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Monday, November 22, 2010

Hospital Nomad / Medical Odyssey

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Hospital Nomad / Medical Odyssey:  It is hoped that this posting/definition will give you some insight as to where we have been just over the past 2 months. Our Senior Editor's 70+ years young father took very sick in early September and had to be whisked away to an emergency room.  He was having severe nausea and chronic vomiting (guess who got to clean the bucket?...) for a period of over 24+ hours.  Having suffered this way, he finally asked for medical care - and got it that day. 

Our Senior Editor and his father found out that he had a partial bowel obstruction - along with several other chronic medical conditions.  A naso-gastric tube was installed & removed about 1500 ml. of dark bile over a period of 30+ hours - thus avoiding surgery.  The recovery in the hospital took about 6 days.  Plus, we also found that Dad had lost his core/trunk strength (he had displayed some kyphosis earlier in April), leg strength, became dysphagic and was declared NPO.  Dad has basically been a bed-bound invalid, unable to swallow, since this time.  We will refer to this hospital as HSJ.

A swallow evaluation/study was done on Dad in their fluoroscopy dept. which determined that he aspirated when swallowing.  Even worse, he displayed no symptoms (asymptomatic).  Thus, he might have been dysphagic for a long time without even knowing it.  He has the possibility of contracting aspiration pneumonia if he attempts to swallow anything - which could even be lethal.

Thus was the beginning of Dad's medical odyssey.  Our Senior Editor and his brother being so concerned (this is their last living parent) that our Editor slept over many, many nights in more than one hospital with his father.  Thus giving rise to the term Hospital Nomad.  In the periods between hospitalization, Dad has spent three separate occasions in Medical Skilled Care Rehabilitation Centers as required by Medicare.  The long and short of it is that our Senior Editor has spent 63 of the last 65 days or so in the hospitals and Rehab Centers with his sick, invalid father during this medical odyssey.  His father is currently staying at his fourth hospital in this time.

A special warning to all who may have a similar situation existing or arising with a loved one.  If you see your elders in decline you may wish to visit their primary care physician with them and discuss the option of in-home rehabilitation before you reach this state of affairs.  One of the undiscussed (?) issues with Rehabilitation Centers and similar communities is the potential for infection by communicable organisms/pathogens/microbes shared by that community.  Each time Dad was sent to one of these centers he developed pneumonia or MRSA

Early in November/late October, he developed pneumonia due to a species of Serratia.  Fortunately our senior editor was present when he began to sink and kept requesting an ambulance.  When Dad stopped talking, they finally called for Rapid Response.  When in hospital, you can usually request Rapid Response by dialling 141.  See your hospital staff for instructions before you panic and need this service - it can be a life saver

As it turned out, Dad 'coded' in the emergency room at a different, nearby hospital ('HSM').  There appeared to be only respiratory arrest - no cardiac arrest - but stopped breathing all the same.  Dad was then intubated, heavily sedated and put on a ventilator.  The ER team at HSM basically saved his life - for which our Editor nominated them for a recognition award.  The Rapid Response team remained in the ER room during the entire revival.  It was quite a moving experience.  But, our Senior Editor's father looked like one of those horrible rubber dummies in a horror movie and our Editor was about to freak out. 

He was eventually transferred to Intensive Care where he remained on the ventilator for about a day.  He coded again the next day and had to be placed on a ventilator again.  The IC team was excellent and they were also nominated for a recognition award.  Dad was eventually transferred to the hospital - for 13 days

He qualified for a specialty rehabilitation hospital where he may receive constant hospital care along with therapy for as long as they feel fit.  He is visited almost daily by the doctor, an RN and other professional staff.  Unfortunately, he acquired MRSA in his sputum and lungs at the start of this go-round.   Which is quite fearsome, as MRSA can then enter the bloodstream in this fashion.  But the antibiotics appear to have it under control.  Hopefully, Dad is coming to the end of his medical odyssey in a positive way and may be released to sub-acute care.  And our Senior Editor is hoping that he does not have to be a Hospital Nomad much longer - again in a positive way. 

Revised/Updated: 11/23/2010

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