Posts tagged ‘healthcare’

Medical Care- A Consumer’s perspective- Brookdale Pt 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/

Part Fourhttps://thatwoman.wordpress.com/2019/04/29/medical-care-a-consumers-perspective-mercy-health-lorain-2/

Part Five – https://thatwoman.wordpress.com/2019/05/27/medical-care-a-consumers-perspective-cleveland-clinic-rehab-hospital/

Part Sixhttps://thatwoman.wordpress.com/2019/06/15/medical-care-a-consumers-perspective-brookdale-skilled-nursing/

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*).
Note: the moment he was home and our cardiologist saw him digoxin was “nixed” and so  were many  of the other medications.
I am sure the administrative staff as well as a number of the aides were not at all happy  with  my  advocacy for my  husband. A “difficult patient” due to  medications, pain and confusion and a difficult wife 😉 . I  would ask you  to  remember this man went to  bed at Mercy  woke up eight days later after being intubated  and having respiratory  arrest unable to  move , unable to  speak ( due to  his vocal chords being stretched, ) not knowing where he was and what happened and having an 8 inch  slice taken out of his scalp. He remembers nothing at all from Mercy  , very  little from CCRH and too much  from Brookdale, Westlake.
 Patients were told they  could eat in the dining room  and for the most part the food was fine, the aides in the dining area were very  helpful  and the view of the duck pond a nice outlook. Mealtimes became a highlight to  one trapped in a wheelchair.
The call light response times were awful, in our case, of course being a “demanding patient” who  wanted to  use the bathroom or get out of the bed  and wheelchair due to  his discomfort didn’t help. The notice on the board in his room “call don’t fall” didn’t count for much.
The  Administrator did print out a  record of the response times to  the call light. Amazingly  they  had response times of 30  seconds  up  to  5 minutes.
What they  hadn’t realized with  the amount of time my  daughter and I  were putting in and the fact that as a blogger and ex- columnist I  have this penchant for documentation we also  kept a record of those call times and for the “most” part they  didn’t concur with  the print out. With  that printed out response time for his room number   I  received a bill for another patient, which  I  duly  returned, that had had that room previously.
March  17th  he fell again , this is an excerpt to  Medicare  appeals as they denied the cost of the emergency  room Dr.  after I  insisted Brookdale transport him to  St. John’s after yet another fall.

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”

As time wore on and actually  his discharge times got put back , I  realized that, in our case , although the rehab therapy was very  good, it wasn’t enough. He was spending too much  time “waiting” and sitting in a wheelchair for the  two  to three hours of rehab and at least two  days a week where there was no  rehab at all. ( Again due to  Medicare restrictions). So  as his Dr. concurred and my  husband was unhappy  at the facility  and was at least able to  use the walker (with  help) and we felt we could manage his  care  we discharged him from Brookdale Westlake  on March 29th.
I am pleased to  say  that in April he went into out patient  physical therapy  at NeuroSpine Care, Sheffield Village, three times a week. He has progressed amazingly  well and they  have him transitioning to  a cane , able to  stand  and do  the things that make life normal. http://www.neurospinecare.com/
I do not agree with  Medicare ratings that this is a 5 star facility, but then again I  do  not know how low they  set the bar!
The best I  can give this facility  in rating , remembering it was supposed to  be, according to  Medicare, a 5 star facility  is a C minus. Although there were highlights such  as the rehab staff, the “aides” were another let down  and remember these are the individual that are dealing with  your loved one.  ( I  would say  my  general impression was that the aides were dealing with  quite a few patients each  shift and if their stated wages were anything to  go  by  they  need a raise in order the attract  better qualified individuals !
Remember this is a FOR PROFIT facility  and you  are the consumer not a charity  case and Medicare  and yourself will be paying for the “business”
of care and rehabilitation!!!!!!!
https://www.ibisworld.com/industry-trends/market-research-reports/healthcare-social-assistance/nursing-residential-care-facilities/nursing-care-facilities.html

 

July 11, 2019 at 1:20 pm Leave a comment

Medical Care – a consumer’s perspective-Cleveland Clinic Rehab Hospital

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/

Part Fourhttps://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.

