Monday, November 15, 2010

I.N.R.'s

International normalized ratio. A number that is used as a report of the ability of blood clotting in someone's system that is on Warfarin. 2 - 3 is good. That's what is aimed for. Under two means you can throw a clot possibly, 4 or 5 means you can bleed. Your blood is too thin basically.

Many people are sensitive to this drug. My mom is one of them. Ever since she's been on this Warfarin (yeah, rat poison) I am forever getting calls from the Dr. to change her dose. She uses between 1/2 mg to 1.5 mg but never more to maintain a Prothrombin time (pro time) of 2 - 3. I'm used to adjusting her medication, been doing it a long time now however for some strange reason she is up to 4 or 5 mg of this drug for a few days now and is only got a PT of under 2. What the hell is going on?

So today, the nurse comes in with her Coumadin again (Warfarin) and I ask her what my mom's INR is. She is unsure since it wasn't taken yet and I question the amount my mom is getting. I know what her INR's were a couple of days ago so ask her to check with the Dr. She does and the Dr says to take it any way. Now, I'm concerned that even though her INR's are low that inevitably they are going to spike with all this Warfarin in her. So we give it to her.

The nurse decides I should talk to the Dr and he comes in and I question him because now it's discovered her INR is over 4 !! 4.16 and I've just given her 5 mg of warfarin again! I'm not happy. He says it will be ok. I guess we'll see but if they don't hold her Warfarin tomorrow I'm really going to start asking questions.

What if she falls again? She can get a bleed with that high an INR. I want her off that damn drug, I hate it and so does she. We are both sorry we agreed to give it a try for her. Her Plavix was doing a great job and now she doesn't have it and she has this crap. Nothing but a pain in the ass.

On Friday November 12th, 2010

My mom fell out of her hospital bed around 3 am'ish and wasn't found until pretty much shift change at 7:30 am. I need to speak to her nurse. She was in excruciating pain. Both her back and her hip. She said she was screaming and crying for most of the time. Mind you she's in isolation so there is a double door and a long space between them and her voice isn't all that strong so I'm sure no one heard her. But why didn't someone peek in on her in all that time? She fell on the other side of the bed from where her call bell was.

What's really pissing me off though other than the fact she fell out of bed are the following matters:

1) Not a freakin person in that hospital picked up the phone to call me and tell me! I am her Power of Attorney. They are all told to call me of ANY changes. One would consider falling out of bed and not being found for an extended period a "change" worth calling about. I found out when I didn't hear from her in the morning and at 10 am called her! It was my birthday and she never forgets my birthday. Imagine my surprise when this weak little thing answered the phone in a lot of pain crying telling me what happened. She was in sad shape to say the least.

2) My brother decided to call the hospital to find out why no one called to tell me too. He decided to go to the Patient Advocacy. A useless waste of space as far as I'm concerned. And I told him so. But he talked to them anyway and the only thing they seemed concerned about was asking him 4 times if anyone called me. Nothing like watching your back (the hospitals) instead of the patients.

3) My brother called back. This time he was told a "Kim" would be contacting me. He told her that I was in the room then. This was 4 pm Friday. I guess Kim is on a long weekend because it's 10:30 pm Monday now and I've yet to see Kim and neither has my mom.

4) No one, not a freakin single person that is administration staff has approached my mom to ask her a bloody question. Not even if she is ok. "Urban Angel my ass".

5) They knew the bed she had was defective. While she was out getting checked out to see if she broke or fractured anything in the fall guess who took out her camera? You got it. Took 43 pictures. Of every freakin sticker on that bed, twice over. Every inspection sticker, serial numbers, every everything including the broken bed rail. And the distance from her bed to the doors.


I'm talking to my lawyer.

Saturday, November 13, 2010

This happened Thursday Nov. 11th 2010

I'm trying to get out of here that morning to go see my sister in East General first then down to St. Mike's to see my mom and I'm hunting dead mice (a whole other story and other blog), answering the phone to St. Michael's bill collectors who are hunting down my mom for her $45.00 ambulance bill !!!! I gave them her hospital # lol then threatened them if they call her. They threaten her, with collection agencies and court for not paying her lousy $45.00 ambulance bill. Excuse me, she's still in hospital!! I've said it once and I'll say it again, St. Mike's, "Urban Angel" my ass. Imagine, threatening an 85 year old woman over a $45.00 ambulance bill. Morons.

