Posts filed under ‘Doctor/Physician’
April 3rd- NO LIMITS -Chapt 3- Chris Ritchey
No Limits- The book
https://thatwoman.wordpress.com/2020/01/02/jan-3rd-no-limits-the-forward-chris-ritchey/
https://thatwoman.wordpress.com/2020/02/03/feb-3rd-no-limits-chapter-1-chris-ritchey/
https://thatwoman.wordpress.com/2020/03/03/march-3rd-no-limits-chapt-3-chris-ritchey/
After the engagement announcement and the resulting kerfuffle with the in laws to be, I decided I would only do what I was asked , no suggestions or real involvement with this wedding. I could tell it would be walking on egg shells time.
A few days after the ring fiasco Chris called and said Angela wanted us to go to Beechwood where she had made an appointment to try on wedding gowns. It was rather short notice but Nikki and I, for the sake of fence mending, agreed to share in what should have been a delightful afternoon. In fact it was except the mother of the bride was not there, aunts and grandmother etc but no Sue Lombardi. Angela duly tried on various gowns and she did look lovely. I suggested that I would purchase the wedding veil of her choice.
Since I had to get back to a meeting – already planned- Nikki and I left. I found out later Sue eventually showed up as she didn’t want to take the time off work. Chris called and said Sue was very upset and
“What would I have done- would I have taken the time off? “
” Chris you aren’t pulling me into that situation”.. and I kept quiet.
Chris had still not recovered his usual good humour , although he was speaking to his sister once again. I couldn’t figure out what we had done wrong now. Finally , Nikki told me : Apparently Chris was beside himself worrying as to how he was going to pay for the wedding items that Sue and Angela had said were his obligation. The rehearsal dinner, cars, flowers , liquor for the reception, gifts, photographer, honeymoon etc. He had spent his savings on that ring and had just been offered a position with Wyse Advertising. Since his family had paid for all his college – 5 years at Cleveland Institute of Art he did not have any student loans and he was trying to get a loan for this wedding.
I thought to myself some of those of those expenses should have been covered by the Lombardi family and they should have realized what a wedding list of over 200 would cost this young man. but as I said
I was going to keep my mouth shut .
Chris came home from work and I asked him what exactly was worrying him and he told me. I told him his father and I would pay for all he needed to pay for and not to worry. He balked at the idea and I said:
OK let us pay for it , rather than you taking out a loan and you can pay it back to us over time.
It was decided and life pretty much went on, people being young and planning. Although it wasn’t all plain sailing as the bridesmaids and groomsmen were picked and Nikki , Chris’s sister was left out of the plans. Chris asked her why she wasn’t going to look at the bridesmaids dresses and she informed him
” I wasn’t asked , I don’t believe I am part of the wedding party” ( although her husband was)
Chris immediately got on the phone to Angela
“Nikki is one of the wedding party right? ( the reply of yes if she wants to be) rather a backhanded invitation ….
Looking back these things faded into the realm of really didn’t matter they were inconsequential in the grand scheme of life. Summer passed , autumn and Christmas and then in February a trip to the Doctors for Chris, whom we thought was not getting over bronchitus and swollen glands .
Our world was suddenly turned upside down inside out and the silent screaming started : I wrote about the phone call 10 days later:
All it takes is a phone call to start you screaming
Hello!
It was a phone call that sent an icy cold that permeated through my very core and has not left me yet, my brain not wanting to “compute” what my ears were hearing, mouth dry, eyes welling with tears , the incredulousness, the denial , the confusion, the sheer terror that runs through your frame, your mind screaming, a few seconds that changes your life forever- nothing will ever be the same.
A phone call that leaves you weeping with fear, that terror, whose tentacles reach through your very being, tearing at your insides, ripping to shreds happiness and laughter. One of the people you love more than life itself, one that you gave birth to, cuddled, bathed, fed and protected is on Route 2 and has answered another (cell) phone to be told that test results (for possible bronchitis) have come back with a life threatening disease.
face of a cancer cell
Someone please wake me from this nightmare……..what am I supposed to do, what do I say, how can I do anything- someone , anyone why????????????????