Chris Ritchey Face book icon

 

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….

 

 

 

May 27, 2019 at 10:02 pm 1 comment

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

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 ………

March 3, 2019 at 7:17 pm 2 comments

Feb 3rd- sick of hospitals- Chris Ritchey

Artwork Chris Ritchey Face Book page

A whole month  has passed since I  last wrote  and I  have in the last three weeks spent more time in ER’s  talking to  Doctors -that  don’t know us -explaining past issues. ICU becoming my  2nd home and all the different  protocols.

I want to  get off this band wagon of monitors, that beep  and fluctuate I have seen too many  of them since you  were in that dreadful Main Campus  Cleveland Clinic (Tausig).  I have traversed the  halls , waiting rooms in hospitals in Elyria, Westlake , Houston Texas  and Lorain.

I  am so  tired of the unexpected and having to  have the strength to  advocate.  This latest ill-health  go  around sudden and quick is going to  drag out into months. Touch  and go  10  days ago…….

The flawed Hand of the Healer by Chris Ritchey

.

I can spot an officious nurse at 10 places, know the ones that listen , talked to  professionals , that know their stuff I  am sure , but the accent is thick so  I  become infuriating to  them as I  have  to say  “repeat that please.”

 

I have sat in ER’s  waiting for results of scans and tests. I have sat in the waiting rooms with  total strangers that reflect the fear , hopefulness and dread that I know is written on my  face just as it is on theirs .

I am exhausted with illness, dying and decisions , keeping up my  strength  to be my  family’s advocate all the while wanting to  run away  and not have to  deal with  anything at all.  Life changes looming.

One of the most infuriating things is the fact that all these different hospital systems  but when it is  an emergency  you  are taken to  the  nearest ER . If they  are under a different network your health  records are not available, so  the ER does not have a base line as to  your previous health issues. Family  are left explaining in layman’s terms as to  your history and then when you  contact you  own medical team you  have to  explain the new issues. You  can request those medical records be sent  ( they  don’t like it  but insist).

Anyway   weeks of hell again looking at those monitors for every  heartbeat…………… and the horrible reminders of your last days flooding in my  brain as the smells , the squeak of rubber shoes on shiny  floor , the monitor alarms add yet another pain to  deal  with as you  sit quietly  waiting………..

I love you  still  and your bravery  still reminds me to  fight

Hands – Touching- Hands – art work Christopher Ritchey

 

 

February 3, 2019 at 11:54 am 3 comments

Sept 3rd – Houston- Chris Ritchey


https://www.cnbc.com/2017/08/28/the-stunning-images-from-record-setting-flooding-in-houston-texas.html
It amazes me sometimes when “connectivity ” happens in my life. Houston has been on the news all week with Hurricane Harvey and the great flood. I watched those streets on the television , buildings, roads , homes and areas I knew so well faced with the deluge and felt helpless and sad – something I have been feeling every day since you became ill.

The memories of those areas and another “Labor Day weekend” and the trip to MD Anderson to save your life.

“the only hope for a “cure was SGN 35” stated the officious (imho) Dr. Pohlman of the Cleveland Clinic as they brushed you off and away from their “treatment” closed to you – https://my.clevelandclinic.org/staff/900-brad-pohlman – the man with hands as cold as ice. Houston we found had the SGN35 trial so with credit card in hand we rushed to Houston. We did go to MD Anderson, Houston and hope was reborn.

Two months I stayed with you in Houston in order for you to have the treatments . When you were feeling alright we toured the city tried to take our minds away from dying. In Houston we had a lovely couple take you under their wing. We were invited to their home and to their ranch. My fond memories of them and their caring hospitality came “flooding” back as I toured, through the news media ,once more those well known streets.

