Author Topic: edible toad primitive has hospital nightmare  (Read 1494 times)

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Offline franksolich

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edible toad primitive has hospital nightmare
« on: October 13, 2009, 02:27:29 PM »
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=222x71594

Oh my.

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Crunchy Frog  (1000+ posts)        Fri Oct-09-09 07:24 PM
Original message
 
Hospital nightmare. What the **** is going on with healthcare in this country?

This whole situation is too outlandish and bizzare not post about it.

My mother's boyfriend is in the hospital right now. He is quite a bit older than she is, has middle stage Alzheimer's, and has become quite frail. He has just gotten in to a program which provides an adult day care, further support as needed for the person in their home, and comprehensive healthcare through the program. He currently lives in the household and my mother is his caregiver.

Day before yesterday, he returned home from the program and it was evident that he had had an innoculation of some sort (turned out to be pneumococcus). His arm was bruised and swollen and painful, and he felt chilled and tired, but could walk and was coherent. A few hours later he became incoherent, unable to walk by himself, and unable to get to the bathroom. The program was notified and an ambulance summoned, and he was taken to the ER of a local hospital. He was eventually given a room, diagnosed with pneumonia (what the vaccination was for, it was too late and the reaction helped to mask earlier symptoms) and started on antibiotics.

My mother did not try to spend the night that night, but went down the next morning. She found him very much improved, quite lucid, and clearly responding to the antibiotics. She was in and out throughout the day and he continued to improve, was eating heartily, and looking like he would be ready for release the next day.

She was away for a few hours that evening and returned to the hopital at 9:30 pm to find him semi-delerious and unable to communicate verbally. It took my mother a while to piece together what had happened, and the wildly inappropriate "treatments" that had brought him to this state.

The apparently tested his blood sugar for no good reason. He is not diabetic and has no history of diabetes or any other blood sugar issues, and no blood sugar related symptoms. They found his blood sugar to be a few points above the official limit for normal, and so gave him an injection of fast acting insulin?!

After this he was having difficulty walking to the bathroom and getting confused about the urinal, so they placed a Foley catheter. Not a condom catheter which is non-invasive, or just using Depends. No, they had to place the Foley.

The Foley was uncomfortable and upsetting to him, so they decided to sedate him with a shot of Morphine?!

Morphine of course is a very powerful narcotic painkiller, but it is not a sedative. The effect of the Morphine on him was to make him completely disoriented and extremely agitated. Oh, and the one thing they hadn't given him was the Aricept and Nemenda that he has been on for years for the Alzheimer's. The runaround that my mother got in trying to get him those medications is a different story.

Finally, at around 11:00 that night, in order to counteract the extreme agitation from the Morphine and the catheter, he was given a drug called Zyprexa. At the time it was given, they told my mother that it was a substitute for the Aricept?!

My mother then came back home for a couple of hours and we did some rapid internet research. What we learned about Zyprexa is that it is a powerful antispychotic, and that Eli Lily has gotten into a shit load of trouble for encouraging doctors to prescribe it off label to treat agitation in elderly people with dementia, for which it is not effective.

We also learned that it is given every 24 hours because it has a half-life of 21 to 54 hours, and that the half-life is considerably longer in the elderly and that extreme caution in dosing is reccomended. It is not in any way, shape, or form a substitute for Aricept.

Oh, and they didn't know about his vaccination earlier the day before, so they gave him another one (for the illness he already had). This is the level of communication that exists between this program and the hospital with which it is affiliated.

At this point it was decided that he could not safely be left on his own at this hospital, and my mother went down to spend the night there with him and make sure they didn't do anymore damage, something whicht they apparently strongly discourage.

She has been there with him all day today. She has power of attorney and has told them not to give him anything besides his regular medicatication and his antibiotic without first informing her and getting her consent.

He has been knocked completely on his ass by this last drug. He is sleeping most of the time with only brief periods of semi-awakeness. He has been largely unable to either eat or drink. A person recovering from pneumonia needs fluids, and they apparently had not seen fit to place an IV. He has gradually been becoming a bit more coherent throughout the day, but a very slow process.

My mother has just been informed that they are no longer allowing overnight visitors, and she must leave him alone there tonight.

This is how things stand at this point. What the **** is it with the healthcare system in this country? This man was given four different inappropriate medications in the space of a few hours, as well as being placed with an inappropriate urinary catheter.

How many other people does this happen to? How many frail elderly people who have no one to advocate for them go into the hospital for something relatively simple and routine and never get out, or are sent to nursing home because they develop accutely worsened dementia symptoms? How many younger people does this happen to?

How many people are there who think that hospitals are safe places to entrust their loved ones and end up with an unexplained tragedy on their hands? Is this another type of death panel that is operating in this country?

People who have more familiarity with hospitals than me, is this sort of scenario common? Is there any accountability for this sort of thing?

Is it any surprise that some of us are accutely mistrustful of the medical establishment in this country?

It's a big bonfire, so only the PoP are quoted here.

