Saturday, July 26, 2008

Adios

I've had enough.

I've had enough of all the "oh, poor me" syndrome and everyone feeling sorry for those who write about the "oh poor me" syndrome.

I'm done.

I've received the LAST of the emails sputtering excuses, etc., and the last of the emails written in self-defense when trust has been breeched and entries have been exaggerated to protect one's self.

It's time for everyone to take personal responsibility and be truthful. Lies only hurt not only themselves but also those surrounding.

Good bye Cyberworld. I'm signing off. I don't need this.

There's a Mole in our Midst

After much discussion with Ole, I’ve decided I won’t be attending the Great Javalina Hunt in October. The major reason is because of Ole’s health and the strong possibility that he may be having surgery on his leg in October. But there is one other reason for my not attending, and I might as well just put it out there for ya’ll to know because I'm VERY disappointed.

Remember, I’m a Minnesota girl – born and bred – grew up a conservative Norwegian Lutheran – and I admit that I’m naïve and a very trusting soul when it comes to people. I take folks at face value and expect them to be what they say they are. In turn – what you see – er – read is what you get. That’s me. No fluff, no pomp and circumstances, just me. That’s the way Ole is too, and I think we’ve raised Lovely Daughter to be the same way. There’s a term up here called “Minnesota Nice,” which means there’s some morals and ethics involved somewhere.

There is a foul wind that has blown up among some of those planning to attend the Javalina Hunt. It’s gotten rather ugly on both sides, and now has widened out to include several others. I’ve become very disillusioned with some of the Javalina Hunters, and all the backbiting and posturing that is taking place, not to mention trust issues – like sharing passwords to locked diaries, or passing on information that was entrusted to you by giving you the password to a private diary. You know who you are. I won’t mention names, but it wasn’t hard to figure out. Just the fact that I left a comment in Blogger #1's private diary, and immediately received a rather caustic and defensive email from Blogger #2 regarding that comment because I know that Blogger #2 didn’t have the password. The comment I left was certainly not negative about anyone; I was just asking a question. And I certainly feel that I should be able to make a comment in a LOCKED diary without fear of repercussions from an outsider – one who isn’t supposed to be there in the first place!! I guess I was very wrong when I thought I could trust mutual bloggers. There’s a mole in the midst.

Just to make things perfectly clear, I'm not now, nor have I in the past, taken sides with either Blogger #1 or #2. They each have their own opinion. Not having met either of them in person, and knowing that folks aren't always what they appear to be, I believe the truth is somewhere in the middle. I could have dealt with that, but when the mole entered the picture things became a bit skewed. I can do nothing more than throw up my hands and excuse myself because I now have a trust issue.

And that’s all I’m going to say about that.

Friday, July 25, 2008

Ole gets released - for now

Remember, I said I couldn't wait to see how things would be changed today? Ole was discharged this afternoon and is currently at home.

But, I'm okay with it this time. Even I could see marked improvement in his leg.

When I called Ole this morning about 8:30 and he told me he was to be discharged this afternoon, I blew. Indian lady doctor was at it again. She had instructed her senior resident to write the discharge orders and the process had begun. By the time I got up there I was fuming and went straight to the nurse's station and asked for a patient advocate. I also informed them that I would not take Ole home until he had been seen by both the infectious disease doctor and the surgeon. It just so happened that both of them happened to be on the floor at that time and a meeting was arranged in Tony's room. Yesterday the surgeon had ordered a surgical stocking to be put on his leg all the way up to his hip. That apparently helped tremendously because a lot of the redness and pain had disappeared over night and he was now able to walk with very little discomfort. Both doctors very thoroughly examined the leg, ordered further blood work and after getting the results they decided they were comfortable with Tony going home this afternoon. The blood work indicated there is very little infection left. Of course Indian lady doctor was nowhere to be found.

I questioned them thoroughly about activity levels, etc. so both Ole and I understand just what can and can't be done.

I can't tell you how relieved I was after talking with both of them. Prior to this I felt like I was being kicked in the stomach every five minutes.

One very interesting thing about this entire scenario. When Ole was admitted to the hospital on Monday he was put in a double room and had a roommate. Never during the entire time that he was in this room did anyone gown when they came in. I thought this was rather strange because I know that staph is very contagious. But at that point, I ASSumed they knew what they were doing.

