My hospital stay

The BBQ Pit
1

I can’t compose a real cool rant the way some of you can. But I’m going to tell you about my troubles anyway.

On March 6, as I was walking from my apartment to my car, I managed to find a rare patch of ice. I slipped and I fell.

As I laid on the parking lot, a neighbor came over and tried to help me back to my feet. I somehow sensed that I shouldn’t try to stand and I let him help me drag myself to the grass instead. This revealed that I had a problem with my left ankle. Laying on my back, I bent my knee and placed my foot on the ground to test it. It was clearly broken. I decided to stay on the ground and call 911. My cell phone was suddenly worth all the money it cost. The ambulance and paramedics arrived in amazing speed. I was surprised at how carefully the paramedics removed my shoe. I would have happily kicked it off with other foot had they asked, but two of them worked for over a minute on it. Then they cut away my sock and my pants leg. The crowd that had gathered reacted in horror to the sight. My foot did not really even look like a foot.

They zipped me into the hospital. On the way the asked me if I wanted anything for pain. Oddly enough, my foot did not hurt very much so I declined. At the hospital, they sent me to x-ray. Here we noticed what appeared to be a bone fragment sticking though my foot. The x-rays showed that that tibia was broken into three pieces. The fibula was badly shattered. I would need surgery to reassemble this mess.

But a broken foot isn’t what I want to complain about. I am writing to complain about my medical care. Before I start, I do want to say that I encountered some caring and helpful people along the way. But I am here to write about the morons who made a horrible situation much worse than it needed to be.

First, I arrived at the hospital at about 9:30 am. The surgeon would not operate until 7:30 pm. I was very thirsty and I pleaded for something to drink. I can understand that a glass of water is out of the question, but a 4" by 4" bandage soaked in water has been given to me in the past under similiar conditions. Even this was denied to me. My doctors later confirmed that the soaked bandage would have been harmless. This is the most minor issue in my complaint, but it did bother me and it a bad start to my hospital stay.

My surgery was finished at about 11:30 pm. My HMO felt that an ankle fracture deserved only an overnight stay in the hospital. Thus they wanted me discharged less than 12 hours after the surgery was completed. My surgeon told me he wanted me to stay for 2 weeks so he started fighting with them on this issue. I had 14 screws, two plates, and 35 staples in my leg. It is simply amazing that the HMO wants to paint all ankle fractures with a single brush.

The day after the surgery I was getting morphine via IV. The gizmo gave me 2 mg each hour automatically. Also I had a button to push that would give me 2 mg with each push. They told me that if this wasn’t working, they would up it to 5 mg. Well, I tried it for a few hours, but the pain was increasing, so I asked for the higher dosage. This involved reprogramming the gizmo. They blew it and instead shut off the morphine. And the shift changed just as this happened. The new nurse confirmed that the morphine had been shut off and assured me that this was intentional. It took me 3 hours to get this reversed. By this time I was in agony. Now imagine if they had pulled this stunt on a mentally handicapped person who couldn’t fight the decision. Shutting off the morphine drip hours after surgery and then insisting that this is normal is an incredible error.

I’m not a doctor, but I believe that sleep is a useful thing to someone recovering from surgery. My nurses did not agree and every time, day or night, that I dozed off they would awaken me. The usual reason was to ask me a question. Typical questions: when was your surgery? how much water did you drink yesterday? who is your doctor? which foot was it? (Yes, only one foot was wrapped in bandages and elevated.) As near as I could tell, rather than writing anything down, they would simply ask me whenever they wanted to know anything. Sleep deprivation therapy…another amazing problem. Also I think that hospital staff should take some notes. Waking me in the middle of the night to inquire about when my surgery occurred is crazy.