The look on your husband’s face as he tries to understand the picture of what is happening with this conversation………
The dread disease that sends a mother into the world of deal making ,
No please – not my child , let it be me, take me ,God how can I bear this?
How can I be brave and make it better when my heart is exploding with pain, every part of me screaming from the gauntlet of emotions that are coursing through my very essence?
You are removed from the world around you –
Nothing matters, not the politics, not the crime, not the state of the roads, not the weddings, the weather, blogs, the pettiness, media , CRA’s, pontificators, principles , presidents, arguments ….. .nothing…. your world has shrunk, your planet consists of no more than 8 people and the all consuming fire of fear that your child is going to be in a world of hurt and you are helpless.
You want to curl up in a dark place – trying not to feel, to escape but the pain and confusion drags you back to the surface of desperation, despair and the reality that is now your world.
Eventually the body decides, through sheer exhaustion, to sleep but the nightmare doesn’t stop, you wake, a pillow wet with tears, a coldness that remains in your very core reminding you there is no escape- you truly do
“wake from sleep exhausted”(Susette Kelo)
Family , friends try to be encouraging and for that you are grateful but in a mother’s heart there is really nothing that they can do or say , you want to wake up from the nightmare, make it go away.
Make it stop
You look for anything that will give you hope -that there is a mistake but somehow inside you know the truth – it will not go away – it is going to have to be dealt with.
No matter how old your child becomes they will always be your child. You see not the young man or daughter – you see the chubby 2 year old with soft plump arms, the eyes that never change
only mummy can’t- no soft butterfly kisses or a cookie is going to fix this – there is no magic bandaid with happy faces.
Your life and that of your loved ones is contingent upon a surgeon’s knife and upon a lab in California – a stranger making a decision that will decide whether there is happiness , hope or pain to come in your life and that of your child. You are just another lab report , a number with an insurance billing code- a job of work.
This nightmare of speculation and waiting for the next body blow , like some sort of insidious torture technique, rips at you and the very fabric of your family . Life goes on around you but you are removed you go through the motions but you aren’t really there and you only care about the turmoil that one phone call caused.
The tests, the scans, the trips to the hospital, the waiting rooms with color co-ordinated furnishings, a laugh echoing through a hallway, people talking about the weather, a child crying as life goes on -biopsies, more waiting – hoping- praying pleading with a greater power
“please let them have this wrong ” “please let it be a mistake”
Watching every movement,
“are they eating , are they paler today , the cough – is it better, worse,?”
Trying to smile, to put on the brave face and make life normal until the results are in, cooking food no one really wants to eat , but the strength has to be kept up.
Laying awake watching the clock tick away the hours of life and darkness, waiting for morning……things always look better in the daylight,
but that isn’t true- the mornings come and there is no sanctuary in the watery, wintery sun. Days run into one another, hours, the calendar and the marked events deemed important enough to make note of are no longer significant in their passing.
The darkness envelopes and you think of other mothers, how do they cope with news that threatens their babies, their teenagers, the mothers whose sons and daughters return from war missing limbs and with horrific injuries, how do they cope even having them in harms way- day after day ?
How does a mother bear the news that her child is gone- no longer to hold them, to feel a heartbeat , to gaze with love upon their face, the hear their laugh , to see their eyes no more ….the gut wrenching sadness the rises up. unasked, unwanted, and overflows with the releasing of tears without warning.
Then the results and you know, even before the Doctor opens his mouth – you see his eyes- what they are…. you hear the bad news tempered with good news and hope and another journey begins…………and you know that somewhere another mother shares your pain and fear and is trying to make a deal
take me, not my child………………..
To be continued
Medical Care- A Consumer’s perspective- Brookdale Pt 2
Part One– https://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/
Part Four – https://thatwoman.wordpress.com/2019/04/29/medical-care-a-consumers-perspective-mercy-health-lorain-2/
This will, hopefully, be the last in the series of medical care received in various medical facilities , three different types of medical care, and three different providers. Ideally this post should be in two parts but I want to leave Brookdale behind so it will be lengthy.