Thursday, when the infectious disease doctor got involved they were suddenly able to find a private room for him and everyone started gowning when they entered with the exception of the ID doctor. When he was in the room at one point and a nurse came in gowned he asked her why. He then informed her that Ole definitely did not have staph - the bloodwork that he had done indicated that it was strep. Now all week long he's been being treated for staph, which requires different antibiotics than strep. When a second antibiotic was added that treated strep, that's when he started making progress. Then the damn lady doctor would come in and change the orders and hang something entirely different, something I'm assuming that was for staph only, as each time she would change the meds his situation would quit improving.

Lovely Daughter and I met with the patient advocate about noon and laid everything out. We had both been keeping notes so there wasn't much that we forgot. Lady Indian doctor has only been at MeritCare for 30 days. I don't know where she came from, but she is titled as the attending physician and has a senior resident and an intern following her around and teaching them - if you could call it that. I informed the advocate that the nursing staff was superior, but of course they have to take their instructions from the attending physician. The attending physician is Internal Medicine. And what right she had to override the specialists orders amazes me. So the patient advocate wrote up the report and assured me that it would be turned in as they supposedly take these kinds of things very seriously. I requested a follow-up call because I want to KNOW what the results are. I'm sure she'll just get her fingers slapped, and then be told to go on her merry way - if that.

I also told the advocate that I was just happy to be bringing Tony home alive and with all his parts - at least at this point. I assured her that if there was a reoccurrence of this I would certainly NOT bring him back to MeritCare. Nor will I bring him to Innovis, the other large medical facility we have in town as I've heard horror stories about things there also. I'll just put him in the van and head for the Mayo Clinic in Rochester.

He has 3 followup doctor appointments next week - one with the surgeon, one with the ID doctor and one with the senior resident that was following Indian lady doctor around. We'll definitely keep the two specialist appointments, but we'll have to THINK about the resident appointment.

I'm exhausted. I'm going to go take a nap.

%&@#*^!+!!!

I was so tired when I got home from the hospital last night there was no way I could sit down to write an entry and have it make any sense. I'm really not sure I'm any better off this morning, but I'll give it a try.

Recap: When I left the hospital on Wednesday night the Infectious Disease (ID) guy had been in, changed the medication in the IV drips and told Ole he would be there for at least a couple more days. He also ordered an MRI. The interesting thing is that the doctor from the ER that had admitted Ole also ordered an MRI way last Monday. Obviously Indian lady doctor didn't think it was necessary, because there hadn't been one done. Remember - she's the one that wanted to discharge him on Wednesday. She also changed the IV drip meds AGAIN that had been prescribed by the ID guy. I think this woman has a control issue. And I think it's at Tony's expense. I'm going to connect with a patient advocate today and discuss things with her.

The MRI was done on Thursday afternoon. It showed that the infection has not reached the bone, but some of the subcutaneous tissue has started to degrade (die). That's the tissue that is right below the surface of the skin. This is definitely not good. So the ID guy called in a surgeon to consult (another Indian by the way) So far we haven't seen a white doctor other than in the ER. The ID guy was Indian also.

The surgeon came in last night while I was still there so I got the whole lowdown. I was a bit taken aback when I read his name badge and it said, "Dr. Mistry - TRANSPLANT DEPARTMENT." He feels that Ole doesn't need surgery right now, but will in the future. How far in the future depends on how he heals at this point. Ole's leg is still very red, the tissue is very hard and causes him a lot of pain when he walks. It's this doctor's opinion that the pain is not being caused by the infection, but by the large varicose veins that Ole has in that leg. He thinks they need to be removed or this problem will be frequently reoccurring. He also told us he wouldn't be discharging Ole before Sunday - depending on how things go. I wonder if Indian lady doctor will come along and change those orders too.

So far, since being admitted to the hospital Ole has seen 5 different doctors and has received 5 different opinions. It makes my head spin and I don't know which way to turn anymore. I truly need some added advice from someone who has Ole's best interests in mind - not their own ego trip.

I'm headed to the hospital shortly to sit in the chair and wait for the doctor(s) arrival. I just can't wait to see how they're going to change things around again today.

The one good thing that happened yesterday is that they moved him to a private room.

More as things develop.

Wednesday, July 23, 2008

AAAACCCCKKKK!! Where do I start??


It’s been a long day and I think my brain may be a bit on the fried side, so please bear with me, and I hope this all makes sense.

First of all Ole has made more progress in the last 24 hours. The area of coverage is reduced and the intensity of the redness is reduced. So that's all good. But he still has a lot of pain. Says when he steps on the leg it feels like it's going to explode from the pressure.