I was awakened one morning by a nurse who wanted to know if I could stand. I would stand on my good foot to use the urinal, so I said yes. She then told me to go into the bathroom and wash myself off. This violated everything that physical therapist and surgeon had been telling me. But I was on drugs and I figured that things had changed so I attempted to comply. I disconnected my air hose…it wouldn’t reach. I saw no easy way to disconnect the IV, but it rolled. I did have a walker and had taken a few steps, but I had a physical therapist and a nurse when I had done it. By the time I reached the bathroom I saw that it had no bath, only a sink and a toilet. Worse, my walker would not fit into the room. I jumped into the tiny room, with my good foot and washed myself as best I could. But I couldn’t finish because I was getting too dizzy to stand. Somehow I made back to my bed. The nurse who started this did not remain in the room to offer any help. I dislodged me IV tube on the way back resulting in quite a bit of blood running down my hand. It took about an hour for another nurse to get this squared away. After this, I closed my eyes but was not asleep as I tried to quell my anger. I was shaken by a third nurse who wanted to know how I had gotten so much water on the bathroom floor. I am shocked that I was asked to bathe myself by a nurse who didn’t even stay around to see I could succeed. It would also help if the bathrooms in the orthopedic ward were handicapped accessible.

By this time I had so little faith in the care I was getting at the hospital that I sided with the HMO and demanded to be be released. My surgeon couldn’t fight us both so I got my wish. First, I was pumped up with extra pain killers for the trip home. Then I was loaded onto a stretcher and taken by ambulance to my apartment. They set my walker outside my apartment door, got me standing beside it, wished me luck, and said good-bye. I discovered that my landlord had entered the apartment and had locked the deadbolt. I only lock the deadbolt when I am home, so I rarely have to deal with it. It took me several minutes to figure out how to open that door. I just barely made it to my chair before I collapsed. I think that the ambulance service should have helped me inside. But somehow it was fitting end to my stay in the hospital.

That is my rant. I ask you to understand that I usually hang out in General Questions. So I apologize for sticking to the facts and not saying “fuck” a lot and stuff like that. I’m afraid that this is the best I could do.

2

That’s okay. It’s known as “catharsis”. We’ve got room for that in the Pit, and it doesn’t necessarily need a lot of expletives to be effective.

You could e-mail a mod and asked to have this moved to MPSIMS and get more support over there.

3

My sympathy. Your episode is symptomatic of the severe shortage of nurses and other qualified nursing assistants in US hospitals today. The best nurses can get less demanding, more family-friendly, higher paying jobs outside of hospitals, and all too often, they do.

Best defense: Keep a friend or family member on hand at the hospital whenever possible, demand they contact the doctor when you’re undermedicated for pain, and if they don’t, be willing to call the doc’s office or answering service yourself to get what needs doing done.

BTW, I hate change of shift. Very little good happens then, and a lot bad can. It’s almost like July 1 (when the new interns start) except it happens 3 times a day!

Qadgop, MD

4

I can sympathize with many parts of your story. I had a pin put in my ankle in the fall of 1999, after a car accident. The ambulance driver assured me that it wasn’t broken, despite the fact that I was screaming in pain, and it looked like a tennis ball was lodged in my ankle. I had the accident at 5:30 pm, and at 11:00 pm, when I finally had someone come in to put a cast on, they still had neglected to give me anything for pain. The cast guy yanked up my leg, I started screaming and sobbing, and he went nuts on the staff there. I could hear him yelling at the nurses in the hallway, for letting him go in there before I got something for pain. I was pregnant at the time, so they wanted to check with an obstetrics before they gave me anything, but I guess no one got around to it.

That was the only really bad part of the time there. If I had known that I was going to be there for a while, I would have gone to the best hospital, rather than the closest hospital.

Anyway, I’m surprised that

A) they didn’t have handicapped washrooms. Huh?

and

B) they left before you got into your house.

I hope you’re feeling better!

5

:eek::eek::eek:

6

Sorry about your hospital stay, Perderabo. That really, really must have sucked. How is your ankle now?

7

Sorry to hear about your problems- that is the pits!

Hospitals can be a real bitch, that’s for sure. The only real problem I had when I was in for a week following back surgery was when one Physical Therapist insisted I get on a
“tilt table”, which is used when a patient is on their back for several days straight- I guess it help orient the person. Anyway, it made me God-awful sick when she started to raise me up, and I told her to stop and put me back. She gave me the “tough love” attitude “Come on, now- you can do it. Doctors orders!”(continuing anyway) and I told her “You’d better have an excellent fucking doctor yourself if you don’t let me down from this thing in about 10 fucking seconds”. It worked, but I felt bad afterwards. It shouldn’t have come to that. I asked her to stop and she gave me that “we know best” crap. Pardon me, but I’m the patient. When I say “this makes me have to hurl, and I just had back surgery”, I mean it!