The common denominator was the insurance coverage Medicare and Medical Mutual. Although I am fighting one bill ( will be explored in this post) and the Medicare evaluation of Brookdale as mentioned in Part SIX is an issue for us, on the whole Medicare and Medical Mutual – so far – has been less than the nightmare I thought it would be.
I believed we were spoiled by the nursing staff/ aides and housekeeping staff at Mercy Health Lorain, upon reflection they set the bar very high– a few of their physicians I found decidedly lacking ( see Part One).
Also , the Cleveland Clinic Rehabilitation was beautifully clean and the food was very good , rehab staff were excellent, you knew what time therapy was every day and who what and where so families could adjust schedules to participate with the patient. You knew who the nurses were that day and your aides. Unfortunately, it was down to a small percentage of aides that spoiled the experience and also caused a health issue ( in my opinion) by spreading C’Diff from one room to another and then sending contaminated material with the patient to another facility. Brookdale
Ah! Brookdale, Westlake Ohio…..the 5 star Skilled nursing and rehabilitation facility which is in the middle of a very large Assisted Living and Senior Living
Brookdale Senior Living owns and operates over 1,000 senior living communities and retirement communities in the United States. Brookdale was established in 1978 and is based out of Brentwood, Tennessee. https://en.wikipedia.org/wiki/Brookdale_Senior_Living
The typical Brookdale Senior Living CNA salary is $12. CNA salaries at Brookdale Senior Living can range from $10 – $15. This estimate is based upon 66 Brookdale Senior Living CNA salary report(s) provided by employees or estimated based upon statistical methodshttps://www.glassdoor.com/Hourly-Pay/Brookdale-Senior-Living-CNA-Hourly-Pay-E6433_D_KO24,27.htm
Independent living prices average $2,900 monthly. The majority of locations will cost between $2,300 and $3,500. Skilled nursing communities are available as a Basic Monthly Service Rate of between $6,000 and $8,500.
I have not received the cost of our one month stay at Brookdale Westlake “skilled nursing and rehab ” in Westlake as of today’s date but I do know one charge was $400 per day.
After the poor experience of “transfer” from Cleveland Clinic Rehab Hosp. Avon (which was paid for by self -pay) I wasn’t in the best of moods . I understood from literature that I had read this was a “newer facilty”. I understood it to be around 10 years old. In my opinion it was becoming a little “shabby” without the chic.
I should point out this is a very large complex and the “skilled nursing” ( bit of an oxymoron in my opinion) section had quite a large turnover of people coming in and out of rehab. However, my first impression after leaving the gleaming white , bright Cleveland Clinic Rehabilitation Hospital(CCRH) was one of “OH!” and not in a pleasant way. The parking for the visitors for the skilled nursing/ rehab section was awful, you had to hope the parking gods were on your side as you drove round and round hoping for someone to leave.
Please note this a critique of the Skilled Nursing and Rehabilitation Section of the complex, I have no thoughts or opinions as to the rest of their complex and assisted living sections.
The facility allows pet visits to the patients rooms, all well and good but unlike The CCRH where there was a designated area tile floor) for those pet visits, animals in all shapes and sizes routinely walked the “carpeted corridors” , one little fella dragged his bottom along the carpet which made me go eeeewwwwwww. Had they been bathed, de-fleaed , some looked as if they weren’t exactly a pampered pet? I did take my dog to see her master at the CCRH after going through the paperwork and a shampoo. I did not bring her to Brookdale!
The room was supposed to be “homey” and an effort was made in the design and décor. However too many bumps and bruises on the paintwork, furniture left an impression of needing a redecorating. The “homey” bedspread with its little bag of goodies, had decidedly seen better days , faded (hopefully) through a lot of washing? Again, being spoiled by the open airiness of the CCRH with large windows this was a bit of a disappointment , his room was dark and yes in my opinion a bit dingy. The photo from their website is really not a great representation as to the “light” in the room we had. After the pristine cleanliness of CCRH it was a bit of a disappointment Oh well thought I different facility not a hospital .