Yesterday the doctor I spoke with on the phone said they were going to keep Ole for a minimum of two more days with IVs. Today I was supposed to meet with the two doctors and one intern that are overseeing him. Well, I did. That's where the AACCCKKK comes in.

All three are Indian, and difficult to understand. I'm beginning to wonder if The Big Hospital even HAS any white doctors anymore - doctors that speak AMERICAN ENGLISH.

Anyway, the head doctor of the team is female - not that there's anything wrong with that - BUT - - she marched in, looked down her nose at me and told me that they were discharging Ole today. They were going to take him off the IVs and send him home with two new oral antibiotics. She assured me that these new oral pills would cover a broader spectrum of "bugs" than the ones he had been sent home with before. And IF he didn't get better on these pills then I should just bring him back.

NOT!!

First of all, if he's finally making progress on the meds he's on now, why not let him make a bit more progress before changing things again. Second, why was I told one thing late yesterday afternoon and now the whole plan was 180 degrees different - yesterday I was told he had to be there for at least two more days and now you want to discharge him. What happened that made such a drastic difference in the treatment plan? Third, these three Indian doctors are Internal Medicine. Why hasn't someone from Infectious Disease seen him, as was ordered by the doctor in the ER on the day Ole was admitted.

Lady Dr. informed me that she had consulted ON THE PHONE with someone from Infectious Disease, but she didn't feel that anyone needed to see him from that department. She felt that he had made sufficient progress in the last 24 hours that he could be taken off the IVs and put on oral meds. I explained to her AGAIN what had happened the first time he was taken off IVs too soon - that's what caused him to end up in the hospital. I told her I wanted him to make MORE progress than just 24 hours worth before I would be willing to take him home.

We battled verbally back and forth for several minutes but she would not change her mind about anything. Finally Ole just gave in and said, okay, let's try it. I gave up also - because I could see there would be no changing this woman's mind. I think her ego was getting in the way and she was refusing to listen to what we were saying.

After Lady Dr. left I called Lovely Daughter and explained to her that her father was being discharged. I could hear the explosion from where I was sitting – 3 miles from her office. I guess there are times when it's okay for your daughter to be assertive and aggressive. She came over to the hospital immediately and asked to see Lady Dr.. She and I went through the same scenario again - let's get him a bit better before we make changes, and again she wouldn't hear of it. Finally Lovely Daughter pulled out the Big Guns and told her that we wanted a second opinion - according to the Patient's Bill of Rights we have the right to have a second opinion and we wanted it from someone from Infectious Disease. Lady Dr. was so taken aback - you could see in her face that she didn't like it, but that she couldn't deny us the second opinion, and said she would make arrangements for someone from Infectious Disease to come over tomorrow morning.

Meanwhile the doggers had been shut up in the garage for more than 8 hours so we decided to run home and let them out. By the time we got back to the hospital the Infectious Disease guy (another Indian by the way) had been to see Ole, looked at his leg, shook his head and said there was no way that he should be sent home. His plan is to keep him on IVs for another 48 hours THEN evaluate. His theory is that once you find something that's working you don't change it - let it work. Although he has added Augmentin to the "syrup" that Ole’s getting. Augmentin is a kind of penicillin specifically used for skin infections - and is super powerful - more so than the oral drugs he had been given.

WHY should things have to be this difficult. I think this woman's ego was getting in the way of practicing good medicine.

Following this entire scenario, Ole's nurse, came in and told us that she was caring for 4 patients on the floor. Lady Dr. wanted all four of them discharged today. In the nurse's opinion only one was ready to be discharged, and if the other three (which included Ole) were discharged she was going to write up a safety report on each case so that if they had to be readmitted to the hospital there could be some documentation regarding care. If this were to happen she advised us to contact a patient advocate and proceed from there. She also told us we could fire Lady Dr. from Ole’s case. If this kind of care continues we just may do that.

So there you have it - at least as much as I can remember as I think my brain has turned to mush. It's been a long day with a lot of stress. You shouldn't have to go through this type of thing when you are in, or have a loved one in a medical facility. You should just be taken care of and not have to worry about getting correct and proper care.

