Tuesday, November 11, 2008

My spouse recently had a very brief hospital stay for a mastectomy. She only spent one night in the hospital. That was unheard of when I first started in medicine. In the old days folks would have been in for a couple of weeks for removal of the gallbladder or a hysterectomy and at least that long for a mastectomy. For a broken hip you could be in for weeks. Those long hospital stays with prolonged immobilization and bed rest caused incredible problems. Pulmonary embolus was common because of deep vein thrombosis resulting from prolonged bed rest.

Now days much of surgery is done as an outpatient and you are admitted only for the real big stuff like cardiovascular surgery. They have you out of bed by the time you are back in a hospital room and all sort of preventive measures are taken to prevent deep vein thrombosis like giving heparin to thin the blood and wearing compression devices on the legs to keep the blood flowing. They have you sucking on an apparatus to inflate your lungs to prevent pneumonia and atlectasis. Even with a broken hip you are out of bed the next day because of the sturdy hardware that replaces the broken bone. This rapid mobilization has greatly reduced the mortality rate. A broken hip in the old days had about an 80% mortality rate in the elderly.

My spouse was in for only 24 hours and for this I was most thankful. A hospital is not a safe place to be. A recent report revealed a scary incidence of antibiotic resistant germs ready to kill you. One that is getting a lot of attention is Clostridium difficile that causes severe diarrhea and colitis and can be fatal in the elderly. It is spread by fecal contamination and about 13 out of 1000 patients get it in the hospital. There is also the deadly methicillin resistant staphylococcus aureus (MRSA) germ that infects 5% of hospital patients. The hospital is a scary place. Even if the personnel wash their hands to get rid of the germs they can kill you with medication errors. In the middle of the night, a nurse came into my spouses room to give her more blood pressure lowering medicine even though her pressure was down to 100/50. We refused the injection.

If the personnel and germs don’t get you the final bill will. You can stay at the very finest hotel in the world for only a fraction of the price of a hospital room.

I ended up suffering more from the hospital stay than my spouse. I spent the night, with only a couple of hours sleep, curled up in an uncomfortable recliner that has resulted in an incapacitating backache for the past several days. It’s sure good to be back on the porch.

We are very thankful for the brief hospital stay and are back safely on the porch where no lethal germs dare live and we are free from the very helpful personnel with dirty hands and syringes containing someone else’s medicine or a fatal dose of your own stuff. I’m thankful for modern hospitals but more thankful if I can stay out of them.


Blogger jeff ludwick said...

Only those who have "walked a mile in your moccasins" can feel your pain, Doc. A stay in the hospital is only explained by those who have experienced it. Since my spouse is a type 1 diabetic her overnight stays are even more exciting than most. I follow the same protocol each time.

The first item of business is to inform the nurses (and usually a physician or two) of her diabetes. Some glare at me with that "mind your own business" look but most fan through the paperwork and incredulously say "You're right! She IS a diabetic!"

Next I check all of food trays and always carry her blood testing kit with me so that I can monitor her levels. After they figure out that she IS a diabetic that is old news and there are more important things to take care of, like stating your full name and birthdate around 200 times a day.

Next comes the nighttime. That is always the most fun, the recliners not withstanding. During her last stay her doctors told her that she could not be released until she had gotten proper bedrest, which seemed like a good idea. The age old problem is that it is hard to get much bedrest when you are awakened about every 45 minutes for some part of your ailing body to be "checked".

During her last stay a cranky old nurse almost took my recliner away when I suggested that they adopt the procedure of most quick-lube oil changes. When I go there they check my tires, all fuel levels, air filter and change my oil all at the same time. I don't have to go back 10 or 12 times for the service. When I suggested that they possibly check all my wife's fuel levels and filters at one time a couple of times a night the nurses did not agree.

As soon as Mrs. M. is fully recovered it might be a good idea to let her go back up there for a few days to "train" a few people. I for one, would pay to watch.......

8:57 AM  
Blogger Michelle Wright said...

The pull out couch was not much better than the recliner. Thank goodness for my i-pod with the sounds of Joshua Bell to help with some relaxation. At least Mom did well.

9:33 AM  

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