Tuesday, December 12, 2006

Plenty of Blame to Go Around

I got a surprise last week. I took the week off to use up vacation time. It was one of those use or lose it situations. I decided to check my phone voice mail Thursday, and lo and behold, I had a message. I have gotten in the habit of turning my cell phone off. Few people call me these days and I have to sleep during the day when on shift, and I don't want to be woken up. Well, it was my Mother. She was in town for surgery which she was to have the next day. That's my Mom, surprise me practically at the last minute. And, this surgery has almost gotten routine. Every 1-2 years, she has to have laser ablation of cells on her inner bladder to remove precancerous lesions, but this time the interval was 3 months, not 12 months or more. Well, I got there and saw her off to surgery. She obviously had a rough time this time, because after surgery during and after recovery, she was throwing up and retching horribly. I attributed it as a nasty side affect of whatever opiate derivative they use to render the patient unconscious during the procedure. I've emerged from surgery heaving and retching, and it is a quite unpleasant experience. Well, Mom wasn't herself. She didn't know her surroundings, or anything. She seemed to be in much pain. Because of the room she was in, I couldn't stay the night and so I showed up the next day, a little after noon because I was tired from the ten hour ordeal the previous day. She was still in much pain. She had her wits about her, but still, she didn't recover from this surgery like she had in the past. I just wanted to get her out of there. I figured that she could heal up better once she got home. Every time she ran to the bathroom, she asked me to leave the room out of modesty. They didn't have a catheter in her and I never checked her urine in the toilet, and I should have in hindsight. In the past they didn't discharge her until her urine was clear and free of blood. Well, at 2:30 PM, the nurse walks in and says that the urologist's partner had signed her discharge papers and she could go home. She signed the papers, and I walked out of the room and waited for her to get dressed. I got her a wheelchair and took her downstairs, put her in my car, drove to the pharmacy, and got her prescriptions filled and drove her back to her hotel room. I helped her to her room and left. I expected her to feel better after a day's rest and be well enough to fly home the next day. I called her the next day 45 minutes before she was supposed to leave and she told me that she'd postponed it another day, that she was still hurting. I had to come into work, but I called my sister beforehand and found out that my Mom was going to see her urologist today (Monday). I thought it was a wasted effort because I couldn't see that he could possibly do anything for her. Unless he had perforated her bladder which he couldn't possibly have done, it was up to her to heal the burns he'd inflicted upon her. Well, once she got to his office, and he saw how much blood was in her urine, he had his staff take her to the Emergency Room for more tests immediately. He was perplexed why she hadn't gone back to the hospital sooner and hadn't called his emergency number. Mom hadn't wanted to put any one out. She put up with two days of extreme pain and suffering. I was angry with her, but even more angry with myself. I had made the assumption that the hospital staff were doing their jobs on Friday and Saturday, but they hadn't if they'd let her go with so much blood in her urine. And, I was kicking myself for not checking her urine. I would have noticed such a tiny detail had I even checked. Mom had thought that the blood in her urine was medications that "turned her urine orange".

Well, for now, she's to stay in until Wednesday for observation. She's got a catheter in and her urine is a deep orange, almost red. She's being given plenty of pain medications, and the tests run thus far show that her bladder is intact. She has a slight fever, but her white count wasn't up significantly which is a good sign. The doctor's best guess is that Mom had an underlying bowel problem that the bladder surgery exacerbated and brought to the fore. But then, there's still the issue of her bloody urine. I'm at work right now. There's nothing I can do, so I might as well finish 10 hours of my current night shift. I'll call her in the morning and see how she's doing. I'll try to see her tomorrow afternoon if possible. I hope she's learned something from this ordeal. I certainly have, but there's plenty of blame to go around!
I have incorrect expectations about hospitals and doctors. Perhaps we all have the wrong idea about what care means. They withdraw service often and push people out when they think about money , beds, staff needs. Nobody thinks anymore in the hospitals about what the patient needs. The best recommendation I have ever read is to have someone other then the patient monitor and talk to staff and doctors and understand what needs to be done and then oversee that it is done.
Sorry about her pain and stress.
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