A Teensy Bit of Progress




I spent the evening at the hospital last night and I'm happy to say that there has been a SLIGHT improvement in the infection in the last 24 hours. His leg is slightly less red and the area encompassed is slightly smaller. So maybe we're making progress. They added a second medication to the IVs and that seems to have made the difference. He's now getting vancomycin and ampacillan constantly. It takes approximately two hours for the bags to run through, and each two hours there are new bags put up. They're still giving him meds for pain and will gave him a shot of morphine last night so that he could sleep.

I spoke with the doctor over the phone tonight. He's Indian, so I had a bit of trouble understanding him, but I think I got most of it. I'll be meeting with the three doctors today at noon, so I'll clarify everything at that time. But here's what I think I understood.

They intend to keep him for a minimum of another couple of days and then will evaluate at that point. Depending on how he's doing they may send him to a transitional unit, which means possibly a nursing home (isn't he going to LOVE that) because they may want to have IVs administered for another 10-14 days. If they feel he's doing well enough they may send him home and have a home health nurse or a pharmacist come out to the house and administer the IVs. Or they may just keep him in the hospital for the duration. That would be my choice, but I guess we'll see what happens.

Then, after he's over the infection and has had a chance to heal, about 6 weeks later he will have to see a vascular surgeon about his leg. He was real happy about that also. The doctor I spoke to said if he doesn't do something about the surface veins he will guarantee that this will come back again.

They still aren't sure whether it's a staph infection or a strep infection. When I asked the doctor why they couldn't tell he explained that the latest blood cultures that they did were masked because he has been on antibiotics for so long so they couldn't get a true picture. So at this point they're treating him for both.

HE thinks he's still going to Sturgis and will go to the VA hospital down there to have his IVs administered. I wonder what fantasy world he lives in.

Thanks to all of you who have sent good wishes and said prayers for both of us. I’ve passed on all the messages to him. And K-Lo, I delivered your very best smooch last night and told him it was from you. That gave him a good chuckle. His comment was, “Well, at least in this position she could reach my lips. Standing up she would have only reached my belly button!”

Ole had a lot of company yesterday, even Jane stopped in after work. She ONLY stayed an HOUR AND A HALF!!

Well, I’m off to the hospital.

Tuesday, July 22, 2008

Never count on anything

My friend, Genny, told me a long time ago that she's just quit counting on anything because she always gets disappointed. She also doesn't plan anything in advance because she gets the same results - disappointment. She kind of flies by the seat of her pants throughout most of her life and has learned to roll with the punches.

I need to learn how to do that - desperately.

Ole and I were supposed to leave on our month's vacation yesterday. This is the third trip we've planned since last March that we've had to cancel. Ole was admitted into the hospital yesterday instead. He wasn't getting any better over the weekend so on Monday morning I threatened him with either getting in my car and going back to the ER or calling 911 and having him taken in by ambulance. (I have my ways, you know.)

After waiting for over two hours to see a doctor, it was decided to admit him where they will pump him full of antibiotics every four hours instead of ever 12. Along with that they'll give him IV pain meds because he was in pretty bad shape. After talking with him on the phone this morning he sounded pretty droopy - hadn't had much sleep last night because somebody was always poking and prodding him. The doctor had been in to visit this morning and said he was surprised that there was very little change in his leg, although the blood work showed the infection was localized and not spread throughout his bloodstream. Thank heavens for that. I know that staph is an extremely difficult infection to get rid of and with Ole's complications of diabetes and crushed cells and surface veins in his affected leg, this will only be more complicated.

I have one friend whose husband died from a staph infection that couldn't be brought under control, and another friend whose uncle died from it also. I'm extremely worried - and a lot scared. So put in a good word with the Man Upstairs for Ole, please, and I could use one too, to keep my sanity. Thanks in advance.

One little bright spot in my life right now is Lucy. Isn't she a pretty little thing?




I have a lot of difficulty working on the computer because as soon as she sees me sitting here she's up on the desk in front of the monitor chirping at me. She doesn't meow, she kind of chirps like a little bird. I had her in for shots and to be spayed so she's truly mine now. For a free little cat that came to my house I've now got over $300 invested. Oh, well, if you can't afford to take care of your pets you shouldn't have them.

Senior Citizen Simon has been such a gentleman throughout Lucy's arrival. Never a fuss or fume from him about anything regarding her. When they're outside she follows him around like a little shadow and he acts like he's showing her the ropes. I can't believe how much she's grown since she came here, but I guess getting some good food in her helped that issue. No more ribs and backbone sticking out. And she's such a little lover. I'm so glad she came into my life.