I was lucky enough to have a top notch nursing staff that took total care of me. Everytime I read a story like yours I think of them and feel like dropping them a card of thanks (which I’ve done several times over the years).

Zette

8

umm, I have bad news. this seems like a pretty typical story to me. I have heard nurses complaining of 16 or more patients a shift (that seems like a lot to me when you consider all the things that nurses do + paperwork) I often find a lack of follow-through from Doctors or PT’s instructions and the actuall care on the floor (if you have to provide+ document meds and change dressings on 16 people, who has a half hour to spare watching and instructing someone bathe?)
And pain control- our society has something against good pain control. people are always complaining about under-medication,or health care providers get all worried about addiction, when they should be worrying about acute stress and panic from pain.
The wages and benefits from nurse assistants do not compare favorably to home depot, or taco bell (in some areas). and lets face it, there are fewer bedpans and less heavy lifting in retail.
The average nurse is over 40. there are fewer and fewer young people going into these professions because the pay does not meet the pay offered in business for people with a similar level of education. Not to mention that the front line health care workers pay the price for understaffing not just with workloads, but they have to face (justifiably) outraged patients and family members. Most of these health care workers went into the field because they just wanted to help people, and instead find themselves trapped in the sucking pit of the health care system. Fuck that. I am now willing take job offers to HURT people for money. then at least the objectives will be clear and no one will try to make me say “we have to do it this way for the benefit of The Patient”

9

Every EMS provider including the one I worked for, you don’t leave until patient is situated at home. Many people have several bags of belongings and such that they are in no condition to carry in. On top of the fact that you are:

A) Hurt and probably a little weak
B) On Heavy painkillers that do wonders for your balance.

Usually there is some kind of a “acknowledgement of service” that you have to sign on the ambulance crews paperwork. Refuse to sign it until you are inside and safe.
If you get any flak about it ask for a field supervisor. They every field sup I have ever met is a fountain of understanding on rough situations, but ignoring patient needs and or safety in a non urgent situation is bad medicine no matter how you look at it. Most ambulance providers (at least in CA) are private companies and take customer service seriously

10

I’m sorry for your terrible experience, Perderabo.

Once you’re feeling up to it, I suggest you edit your post a little and send it as a letter to your HMO and to the administration of the hospital. Be sure to put in the praise for the ambulance workers who picked you up and the other helpful personnel, as well as the complaints, and use names when you know them, for both praise and complaints.

That anyone should meet with this kind of treatment in a hospital is a disgrace. But they can’t even try to fix it unless you complain to them, and paper lasts a lot longer than spoken words.

11

One of the screws was a “locking screw” that connected the tibia and fibula near the ankle. The surgeon removed that on Monday. Now I have another cool souvenir. (The first one is a wallet sized card with my x-ray to explain why I set off metal detectors.)

The bones are lined up nearly perfectly. I can hobble around with a large base quad cane. There are things called ligaments that connect bones to bones. Damage one and you have a sprain. All of mine were destroyed and they have to grow back. The foot feels like a really nasty sprain at this point. Steps are very hard for me, especially ones with no railings. I have started to practice with a small base quad cane. I cannot yet use a single point cane at all.

I believe that I’m on the way to a complete recovery, at worst walking with a limp. Pretty good considering that they were afraid I would need an amputation.

drachillix, I’m sure that the ambulance crew would have complied with a demand for assistance into my apartment. But I was on morphine, oxycontin, and percocets. I didn’t think to make such a demand. I did have a couple of bags of stuff, but the bags were just looped over the walker and were not an issue.

conurepete, pain control involves difficult choices. I had a three day supply of oxycontin and a perscription to percocets when I returned home. After a few days I decided to switch from percocets to a mixture of advil and tylenol. This resulted in a lot more pain, but it was bearable. The pain kept me honest about not using the bad leg. My balance improved a lot and I was using the walker much more adroitly. And yes addiction is an issue…getting off those percs was a tough row to hoe. Incredibly enough in just 10 days those drugs were indeed demonstrating some addictive effects. I think I made the right choice for me. But this was my choice and I had the percs as a safety blanket if I needed them. This was very different from cutting off my morphine hours after surgery…and that was with no advil/tylenol mixture. That was just cluelessness, not a tough decision made for medical reasons.

