Thursday, July 14, 2011

My 3-day stay at Abington Hospital's Neuro Unit: Diagnosis TIA (transient ischemic attack)



I blame it on the prednisone. Sunday nite around midnite, Scott and I were falling asleep at his house, right next door to my own, while watching TV.

From then on, my memory is hazy.

I wanted to discuss some "fine points" of a movie we were watching but...

Scott, I said, I can't get the words out.

I could say that much, but couldn't tap into my higher levels of cognition.

Also, I had an absolutely horrible headache above my right eye.

Then I rolled over and tried to sleep.

Suddenly Scott was standing next to me.

Ruth, he said, Don't you think we should go to the ER.

Oh, I suppose so, I said.

We trooped over to my house where I packed my antirejection meds, diabetes supplies, and took two aspirin before Scott drove me over, down the backstreets, arriving in the ER at 1 am. It's about 12 minutes away.

I was seen immediately.



They drew blood and gave me a CT scan and chest x-ray. They also gave me morphine which lessened my headache 80 percent.

I do not get headaches. The last time I had a terrible one was when I lived in SF and smoked pot. I remember those pounding throbbing headaches.

The service in the ER was excellent, not so much on the ward, where I arrived at 4 am. A nice big room with a view of Highland Ave and Horace Road.

Scott accompanied me the whole time. Luckily it was "his weekend off."



I asked for Percoset for my aching sciatica. I took it round-the-clock cuz I know how hospital stays inflame my sciatic nerve.

By mid-day I was actually feeling my old self again.

Doctors poured into the room. The doc responsible for my care was neurologist James Cook, along w/ attending physician Laksmi Karthik.

He stood over my bed w/Dr Alpa Patel, a beautiful woman, an internist, with long black hair.

I know you, he said. You wrote the article in the Intelligencer about the mental health system.

I was shocked...and overjoyed. So, important people actually read my stuff.

Cook got right down to brass tacks, listening to my heart, my jugular veins, and then doing strength testing and "placement" testing. He asked me to smile wide (facial mobility).

I passed w/flying colors.

He asked me to describe what had happened. I did, also stating, my memory is not good about the actual event.

That could be significant he said.

He ordered a battery of tests including an ultrasound of the heart.

Luckily Medicare is still in effect while les batards-en-charge play havoc w/our future.

Next morning I was scheduled for the dreaded MRI. Not my favorite thing. As you know, I wrote Tips for Getting thru an MRI. Also, I would have an MRA, which looks at blood flow in the brain and neck.

MRI was scheduled for 8:15. Who knew how long I'd be there?

I fought for the arrival of my antirejection drugs, which my guy nurse Orvyl made sure I got, personally going to the hospital pharmacy to get my Prograf. Before taking each pill, I thoroughly examined each one.

The MRI results were normal, except for expected changes that come w/aging. Oy, now I'm three days older having spent three days in the arspital.

Diagnosis upon discharge: TIA. My second TIA. Differential diagnoses were Ocular migraine, which I'd had before manic depression, and seizure.

When I got home, however, I looked up "prednisone aphasia" (speech difficulty) - remember, I'd been taking the 10-9-8-7 packet, and stopped with seven pills after visiting my family doctor, Foxhall.

In fact, Foxhall paid me a visit on Tuesday, which is when he sees all his patients who are at AMH (Abington Memorial Hospital).

He did remark, under his breath, that Foxhall was to blame.

I immediately expunged him from guilt, but on second thot, in the privacy of my upstairs study at home, I think the man should rethink prednisone.

At the hospital they spell it PredniSONE, so it won't get confused w/a similar-sounding medicine.

Okay, day one at the hospital, I get woken up for tests and breakfast.

"Olympia," my nurse, is kind but condescending. Okay, I can live with that. I tell her I've gotta take my antirejection meds and point to my blue box on the bed tray.

Oh, you can't, honey, you can't, she says. Patients are not allowed to take medicine from home.

She temporarily leaves the room and I wolf down all 14 pills but agree to take the hospital's pills from then on.

I have a two-hour window for pill-taking, beginning at 8 am and 8 pm.

No way is this hospital stay gonna jeopardize Sarah's kidney.

Okay, breakfast arrives. It sits on my tray for 50 minutes.

I've rung Olympia's nurse's buzzer many times to ask for my insulin. I did have my own morning dose in my bag, but I figgured I'd start on their insulin, which was different than mine.

