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Posts Tagged ‘Hospitals’

People never just “go” to the Emergency Room, they rush to the ER. And if you’re Mr T, you take your motorcade along, a helicopter would be too flashy. He wanted to avoid the “fake news” after all. The Bride caught wind of his “irregular” trip to Walter Reed on Saturday while she was working in her ER because it was blowing up in her private female MD social media group – I mean Twitter wasn’t even on the story yet. I wonder why Google hasn’t told us the reason for his visit.

According to most news outlets, the White House has a regular mini-clinic-hospital in one of its wings. So this unscheduled, outside of protocol trip to the ER is a mystery. Does anyone believe the press secretary’s line that Mr T was only fulfilling the first part of a routine medical exam? His BFF Roger Stone goes to prison and the impeachment witnesses are heating up reality TV, and rumor has it Ivanka actually observes the Saturday sabbath with her family, so he was all alone in the residence… and figured he’d get a check-up?

Naturally with two-too-many ER docs in the family, we try to avoid ER visits, unless it’s to deliver apple cider donuts. Last week, Great Grandpa Hudson was having a problem breathing, certainly a good reason to call an ambulance. Instead, two ER docs showed up to check him out and he was just fine. Thousands of Medicare dollars saved because a 93 year old man would certainly have been admitted for the complete work-up. His only problem – a salt-loaded free restaurant meal at a local restaurant for Veteran’s Day.

Maybe Mr T had one too many hamburgers? His cholesterol is rather high and his weight is an issue. Or maybe he thought he was having a heart attack, and it was only a panic attack!

I have a friend who went back to work years ago, and left their 3 month old baby with her husband who worked at home. He ended up in an ER with a panic attack that can mimic a full-blown MI – sweating, heart irregularities, a feeling like your world is coming to an end. I’ve had one or two panic attacks myself while I was trying to conceive a second baby and kept having miscarriages. I went into hard core OCD and didn’t want to drive over bridges.

Maybe the constant strain of being presidential, rising at 6 am and taking 3 hours of “executive time” to watch state-sanctioned FOX News, then starting your day at 11 am and ending with very busy Twitter fingers is taking its toll. I wonder if he has dinner with Melania, or if she eats early with Baron? Or is she even there? Then there’s all that golf on the weekends. It must be exhausting!

He left Walter Reed without a jacket, his shirt open, no tie. Sounds like it was a quick exit, the kind of patient who leaves an ER “against medical advice.” You know the type, and Mr T is certainly that type of arrogant, egoist.

He is back at Tweeting his agenda this morning – using middle school bullying tactics and name calling to intimidate his enemies. Nancy Pelosi is “Nervous Nancy.” The “Do Nothing Democrats” are at it again with “Fake News.” Mr Tweety T whines that he was only exercising his First Amendment rights when he live-Tweeted a threat to ex-Ambassador Maria Yovanovitch on Friday.

“Everywhere Marie Yovanovitch went turned bad,” Trump wrote. “She started off in Somalia, how did that go? Then fast forward to Ukraine, where the new Ukrainian President spoke unfavorably about her in my second phone call with him. it is a U.S. President’s absolute right to appoint ambassadors.”  https://www.vox.com/2019/11/15/20966716/impeachment-hearings-trump-yovanovitch-witness-tampering

I was thinking somebody should have removed him from office, or at the very least removed his not-so-smart phone from his tiny fingers. I couldn’t believe what I was hearing; an honorable woman who had been told to leave her post in the Ukraine quickly, “on the next plane,” was again being maligned in public, on TV, by our commander in comedy.

She talked about being “knee-capped,” like his administration is a cast from the Sopranos.

“According to the Department of Justice, intimidation of witnesses testifying before Congress is a crime under 18 U.S.C. § 1515(a)(1). However, in this case it is the president who is allegedly doing the witness intimidation and an OLC opinion (see Indicting a President Is Not Foreclosed: The Complex History – Lawfare) states that a sitting president cannot be indicted.”

It’s a shame really, or a sham that this president who sits around all day surrounded by sycophants cannot be indicted. Because he’s not just intimidating a witness, he’s projecting his insane policy of panic and chaos around the world.

In other weekend news, two ER docs and two writers went out for sushi with two adorable children. Can you find the redhead?

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Football on the Brain

Bet you thought I was going to write about the Pope? Nope. Don’t get me wrong or anything, but once a lapsed Catholic, always a bit of a doubter. Humility was driven into us in Catholic school, and you know who you are my fellow Sacred Heart peeps. It’s nice to see a Pope who practices the Catechism we were taught in the 1950s.