The bed was actually quite small, and no sides. Apparently “nursing homes” cannot restrict the occupants ( such as the side up in a hospital) neither can they belt you in a wheel chair. This was all well and good but for a patient that has very little trunk strength and one who was a fall risk this was not ideal. I was told we could request the sides if we went through the paperwork and the Dr. must write out a prescription to have the sides installed. I said this is what I wanted done. That was the last I heard, and actually he fell out of the bed twice, a chair once and the wheelchair once. Not so good when it comes to the fact he had just had major brain surgery after a fall.
After 4 days of being a resident the bathroom became the holding room for dirty sheets, linens, towels used diapers and pads ( remember that C’Diff) I was ready to remove the patient from the 5 star facility and interaction with some very off putting aides . I called the head nurse and one of the administrators , after my daughter was given the pads etc to clean up the leaking Foley bag. Since she was gowned and wiping down the room with cleaning cloths due to the C’diff maybe they did think she was a staff member, as we were told. Obviously no-one else up to that point – knowing there was an issue with C’diff wore those items. ( Benefit of the doubt)
Some aides did make a half hearted effort to “gown up” after the complaint, however, latex gloves routinely ended up being taken off and thrown into the “general purpose waste basket”, well those that made it in as they were thrown – I was forever picking these up and emptying the room trash!
As for “housekeeping” I can’t remember that happening to any degree maybe weekly and only once was there what I call a thorough cleaning ( the Sunday after I complained ) whereas in the previous two facility it was daily and sometimes twice a day.
The ‘weekend administrator” did get the bags of laundry and garbage out of the bathroom , did send in a cleaner and apologized. The “head” nurse did get the Foley bag removed, changed the mattress to an air mattress, as he was starting to get a bed sore due to being stationary and unable to move on his own ( eg. roll over) and was also very uncomfortable due to a pre-existing back condition. And so it began…………
The rehab staff were very good, he could not have intensive rehab at this facility , again only so often due to Medicare restrictions. But on the whole we were pleased. My goal was to have him ambulatory , able to get into a bed at home and to be able to get to the bathroom. This was going to mean on a walker at least because this “Old House” was not wheelchair friendly.
Since there was definitely an issue with 85% of the aides ( remember the staff that was above average according to the Medicare evaluation ) my daughter would spend every morning going with him to rehab, not the organized times etc of the CCRH we were expecting, she would stay until after lunch and I would come later in the afternoon through the evening. Night times were very bad for him, but he was on digoxin and although he had adverse reactions to this drug we could not get Doctors to take him off of it ( prescribed by the ghost cardiologist from Mercy)
https://www.nhqualitycampaign.org/…/Drugs_that_may_cause_psychiatric_symptoms…visual hallucinations, fear, paranoia, agitation, anxiety. Sudden … Hallucinations, paranoia, delusions, confusion, mania, anxiety … Digoxin (Lanoxin*).
“On March 17th I received a call from the night nursing staff at Brookdale that my husband had fallen trying to get out of his chair. The nurse informed me he had bruising to his abdomen and an abrasion to his left leg.They could not tell me if he had hit his head. Considering they stated he had only fallen 10 minutes previously to calling me I was concerned they could not tell me whether he had hit his head and that bruising to the abdomen was already in place. I deemed it important considering the history of previous weeks of major brain bleed and surgery he should be checked out by someone other than an LPN. Hence the trip to St. John’s Westshore Emergency Dept. He was monitored in the ER and after a few hours sent back to Brookdale .
It is my contention that due to the recent history of falling and two brain bleeds the ER was the appropriate facility at 1 a.m in the morning. Brookdale, in my opinion did not have a qualified individual on duty or equipment to ascertain a diagnosis. The ER was the best place”
Medical Care – a consumer’s perspective-Brookdale ( Skilled Nursing)
Part One– https://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/
Part Four – https://thatwoman.wordpress.com/2019/04/29/medical-care-a-consumers-perspective-mercy-health-lorain-2/
This time when we were told we would have to make plans for my husband to leave the Cleveland Clinic Rehabilitation Hospital ( after 19 days) were were given a list with 54 skilled nursing facilities but more time in which to make a decision.
