When am I going to learn......?

http://www.Homesbythecase.blogspot.com For anyone "just tuning in" this post may leave you wondering what the heck I am rambling about, I hope you take the time to go back and review my earlier posts so you can catch up with our story. I thank you all in advance for your thoughts and comments! For anyone who has been along for the whole wild ride - Thank you!

When am I going to learn......?

It was near 7:00 PM, April 22^nd, 2013 when I followed the ambulance down the street to the other hospital. We had already spent a number of hours in one ER that day before mom was dismissed. I was scared. I was angry. I was emotional. I was completely exhausted; I could only imagine what mom felt like.

She had been retching for hours; mom was dizzy; her blood pressure was dangerously high. She needed medical attention. My mothers’ fifty year history of Rheumatoid Arthritis and the complications of many years of the “latest and greatest” drug therapies had taken its toll on her; mom had experienced nearly every possible complication associated with RA. I hoped the ER doctor here would show an interest in my mothers' impressive medical history.

I had compiled a briefcase full of moms’ medical records, which was no easy feat. I had also done a whole lot of research on the many afflictions plaguing my mother. I shared moms’ past medical history, as well as the most recent discharge summary, with the attending physician at the second ER. Although the doctor didn't discount the earlier diagnosis, he had some questions, “Did they do any other tests”. They hadn't. Since the first hospital had done a CT scan, blood tests and a visual evaluation to rule out stroke, but not the appropriate tests to diagnose BPPV; mom was taken for an MRI.

http://www.mayoclinic.com/health/vertigo/DS00534/DSECTION=tests-and-diagnosis

While mom was undergoing the MRI, the doctor reviewed her health history; he was concerned. “Regardless of the test results” the doctor said, “your moms’ blood pressure is reason for concern”. I felt my very tense neck & shoulders relax some just knowing he cared, his compassion was apparent. The doctor continued, “I think it would be a good idea for us to keep her for observation”. He explained he didn't have reason to “admit” her (per medicare guidelines). I hoped he was as competent as he seemed to be.

I knew there was a difference (a financial impact) between observation and admittance, but I didn't know exactly what the difference was; I didn't care. Mom needed more care than I could provide right then and I needed sleep! http://www.medicare.gov/Pubs/pdf/11435.pdf

I waited with mom until she was settled in a room and I felt comfortable with her care. I introduced myself to the nurse and told her of moms’ recent back surgery; pending knee surgery and a host of other details. I couldn't rely on the charted information to fully relay the complexity of moms’ fragile condition. The obvious concern, compassion and competence shown by that nurse, the entire ER and inpatient staff was comforting to me; I thought I might be able to get some sleep while mom was being observed.

After being awake for nearly 24 hours and in hospitals for around sixteen of those hours, I was exhausted. It was close to 2:00 AM on April 23 when I laid my head down. I desperately needed sleep, but my mind would not shut down; I had so much to do. It was almost 4:00 AM the last time I looked at the clock; I fell asleep wondering how I was going to manage.

I don’t know if one can get PTSD from bad experiences in the health care industry, but I suspect any traumatic event could cause it; I also suspect that I had fallen victim to it. http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml My skepticism of the medical community consumed me. There had been too many errors; too much overlooked and written off to her age and/or her Rheumatoid Arthritis. Even though mom was not currently under the care of the same doctors and hospital where she had nearly died several times, I couldn't relax. My nightmares were terrifying; one more misdiagnosis (or missed diagnosis) could have devastating results. I woke with feeling of urgency at 6:30 AM.

By 7:00 AM I had brought in the paper, fed the dog, let the cat in, and was ready to return to the hospital. I couldn't erase the picture of mom from my mind; she had looked so bad. I had to check on mom before I was going to be able to concentrate on anything else. My daughter was getting married in four days; I needed to concentrate on something else!

When I returned to the hospital, I was pleased to see how attentive the nurse was. At this point “being attentive” simply meant making sure the blue vomit bag was where mom could reach it. Mom was still nauseous and had been experiencing dry heaves for going on forty hours. The dizziness had not subsided; her blood pressure was still bordering emergent; moms’ eyes were sunken and dark. I had a pit in my stomach as I imagined having to plan a funeral the same week as my daughter’s wedding. All at once I knew that a heart really could break; the pain was real.

The pain I saw in my mothers’ eyes was reminiscent of the months before her spine surgery. Even though I only planned to be gone a few hours, I felt guilty about leaving her when she was so sick; I felt like I was abandoning my mother. With assurance from the doctor, nurses and social worker that mom would be closely monitored until it was safe to send her home, as well as my sister stationed by my mother’s side, who would call me if anything changed, I left the hospital. I had missed so much in the planning of her wedding; I needed to spend this time with my daughter.

My daughters’ happiness and excitement was contagious. A long lunch was just what I needed. OK, it was a quick lunch; we still had shopping to do! With the last of the centerpiece supplies purchased and feeling like I might just make it through the week regardless of what happened, I dropped my daughter off and returned to the hospital; nothing had changed, except maybe mom looked worse.

Mom was not getting any better; none of the medications were working to control her nausea, blood pressure or dizziness and nobody seemed to know what was really causing it or what to do about it.

Could this get any worse?