Archive for April, 2019

Medical Care, a consumer’s perspective- Mercy Health – Lorain ( 2)

Part Onehttps://thatwoman.wordpress.com/2019/03/22/the-ratings-of-medical-facilities-series-it-begins/

Part Two- https://thatwoman.wordpress.com/2019/04/09/medical-care-from-a-consumers-perspective-ohio/

Part Three- https://thatwoman.wordpress.com/2019/04/22/medical-care-a-consumers-prospective-mercy-health-lorain/

Mercy Health — Lorain Hospital https://www.mercy.com/locations/hospitals/lorain

After hours of torment and worry , my  husband was in ICU- Mercy  Health , Lorain. The brain surgery  went well, now a matter of time.  I  have been in ICU’s more times than I  care to  remember , each  hospital a little different.

I have to  state here and now the  ICU nurses and team at Mercy were wonderful to  us. I cannot say  enough  about them , they  were so  caring and compassionate. The housekeeping staff who  cleaned  and cleaned would see me sitting in the small waiting room whilst tests and all things happening to  make my  husband comfortable were happening. I would see a hand reach  out and put down a cup  of coffee or fruit drink and a smile.

Yes, they  made things so  much  easier.

I really  had to  force myself to  think and stay  upright and ask questions of the myriad of people who would come in an out including physicians, physicians assistants, residents.

 

Indeed  on a few occasions I had no  clue as to  who  they  were , some not all introduced  themselves, very  businesslike  and with  a clipped manner  when answering my  questions or observations. In the end, I  learned to   ask  those questions of the nurses and they  would check  for me. When  dealing with  “one or two  of the physicians”  the answers were ensconced in medical terms  and a couple of times I  had to  have them repeat their answers  due to  heavily accented language I  found difficult to  grasp. That was something I also  had to  deal with  later on as well.

I wrote to  the CEO of Mercy ( Edwin Oley) after we transferred to  the Cleveland Clinic Rehab Hospital . I have copied parts of the letter and my concerns . I  have left out the physicians names  for this blog but they  were named in my  letter. Needless to  say  I  have not received any  response from Mercy  Health  Lorain ( not that I  expected  any    but “received and filed ” might have been polite at least :

Excerpts and notes  from the letter- February  12th 2019

For the attention of Edwin Oley, Mark Rau and Cheryl Rieves

Dear Mr. Oley,

I am writing today not only to thank the nursing staff for their excellent care, and also “housekeeping ladies” in the ICU who were so kind and helpful during our time of crisis and all but one of the physicians.

January 18th my husband had a fall – although his Doctors are at St. John’s West Shore we were taken to your ER. I have no complaints with the treatment there . He was admitted with a small brain bleed , which they felt would be absorbed and that is what looked like was happening. He was in ICU for a couple of days , then in general population and then sent to your REHAB unit. Again, I find no fault with the care, the nursing and rehab staff or physicians .

January 24th my husband suffered another major brain bleed in your Rehab unit ( on the right side of his brain) It was totally due to your response team , staff and Dr. XXXXX that my husband didn’t die, he literally was minutes away from that happening .

We were so grateful this happened IN the hospital had he been elsewhere he would have died. After major surgery he was sent back to CC11 in ICU – he was intubated and the care was wonderful . It was there I encountered Dr. PXXXX who did not impress me, I didn’t even know who he was and he certainly did not interact with me at all.

 

Wednesday January 30th my husband was finally able to come off the “tube” I must state here , my daughter and I had been putting in 15 hours shifts, trading off so one of us would be there , a terrible and emotionally draining time .

 

Six days after the surgery and two hours off the breathing apparatus I went home for a rest . I was woken by a Social Worker phoning me to explain “I would have to make a decision as to my plans for my husband “ I told her I have no plans he hasn’t even woken up – any plan I would have would be to get him sitting in a chair. She stated I would have to let them know and would leave a list of facilities in his room . which she did!

NOTE THIS IS THE LIST OF FACILITIES GIVEN TO  US BY  MERCY HEALTH  SOCIAL WORKERS!