The case worker at Cleveland Clinic Rehab Hosp. printed out a list of 54 facilities within a 25 mile radius, with ratings from Medicare .gov Nursing Home Compare .
As you can see page one with the closest to home ( as I already had checked them out) were crossed off. “One” of the complaints I have of Medicare in their ratings , in our situation, was we needed physical therapy and rehabilitation and although “staffing” was rated, Health inspections and Quality were rated there was not a rating for the “caliber” of rehab and therapists.
I would like to point out that at Brookdale aka WESTLAKE VILLAGE CARE CENTER 28540, village Drive Westlake Ohio 44145 , the rehab therapy and therapists were excellent. I wish I could say the same for 90 percent of their aides.
20 of the 54 facilities were listed in their staffing by Medicare as “much below or below average”, even when their overall rating was above average or much above average – very confusing .
The star system given my Medicare was also misleading ( Brookdale) – Westlake Village was given a 5 out of 5 star , comforting to me when we chose this facility and also the staffing as “above average” – I don’t know who at Medicare rates these facilities but this was not in any way a 5 star facility unless the bar is set very low!!!!
Take a look at the first page ( first photo) of the report of the 5 facilities 4 received 4 out of 5 stars but each of them has a rating of below average for staffing. and one Lake Pointe Health Care a 1.
NOTE: you really have to do your homework and that is hard when you are having to choose a facility for a loved one during a traumatic time. I thought I had done my homework with this facility. Since my husband was in the University Hospital system, as were all his doctors, I checked and Brookdale had access to either the Cleveland Clinic System and for us a doctor with University Hospitals. It had taken me weeks of being “out of our system to get him back into UH.
I was happy in our choice having done as much research as I could , ratings , recommendations etc. looking on line . https://www.brookdale.com/en/communities/brookdale-westlake-village.html?cid=yext
The trip from the Cleveland Clinic Rehabilitation Hospital via “transport” was again a fiasco of waiting and miscommunication as to what sort of transport was needed.
Although I had had problems at the Cleveland Clinic they had been addressed for the most part quickly and efficiently , however we left on a sour note and with “personal belongings in a large bag”.
Due to the tension dealing with Doc Martens transport I didn’t realize that along with my husband carried by one of the administrative staff to the ambulance was the lift pads and sling pad from both his bed and wheelchairs and various items .
The lift pads/sling pads ( plastic) we discovered later ,when I looked into the closet at Brookdale where the bag had been placed as personal effects had fecal matter attached, bad enough but considering this was also contaminated with C’diff most worrying and dangerous in my laypersons opinion.
Here we were bringing into another facility contaminated matter!!! This practice of transporting these items should not occur , after all you don’t know where they have been.
This was not a good start to our stay and within 4 days I was ready to pull my husband out of this 5 star establishment ……. TO BE CONTINUED…..
Medical Care – a consumer’s perspective-Cleveland Clinic Rehab Hospital
Part One– https://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/
Part Four – https://thatwoman.wordpress.com/2019/04/29/medical-care-a-consumers-perspective-mercy-health-lorain-2/
Cleveland Clinic Rehabilitation Hospital Avon Ohio, was NOT on the list of 34 facilities given to us by Mercy Health social workers – Lorain Ohio. I did some research on my own, went to the internet and to my facebook page and asked local friends if they had had good or even poor experiences with facilities in the area. Cleveland Clinic Rehabilitation Hospital came up as being a good facility. https://my.clevelandclinic.org/locations/rehabilitation-hospital/specialties
My daughter and I spent a Thursday morning touring the facility. It has all the benefits of a hospital doctors , rehabilitation therapists, nurses, aides and the focus is of course on rehabilitation. The facility is only a few years old and shiny , white and extremely clean. The rooms were large , bright and airy. We were most impressed with the rehabilitation area and the state of the art equipment .
