Pain Scale MAXED OUT

Early afternoon on Tuesday, August 16, 2011, my sister called me and told me that Mom's chest and arms were hurting and she was taking her to the hospital, Presbyterian Rockwall.  I took care of some business at home, made sure my own children were taken care of and got to the hospital the very same time my mom and sister arrived.

Because of her past heart problems, they immediately set her up on the heart monitors and drew blood to check her enzyme levels.  On the pain scale, her right shoulder's pain level was a 9 and her left arm was a 7.  Her first set of blood work came back normal, no apparent heart problems, but things may change as time moves on.  They decided at that time to keep her overnight so they could watch her enzyme levels.  Mom threw up half the night because the pain was that intense.  They couldn't get a pain medicine to work properly or the nausea meds to kick in so it was a fun night all around for her.

The next morning they performed an echocardiogram, a sonogram of the heart.  They then determined that her arms and chest pain were not related to the heart, but from her right shoulder.  Her cardiologist released her at that time.  We did however contact an orthopedic doctor who agreed to see her while she was in the hospital and in so much pain.  He kept her overnight again and requested an MRI first thing the following morning.  We personally saw him text the floor doctor, whom I now refer to as Dr. Malarkey (it rhymes with her last name, which I do not know how to say, and since she seems to be such a moron, this just fits nicely) and tell her to keep Mom overnight, to have the MRI done first thing in the morning, and have the results in his office before her 2pm appointment.

I woke up to a missed call and a text message from Breanne that said, "nurse said cardiologist called and put mom back on npo and will be in later this morning".  Her next text said, "bring your stuff.  if mom stays again tonight you're staying with her." I get the kids somewhat taken care of once again, wash my face and brush my teeth and head back to the hospital.

Breanne calls me on the way to tell me the MRI still hadn't been scheduled and it appears no one has any idea why Mom is still in the hospital.  I just so happened to be walking into the hospital at that very moment and had me a nice little chat with the Director of Nursing.  She pulled me aside, listened to my story and we went straight upstairs.  She got to the nurses station and told me she'd be in our room in a minute.  It wasn't but a few seconds later she walks in with the floor doctor and Mom's nurse.  Of course we all stared blankly at the floor doctor, Dr. Malarkey, with all her excuses of why she didn't order the MRI.  The Director of Nursing says she scheduled the MRI of Mom's shoulder at Noon and she was to be wheeled down there and have the MRI started not a minute past Noon.  Apparently, because the MRI wasn't on the schedule, her cardiologist assumed she had either stayed or returned with heart problems, ordered her NPO (nothing by mouth) and had further invasive heart procedures in the works.  If Dr. Malarkey had done her job, the mess with the cardiologist could have been prevented.  We speak one more time with the cardiologist, because Mom's left arm is completely numb, who has now been informed why her patient is still in the hospital, and she talks to Mom and tells them to go ahead and order a c-span (MRI of the spine) while she is already there having her shoulder looked at.  She truly believes the pain from her shoulder is shooting to her left arm and wants her spine looked at as well.  Sure, why not?  We've been here this long!

Apparently, this Director of Nursing can put the staff in their place with in seconds.  She had the staff in tip-top shape and Mom's care was at the top of the list.  She gave me her card AND cell phone number and told me to call her again if we needed her.  She did this very vocally in front of the floor doctor.  She also called and told them to take her back for her MRI, get the results in Mom's hand immediately after and to make sure we were on time for her 2pm appointment.

As Mom is getting anxious to escape this wonderful place, she notices that one of her heart monitors was folded over and not sticking to her skin.  Not knowing how long this has been this way and after being repeatedly told she HAD to have the heart monitors on since she was in the telemetry unit, Mom decides to take it upon herself to take ALL of the monitors off.  We patiently wait for the staff to rush in because the monitors would be beeping, in fear that she has literally just crashed, when we realize they clearly have not been monitoring her heart.  No one comes in to check on her!  Nothing is beeping!  How long has she not been being monitored you ask?  We'd like to know as well.  Remember, their first priority is heart complications from heart disease (not her shoulder pain) and she is in the telemetry unit because they want her heart monitored at all times.

We get down to radiology, and I put in a phone call to the Director of Nursing again.  Poor woman!  I tell her about my mother's defiant moment and the heart monitors and stress once again the lack of care for a heart patient.  What a blessing she wasn't having heart problems!  As I get off the phone I look down to see Mom and Breanne looking defeated once more.  No fear, Dr. Malarkey pulled through for us again!  She CANCELLED the MRI of the shoulder when she ordered the c-span.  Really?  We NEED the shoulder MRI to move forward!  We have an appointment with the Orthopedic at 2pm! 

Back to the phone I go with my new friend, the Director of Nursing, who I've come to refer to on a first name basis now, with her cell phone number in hand.  I explain to her AGAIN how Dr. Malarkey (yes, I called her exactly that) dropped the ball yet again.  She was not happy, again.  Before meeting us down in Radiology, she called the Orthopedic office, explained our tardiness and ordered both MRI's to be done asap.  Of course all of this takes time and since both MRI's cannot be done together, this is going to take extra time and we are now going to be late for the orthopedic appointment.

I also added some other issues to the Director of Nursing's attention: the fact that housekeeping emptied trashes one night at 12:45am.  You already get very little sleep with techs and nurses coming in every hour.  Does the trash really need to be emptied at that particular time?  Or how the tech put the blood pressure cuff on top of Mom's IV.  Wow!  Thanks to Breanne for saying something to him or that would have been a disastrous mess.  This same tech couldn't understand why Mom had gone potty every hour in the middle of the night.  The poor woman wants to sleep already and she's been NPO for days at this point!  And why on earth does the food staff bring her food when she is NPO?  And do you know how long we asked for a bracelet to remind everyone she is allergic to morphine?  We asked in the ER, we asked Dr. Malarkey and her first nurse when she was moved to her first room.  It wasn't until the second day and her second nurse that they finally acknowledged her morphine allergy!

I digress.

We finally get them done, get the results in her hand and head straight to the orthopedic appointment.  The doctor is looking at the scans of Mom's shoulder and spine and I wish I had taken a picture.  He had his elbow on the desk, head in his hand.  He said her shoulder LOOKS like it has been injured for 5 years, if not more.  That her rotator cuff is completely shattered and possibly beyond repair.  He said she has 2 herniated disks in her neck that are causing the pain and numbness in her left arm.  We were all shocked by this because she hasn't had any neck or back pain.

Alas, we have some answers!  They concluded that she will start a 6 week therapy program in hopes that this helps both her shoulder and the herniated disks.  If it doesn't, at the very least, this will have strengthen her muscles for a possible surgery.  The orthopedic surgeon isn't hopeful about repairing the rotator cuff but I'm guessing a shoulder replacement  may be possible. 

As of today, Mom is home and still in lots of pain but not like the pain that first brought her to the hospital.  She starts physical therapy this week, twice a week.  We should know more as time moves forward but for now we are sooooo thankful all of this was not a heart problem.

I love you Mom!!!

Colton's Turn

This is a big season of sports for Colton.  Well, for me too!  This past Saturday, he had his first baseball practice.  He hit from a thrown pitch, not a T.  After that he had his first flag football game.  Football.  It's killing me all this growing up too fast thing!  He actually has more going on this season than his older two siblings.  No more are the days of us toting him around while he admires his brother and sister from the sidelines.  They will be watching him this season!