20 mile ambulance ride and ER stay is not cheap.

They were giving her ever increasing doses of potent, dangerous, powerful, antibiotics with NO effect. They also told her to double her allergy med dose to help with the congestion.

I BEGGED my sister to convince her to go off the allergy meds for a few days and see what happens to her breathing. The SAME thing happened to me in the late 90s. My doctor was getting ready to admit me to the hospital for a direct line antibiotic into my lungs. Doc INSISTED it was my smoking, or pneumonia.

It was neither. It was a stated side-effect of Zyrtec (Claritin and Alovert too).

I’ve found out about over five deaths that can be potentially linked back to these allergy meds (or the doctors incorrect treatment of it, people die from treatments every day, their families blame God or the illness, neither is true in most cases) including my aunt, the mother of a friend, and now I’m watching my elderly neighbor lady die too. Throw in a couple celebrities (the Brittany Murphy death pops immediately to mind) and it becomes frightening. Hell, reading AWD’s obit leads me to believe they got him too.

Medical science isn’t the be-all, end-all, we make it out to be. I’ve found that in order to survive both the disease and the treatments, you have to become a bigger expert than your expert doctor ever thought of being. Thank Al Gore* for the Internets!

Hugs to you my friend. For all my hatred of the Godlike idolization Americans give scientists and medical science, I will not hate the fact they kept you around long enough for me to “meet” you.

Kiss your wife for me too!

ps- please, if not already, both of you could use 400-800 mg of magnesium a day. Multi-vitamins are nearly worthless, please just go forth and buy some good individual supplements. swansonvitamins . com is a great, inexpensive source. Historical mag consumption was 1:1 with calcium. I take more mag than calcium because due to my studies I believe that strong bones are more contingent on magnesium than calcium, which is easily obtained through diet anyway. Over the years the dairy farmers won and magnesium was relegated to the dust bin of not able to be patented and make trillions off of.

For centuries magnesium was found in abundance in our food, with the advent of commercial farming our soils have all but been depleted and things like Round Up and other daily exposed to chemicals further the mag deficiency.

Every single cell in your body has to have magnesium to perform correctly. Even though doctors and health experts recommended mag for heart problems for decades, it is NEVER mentioned much anymore. With the exception of Howard in NYC, and my little brother’s cardiologist, I have never heard a doctor talk about this – magnesium deficiency – even though they know/were told that anything with phosphates (soda, commercial bread, Prevacid) will seriously, and potentially fatally deplete the body of magnesium.

So, pretty please? Try it? If you use the bathroom too much, cut back, but don’t stop. I, finally!?!, got my dad to take it. Maybe too late now, but whom knows, better late than never.

xo

Stucky

TE is quite right about magnesium!!

Some asshole here did a post about it a while back;

Stucky’s Wonderful Adventure with MAGNESIUM

Homer
Homer

Stuck—I have always known that minerals are more important than vitamins, altho both are important.
I take a tablespoon of more than 60 trace minerals every morning.

Magnesium isn’t stored in the body like calcium is and magnesium balances the calcium. Many people have had a heart attack for a lack of magnesium. It is so important for the nervous system.

I never heard of magnesium oil, but I’m going to try magnesium oil.

I read ;your link, thanks.

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