Anyway, today is the highest and holiest day of the Jewish Year, Yom Kippur. It’s a day to ask our family and friends for forgiveness, and to cover all bases, we ask God to forgive even those things we may have forgotten to ask him/her about! It’s also a fast day – meaning Jews everywhere are starving! It’s the one day in the year a Jewish mother won’t ask you, “Did you eat?” This must be where Lent came from, and even Ramadan – give up something good to eat and all your sins will be forgiven.

I’ve been cooking up a storm since returning home. Bob lost a few pounds while recovering from his Cervical Spine surgery in NY, so I feel it’s my God-given right to make dessert these days. Dressed in a Darth Vader neck brace/collar, Bob has spent a few hours watching football lately, both college and professional, and of course I’ve come along for the ride – cause I’m a ride or die girl!

And even though watching football makes me feel like I’m back at the Roman Coliseum watching, “Gladiators (who) were generally slaves, condemned criminals or prisoners of war,” I could appreciate the choreography of a good first down. Nurses would walk into Bob’s room and offer up some banter about the team on the screen – football was that equal opportunity conversation starter. “Did you see Brady walk on?” Or “I’m from Pittsburgh you know,” one nurse told me after I said I was a New England Patriots fan. Whoops.

Still every time I’d hear that distinct sound of helmet meeting helmet, I’d cringe. We’ve known what repeated tackles can do to the brain for years now, research and science has finally won out over owners and NFL managers. One guy got booted off the field for head-butting an opponent. Repetitive Head Trauma, so many concussions over the years, and still we watch these giant men crash into each other. Is it really good sport, or are we kidding ourselves?

When the Rocker and Ms Cait flew out on the red eye from LA to visit Bob during his hospitalization, we learned that our son had worked on the sound design for Will Smith’s new movie trailer, Concussion. http://www.latimes.com/entertainment/movies/la-et-mn-concussion-movie-nfl-20150903-story.html

NFL games are the only programs that regularly deliver the kind of big ratings that were once taken for granted by broadcast television. Nearly all of those viewers watch the games and their commercials live in an age when delayed playback of shows is common. As a result, the NFL was able to demand $5 billion a year in rights fees from its television partners in the pact that runs through 2021.

God forgive us for watching so much football. And please point our new baby grandson toward soccer!    IMG_3227

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…or determination?

Yesterday, I got up early and drove North to attend the public opening of a community hospital’s new ED. Yes folks, it’s a “department” not a “room,” one of the many changes I’ve witnessed tagging along with Bob over the years. “I can’t run a room,” was his constant semantic complaint. But it seems he can run a department.

When we first settled in the Blue Ridge, I thought it would be like old times. Bob would do some shift work at the local hospital, and we’d slide into a comfortable retirement; plenty of time together to visit grandbabies and pursue some new hobbies, maybe  keep a few alpacas? Or donkeys, or chickens? Then one year in, the Emergency Department Director just up and quits, asking Bob if he’d like the honor!

And just when I thought his directing days were over, he not only took over the reins, he became Chief of Staff and sat on the Board for many years. We had plans to go to Australia for a sabbatical that were put on hold, but we did manage to build our little house with a view. And one day he presented a plan to that Board for a new Emergency Department – they were bursting at the seams and the population was growing. He wanted a state-of-the-art facility and he managed to persuade the leaders and shakers with his constant optimism and tenacity.

Yesterday, the ribbon was cut joining the new building with the renovated old department, virtually tripling the space of the old ED. Twelve million dollars and five years later, the CEO introduced Bob and kindly said this project was his baby, and without his “persistence” we wouldn’t be here. Everyone nodded their heads, because everyone who works with my husband knows he can be pretty determined to achieve excellence in emergency medicine. He wrote the book on managing an ED and he served as President of ACEP in MA when we were young and just starting out in the Berkshires.

Unlike lots of physicians his age, he never gave up on medicine and he taught our daughter to love the profession too. To never forget the sacred trust a patient shares with them.

I was pretty proud of Bob yesterday, but we couldn’t celebrate yet. He had a lunch meeting with a colleague and then he was scheduled to work the 8 hour evening shift. Kudos to Bob, his assistant director Harvey, who followed him here from the Berkshires, and all the nurses and administrators who helped to make this remarkable transformation possible.

Maybe someday he’ll slow down, just a little? 19114_10152801541071943_7135939311025461658_n

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Trumpets please. The cast came off and a splint went on, my dominant right hand that is. It seems that despite being told there is nothing one can do about a fractured pinky finger, the UVA Hand Clinic has me doing some serious physical therapy. I’m sure that my three week wait to actually see a doctor after the bounce house fall, planting in my garden and mailing 90th birthday party invitations, didn’t help my hand heal. But that’s just me; delay, deny and avoid doctors at all costs since I have so many at home. That’s my problem.

