Progression Two

Occasional notes in the life of a Parkinson patient & her carer.

Saturday, November 01, 2008

Chapter 147 - Not a Pleasant Week

The hospital called early Tuesday morning for her to come as soon as she was ready rather than the appointed time late morning. A shortening to the tension of waiting.

Last weekend she thought she may be unable to suffer the operation because she had developed a bad case of sniffles, dripping nose, although without a rise in body temperature or blood pressure. When she checked by phone with the hospital on Monday she was asked to cough into the phone then told that it sounded OK and to present next morning anyway. This must be a form of "on-line" diagnosis?

So on Tuesday I left her at the hospital around 9:30am. When I called back near lunch I was told that she would be awake after 3pm. So she missed her noon meds and the 6pm were late about half an hour. As expected, the staff locked the bedside drawer in which were her meds. But only the ones they supplied. Hers were left in her little bag, except for Sifrol which the hospital pharmacy did not stock. I pointed out to the nurse that she had been administering her own meds for 18 years and was told that the bureaucratic system demanded that the meds be locked away. Next morning I complained at the nurses' station about the tardiness of meds delivery, suggesting I would raise a stink even though I realised that at times their duties to other patients may need to take priority. The drawer remains locked. However, the meds have been provided on time, usually early, ever since. Someone seems to written up a standing order for this to happen. Perhaps they observed the tremors in her legs, the left of which is not to exercised.

She has been in pain without complaining about it. In the first 24 hours she had a shot of morphine but since she has only wanted Panadol. She is capable of #1's on a bed pan but is unable to accomplish #2's "laying on a bed pan" (in her words) so the two staff lift her from the bed onto a commode chair then wheel her to the loo. The surgeon is most unhappy about this because he says her left leg must be completely rested and not take any weight or pressure. Fair enough, yet the stress of attempting to perch on a bed pan is much more likely to cause her left leg to tremor sufficiently to be equivalent to running around the block. He is concerned that the graft may not take and an ulcer develop. The leg remains securely wrapped in its bandaging.

What we understood to be a hospital stay of about 4 days will now be at least a week, for the stitches will be removed in theatre under general anaesthetic next Tuesday. The general because the surgeon finds her leg easier to attack without tremors present. This is a concern because her "Caring Physician" has often said that general anaesthetic is just like removing the brain, washing it in chemicals then replacing it and is not good for anyone, let alone patients with neurological problems. But then he is not a cutter and has also said on several occasions that the "blemish" on her leg was OK, just needed monitoring.

She has accepted being in a public ward. A few nights ago when she needed attention her alarm button failed to work and the woman in the bed opposite had to use her button to summon a nurse. The DB9 plug on the wall had fallen out because there were no retaining screws to hold it in place. So she was relieved that she was not isolated in a room on her own. I have since brought a screw from home so now the DB9 cannot fall out when there is movement on the cable and the control box of buttons. In that same box is a very small speaker to provide sound from the overhead TV set, although the sound level is so low that TV dialogue is inaudible. When she mentioned this to the nurse yesterday he said he would put in a work order but it will be Monday before anything can be done. The other night a woman brought from theatre refused to be placed in a public ward, demanded a "private" room because she was a "private patient", so after some debate was wheeled away. I wonder whether she pays the $200 each month like we do? These so-called "private" rooms in this hospital are more like isolation rooms where critical, dying and prisoner patients are placed and priority is on a needs basis. We think she is safer in a more "public"area.

The last time she was in this hospital she did have the luxury of a "private" room for a short while until a cancer patient needed the space. In that room the window was propped up with a rather weathered roll of toilet paper. In her present room the window will remain up without help although the fly screen is damaged so that it will not remain clipped in place. In consequence of this and I suppose other similarly damaged fly screens on other windows, each day I have seen several very large blow flies droning through the ward and hallway. On one occasion, I was accompanied in the lift by a blow fly. A smart one, why fly down toward the kitchen area when you can take the lift? When the flies were brought to the attention of a nurse the reply was " we are not allowed to spray in the hospital any more". I think that is a good idea, but I wonder where the flies' feet have been and what their feeding tubes have sucked on? Apparently the catering staff who deliver the meals are a greater danger to patient health because they have been directed not to touch patient items on those tiny over-the-bed roll-around tables so if there is insufficient space to place food trays then the trays are to be taken away. There was a piece of tissue or bandage, slightly stained, beside an un-occupied bed opposite hers. She told me that she had heard that only the cleaning staff are permitted to collect such things dropped on the floor.

The night before last she developed some chest congestion which she brought to the attention of the staff. So I brought in the ball sucking machine she kept from her stay in a private hospital in Hot Air City and that seems to have helped her. One of the nurses complimented her on using the device and said she could have been supplied with one from this hospital. Perhaps so, but why was it not automatically offered as it was in the other place where it was decreed that it was to be used regularly?

Several days ago she discovered that her meal was not as she had ordered for bed #43. The woman in the opposite bed #42, a diabetic, noticed hers was incorrect also. When they compared the dishes, they realised that their food had been "swapped" together with the menu sheets returned on the trays which showed the correct name and bed number. I tried explaining this at the nurse's station last night and the result was a puzzled stare. I found it difficult to convey the message without sounding confused myself. Yesterday the woman in #42 moved to another hospital so today may be interesting - I have predicted that she will receive no food at all.

I sent to all & sundry an email containing the hospital's switchboard number because I thought concerned friends & rellies may prefer to speak with the horse's mouth rather than hear or read vague summaries of her condition from me. Many have. Unfortunately the hospital restricts when calls can be connected to the room (she does not have dial-out capabilities on the bed-side phone) and other calls are mis-directed. Consequently our daughter made at least 2, maybe 3 or 4, attempts before she was connected.

Yesterday in late morning I found her sleepy, tired and un-washed. She had hardly slept Thursday night, due to discomfort & some pain. When the staff came after breakfast to wash her she asked that to be delayed because she was about to sleep. She later mentioned to them that her rear end felt very tender. At first they thought there was nothing to be concerned about, then after discovering a couple of spots they applied ointment and some bandage patches (so she says, I did not look).

Having said all the above, the staff have been considerate and helpful, even though they often show signs of stress and weariness. As we do ourselves. Should there be a next time, and with increasing age there will be, we will opt for a private hospital in Hot Air City. That certainly will cause contact difficulties for us but will minimise other stresses.

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