How the "mighty" have fallen...all the way from the top of the food chain to the pits.
Not a pretty sight or story.
Most of you probably didn't even notice that almost a month has passed since you last heard from me. Some of you are aware that on July 12, 2011, an event happened that changed our lives.
While it did not carry the same weight as the recent "debt crisis", it did thrust us into the not so gentle hands of this country's medical system.
Early one morning as Jane and I were walking on Park Avenue on the way to a doctor's appointment, Jane suddenly pitched forward and crashed to the ground. She had tripped on a broken sidewalk. It was obvious that she was hurt, so I immediately dialed 911 thinking that in just a flash we would be on the way to Lenox Hill Hospital just a scant 6 blocks away.
Not going to happen. I made two more calls to see when the ambulance would arrive before we spotted one coming from the hospital and turning right on Park Avenue. The only problem was that he was heading in the wrong direction. Another call to 911, and we spotted the ambulance make a U-turn and with siren blasting was on his way to us.
Once in the ambulance I envisioned us speeding to the hospital, but I was wrong. No siren, but rather we stopped for traffic lights and people jay-walking. What seemed like hours but only was minutes we arrived at the Emergency Room. Unlike the medical shows on TV, the first stop was to supply them with proof of medical coverage before entering the triage unit.
Not to worry, as we would be spending the next 10 hours as guests (prisoners?) of the dedicated ER staff. All started well, and the staff was attentive and it appeared that in no time at all we would be on our way to finding out what damage had been done in the fall.
What really happened was that I had to shed my mild mannered persona and become a overbearing advocate demanding action. In all fairness, the ER was crowded and the staff busy doing whatever the staff does. Lots of people in white coats moving around, but none seemed to settle near us.
By this time, TEAM LEVINE (TL) had expanded by one as our daughter, Sandra, joined the fray. The mission of TL started simply to get help for Jane, but in no time we expanded our outreach to help the woman in the next bay who kept calling for help that never arrived.
Finally an x-ray was taken that showed Jane had fractured her right hip and left wrist. In no time at all, a member of the orthopedic staff appeared to tell us that an operation on the hip was necessary and that speed was of the essence. At the same time our personal internist arrived and TL now grew stronger. At least a bit stronger, as we learned that the ER doctors rule in the ER.
The "orthopod" assured us that the hip operation would be a simple one and would only require "pins" and not a hip replacement. Shortly thereafter, we were told that the fracture was worse than it first appeared and a partial hip replacement was called for.
The orthopedic surgeon poked his head into our curtained cubicle and informed us that further study of the x-ray triggered the need for a CT-SCAN. After that, we were told that Jane needed a total hip replacement.
I figured if we remained in the hands of this doctor, we would be told about escalating her condition to one requiring a frontal lobotomy.
Our personal doctor sprung into action, and arranged for the Chief of Adult Reconstruction at the hospital, Dr. Jose Rodriguez, to take over the case. Immediately, we felt like we were in the hands of a professional, and subsequent events would prove us right.
The operation for that night was cancelled and rescheduled on a "stand-by basis" for the next day. We were released from the ER and were on our merry way to a private room. We felt this was necessary so that I would be able to stay with Jane 24/7 during her stay. We had heard horror stories about hospital personnel following the strict protocol demanded by Parkinson's medications (meds).
The room was pleasant overlooking Park Avenue with a wonderful view of nearby Carlyle Hotel. It was almost like being home, but reality set in quickly. In all her time at the hotel, no one appeared to take blood, vital signs, and generally make sure that she never got too comfortable.
Once settled in the room, Jane sent me home to gather up all her meds and bring them back to the room. Her foresight was proven right the very next morning when the nurse arrived with the first scheduled dose of her meds. Jane's schedule starts at 6am and continues 5 times a day every three hours.
The nurse not only was late, but the medicine was not the right one. We were furious, and in front of the nurse I gave Jane the right meds from our private and illegal stash.
This proved to be the opening salvo of a battle that would continue unabated until after her operation when we finally were in a position to blackmail the nurse. The day nurse continued to show up with Jane's meds whenever the mood struck her. She informed us that it did not matter if the meds were not given exactly on time and she was allowed leeway of one half hour in either direction.