First up, the defrocked warped primitive, who knows a thing or two about "misappropriated" medications:

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Warpy  (1000+ posts)        Fri Oct-09-09 07:37 PM
Response to Reply #1
 
3. More like extreme short staffing and a hospital pharmacy that is subpar.

The banal anal primitive:

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annabanana  (1000+ posts)        Fri Oct-09-09 07:29 PM
Response to Original message
 
2. What a horrifying story.

There should be lawsuits all around on this one.

The greedy primitive who, three years ago, was amused at the spectacle of a home health aide high on marijuana administering an injection on her ancient father:

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GreenPartyVoter  (1000+ posts)        Fri Oct-09-09 07:45 PM
Response to Original message
 
6. OMG! That's unreal, but not unheard of. A doctor tried to blame my brother and me for recommending my dad not get his heart stents replaced in a timely manner, leading him to being unable to have that or bypass surgery done. Now, he did in fact take a short time to confer with his other doctors about a different surgery he needed to have, but it was not for the length of time that he wound up waiting for.

That was due to the cardiologist giving him the run-around and putting him off. By the time they saw him it was too late to do anything about the stents. My dad gave them hell for falsely recording that my brother and I made the decision that he should wait as long as he did. To me it sounded like the doc was trying to cover his butt in case something happened to my dad due to his office not seeing him soon enough.

He also had some poor experiences the year before in the hospital. Basically he felt it was poor communication between the different departments with each other and also the patients. And the lack of having enough staff to care for everyone correctly was definitely a problem. They cared and they were competent, but they were stretched too thin to be as effective as possible.

Based on what you said in your OP I think your mom should be very cautious when dealing with these people. (Sounds like she has been, though, since she had the good sense to look up info on her own.) Document, document, document. Don't let anything stand in the record that is not true. (Like the lie about my brother and me preventing dad from getting his surgery.)

The unfrocked warped primitive again:

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Warpy  (1000+ posts)        Fri Oct-09-09 07:46 PM
Response to Original message
 
7. I'm sorry this happened, but there are some things you need to do.

I've seen a few cluster****s like this one. Usually it's good intentions gone horribly awry combined with short staffing.

I think they must've told Mom to go home because she was exhausted and they didn't want her to join him.

She needs to get morphine listed as a drug allergy tomorrow. It causes extreme delirium in some people, more commonly in the elderly. The nurses can do that for her. She also needs to talk to his doc (rounding is usually early in the AM) and try to get him his Aricept. If it's non formulary, the doc can write an order to use his own supply. Some on call doc just thought he could make a substitute with something in the hospital pharmacy. It didn't work. Spectacularly.

Once he's lucid, that catheter needs to come out.

It sounds like his mental status is clearing and once the pneumonia has responded, he'll go home on oral antibiotics.

It's really lousy timing for that pneumovax shot. I got mine on the heels of a pneumonia and reacted badly to it. However, the soreness will go away in a week or so and he will be protected against a lot of what causes pneumonia after colds or flu. Whoever gave it to him did him a favor, although you won't see the benefit for a while.

And again:

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Warpy  (1000+ posts)        Sat Oct-10-09 08:48 AM
Response to Reply #13

16. Good, I'm very glad to hear she's got a nurse advising her

Most of us are very tough patient advocates.

Unfortunately, unless he's got a permanent injury from this, there is no malpractice case. She really does need to let the staff of the other hospital know about the morphine allergy should he need to go there in the future. There are plenty of other pain drugs out there that work beautifully in the elderly, especially in elderly dementia patients.

I've had a pneumovax booster. The CDC guidelines waver a bit, some years saying one shot is enough, the next year saying a booster is needed 5-10 years down the line and that is enough for life. The booster was a hellavulot easier than the original shot since I hadn't had a pneumonia close to it!

His arm will be sore for a week or two when he gets home, and that will likely be the most lasting evidence of this collection of medical mishaps.

At least, I hope it's the case.

FWIW, that ban on overnight stays because of H1N1 is bullshit. The next time he gets sick, take him back to that first hospital.

And yet again:

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Warpy  (1000+ posts)        Sat Oct-10-09 10:10 AM
Response to Reply #17
 
18. If he's not clear enough to be drinking much, he might need that catheter because that's the best way to keep an accurate tally on his output and make sure his kidneys aren't running into trouble. Most hospital floors don't have accurate enough scales to weigh adult diapers, and those diapers contribute to skin breakdown and other things.

Pneumonia itself hurts and he might have complained of pain at the time, you just don't know. It's one of those "he said, she said" things. It's clear the morphine was a really bad idea, as was trying to calm him down chemically when he went wild.

For pain that's too much for Tylenol, I've found that frail elderly people respond quite well to Darvocet, a synthetic opiate like drug combined with Tylenol that does nothing for healthy younger people. I used it when they didn't react well to stronger pain killers after surgery. Many did well on the usual morphine and Percocet. When they didn't, Darvocet was my go-to drug.

Being sick is not for sissies, and I can't imagine the terror of being sick when you really can't remember what's happening to you and why. I hope he continues to clear and is able to go home as he was before this happened.