The memories of you on their ranch driving the feed tractor – riding horses – touring Galveston- the cattle on the ranch and the drying up fishing pond ( due to the drought they were having) the plague of red ants . I wondered how they were fairing, those cattle -were they flooded and struggling, the streets I recognized only from the before photos.

The elation I felt on that November 7th day when your scans showed clear https://thatwoman.wordpress.com/2009/11/07/an-update-houston-and-hodgkins/ only to come crashing into hell less than a month later when you died on Dec. 3rd…. the hope that was Houston obliterated.

Yes! Houston – a city that gave us hope and welcome – I cry for Houston may they find their hope – I will always be thankful for their friendship – and I was thankful for those last days I had with you – but the memories are painful … I love you Chris that never goes away but gets stronger with each tear.

September 3, 2017 at 11:29 am 1 comment

August 3rd- Alarming- Chris Ritchey

Photo by  Chris Ritchey  July  12-2007

Photo by Chris Ritchey July 12-2007


It has been a month since I last wrote on this blog- July has come and gone- I dread July because bad things always seem to happen. Your grandfather died unexpectedly in July , ill-health news over the years has been diagnosed in July, and the engagement I wished had never happened – on the anniversary of the day your grandfather died. You weren’t to know that day held that significance as you had champagne and roses sent to the top of the Lorain Lighthouse with the “will you marry me” .

photo Angela  by  Chris Ritchey

photo Angela by Chris Ritchey


It was also the day and weekend I was introduced to avarice and selfishness of the “incoming family” . A cold shiver ran over me that day – harbinger of things to come. I couldn’t believe your “bride to be” and her ” aunts” spent the day and next day touting the engagement ring around to local jewelers to see its monetary worth.

You had paid six thousand for that ring and I ended up having it professionally evaluated by an independent jeweler just to reassure you and the “family” it was worth what you paid for it. You got what you paid for and in fact was worth two thousand more . But what kind of a “bride” does that ? I remember saying to you –

I don’t understand the ring was a symbol of love and not money, I was pleased with a little diamond because it was given in love..

…… but the cold shiver was a warning of what was yet to come.
tetleyau12
This July has been no different- little Tetley had to be put to sleep . He didn’t suffer and was running around until the very last.

Artwork Chris Ritchey  Face Book page

Artwork Chris Ritchey Face Book page


Then all hell broke loose and once again ambulances, ICU’s waiting in uncomfortable chairs, watching clocks that didn’t seem to move. The machines, the IV’ fluids, every beep of the monitor, oxygen levels, breathing counts, heart rates, every foot fall of the nurses, the chairs, the smells another two weeks of memories flooding in from the dying days of you , the alarms, doctor’s faces, the looks- you know those looks, this is not good. The tests, the scans the results. The drives to and from the hospital four and five times a day, all those emotions invading my new world of worry- pushing them away in order to deal with the latest health crisis, crippling once again. Walking once again in the early morning across the hospital parking lot- holding ones’ breath hoping the news overnight was positive , crisis in the middle of the night , waiting for the damned phone NOT to ring in the early hours, no sleep, running on empty.
nanaandchris1
But your Nana picking up the slack at home- 97 years old- and I would come home to a meal, a clean house, my bed made and a cup of tea. Too tired to answer the many phone calls wanting an update.
So went July- and with it another part of me, a another slice of strength and tolerance …….. August…….. your birthday …… and the cycle continues ….. the past became the present and the future counted in days and the time between remains blurred in the moment
https://thatwoman.wordpress.com/2016/07/03/july-3rd-pastpresent-all-the-same-chris-ritchey/
MASK MIST

August 3, 2016 at 10:19 am 4 comments

Paula Tobias-Department of Defense and Ovarian Cancer

Paula
This is a guest blog post by my wonderful friend – Paula Tobias- Paula has been fighting her own battle with Ovarian Cancer –
https://thatwoman.wordpress.com/2013/03/27/you-have-cancer-paulas-journey-shared/

How are the Department of Defense and Ovarian Cancer connected?
Action Centeres
When I read this yesterday I was in one of many daily Pain moments; you know, on the scale of 1 – 10 (10 being the worst) I was a 9. The weather and more importantly the surgery, chemo and subsequent meds, tests, x-rays and PET/CT scans I believe have something to do with the agony dealt with on a daily basis.

