I got shot again
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@mark said in I got shot again:
@brenda Hope you feel better soon!
Thanks, Mark. This one should be a quick recovery compared to the Moderna shots we had. This one has caused a lot of body aches, but I think it will be a shorter time. I have no meetings this week until Friday, so the timing is good.
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So, MS had an experimental procedure done today -- stellate ganglion block -- as hopeful to reset her sympathetic nervous system which evidently is associated with orthostatic intolerance, parosmia (weird tastes and smells), loss of taste and smell, a whole bunch of dysautonomia problems -- a lot of long haul complaints. the SGB has apparently been used for a long time for PTSD and is considered safe. It seems to have something to do with the vasovagal nerve. That's the extent of my understanding, but the docs doing the study have seem some significant improvement among patients.
She's also in the pipeline for a round 2 study of platelet rich plasma (PRP) for loss of taste and smell (her main complaint), and it was her doc Dr R1 who is doing the study at Thomas Jefferson University Hospital who recommended the SGB procedure.
Jefferson is (I thought) a top notch research hospital, esp in neurology. The experience was a shit show.
Her doc Dr R1 specifically gave orders for either Dr R2 or Dr Z to do the procedure. Dr R1 has his own neurological issues, and only lets Drs R2 or Z do any nerve work on him. So we booked with Dr Z as he was available at the earliest date. MS has been long haul 20 months now, and wanted to get on with it.
The STB is about a 20 - 30 minute procedure. We were booked for 10:30, got there as requested at 10 for admission and prep. Her instruction was no food or water 12 hours prior, so she had nothing after 11 pm. We were told at 1030 that MS would be soon transported to the short stay surgery floor for the procedure. At noon I asked the charge nurse what the ETA was for transport, and she said someone was on the way up. By 1PM she was getting hangry and agitated, checking her blood sugar (another long haul issue). Ready to just leave. MS finally was transported at 2 pm. I didn't go along, so she had no advocate. I was told I could go to the cafe or waiting room and they'd call when she was ready.
A couple of docs -- surgeon, anesthesiologist -- introduced themselves and said they worked with Dr Z. Dr Z never showed up. Some other unknown doc did the procedure. She was expecting Dr Z and they swapped out on her. She had been told she'd be put under, a short acting anesthetic that she'd quickly wake from. Which we suppose is why she was NIL by mouth for 12 hours. She was then told she wouldn't be put under. She told them she was worried and anxious, and didn't want to be awake. "There's nothing to worry about -- relax". "I'm not relaxed, I'm anxious, are you going to give me something to relax me?" No.
She had just had knee surgery a few weeks prior -- they had her strapped to the table for the CAT tube (which is I guess how they work on the nerve point), and her leg can lay straight, so she was distressed but no one paid attention. So she was awake, alert, freaked out, and someone was jabbing a needle through her just below the clavicle. The procedure took 20 minutes. So 2:20 or 2:30.
She was left in the hall for around an hour. No one transported her. Finally she started to get up, and said "Get someone to move me or I'm walking out of here". Plenty of transport people around -- no one was assigned to move her. She got up off the gurney and asked "Am I getting a transport or do I have to take the elevator myself?" A nurse put her back in the gurney. Finally another nurse apologized and took her back to the pre op/ post op unit. I was contacted at 3:43 pm that she was back in the post op room. She was in tears. In pain. No one thought to give her pain meds. I talked to the discharge nurse, who was formulaically reading the instructions. "Don't you have any meds?" "I'll have to see if the doc is available".
MS just wanted to get the hell out of there. Fortunately, we had pre packed some ibuprofen so just self administered. But she had just been pierced by some needle, which doesn't seem like advil would touch it. I talked to the charge nurse -- "why didn't Dr Y do the procedure?" "why didn't they give her pain meds?" "why did they leave her in the hall for an hour afterward?" She (who was really good actually) had no answers, but acknowledged that this was really bad. MS again wanted to leave, but I needed to know even who the doc was who operated on her, why Dr Z never showed up, why she was left out in the hall, why meds weren't given, etc.
As I was trying to get answers I saw some doc talking to her. She was still teary. He said he was Dr P and did the SGB. "Where was Dr Z? Dr R1 specified him, and we were booked with him." hesitating... "He's out of the country". "Everything went well."