The subway cat, who hasn't yet posted photographs of herself being the largest float in that one parade last Saturday:

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undergroundpanther  (1000+ posts)        Fri Oct-09-09 07:57 PM
Response to Original message
 
10. I have had crazy crap happen to me in hospitals,stuff that was damn dangerous,stuff I WARNED them not to do to me ,but they did it anyway.I hate going to a hospital,because once they find out you have issues, they ignore pain(assuming addictions which I have NO history of)

They'll keep restraints()used for ambulance transport on far longer than necessary,I was injured and warned the ambulance guys,the nurses that I cannot stand the emotions restraints cause me,In a neck brace I wound up trying to get out of the restraints.I got half out before they bothered to take them off.

Wow.  The subway cat in restraints.  Probably the best thing for her to be in.

Dorothy, the snobbish primitive:

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uppityperson  (1000+ posts)        Sun Oct-11-09 04:33 PM
Response to Reply #29
 
33. Unless they are mentally ill, they used to give high doses insulin in the past to throw them into a hypoglycemic event, rather like zapping them.

This sounds very wrong.

Dorothy again:

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uppityperson  (1000+ posts)        Sun Oct-11-09 04:31 PM
Response to Reply #22
 
32. As a RN, wtf "the confusion may be the result of high blood sugar"? Wrong

that is backwards. People get confused with low blood sugar. High blood sugar affects things like eyes and kidneys and neuro stuff and healing. LOW blood sugar gets you confused. Sometimes people are considered drunk, stoned, drugged when they actually have low blood glucose levels. Had 1 local guy drive off the road, deputy tazed him because he thought he was drugged out, actually was hypoglycemic.

I am sure some may act weird with high levels, but good grief and good lord that is WRONG.

LOW causes confusion. High causes other issues.

Been an RN for over 30 yrs. Talk with your doctor as that is wrong.

The defrocked warped primitive, being sure she gets more said than Dorothy:

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Warpy  (1000+ posts)        Mon Oct-12-09 12:41 PM
Response to Reply #22
 
40. You have the right to fire that doctor and I suggest you do so if you haven't already. Someone else in the practice will assume Len's care. You don't need a screwball who writes insulin orders for an elderly person with a BG of 75.

That doc is eventually going to kill someone.

Docs prepared in the Caribbean are not all bad and most have adequate grades for US medical schools. The problem is that there are too few slots in US medical schools to take all comers.

This guy, however, sounds like a crackpot.

The edible toad primitive updates us at the end of the bonfire.

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Crunchy Frog  (1000+ posts)        Mon Oct-12-09 02:14 AM
Response to Original message
 
35. Update.

Well, my mother had a long and uncomfortable (for him) discussion with the doctor on Len's case. He was surprised to hear that Len had been administered insulin. He didn't order it, didn't know about it, and doesn't know about the protocol under which it was administered.

He was the doctor in charge of Len's case, but he never even saw Len prior to the point at which he became delirious. That is a period of approximately 8 hours. He was unfamiliar with Len's medical history and chart. He had no idea that Len had ever been lucid, let alone that he had been lucid just two hours earlier.

He didn't know much of anything about the drug Zyprexa. He did not know that it stays in the system for a long time, and for a longer time in elderly persons. He did not know that it is contraindicated in elderly patients with dementia.

He did not have any reason for neglecting to put Len on his regular Alzheimer's medications. He said that he didn't know the correct dosage, but he couldn't say why he never bothered to ask anyone who did know (like my mother who was present most of the time and was trying and trying to get the information across to them).

For him, Len was just some crazy dementia patient who needed to be drugged.

From the timeline of events, it's looking like Len most likely did have a bad reaction to the insulin, and that was what precipitated everything else. My mother left him at ~5:45. He was lucid and in good spirits, conversational and joking, and had just finished a substantial meal. The insulin was given to him at 6:15 (outside of the timeframe in which this insulin is supposed to be administered). By 8:00 he was completely delirious.

Nobody in this family will ever sign a blanket hospital consent form again. The next time Len needs to be hospitalized, every treatment decision and medication will have to be individually and separately consented to by my mother.

Len seems to be back in the land of the living, and will probably be discharged tomorrow.
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Offline The Village Idiot

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Re: edible toad primitive has hospital nightmare
« Reply #1 on: October 13, 2009, 02:46:14 PM »
was this a government hospital?

are the doctors foreigners?

If Alzheimers is not curable, ObamaCare stipulates we dope them till they die.

Offline AprilRazz

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Re: edible toad primitive has hospital nightmare
« Reply #2 on: October 13, 2009, 09:50:41 PM »
The OP surly has brown eyes due to being so full of  :bs:. I love how people discover google and proclaim themselves smarter than the doctors. Like the catheter. If he was not lucid they usually use a Foley because it can't be yanked off like a Texas cath can. That was just the tip of the iceberg. I think this guy would be better off in the care of a responsible person. Not who he is with now.
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