kitchen table math, the sequel: in Evanston

Sunday, August 23, 2009

in Evanston

I'm in Evanston, still. My mom fell the night before we left for vacation, and has been in the hospital ever since. So have I. 
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31 comments:

Catherine Johnson said...

Dealing with my mom's situation in the midst of the health insurance debate .... has led me to thinking about where money gets spent.

The total bill for public education is apparently up to $7 billion (can't remember my source - but we're beyond the half-trillion I used to cite). And of course that doesn't count the money people spend on remedial education when kids graduate high school unprepared to do college work.

Total bill for medical care annually is 1.6 trillion.

Both of these figures are rising. Talk about unsustainable.

August 23, 2009 at 8:56 AM
Catherine Johnson said...

I've been thinking: you can homeschool your kids, you can't home doctor them.

August 23, 2009 at 8:57 AM
Catherine Johnson said...

I need food.

August 23, 2009 at 8:58 AM
Catherine Johnson said...

And a shower.

August 23, 2009 at 8:58 AM
Catherine Johnson said...

from the middle school math thread:

I have never heard of "formative assessment", and can't define it.

Am putting this here because I've also had a "formative assessment" moment vis a vis health care....

August 23, 2009 at 9:02 AM
Anonymous said...

Can I bring you some food? I can't help with the shower much.

You're at Evanston, right?

I could just call you, I suppose.

SusanS

August 23, 2009 at 9:07 AM
Catherine Johnson said...

Susan - just tried to call you back - can't get reception here in the basement.

I'm finally IN the basement, which is the good news.

I got to the hospital late yesterday -- around 4 -- and things weren't good. By 6 or 7 or so, my mom looked like she was possibly having a heart attack. (Apparently we won't know whether she did or did not have a heart attack last night until we've got through all this. That's assuming we do get through all this, of course.)

In any case, I stayed the night, and then, this morning, waited for hours for various interns, residents, medical students, and full-fledged doctors to show up.

I'll call when I get back up to ground level.

Don't need food today - but I would really appreciate it if you'd STAND BY.

(Evanston Hospital - right.)

I'll be here 'til Thursday --- want to see you!

August 23, 2009 at 10:24 AM
ChemProf said...

I hope your Mom is okay soon.

August 23, 2009 at 10:29 AM
Anonymous said...

I tried to call you a couple of times. I'm glad it was just from being in the basement.

They ought to be able to figure out the heart attack thing pretty quickly. My mother had several little ones in her last couple of years. She'd just feel funny, go in and get strapped to something, and yep, she'd be having a little heart attack.

Hospital Hell. Been there done that. And waiting for the actual doctor to show up is one of the most aggravating things that most people go through.

I'll keep the cell on.

SusanS

August 23, 2009 at 10:49 AM
Catherine Johnson said...

Thanks you guys!

Susan --- yes, that's the situation.

August 23, 2009 at 12:01 PM
Catherine Johnson said...

I must say... I'm partially revived by the discovery of the Class size reduction versus RAPID formative assessment study.

heh

RAPID formative assessment

That works.

August 23, 2009 at 12:02 PM
Catherine Johnson said...

I'm going to get more coffee & go back upstairs.

Here is the astounding thing.

My mom's in the hospital because she fell HARD. Bad, bad fall. She's in enormous pain; can't sit up, can't stand up.

Her doctor said it was a pelvic fracture.

Then my mom said it wasn't a pelvic fracture.

Back to the doctor, who said she must have been groggy from the meds; it was definitely a pelvic fracture.

Then the weekend attending doctor said it was a pelvic fracture.

At that point I was done having conversations about the fracture when the bizarrely handsome medical student (like Brad Pitt at 20 only better looking), who seems to be singlehandedly managing my mom's case, told me, unasked, that my mom didn't have a pelvic fracture.

So there we were: the medical student & my mom saying she doesn't have a fracture; all the grown-up doctors saying she does.

Turns out she doesn't have a pelvic fracture. She has a sprained back.

This means that, a week shy of her 80th birthday, my mom could fall hard and break NOTHING.

The hospitalization for the fall may kill her (not because of lapses in hospital care - I'll write more about that: watching people do their jobs seriously & well is inspiring), but her bones survived.

August 23, 2009 at 12:10 PM
Anonymous said...

Best wishes and prayers for your mom. No hospital I know lets you have your cel phone on, but some have some comfy wi fi rooms. hope you can find one and get some rest.

August 23, 2009 at 12:27 PM
Catherine Johnson said...

Hi Allison -- Evanston allows cel phones AND has wireless in all the rooms.

When you turn on the TV set, it says, "Thank you for choosing Evanston Hospital."

August 23, 2009 at 3:47 PM
Catherine Johnson said...

It's pretty great.

First time I heard "Thank you for choosing Evanston Hospital," I thought: If I get in serious trouble I wonder if someone can fly me a thousand miles across the country so I, too, can choose Evanston Hospital.

August 23, 2009 at 3:48 PM
Anonymous said...

This helps to keep the masses from losing it while being stuck somewhere in the hospital waiting for someone who knows something.

In the small town where my mom lived, we had cell phones and wi fi, too.

We had been there for a few weeks with my mother. We hired round the clock sitters since we knew we would be planning a funeral and we couldn't be there every second. We also knew that on one would be looking out for her either since the nurses rarely came by except to administer something.

Five minutes after she passed, the "patient advocate", who I had never seen or heard of, came in to see if there was anything he could do. I told him he was a little late.

SusanS

August 23, 2009 at 4:17 PM
Anonymous said...

oops, "no one.."

SusanS

August 23, 2009 at 4:20 PM
Catherine Johnson said...