Here is the story... happened April 3, 2010 @ St. Michael's Hospital Toronto

On April 3rd/4th a Toronto hospital (St. Michael's Hospital @ 30 Bond St.) put my mom at serious risk by putting a male patient in her room with her that is in detox. I wanted him out but I was told no and that he was no threat, he wouldn't even get out of bed. I almost lost my mom on the Wed. that week and then again this day. Critical care had to literally sit in her room for an hour and a half monitoring her, etc.

So they move this guy in the room against my wishes. A half hour after I'm assured that not only will this guy not get out of his bed, that even if for some strange reason he managed, he would pull off all his leads (he's monitored, cardiac, etc. like my mom) and they would see it on the monitor and come running. I told him I still didn't like it. I'm told he's in detox as if that's some kind of comfort.

No sooner was I given this reassurance when I was sitting watching my mom and talking to her doesn't he get up out of bed! He rips off all his leads, he walks over to almost the foot of my mom's bed, he the pulls out a packaged syringe from the dead syringe box (have no idea why there was a good syringe there) and he then pulls off the wall the large container of anti-bacterial hand gel and stands there with one in one hand and the other in the other hand staring at us. Looks like he may club us or stab us for all we know. He finally starts back for bed!! No one comes.. I tell my mom to hit the button, someone comes on and asks what I need, I tell her the guy is out of his bed and she says "ok"......... and no one comes!

The guy is delirious, he was seeing bugs, hallucinating and was holding complete conversations with himself. What if he took that syringe and stabbed my mom?? Anything could happen. I demanded they remove him from her room. Long and short of it, they didn't. I had to argue with them about what they were going to do to protect her. I had to remind them that her safety is first and foremost. I told them again to remove him but they wouldn't. I told them to put him back downstairs in Major Trauma where there are monitors and monitor him there. They wouldn't do that. I then suggested they move him to another floor. They wouldn't do that. I suggested they call security and have them sit in the room with them and again, that wouldn't work either. I was told security wouldn't do that! I reminded them that there are facilities across this city for those in detox and he should be sent there or even to another hospital via ambulance which is done a lot in Toronto. Still they wouldn't.

The charge nurse tells me she'll figure something out and in a half hour I go looking for her.

The plan was to have a "sitter" sit in the room with them all night long. I had to wait for 90 minutes though, around 11 pm by then. I guess they needed to replace her. It was a small young woman. He could have overpowered her in a heartbeat. Regardless of the sitter my mom was too scared to go to sleep. My mom jumped and yelled that he was out of bed again when she saw a pair of shoes. The shoes belonged to the person sitting in her room to watch. My mother almost died that day, I was told to call my siblings and this is how she is suppose to get her rest now they have her stats somewhat under control? This is how she's suppose to keep her blood pressure stable? And her heart? She called me around 2 am that morning, wide awake. She thinks she managed to get 3 hrs sleep that night if she was lucky. My mom has arrhythmia, dangerous arrhythmia. They can't get it under control and her blood pressure is out of wack too. Her safety is at risk as is her life as far as I'm concerned if she's kept up all night from fear.

This isn't the entire story. I left out the part where the nurse confronted him. He was going to drink that damn stuff because it's made with alcohol. I also left out the part why he was in her room, which is bull, as far as I'm concerned. I left out many parts of this story, like when a lawyer friend of mine had to show up the next day to get him removed from the room. And the part where the next evening a Hospital Director showed up apologizing profusely and remarking that he wasn't contacted and no one followed hospital policy/procedure in this matter, etc.

This should ever happen in any hospital. No woman or senior citizen should ever be put in this kind of harms way. He could have stabbed her, raped her, clubbed her to death with that big bottle of anti-bacterial gel. There is no telling what a large man in detox having hallucinations could do. He was far too unpredictable and unstable and my mother was defenceless. Especially since no nurses came. Who the heck was watching my mother's monitor if no one was watching his??? And no one will ever convince me that if my mom was a young woman that this man would have been put in that room with her. She had 2 Dr’s that continually told me “she’s old you know”.

