Wednesday, June 8, 2011

Adventures with Kidney Stones

Or "Tales from the ER!"

So by the title of this post your first thought is, okay, since she has stopped tutoring she has REALLY lost her vision for the purpose of this blog. But stick with me, I have a purpose.

My husband was recently in the hospital for 3 days, intermittently, for kidney stones. I have never had them personally, but every time I told someone he had kidney stones, the person's face would get all squinchy (it's a word) and they would say "OH, I/My Spouse/My Aunt/My Grandma/My Hairdresser's Sister's Cousin, had those and that was the worst pain I/They ever experienced.

So I tried to understand the pain and be supportive while with Tom in the ER.

I really dislike hospitals. The smells, the sounds, the sick and sad people every where. And then there is the staff.

Now before you start in on me about how You or Someone You Love or Know works in a hospital and they are the nicest most caring person you know, I am totally aware that there are exceptions to the rule. I also have a mom and sister in law who are nurses, and many friends who are nurses, and my Aunt and Uncle are doctors. It doesn't mean I don't love THEM, it means I generally dislike the people in hospitals OTHER than them.

Anyway, the first time he was in the emergency room of our local hospital, Sunday evening, he had a really sweet nurse, who actually took the time to explain everything to us. But the doctor was the opposite of this. Dr. Mean Face (her face was scary) was about as warm and caring as a metal chair.

After Tom had been there for about 500 hours (I realize that is an exaggeration, sue me), had thrown up all over the bed from the pain, had a CAT scan, been given 3 different pain meds. that did not work, here comes Dr. Mean Face. She came in and said "I am sending you home and I am giving you prescriptions for these meds., drink lots of water and see a urologist."

My husband is on many many meds. already. He has seizures and needs meds. for that, and then he also has these weird hives and joint pain that we are working with an allergist for, so he is on 3 more meds. for that. So I said to the doctor "Can you please write down instructions for when and how he should take these." I figured this was a reasonable request, and wouldn't take much time, and wouldn't she want to make sure we knew all the information we needed?


Tom after brain surgery in 2005.

She looked at me like my face was on upside down, and had spoken in Klingon language, and said "The information will be on the prescription bottles." And she promptly walked away. Thanks, for that Dr. Mean Face. Luckily Nurse Sweety was nice enough to take the ONE minute it took to write it out for us.

Next time in the ER, Monday afternoon. The urologist, after hearing that Tom had been vomiting all night, totally writhing in pain, and incapable of keeping any of the pain meds., or any other meds. down, told us to go straight back to the ER. The Dr. said he would call ahead and make sure they knew he sent them. I felt a little better about this, and figured, hey maybe they will actually treat him this time. WRONG!

We get there, tell the NURSE, NURSE'S ASSISTANT, DOCTOR, NURSE PRACTITIONER, JANITOR, LADY IN THE HALL, everything that has been going on for the past 24 hours.

In comes Dr. Speedy (he talked about a mile a minute and saw Tom for about 2 minutes and then left for about 3 hours, so I am assuming he was on Speed). He asks what has been going on, feels Tom's stomach and back for one second and says, "It's a Kidney Stone."

I wanted to scream. Instead I said, "Yes we know this, we were here LAST NIGHT for this, but the Urologist sent us back because he has been vomiting and is still in great pain." Dr. Speedy looks at me like my face is on upside down when I also tell him that the Urologist wants this test done (KUB) and he would like you (Dr. Speedy) to call him (Urologist) and speak to him about it.

Dr Speedy says, with obvious contempt, "I don't know why he wants THAT test done, all it is is an X-Ray."

"Please call him (Urologist)." I say.

"Let me go call him." Dr. Speedy says as if he just came up with that idea.

After sitting in the ER for another 3 hours, which included being moved from an actual room in the ER, into the hallway, then back into another actual room, here comes Dr. Speedy again.

This is my favorite part of the whole day.

Dr Speedy says, "Did you have your CAT scan done here yesterday?"