You might think that a doctor’s family has it made in the shade. But I’m here to tell you that’s not the case. It’s pretty well known that anyone involved in health care will be treated differently in a hospital. It’s kind of the opposite of selection bias – once the person treating you finds out you’re in the same field – nurse, doc, therapist or spouse of same, whatever – they may subtly change their strategy. The person treating you may not even realize they are doing this, but by being nicer, kinder and making exceptions to their rules and treating you differently, they are shortchanging you.

Let me find an example. When I came down with West Nile before moving to VA, after a week of unendurable headaches and fever, I finally got to an Opthalmologist who knew what he was doing. I was sent pronto to the nearest hospital’s MRI machine and ended up waiting in the hallway until one became available. I was in such pain and going blind that I hardly registered what Bob was saying to all those people who knew him so well, all I remember is everybody apologizing for me being in a hallway.

I really didn’t care about the hallway at that moment, I wanted the pain to stop.

They didn’t do a lumbar puncture (LP) because well I didn’t see the ER doctor on duty, and they didn’t have an available room, and besides I didn’t want an LP and nobody wanted to question my husband and his wife as to what they wanted in this emergent situation. I hope you’re getting my drift…

If I hadn’t been with Bob, if I’d have been anybody else, the eye doctor probably would have called an ambulance and I would have been whisked away toute suite to a hospital with a bed and an available MRI machine and an ER doc who would have punctured my spine alright, and I would have been admitted to the hospital. Instead I was sent home on steroids.

In the worst of circumstances the very best people in health care will try and make our (meaning everyone else in the health care field) lives easier – thereby putting us at greater risk.

This is why when I went to another state while pregnant with the Rocker for my “older mother” test – the one where they stick a needle in your pregnant belly to get some amniotic fluid – I told the receptionist that my husband was a contractor! Yes sir, I lied because A) this amniocentesis test was fairly new, and 2) I didn’t want anyone to know my husband was a doctor because I was unconsciously already aware of this selection bias.

I know I’m complaining in a sort of ‘poor privileged me’ way – first world problems. And I know this anecdotal bias has probably never been studied, but I’m not the first to notice it. Ask anyone you know in the health care field. Oh, and when my wonderful NP asked me at the UVA Hand Clinic to rate my pain on a scale of 1 to 10, I had to smile.

Because Bob has always said the day he hammered his thumb accidentally putting up a shelf was a BIG 10. He saw stars, he couldn’t speak, and finally when he could, all he could do was swear. When he walks into a room to see a patient and they are texting, he remembers his thumb and knows this is not a 10 on the pain scale. But pain is pretty subjective, your 7 may be my 3?

This is the first time in 2 weeks I’m using more fingers than two thumbs to write. And for that I am grateful. It’s good to start off your day listing two things you’re grateful for, soooo 1) Yay for 9 fingered typing

And B) I’m also happy my 6’3″ son and Ms Cait came to visit this past weekend. That baby who backed away in the womb from the needle in the ultrasound of my amniocentesis test, is going to turn 30 this summer! And his Grandmother Ada just turned 90! Bring on the fanfare!   IMG_0699

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In all this talk about Syria, we Americans may be forgetting that the biggest public policy shift in our lifetime is about to take place. The Affordable Care Act is rolling out on October 1st, whether Kerry manages to corral Syria’s chemical arsenal or not. Even though employers of 50 or more get a one year delay to implement a health insurance plan for their companies, and smokers get a one year reprieve from being charged more than non-smokers, Obamacare is scheduled to debut on time with:

“…health exchanges (marketplaces), community-rated health plans, tax credit subsidies, individual insurance requirements, prohibiting annual and lifetime limits on coverage, requiring insurers to accept all applicants without regard to their health status (pre-existing conditions) and limiting how much more they can charge them…” http://www.kevinmd.com/blog/2013/08/delays-pose-big-problem-obamacare.html

What a monumental effort, making health insurance available for all just when we qualify for Medicare! Then I heard about thousands of hospital workers being laid off in TN, and naturally asked Bob what’s up. After all, we Boomers are just the beginning of a tsunami of health-related consumers to wash ashore; how could our country possibly be laying off medical personnel? Of course the easy answer is to blame the government, Obama and all his caring, that’s what the GOP would like us to believe.