Not 2 months after they tried to put her from a “step-up” unit into another room with a man again! Needless to say, she got very upset and I said flat out No.

Saturday, October 30, 2010

Again....

What is it with this place? Again with equipment that doesn't work. First there's her nasal tube that continually blocks on her. Today I don't get a phone call from her so I know something is wrong. I wait. No call. Finally I call her and she is awfully groggy and not talking much. I tell her to call me back in a while and again I hear nothing. My phone goes and now my brother and sister can't get through to her. They call and no answer. I'm hoping it's simply a matter of someone moving her phone and she can't reach it. Happens all the time. Drives me crazy and frustrates the hell out of her. So finally around 12:30 I try calling her myself and still nothing. I call the nurses station, tell them who I am and why I'm calling and I'm put on hold. For a long time I sit there listening to canned music. Occasionally someone comes back on and tells me they are checking. Finally after about 10 minutes someone comes back on and says "she's sleeping". Now, I know that's not right because she would hear the phone and pick it up even if she was sleeping. I figure I best get the hell to the hospital.

The minute I walk in I take one look at her and know something is really wrong. She can't even open both her eyes all the way. Her pupils are pinpoints. Her mouth is pouted, her hand swollen again. Her eyelids too. She has no feeding tube working. I can't get her to respond to me and when she finally says something it's so garbled I can't barely make it out. I see.......... she's sleeping right??

Exactly who the hell is this dim twit that answers the phone and thinks she's a Dr or nurse? I had issues the other night too. Whomever answered the bell in my mom's room didn't bother to call her nurse when we rang it because my mom couldn't breath and was gasping for breath and there was no oxygen tube for whatever reason. Some idiot had removed it.

I go back out and tell this woman I want both Michelle the dietician and her Dr. And she looks at me like I'm crazy. I go back in her room and wait and nothing. I go back out and tell her that something is very wrong and I'm not sure if she's had another stroke or what but someone needs to get here fast. Finally this woman manages to take it seriously and tells me she'll get the nurse. I told her to get the Dr.

Nurse comes in, one she's had just a few days ago and says that she wasn't like this this morning. She even ate a bit of lunch (liquid). Her n.g. tube is blocked so that's why it's not on. She can't get my mom to respond and goes for the Dr. In the meantime she is going to do an e.c.g. That is if the freakin machine will work. She can't get it to go no matter what she does. She goes and gets another nurse and she can't figure it out either and because it's Saturday there is no technician in either!! What?? Are people not suppose to get sicker on the weekends here? They finally manage to figure it out, it was a paper jam, and they get the thing to work. They even do it twice to be on the safe side.

The Dr. comes in and she can't get a response out of her either. She looks at how swollen she is. Asks me some questions like was she like this yesterday? Nope, I had a conversation with her when I left at 9 pm. She was a bit sluggish througout the day but certainly not to this point. The day before too. She had the gastic tube put in 3 days ago and even as terrible as that was for her (it took 4 tries to get it in) she had a really good day. She had several visitors and talked to all of them and had a really good day. The next day however she started to get tired and a bit weaker. The following day too but she had a low grade fever later that night but yesterday she seemed a wee bit better and we talked again for some time. Remarkably her hands had lost almost all the gross swelling too! They looked almost like her normal hands.

Today though her right hand is swollen up again. They take an x-ray. The Dr orders blood work done and then she orders cultures done too. The nurse takes all the cultures from her picc. I know that's wrong but when I make a remark about her last cultures and how then were taken from different arms she said nothing. Just continued what she was doing. The Dr tries to get her to grip her hand but nothing. She also tries to get her to hold her arm up but again nothing, it crashes down to her bed limp. She calls her and she barely responds if you're lucky.

She remains like this most the day and night. She's so unresponsive that they won't even let me give her ice chips. Nothing. So now she's not only not getting tube fed, I can't even feed her or give her anything liquid.

