Text 19198, 108 rader
Skriven 2014-11-10 22:02:00 av NANCY BACKUS (1:123/140)
     Kommentar till en text av MICHAEL LOO
Ärende: Re: hospital 230
========================
-=> Quoting Michael Loo to Nancy Backus on 11-07-14  17:49 <=-

 NB>> residents that were with a Family Medicine practice that MJ was a
 NB>> patient of.  She'd get a new resident every 3 years or so, so we
 NB>> got to train a number of them... Most of them were inclined to be
 NB>> open-minded, thankfully.  Not always the case with the residents in
 NB>> hospital, however... 
 ML> And these guys suffer the additional handicap of basically
 ML> being graded on their ability to follow instructions.

In most cases.  I suppose one might consider that the stakes might be
higher in the hospital setting...   

 ML> Totally unclear. There is another effect of the regimen
 ML> that came pretty clear, but I didn't say anything lest
 ML> they try to put me on yet another set of drugs - I started
 ML> getting numbness in my extremities and in the left thigh;
 ML> peripheral neuropathy is a recognized effect, and the
 ML> standard procedure is to shut down the Flagyl and start up
 ML> with something else. I just didn't want to stir up that
 ML> particular can of worms.

I trust that those symptoms have subsided, now that you are no longer on
the meds...?  You might want to note it somewhere, so as not to be given
Flagyl again, just be started on something else to begin with...

 ML>> So my veins are all blown, and my last IV blew, and
 ML>> they still wanted me to take the antibiotics IV,
 NB>> That's the point they start talking about piclines and ports,
 NB>> generally...
 ML> When the chief of the IV people said that a PICC was the
 ML> next course of action, and I thought I was pretty much ready
 ML> to be released, that's when I started getting fractious, and
 ML> that's when they started accelerating my discharge.
 
Thankfully you were at the point of being dischargeable... :) 
Similarly, a discussion of piclines got tabled for MJ at one point,
since it was agreed that it would be overkill at the moment, the test
having been finished... but that it would be put back into possibility
for a next time...  She moved away before that actually happened.

 ML>> done already. One of the nurses admitted that the
 ML>> resident could have been in some jeopardy for actually
 ML>> making a decision. (Of course it was such a resident's
 ML>> decision that was the proximate cause of my father's
 ML>> death.)
 NB>> Sounds like a hospital to me...
 ML> They're just following orders.

Nice for hiding behind...  ;0

 NB>> One good(-ish) reason for doing it IV rather than oral is to spare
 NB>> the already badly irritated digestive system any of the side effects
 NB>> of the drugs... and to get the meds in-stream faster...  
 ML> But I already had a loading dose in my body, so speed wasn't
 ML> much of an issue. And badly irritated digestive system had
 ML> to be balanced with a badly irritated venous system.

Good point.  :)

 ML>> A set of labs was ordered, and they got the supposed
 ML>> whiz of the regular service who failed in three
 ML>> attempts and gave up.
 NB>> They couldn't have just got the labs when they finally got something
 NB>> in...?  ;)
 ML> One of my gripes is that when something was being done,
 ML> they seldom doubled up purposes even when that seemed the
 ML> eminently practical thing to do.

As above, sounds like a hospital... and just following orders... ;)

 ML>> Previous to that, two labs successfully drawn in seven sticks.
 ML>> That's 13, maybe 14 failures that I remember in one 24-hour period.
 NB>> Not a pretty record, to be sure...  Sigh....
 ML> I was beginning to get needle-shy, and usually I'm
 ML> pretty good about stuff like that (though I strongly
 ML> prefer not to look when it's happening).

Can't say as I could blame you on that... 

 NB>> Is the usual routine to send the patient home whilst following the
 NB>> regimen...?  It would seem to me (yeah, silly me) that keeping one
 NB>> where things can be monitored would be safer, maybe even wiser... 
 NB>> And certainly in retrospect in your case it certainly seems so.  
 ML> Unclear about cause and effect for admission #3, whose
 ML> etiology remains unknown, which is scary. Admission #2
 ML> might have been fixed by lengthening admission #1, but
 ML> even that is unclear.
 
Admission #3 had a definite meds side effect feel to it... but, you are 
right, even in hindsight, it's hard to say cause and effect and
probabilities...  Possible that you would have been kept just a little
longer and then sent home for the same thing to have happened, I suppose. 

 NB>> I thought MGH was supposed to be one of the stellar hospitals...?
 ML> Well, it almost put me in heaven.

har.

Glad it didn't.

ttyl         neb

... "Gin rummy with Brandy's scotched, Bud" whined Sherry wryly.

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