"Why wasn't she brought back here afterward? Why no pain meds?"
"Let me look at the wound site -- looks good. Might be painful for a day or so. Take some ibuprofen. If it gets hot, painful, inflamed, yada yada call us"
6 hour in the hospital for a 20 minute procedure. 18 hours without food or water, which she could have had at 2:30. AND the discharge instructions had a page on prep for the procdue which told the patient STAY HYDRATED. FFS.
We didn't get out until almost 4:30, then another hour to get home and fed. All because of piss poor patient management.
Then, 9PM and she's got a stabbing pain in the middle of her back. Called the number on the discharge sheet -- no answer. So we had some odd collection of old percocet from previous surgeries that we dosed.
She'll be OK, afaict, but what a nightmare. We just hope that the procedure works -- which should manifest in 3 days or so, if it works at all.
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So, MS had an experimental procedure done today -- stellate ganglion block -- as hopeful to reset her sympathetic nervous system which evidently is associated with orthostatic intolerance, parosmia (weird tastes and smells), loss of taste and smell, a whole bunch of dysautonomia problems -- a lot of long haul complaints. the SGB has apparently been used for a long time for PTSD and is considered safe. It seems to have something to do with the vasovagal nerve. That's the extent of my understanding, but the docs doing the study have seem some significant improvement among patients.
She's also in the pipeline for a round 2 study of platelet rich plasma (PRP) for loss of taste and smell (her main complaint), and it was her doc Dr R1 who is doing the study at Thomas Jefferson University Hospital who recommended the SGB procedure.
Jefferson is (I thought) a top notch research hospital, esp in neurology. The experience was a shit show.
Her doc Dr R1 specifically gave orders for either Dr R2 or Dr Z to do the procedure. Dr R1 has his own neurological issues, and only lets Drs R2 or Z do any nerve work on him. So we booked with Dr Z as he was available at the earliest date. MS has been long haul 20 months now, and wanted to get on with it.
The STB is about a 20 - 30 minute procedure. We were booked for 10:30, got there as requested at 10 for admission and prep. Her instruction was no food or water 12 hours prior, so she had nothing after 11 pm. We were told at 1030 that MS would be soon transported to the short stay surgery floor for the procedure. At noon I asked the charge nurse what the ETA was for transport, and she said someone was on the way up. By 1PM she was getting hangry and agitated, checking her blood sugar (another long haul issue). Ready to just leave. MS finally was transported at 2 pm. I didn't go along, so she had no advocate. I was told I could go to the cafe or waiting room and they'd call when she was ready.
A couple of docs -- surgeon, anesthesiologist -- introduced themselves and said they worked with Dr Z. Dr Z never showed up. Some other unknown doc did the procedure. She was expecting Dr Z and they swapped out on her. She had been told she'd be put under, a short acting anesthetic that she'd quickly wake from. Which we suppose is why she was NIL by mouth for 12 hours. She was then told she wouldn't be put under. She told them she was worried and anxious, and didn't want to be awake. "There's nothing to worry about -- relax". "I'm not relaxed, I'm anxious, are you going to give me something to relax me?" No.
She had just had knee surgery a few weeks prior -- they had her strapped to the table for the CAT tube (which is I guess how they work on the nerve point), and her leg can lay straight, so she was distressed but no one paid attention. So she was awake, alert, freaked out, and someone was jabbing a needle through her just below the clavicle. The procedure took 20 minutes. So 2:20 or 2:30.
She was left in the hall for around an hour. No one transported her. Finally she started to get up, and said "Get someone to move me or I'm walking out of here". Plenty of transport people around -- no one was assigned to move her. She got up off the gurney and asked "Am I getting a transport or do I have to take the elevator myself?" A nurse put her back in the gurney. Finally another nurse apologized and took her back to the pre op/ post op unit. I was contacted at 3:43 pm that she was back in the post op room. She was in tears. In pain. No one thought to give her pain meds. I talked to the discharge nurse, who was formulaically reading the instructions. "Don't you have any meds?" "I'll have to see if the doc is available".