She seemed to be alert almost some time later and kept telling me she loves me. As much as it's nice to hear it it's spooking me. I tuck her in and I headed home since there was nothing else I could do for her.

Thursday, October 28, 2010

gasping for a breath...

Last night as I was about to leave my mom for the evening she started having a problem breathing, this is nothing new, it's been a terrible problem for her for some time. When her heart races (which it does on a regular basis due to the A-Fib) it causes her to gasp for breath. So when this happens last night I go and get her oxygen only to discover that someone has managed to toss the tubing out!! Real smart.

So I buzz the nurses buzzer. I think this has been buzzed all of 3 times in the past 20 days she's been there so you can't say she's a nag or a bug of any kind. The nurse comes on and asks what she needs. I tell her that she's gasping for a breath and needs her oxygen. She says "ok, I'll tell her nurse".

In the meantime I try to comfort my mom, ease her mind, relax her, whatever I can do to try to help the issue since there is nothing else I can do. Finally it starts to ease up for her after a lengthy enough time battle with it, she's exhausted now and it scared the hell out of her. It's been 15 minutes almost since I called. I buzzed at 8:56 and it's now around 9:10. I ask her if I can leave her for a few and she says ok so I go out into the hall to see if I can find anyone. I see her nurse and I'm puzzled as to why she didn't come. She's using the phone there to call the desk and she tells me she got no notice my mom needed her!

I tell her she was gasping for breath and needed the oxygen and she asks the person on the other end of the line if they called her and they said no!!! No.. nice huh? You have a patient gasping for a breath and whomever is on the desk answering the patient calls doesn't think it's important enough? Tell that to my mom why don't you? I told the nurse I was putting in a complaint and I will when I get the time but I know the date and time and that's pretty much all I need, they can look on their schedules and see who was on duty. Her nurse realized how important this was though and once hearing that came directly to her and got her oxygen hooked up again for her.

What is the matter with these people? All they have to do is answer a freakin call button and relay the message to the nurse that she's needed. And one would think gasping for a breath would qualify for action.

Tuesday, October 26, 2010

This is why people get sick in hospitals....

Back at SMH... We are trying to get fluids into my mom, she's on a liquid diet and can eat stuff like puddings, etc. soft foods. So I decide to make her one of her favourite hot cereals. And this is what the patient lounge microwave looks like: Oh, btw, this is not unusual. Not in the least. I've seen it pretty much like this several times I've been there. One would think that as the "cleaning person" shuffles around the magazines in there and even pushes the microwave back into the corner, turns the tv on or off and "dusts"... they would think to open the microwave and clean the damn thing. No wonder people get sicker in hospitals. This will make you sick just looking at the pictures.









Their staff's response to this???? Oh, well we should tell them and they'll get it cleaned. ok, but why it's my responsibility is beyond me since they have cleaning staff but I told them last Wednesday and it's now Monday when I took these pictures and it still looks like that. Who's responsibility is it now?

I ended up scrubbing it as clean as I could with clorox wipes. Then well soaked paper towels to get the clorox smell out. It's not my job but I wanted to heat something up and to do it in that thing was just asking way too much. No wonder people pick up stuff in this place that makes them extremely ill. Imagine, like this for days on end and no one notices???

Monday, October 25, 2010

starting out..

First note in here... I am sitting in SMH. My mom is in isolation. Why? Because she was admitted 18 days ago with major heart issues and while in i.c.u. 10 days into her stay, she contacted what could be a deadly virus called C-Difficile. So now they stick her in isolation. And isolation it is. I've been sitting here since 1:30 pm and it's now almost 5:30 pm and I've seen her nurse once for about 3 minutes. That's it. Once. My mom is very weak, can't even hold a cup with water in it for a drink so it's a damn good thing I'm in here now isn't it? Who else is going to feed and give her something to drink? Obviously not this nurse. There is always one isn't there? For the most part her nurses have been good and even great. But even this one can mean another problem for her. They are just managing to bring her back from dehydration so leaving her be like this could make her dehydration much worse if I wasn't giving her liquids.