Senator John McCain Off.photo

Senator John McCain Off.photo

The Department of Defense has funded innovative biomedical research programs for years that impact troop readiness. The Ovarian Cancer Research Program was added in 1997 and has since been funding research primarily aimed at finding an early detection test and better treatments for ovarian cancer.
Finding an early detection test for ovarian cancer is of critical importance to the military. Currently, any active duty military woman with a suspected case of ovarian cancer must receive her treatment in the United States (due to the availability of specialists here), so correctly identifying women that either do or do not have ovarian cancer is of critical importance to the military. Over the last five years alone, over 2,600 military women have had a suspected case of ovarian cancer. “
Senator John McCain will be adding an amendment to a bill in the Senate that would strip many of the research programs run by the Department of Defense, including the $20 million for the Ovarian Cancer Research Program(OCRP). The OCRP funds $20 million in innovative, high-risk, high-reward ovarian cancer research each year.
Senate staffers are calling this the biggest threat to medical research in 20 years.

I immediately called my Senators and left voice mails with my history. It took a lot to maintain composure while doing this and as soon as I was done, Frank (my loving, caring, patient husband) came in from work and surprised me. Well I surprised him with a burst of tears and language a soldier would blush hearing. At the end of that tirade I said, “Do you think the Senator would be asking this if it were his testicles at stake?”

I support all battling their cancer diagnosis, patient or family. I volunteer at my Oncologists office to empathize with those. I try to offer hope and comfort.

• Click here to send your Senator an action alert email that will tell them to oppose the McCain Amendment.http://cqrcengage.com/ovarian/app/write-a-letter?0&engagementId=108520
• Call your Senators and tell them to oppose the McCain Amendment
http://www.ovariancancer.org/
http://cdmrp.army.mil/ocrp/default.shtml

Please help and pass along this information and if we (Frank is still my miracle -13 yr. Pancreatic Cancer Survivor) can help anyone with their Cancer Battle, contact Loraine and she’ll connect us. Paula Tobias

ED NOTE: Whilst looking for the date of the vote I came across the following – it seems McCain’s amendment will not only effect Ovarian Cancer funding but Prostate Cancer funding as well
51

Senator McCain amendment might kill Prostate Cancer research funding
http://advancedprostatecancer.net/senator-mccain-amendment-might-kill-prostate-cancer-research-funding/

Again and again and again Senator McCain (R-AZ) has attacked the Congressionally Directed Medical Research Program (CDMRP), which for PROSTATE CANCER has been among the most productive research vehicles we have to conquer PROSTATE CANCER.

It is beyond my understanding why he has taken up this vendetta. Every year he is our biggest enemy, trying his best to stop the great progress we have made. As usual, he is at it again!

Senator McCain is a major advocate for funding of the Defense Department, but he seems not to understand that the money that flows to the CDMRP does not take one dollar away from our defense budget. The money that flows to the CDMRP is over and above any budget dollar that will go to the Defense Department. So, why the vendetta against the CDMRP, I cannot explain it.

June 17, 2015 at 8:06 pm 3 comments

Humira -auto-immune medicatons check the box

selfportrait- Chris Ritchey

selfportrait- Chris Ritchey

ED Note
Every single day this blog receives searches looking for answers and information on Humira and other auto- immune medications. The information on this blog has been garnered not from the medical community, the drug sales force, the commercials but from the mothers of those who are the faces of the “black box warning” .

https://thatwoman.wordpress.com/2014/05/06/humira-the-black-box-and-you/
https://thatwoman.wordpress.com/2013/08/12/black-box-warnings-take-heed-humira-etc/
https://thatwoman.wordpress.com/2013/08/07/the-faces-of-the-black-box-warning-humira/