MS just wanted to get the hell out of there. Fortunately, we had pre packed some ibuprofen so just self administered. But she had just been pierced by some needle, which doesn't seem like advil would touch it. I talked to the charge nurse -- "why didn't Dr Y do the procedure?" "why didn't they give her pain meds?" "why did they leave her in the hall for an hour afterward?" She (who was really good actually) had no answers, but acknowledged that this was really bad. MS again wanted to leave, but I needed to know even who the doc was who operated on her, why Dr Z never showed up, why she was left out in the hall, why meds weren't given, etc.
As I was trying to get answers I saw some doc talking to her. She was still teary. He said he was Dr P and did the SGB. "Where was Dr Z? Dr R1 specified him, and we were booked with him." hesitating... "He's out of the country". "Everything went well."
"Why wasn't she brought back here afterward? Why no pain meds?"
"Let me look at the wound site -- looks good. Might be painful for a day or so. Take some ibuprofen. If it gets hot, painful, inflamed, yada yada call us"
6 hour in the hospital for a 20 minute procedure. 18 hours without food or water, which she could have had at 2:30. AND the discharge instructions had a page on prep for the procdue which told the patient STAY HYDRATED. FFS.
We didn't get out until almost 4:30, then another hour to get home and fed. All because of piss poor patient management.
Then, 9PM and she's got a stabbing pain in the middle of her back. Called the number on the discharge sheet -- no answer. So we had some odd collection of old percocet from previous surgeries that we dosed.
She'll be OK, afaict, but what a nightmare. We just hope that the procedure works -- which should manifest in 3 days or so, if it works at all.
@Ivorythumper said in I got shot again:
Called the number on the discharge sheet -- no answer.
Are you kidding me??? A number to call if she becomes hot or painful, and there's no answer???
This sounds like the worst kind of clownfest horror show. The poor woman, to have suffered all that in addition to her complaint. My sympathies, FWIW.
I hope she is in better case this morning, IT.
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Uncontrollable shit happens, and I understand delays.
"Why is my case late?"
"Because your surgeon is taking all the time it takes for good care for the person ahead of you. I'll tell him to hurry up on you so the next person doesn't have to wait."But you were not given an explanation.
Had you met Dr. Z before the procedure? Personally, I would never let anyone touch me without having had a long conversation beforehand. I've seen this type of shit, and it just pisses me off. There's a lot to be said about personality and trust. If you're just thrown in with someone unknown, that doesn't build trust. Bad docs don't (usually) get sued more than good ones. Untrustworthy ones do.
She was NPO for a local procedure? I can maybe understand that if they were going to be doing something which could compromise the airway. Maybe. But, to say "we're going to sedate you," and then not do it is a ... betrayal of trust. Explain WHY the change in plan. I can see reasons NOT to sedate, but an explanation should have been offered.
Leaving an unattended patient in the hall is a big no-no. Did staff have eyes on her? Did she have access to a call button should she need help?
Did she have significant pain after the procedure before discharge? If so, she shouldn't be discharged.
As @Aqua-Letifer said, no answer on the phone? Unacceptable. At least there should be instructions on how to reach someone.
As you said, Jefferson has a good reputation, but it's crap like this which make you wonder.
I can't wait to read your strongly-worded letter.
And yeah, keep us posted on her progress.
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An absolute shit show and I would be chewing off a manager's ears, relishing every bite.
But...Right now, medicine is in flux, with some places better off than others. There has been a big shift in personnel and a huge increase in travelers.
Does not make for good care.
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For crying out loud.. So sorry MS had to go through this.
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IT, this is worthy of one of your best and strongest communications to voice your righteous outrage at such treatment, or lack thereof, for MS. Is your attorney available to assist with this communication to the medical facility?
Best wishes to MS for relief of her long Covid issues.
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IT, this is worthy of one of your best and strongest communications to voice your righteous outrage at such treatment, or lack thereof, for MS. Is your attorney available to assist with this communication to the medical facility?
Best wishes to MS for relief of her long Covid issues.
️@brenda said in I got shot again:
IT, this is worthy of one of your best and strongest communications to voice your righteous outrage at such treatment, or lack thereof, for MS. Is your attorney available to assist with this communication to the medical facility?