12

Is that because your metal is stainless steel? I have 2 18" titanium rods in my back, along with assorted pins and such, but have never (knock on wood) set off a detector. Since they’re pretty close the the skin (parts of the hardware), I’m always surprised by that.

Zette

13

The composition of my implants is currently an unresolved issue. My surgeon told me that they are stainless steel. However I cannot get a magnet to stick to my leg and I own an extremely powerful magnet. I also cannot get a magnet to stick to the screw that was removed last Monday. I suspect that I have titanium implants. I will persue this in future visits to my surgeon. It hasn’t been a high priority.

The card was offered to me by the x-ray tech who works for the surgeon. I rarely travel and I don’t expect to go through any metal detectors anytime soon. But the card looked cool and was only $30 so I jumped at it. I mainly use it to show my friends. The HMO would not pay for it 'cause it’s not medically necessary. I am thinking about getting a second one since my screw was taken out.

If I did go through a metal detect and it beeped at my implants, I actually hope that the card is not simply taken at face value. It would be very easy to forge such a card.

And lastly, I am shocked that you are not tripping the metal detectors. I certainly expect that I would. But I’m not going to cruise out to the airport to test it. Steel or titanium, I have enough metal to make a very effective knife. So do you. For that matter, large portions of my glock handgun are resin. I might come close to having enough metal for a gun. I hope those metal detectors are working.

14

This could be a job for Cecil!

15

Hey, Pederabo, did you happen to notice that each week after surgery you feel a hundred percent better, week after week?

Sort of makes you wonder exactly how shitty you felt to begin with, no?

I’ve already bored everyone here with the horrific details of my own recent hospital experience (double orchidoplexy, man; I now laugh at pain), but I also noticed some interesting irregularities and some similarities to your own experience.

It only occurred to me much later that had I not used my own initiative, a lot of common sense that I didn’t know I had, and the great folks here at the SDMB, I could have seriously damaged myself. I was a prime candidate for a Darwin Award, since any mistake would have directly affected The Boys.

I think you and I are wondering the same thing: what happens to all those people out there who don’t question the process?

Right now, I don’t have an answer.

16

Man, that really sucks.

And it is just the sort of thing I don’t want to hear at the moment. I am having surgery at the local hospital in a couple of weeks to donate bone marrow.

I wasn’t worried before, but now…

17

Most types of stainless steel, unlike plain carbon steel, are not magnetic. Have you tried your magnet on your silverware? It probably won’t work there, either.

18

Sofa King, I had to look that up…

Ouch! But anyway, my recovery has not been linear. I went for weeks at a time with little improvement. I have had my ups and downs. It is certainly not true that I felt 100% better with each passing week. It took me 6 weeks to reach the point where I could even set my foot on the floor. And that was a very rough 6 weeks. But then it took about 2 weeks to reach the point where I could walk with the walker. That was a great 2 weeks. And so on. The plateaus were depressing and I had to work hard at maintaining a positive attitude. Full recovery may take another year or so.

MrWhy, I can only hope that fore warned is fore armed. I was blind sided.

ENugent, I am in your debt. I had assumed that all steel was magnetic. This site confirms that at least some is not. I can scratch this off my “to-do” list.

Dang though! Titanium implants like Zette has would have been much cooler! But I guess this is not the optimum time to be bringing that up…

19

Check out this link:

Which shows several types of spinal hardware- Yes, I am the real bionic woman. Lindsey Wagner, look out!

Also, check this out:

Shows an x-ray view of the stuff in place. The one on the far left looks closest to what I’ve got in me.

Now go run around the block a few times for me, would ya’?(not you, Perderabo- heal that foot up first!)

Zette :slight_smile:

20

Perderabo,
I have to say that not only do I hope you get better soon, but that I think you would be one fun person to hang out with.

I truly enjoied the image of trying a magnet on internal metal bits. I’d do that, but it never occured to me that other people would to. So, I think you rock.

And hospitals can stink horribly, though for my major stuff I have been lucky with my nurses. Doctors less so. (though there have been several awesome docs as well.)