Sandwich with a Pickle on the Side – Part 3
After a few weeks I began to notice that Sis’s speech was slurred and she’d fall asleep on the phone. Her hubby reported similar observations. I called the nursing home doc to go see her. They only need to see patients once every two weeks, so I knew he hadn’t evaluated her. From what I was hearing on the phone, I believed she was shutting down. He immediately sent her to the local ER, where the doctor told Sis she was dying. To go home and get her affairs in order. She and her hubby spent the night in tears as they awaited transfer back to the medical center. I drove over the next morning to begin another 10 day vigil.
From the beginning, I insisted that they transfer her to a tertiary care center. They had obviously done all they could at this facility. We started with the same hospitalist who had previously finished her stay – the one who refused a second opinion. Now he brought in one of the vascular surgeons I had requested the previous month. Most of her clots other than the one in the aorta had dissolved, and he thought they could now do the surgery. The vascular guy disagreed, saying he didn’t think that the wounds were caused by the aortal clot (which was what everyone else believed). Therefore, he was unwilling to do such a risky surgery on someone so compromised. Back to square one. Of course, if we could have had that evaluation six weeks earlier, it might have changed the course of her treatment. And of course, the hospitalists changed shifts again and we had another new doc. One who obviously had her orders and didn’t use a lot of independent judgment. I kept insisting that Sis be transferred; the doctor kept bringing in more specialists, and then said everything that could be done had been done. That a tertiary care center couldn’t do anything new. Therefore, no transfer...
The one thing they did during this admission was a nerve and muscle biopsy, via a sizable incision on her good leg. The surgeon was reluctant, but didn’t directly advise against it. Turns out we should have listened to the subtext. Since the surgery in June, she has been unable to flex her foot at the ankle or stand on it. Unfortunately, because all the wounds are on the left side, she needed the right leg for any standing or transfers.
While she was still in surgery, the case manager was beginning to plan her discharge. The nursing home where she had been for months refused to readmit her, supposedly because her Medicare days were running out and they don’t take MediCal (which Sis didn’t have anyway). Her hubby and I were left making arrangements with a different nursing home on my last afternoon there. The new facility was miles from their home, in the opposite direction from his work, and inconvenient for everyone. But they allegedly specialized in wound care. And they had an opening. I left, very frustrated. I had worked hard to develop relationships with the staff at the first nursing home. My family and I were leaving for Europe in less than a week, and now I had no relationships with the new staff. (Meanwhile, of course, Mom’s appointments continued, although I wasn’t able to manage all of them. Oh, and did I mention I was in grad school until mid-June.) (To be continued tomorrow...)
Photo Courtesy of Flickr/Deedoucette
Labels: hospital, sandwich generation
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