Shortly after the operation, she was late with the 3pm meds. After a half hour I went out on the floor and the following conversation took place:
ME: Where were you, it is now 1/2 hour past the time for my wife's medications
NURSE: Why did you wait until now to come and get me? I have told you that you are not to administer to her and if you did I would turn you into security.
ME: Sounds reasonable to me, but I have another possible solution.
NURSE: What!!!
ME: If you get off my back and show up on time from here on in, I will not turn you in to your supervisor for endangering a patient and your unprofessional manner.
After this short "discussion", the problem disappeared.
We met the surgeon Wednesday morning when he and his entourage made their rounds. When he entered the room, TL knew that we were in the hands of a top professional and the medical version of a rock/movie star. As Sandra remarked, "he was gorgeous!" He explained that Jane could not eat (her second day without food) as she was standby for an operation later that day.
At 4pm, she was taken to the operating floor to await surgery. Sandra and I were in the waiting room until 10pm when she came out of the recovery room and went back to her room. The operation itself only lasted about 1 1/2 hours, and was a resounding success.
A really cool thing that they do to enhance the patients' stay is fostering a connection between the food service personnel and the patient. This takes the form of a visit to the room by a member of the "nutrition" team to discuss the day's offerings with Jane and deftly exhibit a hand held computer and enter the next day's selection into the system. The only problem with this hand on approach is that on two occasions, Jane received no food.
Our stay at Lenox Hill came to an end on Friday with the transfer to Mt. Sinai Hospital Rehabilitation unit. One of the top rated rehab centers in the city and the country. As we climbed aboard the ambulance, I could swear that the entire hospital breathed a deep sigh of relief with our departure.
We arrived at the rehab center in the late afternoon. It was chaos as our arrival seemed to be a surprise and confusion reigned supreme. We also found out that all the physical and occupational services were closed on the weekend except for an evaluation of Jane and my getting certified to operate a wheelchair. Both of these were done early Saturday morning and we were free to hang for the weekend.
Before I describe the ordeal we encountered during this phase of our travails, let me say that the therapists were outstanding and almost worth the lack of support by the nursing staff.
If we thought that we had problems at Lenox Hill, in no time at all we discovered that there was a major disconnect regarding patient care. A cardinal rule of this center was that no patient was allowed off their bed unsupervised. This was to make sure that no one would fall. Sound policy with only one major flaw. When Jane (or anyone else) pressed the call button, there was no response. Early in our stay, I saw Jane's 80+ frail roommate crawl out of bed, get her walker and stagger to and from the bathroom. She did not set any world speed records and in the time it took her to complete her journey, not one member of staff appeared.
I was awakened at home one morning at 1am by a phone call from Jane saying that she had made it to the bathroom herself, but could not get back into bed. She had pressed the call button many times with no response. I managed to get someone on the phone and after much yelling and screaming got them to send someone to the room to help Jane. The nurse delivered a strong message that Jane should never call her husband and upset him.
Another example of patient care redefined was after waiting one night foran hour for someone to answer the "call bell", she walked out into the hallway heading towards the nurses' station. Like good "old St. Nick" much to her surprise what did she see but all the floor nurses gathered around the desk laughing and having a good old time. When one of them spotted Jane, she quickly rushed over to see why she was out of bed and what she wanted.
On Thursday, the therapists wanted to release Jane, but the doctor felt that a little more therapy would be helpful. Facing the thought of another non-productive weekend in the clutches of the staff, we opted to be discharged on Friday.
Yesterday we received a bill for the private room charges at Lenox Hill. To our dismay, we discovered that we were charged for an extra night's stay. After calling and pushing 1, 2, 3 etc. buttons as directed I finally spoke to a "live" person. Waiting for a call back and notification that they have corrected the mistake and they will correct their mistake and refund the money.
Then again, I am by nature an optimist!
One of the things we learned through our experience at the rehab center was if you could handle the lack of care exhibited by the staff, the therapy was well worth most of the angst.
Probably the greatest lesson learned from Lenox Hill and Mt. sinai was that some people make friends wherever they go, The Levines make friends whenever they go.