Actually, hospitals across the country are massively laying off workers for a few reasons. One big one is the sequester – you remember that courtesy of the Tea Party. Our budget was cut by 1.2 Trillion, that’s trillion with a “T.”  Since nobody on The Hill could find a way to stop The Sequester, Moody had this to say: “…sequestration is expected to lower the revenues of hospitals, physicians, and other health care providers by $11 billion in 2013.” That’s Billion with a “B.”

Medicare under from budget sequestration could “exacerbate an already challenging operating environment for not-for-profit hospitals” that are facing “low revenue growth” from government and private insurers, Moody’s Investors Service said this week. The sequester involves about $1 trillion in across-the-board spending cuts, including a 2% reduction to all Medicare reimbursement rates, that took effect on April 1. http://www.advisory.com/Daily-Briefing/2013/04/10/Moody-Sequester-Medicare-cuts-threaten-hospitals

And the funny thing is, well it’s not really funny, but if you happen to live in a red state, with a governor who said thanks but no thanks to the Affordable Care Act, well the chances are that your favorite nurse, or physical therapist, or doctor may not be there is undeniable. http://www.wkrn.com/story/22942014/laid-off-workers-rally-outside-vanderbilt

You decide, is this job loss due to a bill that gives all Americans access to health care? Or is it due to an intractable Congress?DB_medicaid_map

 http://www.advisory.com/Daily-Briefing/2013/08/27/In-states-that-say-no-to-Medicaid-hospitals-worry-of-death-by-1000-cuts

 

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Bob and I lost the Bride and the Groom in the hospital parking garage. Well we didn’t really lose them, since we have smart cells and can always find them again, wherever they are. Except for maybe a Caribbean island, our collective happy visualization spot! We were headed for Labor and Delivery; we picked up the happy couple on another subterranean floor and as we’re going up in the elevator, I repeat “BJ,” maybe a touch too loud. That is where we will presumably find my car again, once we are grandparents. Basment level, row “J.” Except for a small giggle from the back of the elevator, the Bride turns to me and says, “Don’t you have that App?” “What App,” I say.

It seems there is an App that will locate your car for you when you are stuck in an airport or mall parking lot, or even a covered, cavernous hospital garage. Now not only will I never get lost, I’ll never lose my car again! “Interesting,” I said, “Have they created an App that will tell me – “‘Why am I here?'” The whole elevator had a smile about that one. But really, besides the existensial question in general, why do we need grandparents? Let me count the ways.

To Cook! Your children will be busy, very busy with a newborn. Cooking anything will be appreciated. I lucked out cause the Groom does dishes.

To Shop! Of course you need to shop for the groceries to cook, which should include all your daughter’s favorite things…avocados, peaches, grapefruit juice. Don’t forget the new Dad, he needs beer and beef. You won’t go wrong. And be prepared to go on special hunting expeditions for things like Lansinoh Soothies Gel Pads – amazing things! Spell it out on your Notes App, L-A-N-S-I-N-O-H. ps Target carries them.

To Burp, Rock and Change the Occasional Diaper! Be prepared. Dads are way more involved than they were in our day. So the actual baby nurse duties will be minimal with a nursing Mom and today’s Dad.

To Give Nursing Advice! Who needs a doula when you have a Grandmother? Well, maybe we did. It’s been over 30 years since I nursed the Bride and for some strange reason this hospital doesn’t employ Lactation Counsultants on weekends. I had a 1-800 La Leche number, and now I have a post-menopausal brain that tends to forget the tough times of sleep deprivation and an inverted nipple. Lucky for me, the Bride has a very cooperative baby girl!

To Know When NOT to Give Advice! This can be tricky. I learned a long time ago never to give anyone advice unless they asked for it. But when it’s your daughter, and your brand new grand daughter you may start to feel just like one of those crazy, old women who would constantly tell you what to do when you were a new mom. “What do you mean the nurse recommends not putting lotion on her bottom?” “You’re going to swaddle her that tight?” Anyway, try very hard to keep most of your opinions to yourself – unless asked. My daughter said she only sees babies in the ER who are either dehydrated or febrile and septic, so I trust her to know what to do in most every circumstance. Still, that leaves a wide range of normal neonate behavior, right? “Wait, you want the dog to lick her face?”

To Take Pictures. My phone has like 4 or 5 picture Apps! Here’s the thing, you get to take pictures as much as you want! And you get to catch those unlikely times with the whole new family. For instance, I think this looks like a soap opera. First time nursing in the recovery room: nurse at the computer, BFF and colleague Kristyn comes in, off camera are many of their friends who are residents…all crying. And bam, the Groom turns. What is he thinking?

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