Best wishes to MS for relief of her long Covid issues.
️Thanks to all for the good wishes and insights.
Dr Z called the next morning. Turns out he hadn't been out of the country as Dr P had said, but was leaving for vacay. We're still not clear about the timing issue if he had been there in the morning for the scheduled procedure but a whole series of other scheduling conflicts for the CT tube delayed everything too long... He really should have come up to see us if he were going to do a hand off, tell us what was going on, introduce us to Dr P who is a 6th year musculoskeletal fellow who has done 19 of these procedures under Dr Z's supervision, etc...
Turns out the bad pain is (Deo gratia) not connected but perhaps having been strained on the hard CT table where MS was strapped in a contorted position. Again, no chill pills to relax her?
MS is feeling better. We'll see if the procedure takes -- the timeline is peculiar, like some minor recovery of taste and smell after 12 hours, then it might go away and come back on day 3.
As for complaining or ginning up a lawyer, I don't see any payable damages here -- and lawyers tend to attract lawyers. Dr Z was extremely apologetic, and promised to do a root cause when he returns. We have a laundry list, and if he's interested to fix the problems in his work flow and make a much better patient experience, then MS is the person to talk to: she does operational risk analysis for a living.
Additionally, we want really good relationships with these docs because they are the best hope for MS's healing, which is all we care about. And we want to get into the PRP study, which is being done by the same hospital. We don't want to be seen as the least bit litigious or troublesome. Some things are a lot more important.
Again, thanks for everyone's thoughts and prayers.
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@brenda said in I got shot again:
IT, this is worthy of one of your best and strongest communications to voice your righteous outrage at such treatment, or lack thereof, for MS. Is your attorney available to assist with this communication to the medical facility?
Best wishes to MS for relief of her long Covid issues.
️Thanks to all for the good wishes and insights.
Dr Z called the next morning. Turns out he hadn't been out of the country as Dr P had said, but was leaving for vacay. We're still not clear about the timing issue if he had been there in the morning for the scheduled procedure but a whole series of other scheduling conflicts for the CT tube delayed everything too long... He really should have come up to see us if he were going to do a hand off, tell us what was going on, introduce us to Dr P who is a 6th year musculoskeletal fellow who has done 19 of these procedures under Dr Z's supervision, etc...
Turns out the bad pain is (Deo gratia) not connected but perhaps having been strained on the hard CT table where MS was strapped in a contorted position. Again, no chill pills to relax her?
MS is feeling better. We'll see if the procedure takes -- the timeline is peculiar, like some minor recovery of taste and smell after 12 hours, then it might go away and come back on day 3.
As for complaining or ginning up a lawyer, I don't see any payable damages here -- and lawyers tend to attract lawyers. Dr Z was extremely apologetic, and promised to do a root cause when he returns. We have a laundry list, and if he's interested to fix the problems in his work flow and make a much better patient experience, then MS is the person to talk to: she does operational risk analysis for a living.
Additionally, we want really good relationships with these docs because they are the best hope for MS's healing, which is all we care about. And we want to get into the PRP study, which is being done by the same hospital. We don't want to be seen as the least bit litigious or troublesome. Some things are a lot more important.
Again, thanks for everyone's thoughts and prayers.
@Ivorythumper said in I got shot again:
As for complaining or ginning up a lawyer, I don't see any payable damages here -- and lawyers tend to attract lawyers
Malpractice needs three conditions to be met:
- Harm occurred. Proving "emotional" harm is a steep hill to climb.
- The harm occurred because of acts performed by the physician.
- (and this is most important) The acts performed by the physician were outside the standard of care.
It's good that Dr. Z reached out to you, and that he's going to look into the "workflow" problems. None of these are a big deal, from a medical standpoint. But they are a HUGE deal when it comes to patient care, which was, in this case beyond shoddy.
It was a cluster. Hopefully it'll not recur.
As I said in an earlier post, Jefferson has a great reputation. Hopefully this series of events will provoke some introspection beyond just what the medical outcomes are, and look at the entire patient experience.
Thanks for the update, IT. And, by all means, a strongly-worded letter is appropriate, just for the sake of leaving a trail.