 

 I want you  to  put yourself in our position, we had had a terribly  traumatic time very  little sleep for days  and we were given a list of 34 places  one of which   my  husband needed to  be transferred to  in coming days. We didn’t know “what his prognosis would be, if he had major brain damage and here is the list  “check them out…….( this certainly  was not helpful)

Saturday February 2nd My husband was moved to Tower two North– Once again hours after being in the new room I was sent another Social Worker – I had to make plans – he was still out of it and on a feeding tube and unable to swallow on his own . I reiterated I had no plans I couldn’t make an educated decision until I talked to my medical professionals who knew his history and were not in your network. I asked if this is rehab why couldn’t he stay at Mercy in the Rehab unit where he was initially – I was told flat out he would no longer meet the criteria of 3 hours daily . Dr. AXXXXXXXXXXX of Rehab would not accept him. I said well I am not making a decision until I know more.

Every day I was prompted by   staff as to my decision.

Tuesday February 5th – during rounds – Dr. PXXXX and a host of people came into the room . I had only had cursory glances with this Doctor – I didn’t even know why he was there, every other physician explained who they were and what their specialty was , including therapy professionals. The communication in that area was excellent.

 

During this particular round Dr. PXXXX informed me they would have to put a feeding tube in his stomach, and I would have to make plans as to where I was sending him. The Social Worker also reiterated when I asked:

 Why can’t he stay at Mercy Rehab after all I felt comfortable and they saved his life.

ONCE again I was told Dr. AXXXXXXXXXX wouldn’t accept him .

 

Dr. PXXXX said:

you have to decide and he needed “skilled nursing”

I said

No I need to talk to his Drs.- PXXXX informed me “transfer him to St. Johns , I said the insurance wouldn’t cover that as it would be a lateral move, I would  check out some of the facilities on this list and since I had been in the hospital for days on end I hadn’t had time . He informed me that once the feeding tube was in he would be ready to leave.

I suggested, it seemed to me they were doing that to   get rid of him.

Dr. PXXXX left the room whilst my daughter was asking a question re the stomach tube….. only to return and said AXXXXXX  MXXXXX ( name of local facility) !!!! I understand he some interest in that facility.

Actually the next morning ,my husband who finally woke up to some degree, pulled out the feeding tube from his nose, they couldn’t put in the stomach tube due to food in the esophagus and it was delayed until Wednesday at which stage he had been now moved to Cardiology .

He has AFIB and because they couldn’t feed him his heart medication in liquid form they moved him so they could give it in his IV. Whilst in Cardiology they once again tested his swallowing capabilities and he passed- no stomach feeding tube)

 

Again another Social Worker came in what were my plans ????I spent the next hours researching and pop in visiting these facilities –

I was told Mercy Allen had no beds available and I couldn’t give them a date anyway .

 

At this point in the epistle I would like to add that my husband has for the past 16 years has NOT been able to take Statin Drugs of any kind. In fact in ER we specifically stated and it was put on his wrist ALLERGY STATINS  HOWEVER, some Physician , whom I never heard of or spoke to PRESCRIBED LIPITOR- A STATIN which actually started to cause my husband issues.

My daughter stopped the nurse from giving the 2nd dose. After checking I found written in the note “QUESTIONABLE ALLERGY”) NOT ONCE DID ANYONE ( INCLUDING THE PHYSICAN ) ‘QUESTION THE FAMILY AS TO WHY THIS DRUG WAS NOT ALLOWED!

 Cardiology sent my husband back to 2 north

( NOTE: it was only  later at the Cleveland Clinic  I  found out my  husband had been prescribed  Lanoxin by  the same “unknown physician”. Had I  known  I  would have mentioned that  it was found in a previous “heart issue” Lanoxin did cause serious side effects with  him.. such  as paranoia , confusion ( remember that  for chapters two  and three of the journey. Again this is partly  due to  my  not remembering all the drugs he has had issues with  and the fact they  did not have access to  his full medical history

As I researched, Wednesday and talked to many people I decided on the Cleveland Clinic Rehabilitation Hospital – Avon. Their representative came an evaluated my husband late Wednesday evening . My daughter and I toured the facility on Thursday morning the 7th . We were very pleased with what we found . THIS FACILITY WAS NOT ON THE LIST GIVEN TO ME!  ( Note you  can see I  penciled it in on the list from Mercy  Health)

 

THEN IT STARTED – For days and days I was told Mercy would not accept him back into their rehab unit WHERE we had asked to go time and time again. BUT LO AND BEHOLD HAVING BEEN TOLD FOR OVER A WEEK NO!!!!! ALL OF A SUDDEN – OH WE WANT HIM HERE- HE CAN STAY PLEASE ! I had all sorts of staff and Directors etc – stating he COULD GO BACK to Rehab. I spoke to Rehab representatives who had found out that morning he wasn’t coming back –

Dr. PXXXX actually told the staff  I was sending my husband to a skilled nursing facility – which was NOT TRUTHFUL I hadn’t made up my mind at that point and was waiting to hear back from the Clinic. HE HAD NO BUSINESS SPEAKING FOR ME!!!! AND Dr. AXXXXXXXXX had not made any such determination as to my husband’s status as I was told by Rehab. Staff on Thursday morning .