This helps to keep the masses from losing it while being stuck somewhere in the hospital waiting for someone who knows something.

lolllllll !!!

Waiting for someone who knows something: that's pretty much a lifelong undertaking.

August 23, 2009 at 4:23 PM
Catherine Johnson said...

The folks here are on their game --- and the nurses are in and out. Each patient has a nurse and a nursing assistant, and their names are written on a whiteboard across from the patient's bed, just above the Room number & the patient's direct-line phone number.

August 23, 2009 at 4:25 PM
Catherine Johnson said...

Key word alert: "PAIN CONSULT."

That's what you ask for when your mom is in agonizing pain and everyone keeps telling her to Walk or Die.

In fairness, the Walk or Die admonishments ceased after the first couple of days ('round about the time we figured out that the person giving the Walk or Die admonishments was a medical student, not a Fellow specializing in cardiac medicine).

Still and all, pain is a huge, vast problem for my mom; she's not going to be getting out of bed without significant pain TREATMENT. (All caps because I have progressed from the concept of pain 'relief' to the concept of full-bore, specialty pain TREATMENT.)

Finally today I figured out I needed pain "specialists," although I didn't know where one might find such an animal. A clinic, I thought.

I mentioned it to the nurse, who said, "You mean a pain consult?"

bingo!

So tomorrow I'm requesting a pain consult.

August 23, 2009 at 4:29 PM
Catherine Johnson said...

Today's nurse got on top of the pain issue; she asked my mom, repeatedly, to rate her pain on a scale of 1 to 10.

Turns out my mom was at 9 and not telling anyone.

The nurse told her she needs regular pain medication; then the doctor came in and told her that extreme pain causes her blood sugar to rise. I'm guessing extreme pain probably also stresses her heart, but of course I don't know.

This is an example of the critical importance of "patient-centered" medicine as opposed to "book-centered" medicine or "protocol-centered" medicine or even "evidence-centered" medicine (or what I take to be evidence-centered medicine in Town Hall-speak).

My mom has an extremely high pain threshold AND she's stoic and uncomplaining. I've been here every day for 12 days and had no idea she was anywhere near a 9.

When she says she's in too much pain to sit up, that's like anyone else saying they're in too much pain to live.

Tough talk from a medical student isn't going to fix it.

August 23, 2009 at 4:42 PM
Anonymous said...

I had both kids at Evanston and the nursing was top notch, for the most part.

It's the emergency room you want to avoid there. It's a public hospital so the gun shot wounds are mixed in with the kids who need a couple of stitches.

I'm glad they're dealing with the pain finally. I had trouble with that in my little town, also, but it had more to do with the tension from nurses about potentially administering a fatal dose of morphine to a dying patient.

I can't blame them, really, but my mother was in a lot of pain from just basic organ shutdown. It finally became clear to me that I was not going allow her last days or hours to be in excruciating pain, no matter what, and that I was going to overcome any shyness or inertia I might have about confronting the various nurses and doctors.

I'm sure I started to resemble Shirley McClaine in that "Give her the SHOT!!" scene in Terms of Endearment.

SusanS

August 24, 2009 at 5:33 AM
LynnG said...

Thanks goodness for the wifi. Now just send us a link for that rapid formative assessment study!

Seriously, I hope they get the pain under control. Too much pain is always a bad thing.

August 24, 2009 at 6:54 AM
Anonymous said...

Does she have a PCA setup? (patient controlled analgesia). An IV line is set up to deliver medication when the patient presses the button. It's set up on a doctor-prescribed "up to x dose every x minutes. With any pain medication, the key is NOT to wait until the pain is unbearable; you will not get good relief.

August 24, 2009 at 8:07 AM
Anonymous said...

Catherine,

Just checked in on KTM (been reading and posting for nearly 3 years now) and I'm so sorry to read about your mother. However, she sounds like my 78-year-old mother who is tough as nails. I couldn't help but smile when you mentioned your mother's self-diagnosis...no pelvic fracture. Here she is in massive pain, but absolutely will not discuss it!

--PaulaV

August 24, 2009 at 2:14 PM
SteveH said...

Catherine, I'm sorry to hear about your mother.

I've just been through two weeks of hospital hell with my mother-in-law. She had emergency surgery and didn't make it. DNR is not so easy when you're already hooked up after surgery. It's then a matter of unplugging, which is quite different.

Although the hospital used a "hospitalist" to coordinate the team of doctors, we had too many facts and doctors who wanted to try one more thing. The best advice came from Hospice, but they were called in only after we made the decision. We really needed them a week ago. We had to figure it out ourselves.

August 25, 2009 at 7:49 AM
RMD said...

Catherine,
I'm sorry to hear about your mother. These things are always difficult.
Our thoughts and prayers go out to you.
RMD

August 25, 2009 at 7:56 AM
K9Sasha said...

SteveH,

I'm sorry to hear you've been through hospital hell with your mother-in-law. It sounds just awful.

August 25, 2009 at 8:59 AM
Anonymous said...

Steve,

I'm so sorry to hear about your mother-in-law. That's so tough.

Boy, no one really prepares us for this part of life.

Hospice is a great thing. My family had to use them a couple of times.

I just wish there was a kind of in-between hospice. I guess that's supposed to be the hospitals.

SusanS

August 25, 2009 at 4:39 PM
Anonymous said...

SteveH,

I'm so sorry. My condolences for you and your family.

August 26, 2009 at 5:19 AM
Tracy W said...

SteveH - I am sorry to hear about your mother-in-law, my condolences to you and your wife and the rest of your mother-in-law's family.

August 26, 2009 at 9:10 AM

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