Thursday, March 28, 2013

Romy's Appendix Ruptures: Day Six

This morning a meal arrived for Romy but it was a gluten meal (cream of wheat and french toast). We were never notified that he could eat again, so it was surprising. Apparently, late last night the doctor responded to the nurses calls, but the nurses never told us Romy could eat or drink (with the most important part being that he could drink!) I kindly told the man who delivered the food to take back the plate because Romy needed a gluten free plate (as he was getting previously) but they did not return. We figured since he got a meal (even though it was the wrong one), that meant he could eat or drink again, even though we were never notified officially by any nurse or doctor. After an hour later when no replacement meal came, we asked for it again by way of a nurse. One hour passed after this, and he still did not have a meal. Every time a nurse came in to check on him we notified them that there was no food yet. Two of Romy's doctors came in and we told them also that he didn't get food yet, and they told a nurse. It was literally like this for so long. We would tell somebody, they would tell somebody, and supposedly a food order was placed. However, it does not take 3 hours to whip up breakfast. Finally a nurse said she would put in an order for yogurt and fruit separate from the breakfast order. That never came either. Finally at 12:30pm I got so fed up, I went to Whole Foods to buy Romy something and notified the nurses at the front desk that he still did not get food and I was going to buy him something. I was so mad at this point! I yelled at the nurses and they kept apologizing, but didn't actually do anything. I figured that if he still didn't have food by the time I got back from Whole Foods, then I would talk to the charge nurse. 20 min later, I was back, and Romy still didn't have food!!!! I requested the charge nurse, and spoke to her regarding yesterday and today and asked for a manager. I kept asking her who is responsible and who is held accountable, because it didn't seem like anybody gave a damn. Finally around 1:30pm he received a gluten-free lunch (but never got breakfast).

Romy Walking the Halls
Romy is well and walking the halls.

I finally got to speak to the manager around 2:00pm. She was very nice and identified that there were multiple areas and incidents where mistakes and oversights were made by the nurses and the doctors. I told her that I was concerned mostly about yesterday when we kept asking the nurses if Romy could eat or drink anything, and they never allowed him to have anything, but also didn't give him the IV we asked for either. She said that although the nurses were not allowed to give IV without an order, they are supposed to advocate to the doctor and they were supposed to relay our request for an IV yesterday when he was not allowed to drink anything. No request was made by the nurses. When we asked Dr. Westeguard personally if he could eat or drink, and she deferred to Dr. Fowler, she did have the power to recommend IV fluids since he couldn't drink, but she did not! On top of all this, when he didn't get food this morning, it just made things worse. He didn't eat anything at all yesterday, and now today, for no apparent reason, he didn't get food until lunch! What a dysfunctional hospital!!! ALTA BATES SUCKS! Why is it so hard for them to relay simple information? What's scary is that supposedly this is one of the better hospitals in the bay area!

After everything calmed down, and the nurses changed shifts, things were back to normal. The doctors came back with Romy's blood cell count, and his white blood cell count was going down and it was now within the normal range (below 10 units). Amidst all of the drama earlier today, the doctors decided that Romy could go home today with IV antibiotics taken at home. This required that Romy get a PICC-line in, because they didn't allow patients to keep an IV thing in their arm after they leave the hospital. Romy kept asking if there were other options, like coming in everyday to get the antibiotics instead. Nobody knew of any other options until the infectious disease doctor mentioned an outpatient diffusion center just a few blocks away. He said that they should be able to give him the IV antibiotics everyday, as long as Romy didn't mind getting poked with a needle everyday and sitting there for an hour. Romy thought this was preferable to the PICC-line, and at least if he goes to the diffusion center, a nurse will be able to check on him everyday and if he needs blood work done, they can take his blood there too. The infectious disease doctor thought this was preferable too.

Relaxing - Last Night!?
Romy passes the time talking to friends and relaxing.

So things were arranged to get everything worked out with our insurance plan. But the insurance was sooooo slow authorizing the diffusion center care, so we couldn't leave the hospital until they worked it all out. It was already close to 4pm by the time everything was decided. The case counselor woman told us that it typically takes 24 hours to get insurance authorization on something like outpatient care at a diffusion center. So guess what. . . we had to spend one more night at the hospital! How exciting!

The Polish guy with the broken leg next to Romy left this afternoon. He does body work on the head and back, and invited us for a free practice session (he is learning so he practices on patients for free). We exchanged information. Almost immediately after he was wheel out the door, the cleaning people came in and changed all of the sheets and wiped everything down. They were so fast. The bed was left empty for maybe one hour before the hospital wheeled in another old Japanese man. He just had surgery to remove a quarter of his colon! He was kind of funny and alert. I never saw somebody so persistent in calling the nurses. He made some funny jokes too.

There was a lot of down town, sitting around and waiting today, so I graded homework and lab reports, and I tried to do some work on my paper. It was in general a slow day with lots of frustrations, but hopefully we get the hell out of here already. I am afraid to look at the bill when we finally do get out!