 

The decision to leave was very hard we had received excellent care but what with the No Room at the Inn fiasco  and the pushing to leave and make other plans during a time of great distress for me and my family and the “statin” situation we have moved my husband. He is very weak but starting to respond.

 

My feeling is your facility fell down in not communicating to the family properly – social workers should give “all pertinent information”- in laypersons language and a full explanation as to why ( days of paper work etc) to families who are under stress as it is.

 

At least two of your physicians caused more harm, emotionally to the family and in one case could have caused other issues. Due to the protein treatments given in ER , to combat the Xarelto I informed them that within days he would get a major gout flare up ( Gout initially   due to statins after his open heart surgery in 2002. Which is WHY NO Statins) . He did get a Gout attack on the Wednesday Jan 23rd in Rehab, they drained the knee and gave him a cortisone shot but the damage was done.

Photo  source : https://www.researchgate.net/figure/Healthcare-professional-views-of-hospital-to-home-care-transitions_fig1_230565561

Why the 2nd massive brain bleed the next morning – well we aren’t sure, but REHAB staff saved his life and the fact he isn’t there today at your facility is entirely at the hands of administrative decisions poor communication between social workers and overriding a medical allergy without discussing why it was necessary with the family. Questions feel free to contact me……

I  don’t think  I  need to  go  into  further detail this letter pretty  much  said it all. And the cost so  far  for Mercy Health  –  is approximately  $70,000.00 and climbing .

 

Next Up  Cleveland Clinic Rehabilitation Hospital

 

 

April 29, 2019 at 9:59 pm 9 comments

Medical Care -a consumers prospective-Mercy Health Lorain

 

Part Onehttps://thatwoman.wordpress.com/2019/03/22/the-ratings-of-medical-facilities-series-it-begins/

Part Two- https://thatwoman.wordpress.com/2019/04/09/medical-care-from-a-consumers-perspective-ohio/

Mercy Health — Lorain Hospital https://www.mercy.com/locations/hospitals/lorain

Our particular health  care journey started with  a fall January  18th/19th 2019 and a call to  911  and a rescue squad. Since the patient, my  husband, had fallen and was unconscious for a few minutes it was decided to  take him the the emergency  room. In this case  although  our physicians and hospital of choice is St. John’s Westshore, the drivers  would only  take him to  the nearest ER.

29000 Center Ridge Road
Westlake, OH 44145
https://www.uhhospitals.org/locations/uh-st-john-medical-center
 The rescue squad insisted he be taken to  Mercy Health Lorain.
https://www.cincinnati.com/story/news/2018/02/22/mercy-health-merge-bon-secours-health-system/362456002/

In July 2016 – another fall had required a trip  to  the Mercy  Health Lorain ER. I was not impressed at all with  that particular visit, the ER at that time left a lot to  be desired, imho  and after three hours of not seeing anyone higher that a Nurse Practitioner  I  insisted my  husband be transferred to  St. John’s West Shore.

The diagnosis was very  serious  Rhabdomyolysis 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365849/.

Many  days were spent in the hospital recovering from this health  issue and all the problems it entailed.

Needless to  say  a trip  to  the Mercy  Health ER in Lorain was not something I  relished, but I  knew I  could insist on him being transferred if worse came to  worse.  I  have to  say  I  was pleasantly  surprised in the difference from 2016.  We were seen quickly  by  a team of nurses and a physician ( not one lone nurse practitioner) and when the diagnosis of a small brain bleed an intracranial bleed   was determined.

A brain hemorrhage refers to bleeding in the brain. This medical condition is also known as a brain bleed or an intracranial hemorrhage.