– No one wants another mother to share their pain. Graciously in the midst of their own suffering they have answered emails sent through this blog and elsewhere to advise from their own personal experience- the following is one such response to those that search.

drugshot
You are right to look for information about Humira, and any other kind of powerful auto-immune medication–and there are several on the market today of similar biological make-up. In addition, there are other drugs that are frequently prescribed in combination with these auto-immune drugs (a protocol called recombinent drug therapy) which when taken together, can have additional serious (deadly) adverse side effects. All of these meds are/can be very, very dangerous, but every situation and individual is different.

If you are concerned, it will be entirely up to you and/or your family to do the appropriate research before you make a decision one way or another to take these kinds of medications.

Please, DO NOT waste your time contacting the sales reps for the drug company. They do not know, and WILL NOT tell you anything even if they do. They are not research scientists, doctors, or experts in anything except how to sell a product and make a commission.

Unfortunately, it is probable that your doctor will not know much more since they, too, purchase the meds from these same salespeople. Nor can you assume or expect a pharmacist to know any more about the dangers of these drugs than what is included in the package insert they dispense. The bottom line is no one can give you information unless it has first been provided by the drug companies and this is precisely why we are in such trouble.

dollars for docs

http://projects.propublica.org/docdollars/
I strongly suggest that you do as much research as possible about any auto-immune medication being prescribed for whatever your particular condition might be. Humira and other similar medications can be, and are used safely by thousands of people, but not everyone.

You may be fine with this medication, but it would probably still be a good idea to

1. find another one or two doctors for second or third opinions.

2. Ask as many questions as you can about length of treatment and expected outcome.

3.You should also go online to the FDA website for information about Humira (and other auto-immune drugs) and look for material specifically regarding adverse events. You need definitely to do this, if you do nothing else.

Any information about dangerous side effects for these drugs will be listed there. You will not be able to get this information in any format that is intelligible, providing you can even find it, on the label.
Canda FDA
It is interesting to note as well, that Canada’s equivalent of the FDA is often years ahead of the U.S. in terms of issuing safety warnings for a variety of drugs that are freely prescribed in this country without a second thought. I would suggest that anyone with concerns check Canada’s governmental health website.
http://www.hc-sc.gc.ca/index-eng.php
Also, here are two excellent websites.

http://www.worstpills.org/aboutus.cfm
https://www.citizen.org/hrg

Do a thorough search of your condition and its drug treatment in the professional medical journals. I cannot stress this enough. This means you will need the help of a librarian, possibly at a University, school, or hospital who will have electronic access to a wide range of peer-reviewed serials and/or medical databases that you will not be able to find online on your own. This is important because a lot of what you can locate through a Google Search will not include the kind of information you will find in peer-reviewed medical journals—which are ONLY available at a medical (hospital) or university library. And it is this specific information you want.

Finally, don’t take any one doctor’s word on the safety profile for this (or any, drug). You need to gather as much information as possible on your own so you can present your concerns up front.
calm and research

The important thing is not to panic. Do your homework and don’t rush into anything before you feel as comfortable as possible with your decision. Our sorrow is a result of not being fully informed (warned) in advance of the dangers associated with these meds–because the information was not made available either to the general public or prescribing physicians until years after my boy died.

The bottom line really is ask questions about everything, do your research and if you feel uncomfortable with any kind of vague response…be cautious. Ultimately, you will have to make a decision, but an informed decision is absolutely necessary.

Consider all possibilities, including NOT taking a drug and what that might mean for you as well. Sometimes, horrible things happen regardless of how much you know and the most carefully considered decision. Sometimes, all that we can do, and have done, is not enough. Sometimes, there is no other choice–taking a particular medication is the lesser of two evils (disease vs. treatment). But, there is everything to be gained by being fully informed about ALL possibilities/options before you put yourself or a loved one at risk.

May 7, 2014 at 12:34 pm 2 comments

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