However, my husband ( due to Medicare Insurance rules) apparently could only stay for 19 days. It is my belief he probably should have been released to that facility further along in his recovery. He was paralyzed down one side and was on a plethora of medications. One which was given to him at Mercy by the “ghost dr.” which causes confusion etc. Again not being a physician and not knowing at the time he was even on this medication I was also unaware that in order to combat the confusion ( also he was on pain killers) he was being given another drug for Alzheimers.
I must interject here as to hospital to hospital transportation, I wish I had something good to say , you really are at the transporters “mercy”. The time arranged leaving Mercy to the Clinic was supposed to be 11 a.m However, although I was supposed to follow him to the new facility I couldn’t by 6 in the evening after waiting hours and hours I went home and told them to call me when he was being transported . You see I had to sign the admittance papers and permission to treat. At 9:00 p.m. I called the Clinic who told me that it was so late he would probably now be transported the following morning . I went to bed only to be called at 11:15 by the Cleveland Clinic Nurse that he had been sent to them a few minutes prior and could I give the permissions verbally. ( This was not the only hiccup with transport).
I was, on the whole, extremely pleased with this facility but it was not all good news. Once again the rehab staff were wonderful, and it was so organized, you knew exactly what he would be doing and when, I was very impressed with the rehab staff, also the cleaning staff once again were in the rooms every day and sometimes more than once. The nurses were for the most part very professional and helpful as were 80 percent of the aides.
My husband needed help initially from two and on some occasions three individuals to see to his needs. The confusion caused by the drugs did not help, that and the weakness and immobility of his left side. He had to learn to use his vocal cords again ( which were stretched due to the intubation) . It was a few days before I realized he was still taking the medication for gout which should have been stopped at Mercy. The medication Colchicine, can and does cause diarrhea and stomach upset. The gout symptoms had abated and he really should not have been still on this drug , especially since it does also react with Digoxin but of course I was unaware he was on this drug as well.
I did insist since the diarrhea was an issue they stop the Colchicine. I also , once I found out he was on Digoxin ( Lanoxin), they stop or change that medication BUT and here is the issue it seems that doctors at this facility and other facilities in the chain are loathe to change another “specialists” diagnosis and treatment. This was a huge problem for us. One because we were out of our network and OUR team of physicians and specialists who knew his history and his courses of treatment we had to rely on basically strangers to his situation.
Therefore I started asking for a daily list of all his medications
Once he was off the Colchicine he stomach upset went away. BUT not for long a woman in the next room came down with C’diff https://www.cdc.gov/cdiff/what-is.html . Now it was put to us that my husband came down with this due to the huge amount of antibiotics he was taking and had taken. BUT that is not the whole story:
IF the lady in the next room and not had the infection first I would not have done more research thinking it was because of the antibiotics . Although the staff were for the most part adhering to handwashing etc protocol not all of them did . Infact I would say 20 percent of the aides were lax in that area. I actually had to throw away his cellphone as it somehow became covered in fecal matter ( C’diff contamination) and was put on the bedside table. My husband was incapable of having reached the table. I will say that for the most part the aides and nurses did respond to his call light in a timely manner.
One aide, in particular, left a lot to be desired, from his treatment of my husband and his response times were not great, his laxness in this area and lack of hand washing protocol was a great concern.
Please understand a patient is in pain and although they had been told of the back injury it took at least a week for them to address the situation ( it hadn’t been addressed at Mercy so not on his record) , which meant sitting in one position or laying ( when you are partially paralyzed) can be unbearable and since you can’t move the aides had to do it for him. This did cause “some ” of the aides frustration and it showed.
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There was another aide who also needed to be retrained or let go in my opinion. I came into find my husband half in and half out of the bed, the top sheet wrapped around him and soaked with water. Actually I had just walked into the room with one of the hospital administrators, so she did witness the situation. She immediately went to work taking care of my husbands comfort. The aide , when she was called , said he spilled water on himself… remembering the jug was on a table out of his reach and he was not able to move his left arm at all, that scenario was very unlikely. I looked at this aide and said:
“so he spills a jug of water all over his bedding and you leave him laying in it?”