I was relieved to  have a  Neurosurgeon who  was already  in the ER  come in an explain the situation. The fall had caused this small brain bleed but it was exasperated by  the fact that since 2016 my  husband was on the blood thinner  Xarelto

https://www.mayoclinic.org/drugs-supplements/rivaroxaban-oral-route/side-effects/drg-20075013

The ER “team” had to  use other meds in order to  lessen  and counteract the effects of the Xarelto. I had to  sign papers to  that effect. As I signed the required documents I read of the “proteins” that would be used.  This brought up  another problem … because all my  husband records were with  St. John’s and his UH physicians  the records at Mercy  were very  sketchy  and out of date.  Proteins being pumped in to  my  husband will cause ( within 4 days) an attack of gout.  Of course his doctors at UH  were aware of that  but I had to  inform the ER physician of this, I  think  he thought I  was  not at all to  be taken seriously  and the almost “pat on the head – there/ there” look crossed his face. Gout indeed?????

So  there you  are in the ER at 1 in the morning trying to  rack  your brain , as you  are worried and anxious as to  what this particular “team needed to  know” allergies, past medical history , medications he was on, when he last took anything, insurances  because Mercy  did not have access to  his patient information – they  are under a different system.

 

I  am sure they  thought I  was over stating the problems, gout and bad reactions to  statins, so  NO  STATINS- remember that because it does come back  to  haunt, both  the gout and the Statins.

This is something in my  opinion that needs to  be addressed. We  as a family  decided to  have him admitted to  Mercy  for observation, the bleed location was not operable and they  hoped it would be absorbed. The decision to  stay was based on two  reasons:

1. The Neurosurgeon  I  immediately  liked and felt comfortable with  and 2. that particular weekend there was a major  winter storm hitting the area and roads were closing.

Hindsight has confirmed that our decision to  stay  was indeed the right one.

A hell of a storm broke that morning and roads were closed. I  could not get out of my house for two  days. My  daughter and husband with  their large vehicle did manage.  Cat scans were done and all was progressing nicely . However, 4 1/2 days after he was admitted the “proteins” did do  their damndest   and a major gout attack  took place, blood pressure and pain were an issue. A doctor was called in to  give  a shot and to  drain the knee on that Wednesday  evening.

 

Early  Thursday  morning I received a call from the nurse at Mercy …

 

“my  family  had to  get to  the hospital right away – there had been a complication- my  husband had collapsed with  a massive brain bleed- we needed to  get there quickly”

By  the time we arrived at Mercy Health he was already  intubated and prepped for major brain surgery. He had had a massive subdural hematoma:

 

“People with a bleeding disorder and people who take blood thinners are more likely to develop a subdural hematoma. A relatively minor head injury can cause subdural hematoma in people with a bleeding tendency.”

  https://www.webmd.com/brain/subdural-hematoma-symptoms-causes-treatments#1

As luck  would have it the Neurosurgeon  that had inspired confidence in that ER was ready  to  operate . My  husband was rushed into  the operating room , we were told to call relatives etc. I  have to  say  the “rapid response team” of nurses and professionals were wonderful , they  did along with my  favorite neurosurgeon ( by  now)  saved his life that morning . 

Hours in the waiting room, moved to  ICU and prognosis iffy– the next 72 hours  would tell the tale …..

To be continued …………….

 

 

April 22, 2019 at 11:26 pm 3 comments

Medical Care – From a Consumer’s Perspective- Ohio

 

Photo Source :  https://revenuesandprofits.com/top-20-u-s-healthcare-companies-by-2016-revenues/

 

Part Onehttps://thatwoman.wordpress.com/2019/03/22/the-ratings-of-medical-facilities-series-it-begins/

 

The amount of money  spent “annually” in the United States on health  care  is, according to  Forbes Magazine

Americans spent $3.5 trillion on healthcare in 2017, adding up to 17.9% of GDP, nearly the same as 2016’s 18% share. Healthcare spending grew by 3.9%, the slowest it’s grown since 2013 and slower than the previous year’s 4.8%.

The main reason overall healthcare spending grew more slowly was because of less growth in the amount of healthcare services people used and in the use of fancier services like MRI instead of CT scans. This is one category called “use and intensity” and is what’s left over after the report authors at the Centers for Medicare and Medicaid Services subtract out spending growth that is attributable to U.S. population demographic changes and healthcare prices going up.

https://www.forbes.com/sites/elliekincaid/2018/12/06/the-amount-americans-spend-on-healthcare-is-still-growing-but-more-and-more-slowly/#66d12d242eea

And you  can find a good article on the breakdown of those costs in this article by  the Washington Post https://www.washingtonpost.com/news/wonk/wp/2016/12/27/the-u-s-spends-more-on-health-care-than-any-other-country-heres-what-were-buying/?noredirect=on&utm_term=.d76a430d79f9

