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Jay Lake
Date: 2010-04-23 08:14
Subject: [personal] Medical follies, family edition
Security: Public
Tags:cancer, family, health, healthcare
Sometimes they keep you in the dark and feed you bullshit.

tillyjane a/k/a my mom is not having her angioplasty this morning. The hospital committee has ruled it doesn't sufficiently address her symptoms. Mind you, this is a procedure she needs at some point in the not too distant future regardless, and right now it's the only option the cardiologists have come up with for addressing her symptoms, but as they have said, they're not certain.

This is closely akin to coming into the ER with a broken ankle because you have a bad hip, and the hospital refusing to treat your bad hip because it won't help the broken ankle. It doesn't make any freaking sense. And that after both patient and cardiologist have agreed upon it as the next step.

Her entire stay, both of them, at this hospital (part of a major West Coast provider that is both hospital operator and HMO) has been characterized by bizarre medical behavior that, while not rising to the level of malpractice, falls somewhere between incompetence and black comedy. This particular hospital system requires the hospitalist (ward doctor) be the single-point-of-contact and gatekeeper for all communications with specialists or other departments. This means the nurses, patients et cetera don't get to ask questions or see the specialists unless the specialists happen to think to come to them.

Which might be okay, except so far the hospitalists on my mother's case have been bizarrely incompetent. During her first admission, the hospitalist tried to send her home because she'd "had too much caffeine", and there was nothing wrong with her. It was also utterly clear that the hospitalist was either reading someone else's chart, or badly misreading my mother's chart. Later one we had the other hospitalist carefully explain the results of the first angiogram quite erroneously, directly contradicting in detail what the cardiologist who'd performed the procedure had told me and lillypond immediately after the procedure was done. On investigation, it turned out we were right and the hospitalist was wrong.

It's pretty clear that the nurses on the ward aren't very happy with the hospitalists and their gatekeeping. It's also pretty clear that the cardiology team is internally divided along some political fault line (I've never before heard a doctor badmouth another doctor in a professional setting). It's pretty clear the hospital has serious medical communication issues.

Meanwhile, my mom is not being treated. The current "plan" is to send her home, and if the undiagnosed and untreated cardiac symptoms recur again, to re-admit her and perform the procedure they have denied her today.

Unfortunately, because her insurance is tied to this hospital chain, she can't go anywhere else unless she goes out of pocket. Which isn't financially possible for her or our family. So we're stuck inside their web of lousy communication, incompetent hospitalists, and treatment denial.

Meanwhile, I am off to chemo and can influence none of this. Grr.

Post A Comment | 18 Comments | | Link

User: nicosian
Date: 2010-04-23 15:44 (UTC)
Subject: (no subject)
ack, ouch. seriously ouch.

My only issue with my system and seeing a specialist was that they booked the appointment too early. As in, we got in faster than anticipated, beating some extensive genetic testing results to the office.

It turned out ok, because it allowed us to get some other minor details sorted, but overall, the communication between ER, ward, specialist, has been fairly exemplary. Across provinces. I'm in ontario, some of my file is in Vancouver and within 12 hours they had the file faxed over.

( aside from the receptionist who can't read the specialist's writing and was terribly ADD when I was trying to schedule a future appt.

I hope you guys get some answers. ( meanwhile I'll ponder how it is that I'm told my heath care, universal style, is as oppressive as I've been told it is. i wish you lot could be here, because it doesn't HAVE to be so convoluted. You and your family have better things to worry over!)

Take care.

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User: aprilhenry
Date: 2010-04-23 16:36 (UTC)
Subject: (no subject)
If the chain's initials are "KP" they take complaints seriously.
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(no subject) - (Anonymous)
User: aprilhenry
Date: 2010-04-23 19:24 (UTC)
Subject: (no subject)
That's where I used to work.
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The NewroticGirl
User: newroticgirl
Date: 2010-04-23 17:05 (UTC)
Subject: (no subject)
Oh jeez.
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User: klwilliams
Date: 2010-04-23 17:06 (UTC)
Subject: (no subject)
One of my friends is a hospitalist at a Portland hospital. If you let me know where your mom is, and he's at that one, maybe I can get him to help.
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User: twilight2000
Date: 2010-04-23 17:52 (UTC)
Subject: (no subject)
Gah - wish this were easier...