The woman was incompetent. At every single meal I was forced to wait the better part of an hour for my insulin.

The final indignity was when I left my room to take a constitutional down the hallway.

The halls are a beehive of activity, with docs n nurses on computers, or in conference w/one another. This is good.

But it's no good when Olympia embarrasses me in front of a dozen people.

Where dyou think you're going, she says.

I'm going for a walk, I say, walking past her.

As I pass by, she says, Your hair needs combing.

I then walk up to the nurse's station and ask for the location of the Nurse Manager's office.

I'm wearing a blue hospital gown over my front, and another one over my back to hide my gorgeous 65-yo butt from view.

The nurse manager was in her office. Holly Badali, RN, MBA, has been on the job for 6 weeks. She's a dynamo, a real game-changer.

She is happy I've come in to talk about Olympia.

Prior to AMH, Holly had been head of the ER at Chestnut Hill Hospital. She is responsible for turning that ER from one of the worst around, into a state-of-the-art facility, esp. where stroke victims are concerned.

Several yrs ago, before her time, Larry Kirschner's 95-yo golf-playing father, died at Chestnut Hill. Their stroke team didn't have the knowhow or equipment to save him.

I'd always said to Helen, Larry's wife, that Henry would still be alive if he'd gone to Abington.

Holly and I spent a lot of time bonding. She showed me the photos of her young children on a shelf behind her. She's a wonderful woman.

At the end of our interview, I said to her: Ya know what?

I'm gonna go talk to Olympia myself.

Found her outside my room on the computer.

Olympia, I said, May I talk to you?

She paid no attention to me, just like when she was my daily nurse.

Olympia, I said moving in closer, I'm talking to you. May I talk to you in private?

To her, patients don't count. She grabbed my arm in a sympathetic manner, and sat next to me on the bed.

How are you doing? she said.

Fine, I said, I'm going home later today.

Oh, I'm so happy for you, she gushed.

I had a good stay, I said, but there are a couple of things that could've made it even better.

I told her what they were - insulin and humiliating me - she apologized profusely - and then to show I bore no animosity - I shook her hand.

She hugged and kissed me.

Tomorrow she will defend herself in front of the nurse manager, while I attend Helen's meeting at the Willow Grove Giant Supermarket.

Another beef I have - and, yes, they should use me or another "aware patient" to determine how patient standards are met at the hospital - is the state of my arms.

A needle for an IV drip of sodium was improperly placed in the crock of my left arm. Blood oozed down my arm. My nurse Orvyl was not alarmed, but I thoroughly washed off the bloody arm.

Everyone who took my blood caused me an unnecessary amount of pain.



Except for Nurse Sandy Landau who used a butterfly clip. She was actually my favorite nurse, an absolute hoot. We had fun together.

All nurses should use a butterfly clip.

Housekeeping? My used washcloths sat in the bathroom for a day and a half before I brot them outside my room to be taken away. Bathroom wastebasket was not changed until the day I left to go home.

Abington Memorial Hospital? Make it your hospital?

One more thing. So I'm home now. My pharmacist said he would never go back to AMH. My friend "Annie" took her husband there twice. The first time, after he suffered a stroke, her then-psychiatrist at Penn, orchestrated "David's" removal via ambulance of Penn.

The second time, which was about 2 months ago, when David had a bowel infection, the care was, again, simply dreadful. Like little kids playing Nurse.

I know that many people have excellent experiences. I just don't know of any.

3 comments:

  1. Damn. Ruth, I had a funny feeling that something was wrong but chalked it up to my state of mind.I even thought about calling you on Monday just to make sure you were ok. I hate predisone and the occasions when it has been prescribed have fought against it.
    On the other hand, my brother-in-law, my sister's widower, has had muliple TIA's as well as other medical problems since the age of 50 and he is past 80 and as you know, outlived my sister, who always took care of him. I hope it wasn't one but if it was, it doesn't mean it has to happen again.

    As for this nurse, she is a jerk, clearly!
    I am adding you once more to this prayer list, group, I like. It doesn't matter whether one believes or doesn't. I think it is good to put these positive thoughts out there.

    Good for you. YAY is more what I mean, for letting the nurse know. Maybe she will learn something but probably not.

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  2. PS You were absolutely smart to examine your pills and to advocate for yourself. It makes me cringe, though, to think of all the folks who can't self-advocate and how bad the medical system is for many of them.

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  3. So glad you are okay and Scott was there! Grace sends her love!!

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