The aid turned to me and said:
“SORREEEEEEE”( in a very sarcastic tone)
I then turned to the administrator ( names available) and said
“she is done I don’t want her anywhere near my husband
The administrators at the Cleveland Clinic Rehabilitation hospital did address my concerns but as I told them what stopped them from getting great review on the place as a whole in my opinion was 20 percent of their “aides” and it was those 20 percent that caused situations that should not have happened, but it is those situations you remember .
HEALTHCARE IS A HUGE BUSINESS AND EVEN THOUGH WE THE CONSUMERS ARE PRETTY MUCH AT THEIR MERCY (NO PUN INTENDED) WE ARE STILL CONSUMERS PAYING FOR A SERVICE.
We were assigned one doctor for my husband and he called in others as needed such as another cardiologist, ultra sound etc. The doctor was quite nice, spoke very softly but with a heavy accent so I was once again forever asking him to repeat what he was saying and every time he was in the room he was costing ( according to the bills I received) 350 to 500 dollars for up to 35 minutes. I should go through the dates to see how many times a day but considering I received 74 pages of bills each page having at least 5 charges on them I am honestly too tired to do the homework.
The discharge date ( the 19 days being almost up) I was given another list of this time 54 “skilled nursing facilities ” for the next part of the journey and this time I did have time to do some homework……….. To Be continued
Cleveland Clinic Rehabilitation Hospital gets a B plus…. it was an A minus But then that C’diff situation was made worse…… more on that as we continue….
Medical Care, a consumer’s perspective- Mercy Health – Lorain ( 2)
Part One– https://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
Medical Care -a consumers prospective-Mercy Health Lorain
Part One– https://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.
Westlake, OH 44145
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
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
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:
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.”
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 …..
Medical Care – From a Consumer’s Perspective- Ohio
Photo Source : https://revenuesandprofits.com/top-20-u-s-healthcare-companies-by-2016-revenues/
Part One– https://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.
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.
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
“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.”
The Ratings of Medical facilities Series- IT BEGINS
These past weeks have been very tough both emotionally and physically on this family. I have not written anything for those weeks except of course for the 3rd of the month remembrances of my son, Chris.
Hopefully as we come to the end of “hospitalization” and I am still in a state of hope that will end soon and we can move on to healing at home and with “out-patient therapy”.
Honestly every single day since January 19th has been taken up with the health issue , there has been no room in my life for all things “Lorain”, blight, history , drug dealers and housing courts and “less than ” judges , slum lords, or any of the other 60 categories covered over the years on this blog.
I am lucky if I can get home , get something to eat and fall into bed. I am too tired to research and weigh in on , Lorain City school fiasco https://www.forbes.com/sites/petergreene/2019/02/27/lorain-ohio-and-the-failure-of-school-takeover-policy/#47fa8004faa6 as I have done in previous years , saving historical sites, attend any of the meetings. I was lucky I had a break to do the tax papers for Charleston Village Society Inc. – the “site” on 2nd and Oberlin has not had my attention at all, thanks has to go to the volunteers and City of Lorain Utilities for stepping in. I haven’t even written our annual report for the website but I will.
the site today
I will focus on the three healthcare facilities we have personally been involved with since January 18th 2019
Mercy Health — Lorain Hospital https://www.mercy.com/locations/hospitals/lorain
I would remind readers of this blog , as always :“these are my personal opinions based upon my personal experiences with documentation and records where applicable”.I will of course be sending the links to these posts as they happen to the administrative officers of all the facilities involved with their chance for rebuttal or explanations and for their information.
Chris Ritchey Face book icon
March 3rd – The Rating – Chris Ritchey
ART WORK- CHRIS RITCHEY
It has been a short month February but one of the longest in other ways. We are now on our third venue with regard to “hospitals and rehab”. As we traverse yet another life changing road, I believe it is time to rate the experiences.