(I've never before heard a doctor badmouth another doctor in a professional setting)I've seen this ONCE - in front of me, two of the docs at my own doc group (I go to a group of docs) discussed which dermatologist to send me to (I had an all over limbs rash and was going insane - I also had a 3 day old daughter at the time) - the senior doc dismissing one option as "charges far too much for what they do and over-prescribe meds anyway" - the other doc agreed and they sent me to the other option - but I had never heard such derision in the voice of one doc for another before.
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Kari Sperring
User: la_marquise_de_
Date: 2010-04-23 19:05 (UTC)
Subject: (no subject)
Oh, ffs. I am so sorry.
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User: nolly
Date: 2010-04-23 19:19 (UTC)
Subject: (no subject)
Does the chain have another location in reach, which might have better staff?
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User: cathshaffer
Date: 2010-04-23 19:25 (UTC)
Subject: (no subject)
If you know the cardiologist's name, call him/her at his/her office--look it up in the phone book. The staff will either take a message or page him/her at the hospital to call you. Sorry for the idiocy. It sounds incomprehensible.

I've gotten rather good at dealing with hospitals and red tape and medicalese and incompetent staff and stupid medical mistakes. (Oh, my favorite--when they refused my mother food and water all day for a procedure that turned out to be for a different patient. She ended up getting nauseated from the empty stomach and threw up and couldn't keep her regular meds down--you know, the meds that were actually prescribed for her, to treat her particular condition, not the meds intended for the patient next door.) Feel free to use me as a resource any time.
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User: cathshaffer
Date: 2010-04-23 19:27 (UTC)
Subject: (no subject)
Wait, that's not the best one. The best one was when Mom was kept in an isolation room in the critical care unit for three days, when she was not medically in need of hospitalization, but she did need psych hospitalization. The director of the psych ward kept trying to get rid of her onto medical, and medical kept trying to discharge home, and I kept showing up, delicately pointing out that she was still crazy and the minute they discharged her, I was going to take her to psych emergency again, at which point she would end up back on the psych ward. Good times.
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Leah Cutter: Stress lab 2
User: lrcutter
Date: 2010-04-23 19:37 (UTC)
Subject: (no subject)
Keyword:Stress lab 2
I am so sorry you're having to deal with this Jay. You and your family are in my thoughts.
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carmiel: angry cat
User: carmiel
Date: 2010-04-23 20:23 (UTC)
Subject: (no subject)
Keyword:angry cat
Remember that we have "The best medical system in the world!" according to some boobs in D.C. *snort*

How you're mom is being treated is very familiar to me, a person without medical insurance. The people in charge make decisions based on cost not care.

My thoughts are with her.
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User: martianmooncrab
Date: 2010-04-23 20:57 (UTC)
Subject: (no subject)
Does this hospital have a Social Worker you can get to help you?

if its Bad Sam, you have my sympathies.
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User: adelheid_p
Date: 2010-04-24 00:43 (UTC)
Subject: (no subject)
I hope you or someone else in her family can get this sorted out quickly for her. I'd suggest finding a lawyer right away but it doesn't sound like a financially viable option and it sounds like others have made better suggestions, like finding the the ombudsman or quality of service department and making a statement.
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User: supersniffles
Date: 2010-04-24 00:44 (UTC)
Subject: (no subject)
Call Patient Relations and complain. Sometimes they're called Quality Assurance. At the hospital I work for they're called Guest Services.
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User: quantuminsanity
Date: 2010-04-24 06:32 (UTC)
Subject: (no subject)
Are you sure you didn't accidentally wander into an episode of Greys Anatomy?

I hope it all gets sorted out soon, it sounds awful.
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Erin Cashier
User: therinth
Date: 2010-04-24 08:14 (UTC)
Subject: (no subject)
Jesus Jay, as a nurse that hospital sounds like some horrible version of hell. *hugs*
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User: jetse
Date: 2010-04-24 18:01 (UTC)
Subject: (no subject)
Very sorry to hear this, Jay.

It sounds like Kafkaesque shenanigans in a capitalist healthcare system, and it must be horrible to be a victim of that.

Here's to hoping that your mum gets an appropriate and decent treatment, and that chemo works out for you.

If there's anything I can do, let me know.
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