White Coat of Death by Chris Ritchey

My  point is: This healthcare industry  is a HUGE , unwieldy , money  devouring creature ,  as we spend  to  stay  alive, enjoy a “healthy ” life for longer .   Americans are paying through  the nose.  The healthcare “industry” from doctors offices, clinics, drugstore/ drugs, emergency  rooms, ambulance services  hospitals , nursing homes – they  truly  do have a lucrative business https://www.payingforseniorcare.com/longtermcare/statistics.html

Percentage of all federal domestic spending that goes to the elderly: 46%. Average annual health care costs for older Americans who earn more than $30,000 a year: $11,000 … Average cost to stay in a US nursing home for one year: $76,680.
and yet  the hourly  wage for a nursing home assistant according to
https://www.indeed.com/cmp/Nursing-Home-Rehabilitation-Facility/salaries
Average Nursing Home / Rehabilitation Facility hourly pay ranges from approximately $11.46 per hour for Dietary Aide to $19.00 per hour for Admissions Coordinator
Photo Source https://smithandjones.com/resources/blog/rise-of-the-healthcare-consumer
“The consumer movement is partly an age-related phenomenon. Each generation of patients has unique emotional triggers and motivations for how they choose care providers. Seniors (age 70+) still follow their doctors’ recommendations, but Baby Boomers (age 45-65) treat healthcare decisions more like consumers: they research their options, challenge assumptions and rely on conversations to make their choices. Young adults (age 20-45) are more inclined to shop around and show preference for healthcare brands; while they won’t admit it, they’re heavily influenced by great advertising, social networks and word of mouth recommendations.”
All the cost involved in healthcare  comes from “we the people”  in the form of paying for insurances, through  various programs, government, private and out of  our pockets – we pay  one way  or another . Therefore, it seems to  me the healthcare industry  needs to “listen to  their consumers”. That is probably  wishful thinking  because  we the consumers are a “renewable source” so not really  important in the business plans of CEOs or CFOs.
One woman and her blog is not going to  change a damned thing ( and they  know it) , but at least the information will be out there and some of the situations that needn’t have happened on my  family’s latest “health  journey” could be addressed, by  Medicare , the hospitals and skilled nursing facilities  we have dealt with  in the past  three months – after all someone’s life , happiness and health  were at stake  and we are paying for it- big time .
I will document the good the bad and the downright ugly from my  perspective as a CONSUMER, NOT a MEDICAL PROFESSIONAL……….
To  be continued……..

April 9, 2019 at 12:52 pm 5 comments

April 3rd- FORGOTTEN- Chris Ritchey

In the days and weeks I  have been in this latest medical situation I  managed to  watch a movie – Hunters Lodge– not a wonderful movie but entertaining enough  to  take my  mind off of things. However, the opening lines  resonated with me:

“They  say  you  die three times – once when your body  fails you – again when you  are buried ( funeral) and again when you  are forgotten”

Those were the lines that  set me watching the rest of the movie… I agree with them.   I believe   you  have died twice and in some cases  three times. There are those that  forgot and dismissed you  from memory  in the very beginning of our loss but there are those who  truly  love you  from whose memory  and life you  will not be forgotten.

 

 

Gavin, just a few months old when you  passed  and Braedyn  born 3 years later KNOW you,  talk of you  and “remember” not in the usual way of remembering a life  but who  you  are now! You  are still very  much  a part of their lives.

Very  few of my  family  left remember my  Grandmother  “Nanny  Bunyan” and her sons, my  mum’s mother , Nanny  Hines – such  a different person from my  Dad’s mother  not the exotic sophisticated wealthy  red- haired fashion conscious , jewel wearing and Channel  No  5   for her. Nanny  Hines  a nurse/ midwife  mother to  6 – 3 boys and 3 girls and all that entailed, no,  she was warm and loving and gentle .

 

Soon, those of us that still remember each  of them as they  were when they  were alive and part of our living memory  will also  have passed  and apart from the little bits of information  left in  my  mothers” ” MY BOOK” ( hopefully  passed down to  the younger family  members) we too will die our third death.

Cover Design Chris Ritchey

I  have tried to  hold (in the present )  the “man that time forgets” – you- by  keeping your life, your art, your thoughts and our love for you  alive on this blog- archived (hopefully  for  all time)   – and  with  my  own book, when it is completed

and our own  contributions to  the great – what happens after you  die  theories ……

 

Love doesn’t forget……. and neither do  we

April 3, 2019 at 10:31 am 4 comments


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