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@brenda said in I got shot again:
IT, this is worthy of one of your best and strongest communications to voice your righteous outrage at such treatment, or lack thereof, for MS. Is your attorney available to assist with this communication to the medical facility?
Best wishes to MS for relief of her long Covid issues.
️Thanks to all for the good wishes and insights.
Dr Z called the next morning. Turns out he hadn't been out of the country as Dr P had said, but was leaving for vacay. We're still not clear about the timing issue if he had been there in the morning for the scheduled procedure but a whole series of other scheduling conflicts for the CT tube delayed everything too long... He really should have come up to see us if he were going to do a hand off, tell us what was going on, introduce us to Dr P who is a 6th year musculoskeletal fellow who has done 19 of these procedures under Dr Z's supervision, etc...
Turns out the bad pain is (Deo gratia) not connected but perhaps having been strained on the hard CT table where MS was strapped in a contorted position. Again, no chill pills to relax her?
MS is feeling better. We'll see if the procedure takes -- the timeline is peculiar, like some minor recovery of taste and smell after 12 hours, then it might go away and come back on day 3.
As for complaining or ginning up a lawyer, I don't see any payable damages here -- and lawyers tend to attract lawyers. Dr Z was extremely apologetic, and promised to do a root cause when he returns. We have a laundry list, and if he's interested to fix the problems in his work flow and make a much better patient experience, then MS is the person to talk to: she does operational risk analysis for a living.
Additionally, we want really good relationships with these docs because they are the best hope for MS's healing, which is all we care about. And we want to get into the PRP study, which is being done by the same hospital. We don't want to be seen as the least bit litigious or troublesome. Some things are a lot more important.
Again, thanks for everyone's thoughts and prayers.
@Ivorythumper said in I got shot again:
And we want to get into the PRP study, which is being done by the same hospital. We don't want to be seen as the least bit litigious or troublesome. Some things are a lot more important.
"Seit night ein troublesucher."
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@Ivorythumper said in I got shot again:
And we want to get into the PRP study, which is being done by the same hospital. We don't want to be seen as the least bit litigious or troublesome. Some things are a lot more important.
"Seit night ein troublesucher."
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@brenda said in I got shot again:
IT, this is worthy of one of your best and strongest communications to voice your righteous outrage at such treatment, or lack thereof, for MS. Is your attorney available to assist with this communication to the medical facility?
Best wishes to MS for relief of her long Covid issues.
️Thanks to all for the good wishes and insights.
Dr Z called the next morning. Turns out he hadn't been out of the country as Dr P had said, but was leaving for vacay. We're still not clear about the timing issue if he had been there in the morning for the scheduled procedure but a whole series of other scheduling conflicts for the CT tube delayed everything too long... He really should have come up to see us if he were going to do a hand off, tell us what was going on, introduce us to Dr P who is a 6th year musculoskeletal fellow who has done 19 of these procedures under Dr Z's supervision, etc...
Turns out the bad pain is (Deo gratia) not connected but perhaps having been strained on the hard CT table where MS was strapped in a contorted position. Again, no chill pills to relax her?
MS is feeling better. We'll see if the procedure takes -- the timeline is peculiar, like some minor recovery of taste and smell after 12 hours, then it might go away and come back on day 3.
As for complaining or ginning up a lawyer, I don't see any payable damages here -- and lawyers tend to attract lawyers. Dr Z was extremely apologetic, and promised to do a root cause when he returns. We have a laundry list, and if he's interested to fix the problems in his work flow and make a much better patient experience, then MS is the person to talk to: she does operational risk analysis for a living.
Additionally, we want really good relationships with these docs because they are the best hope for MS's healing, which is all we care about. And we want to get into the PRP study, which is being done by the same hospital. We don't want to be seen as the least bit litigious or troublesome. Some things are a lot more important.
Again, thanks for everyone's thoughts and prayers.
Glad to hear the main doc is back and working to keep the relationship positive. You are wise to keep things positive for staying in the study program. The bigger picture is important, and now that he's aware, I doubt the doc will allow such mishaps to reoccur.
Please let us know if MS sees improvement from all this. She certainly deserves a good outcome for putting up with such treatment.
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@Ivorythumper So sorry to hear about all of this.
Any updates?
