My first Patient
What a year it’s been…and it’s only February! My poor grandparents (well Grandparents in law, but I dropped the “in law” a long time ago!) both fell last month. Grandma was diagnosed with a lumbar spine fracture and Grandpa fractured his long leg bone- the femur. Both are going to be okay- luckily broken bones heal!! It just takes time, patience and a lot of hard work to get the right medications, treatment and care. My take home messages from helping my grandparents after their fall? The healthcare system should NOT be that hard to navigate, every patient should have a strong advocate, and don’t work with Family!
Both my grandparents were taken to the ER after their fall. Grandpa was admitted and prepped for surgery and Grandma was kept in the ER while awaiting imaging results. This post will focus on what I learned from being on the other side, helping Grandma. Thanks to cell phones, no one memorizes phone numbers anymore. Neither Grandma or Grandpa could remember any numbers to call, so it was awhile before we even heard the news that they were in the hospital, in a state away from us. Being so far away is scary and stressful, and you just feel helpless.
I spent a lot of time on the phone that night, with family and Grandma’s nurse. I tried desperately to convince the nurse that he could not possibly discharge my 83 year old Grandma that night to an empty home, pulling out the big terms of “fall risk”, “high risk readmission”, “unsafe discharge plan”…oh yah, I know the lingo from working in the hospital. I was able to get them to hold her over night, purely for a physical therapy evaluation. The next morning, my mother in law and I left super early in hopes of getting to the hospital before Grandma was discharged. When we got there, by 10:00 in the morning, we found Grandma, discharged, sitting in a wheelchair next to Grandpa’s bed, in incredible pain and an ill fitting brace. Her discharge instructions were essentially non existent. She had received inadequate pain medication and absolutely NO training on how, when or why to wear her brace. She had no instruction or contact numbers for questions and no doctor’s names to schedule her follow up appointments. And the physical therapy eval that she was held for over night? Cancelled!
Needless to say, I was stunned. The medical system that I encourage my patients to trust on a daily basis had failed me and my grandma. And she didn’t even know! That’s the thing I don’t get. If you’re not in the field, don’t know the lingo, how do you even know what you don’t know or what you should know? I don’t blame Grandma by any means…I blame the medical system. We’re supposed to educate and advocate for our patients. Where was the education? All Grandma was told, at 1:00 in the morning, was “here, where this super uncomfortable brace to heal your back”. Her impression was it needed to be on 24/7. She had no idea how to manipulate the brace or how to care for herself in the new confines of being braced.
The next few days were busy with trying to get Grandma comfortable and get our questions answered. I was all over the hospital, from trying to talk with the case managers and nurses that treated her, to medical records to try to find the answers myself. Between my persistent mom-in-law and I, we were able to get Grandma into a neurosurgeon the next day. This was our hail Mary- the turning point in her early recovery. We dragged poor Grandma up and in the car and to a hospital 20 minutes away to be squeezed in during this gentleman’s lunch break. The PA we saw was just as sweet and wonderful as could be. He finally listened (what a concept!), got Grandma the right pain medication and a new, better fitting brace. He also explained her exact injury in a way she could understand, including showing her the CT scan images. After this point, Grandma was on the road to recovery. It’s amazing what a few good muscle relaxers and pain meds can do for you!
The next morning, Grandma was moving better. We were able to simulate an entire morning routine for her, problem solving how to dress and bathe while staying safe and protecting her back. I always knew I had an inner OT in me! This is something that should be done with home therapy, but that was another problem in itself to schedule. When they finally did make it out, almost a week later, Grandma was able to show off her skills and everything I had been able to teach her.
Overall, I’m incredibly frustrated by the medical system. It should NOT be that hard to get answers to your medical questions, get appropriate and effective medication and braces. I have a new appreciation and respect for my patients and their family who have to maneuver through the system. If you don’t know what you don’t know, then your only option is to trust what the discharging medical team says. And if they do a poor job on education, then what?
Here’s my message to you all…don’t be afraid to express your concerns of safety, pain or lack of understanding of the medical plan. If you don’t know who to ask to get your questions answered, ask everyone who comes into your room. Ask every healthcare provider you see. Eventually, you will get one who will help. I know on a daily basis, I go above and beyond for my patients, even if it’s outside “my job”. The fact is, I treat each patient I have as if they were my personal family member. Being sick, injured and in pain sucks. There’s no other way to say it. It just sucks. Let the people who want to and who can help you help. I’m sure you would do the same thing for them if the situation were reversed.