Chris Ritchey Face book icon
Your hospital experience found me pretty much a novice and very naïve, because your “bride” was part of the Cleveland Clinic System, Southpointe and Main Campus I deferred to her- a huge mistake– I will always believe that to be the case . That perceived mistake is not one I will ever make again. Much to the irritation of CEO’s, some Doctors, not so much the nurses, but aides and hospital protocols I am involved more than just visiting at regular hour, I am an advocate for “my patient and loved one” and your sister is just a younger version of me!
It is you and your strength that has kept me , if not on an even keel at least afloat and once again it is anger that keeps me upright.
I know the signs and I know you are with us on this journey , just as I carried you beneath my heart and shared souls – that continues as does my love for you. I will write the story of our latest journey , the Kudos, the positives and negatives of each of the facilities – maybe others having similar journeys will see the pitfalls and the solutions.
I love and miss you more than ever ………
Sherrod Brown and Hospice THANK YOU- Lorain
This blog has been all about death and dying recently – more so than usual. It has been a long 6 months since my mum was put under Hospice Care. I have to give a shout out to Mercy New Life Hospice – Kolbe Road. https://www.mercy.com/locations/specialty-locations/hospice-care-palliative-care/mercy-new-life-hospice
because their nurses and aides helped me keep my promise to my mum that she would stay in what became her home here with us.
It was NOT easy, anyone that tells you that being a “carer ” 24 hours a day 7 days a week will not leave you drained, frustrated , emotionally pulled in so many directions has not walked that path.
I found myself having to do things for my mum in those last weeks that I hated doing and she hated having done. She could tell by my face that I was struggling with things. I was never cut out to be a nurse , never wanted to care for the ill but you do things you never thought you would because of love. There were times I didn’t think I could keep my promise as lifting and being “on duty” 24/7 took their toll physically, my husband and I were the walking wounded to begin with. Thank goodness for my daughter who stepped up to the plate on more than one occasion.
And then all of a sudden she was gone, my job was gone as well, it has taken many days not to listen for the sound of her “chimes” calling me upstairs to help her. Not to look at the clock , not to wake at 3 in morning and get up and check on her. The days of trying to find something she could eat or might tempt her to eat put aside. Tea was her elixir of life in this house.
I am grateful to the Doctors , nurses and aides because those last months she and I didn’t have to worry about the prescription coverages, the medical bills. WHY because she was covered by insurance and why was that ?
Regular Readers will remember this time last year I was fighting the gatekeepers . Kasich , the Governor of Ohio , had done away with the medical program under which my mother was covered and paid into for decades. People who should have known a way forward did not help this 98-year-old woman , bureaucracy abounded and for months I fought and cajoled only to be turned away by the local Social Security Offices ( Medicare) – Job and family Services – all this is documented and one day I will write in-depth the whole sorry fiasco. I was at my wit’s end for so many weeks – I was helpless – ME who can cut through the crap to solutions stymied , lost in a healthcare limbo, not knowing where to turn next.
https://thatwoman.wordpress.com/2018/02/21/the-gatekeepers-keeping-us-out-part-one/
On November 6th we will be voting , I am in a quandary as to how most of my votes will be cast BUT there is one person who will receive my vote as well as that of my family Sherrod Brown – https://www.brown.senate.gov/
Why???? because his staff in Lorain and “his” caring , expertise and knowledge of the medical system, federal programs cut through all the gobbledegook I was facing and pointed us in the direction of HELP when not one other agency or politician would or could.
Still the confusion with bureaucrats and up jumped Muppets of Medical abounded BUT now I had people with knowledge to help us through and that was totally thanks to Sherrod Brown and his offices. Because of that my mum and I only had to deal with “dying” and could access the medical assistance she needed .
So yes this is a political “Vote For” post but I know in my heart of hearts this man and the people he employs CARE and cared when I needed the help the most. I am not a Democrat or Republican and haven’t ever before asked anyone to “vote For” but I am doing so now and I take this plea very seriously please vote for Senator Sherrod Brown thank you ………..
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