"Yes, we were here in the ER why would we go somewhere else?" (I was obviously losing my patience with Dr. Speedy by this point.)

"Well I can't find the report in the system, would it be under another name?"

"Um no, he only has one name." (I look at Dr. Speedy like his face is on upside down this time.)

"Can you check again?" I say

"I can't pull up a report that isn't there." says Dr. Speedy

At this point I want to punch Dr. Speedy in the face but he walked away. He came back about 2 minutes later and hands the report to the Nurse Practitioner who is now taking Tom's entire life history back to when he fell off his bike in the third grade.

Dr. Speedy looks at ME and says, "The report was under just his name without the Jr."

Then he says with serious annoyance in his voice, "That is why I ASKED you if it would be under any other name."

What I said back to him at the time was, "Oh good."

What I wanted to say back to him was, "You flipping idiot, how many years of education does it take to have the common sense to know that if you can't find the report under the person's name and they have a Jr. at the end, MAYBE I should try looking it up WITHOUT the Jr."


Tom wearing a portable EEG machine in 2008.

Sigh...

So after spending the night in the hospital and not being able to eat, and possibly getting exposed to about 5 million other illnesses, Tom came home in pretty much the same condition. He is not in as much pain, and is able to keep food down, but honestly it was not because of anything the doctors did. From what I hear from Tom, he was pretty much left alone in the room the entire time with intermittent visits from Dr.'s and nurses saying "Everything looks fine you should be able to go home soon." Obviously the definition of soon means something entirely different to them.

Why am I telling you all of this? Well first because it is making me feel better to share this experience. But mostly because it made me think about the health literacy epidemic.

I call it an epidemic because it really is everywhere, and while there are few people working to make it better, the health care professionals and systems in general are pretty much ignorant.

When I asked our Dr. Mean Face if she could write down instructions for us about the meds., why did she treat us like that? Isn't the goal of doctoring to make people feel better, and doesn't that include making sure they understand their medications? What if my husband and I could not speak English. When I think about the implications of that, I literally get knots in my stomach.

When Dr. Speedy was "helping" us, was it really that difficult for him to treat us with just a little compassion? Was it necessary for him to have speak to us with annoyance and contempt?

The main thing I kept thinking while we were there is "what is that smell?" But also, "where is the disconnect?"

When did it become THE DOCTOR on this huge pedestal, and the patient, down here in this little hole? Or was it always that way and now there are some of us who are saying, "this is not acceptable."

Just because we did not go to med school, we have every right to know what is going on with our bodies and to expect that our questions about that will get answered with the same respect we show them.

Maybe I am generalizing too much, but I don't think I am, the statistics prove that most people do not know what their Dr. is saying to them, and even if they ask, what are the chances that the Dr. is going to answer them with any kind of respectful thoughtful answer. My fear is that those chances are slim.

Now like I said before, I know that not all Doctors and Nurses are like this. And I will say that most Nurses seem to really care and be concerned for their patients. Also most of us have health insurance and are lucky enough to pick and choose who we go to for help. But when you are suddenly hurt, and sick and afraid and you visit an ER, you don't have that luxury.

The CDC released a study in 2010 showing that about 46.3 million Americans do not have health insurance, that is about 15.4%. In my mind these people are at the greater disadvantage because they are sometimes forced to use only the Er's or Urgent Care Facilities. They are faced with over worked, over tired, doctors and nurses. And it is abundantly clear to me that they are severely understaffed.

I think more than ever we need to put an emphasis on the need for health literacy for anyone working in the health care arena. It should be a requirement.

Even more importantly we as patients need to stand our ground and not allow ourselves to be bullied. That never means it is ok to be mean, but maybe it means we can get a little bit angry, and a little bit loud, and make ourselves heard.

My husband and I are coming away from his experience with knowledge and understanding. We understand that doctors and nurses have a really hard job. We now know that in order to break through that barrier we have to be much more assertive.


Tom with a little home health aid.
(He obviously decided against the ER that day.)

Do you have any stories like this? Any thoughts on how to handle them? We all need to be our own best advocates!