Sunday, January 25, 2015

Why I Have A Love-Hate Relationship With Hospitals

Before I begin, I want to say I'm thankful for those who choose to go into the medical profession. I also have the deepest respect and gratitude toward nurses who spend their day in the front lines caring for patients. I don't like hospitals  and every time I stay in one, the list of why I hate hospitals grows.
Here are my new reasons based on my last one day hospital stay for a penile implant.

1. When I was first brought to the post surgical unit I wasn't set up with a call button. I discovered my predicament when I was hit by waves of pain.  I had no way to call for a nurse. Fortunately, I had my cell phone. I called UCSF and asked for the 4th floor nursing desk. When a nurse answered the phone I told her that I was a patient on her floor, what room I was in, and that I needed a nurse to come into my room with pain medication.  I'd hate to think how long I would have waited for help if I hadn't brought my cell phone with me. This incident made me realize just how much I hate feeling so helpless, unable to care for myself and totally dependent on the care of another person.

2. I've had awful experiences with pain control following surgery. Therefore, I make sure to meet with my Surgeon in order to find a mutually agreeable plan for pain control.  When my Surgeon told me the implant is a relatively painless procedure that does not require narcotic medication, alarm bells went off in my head. If he wanted to have me as a patient,  I needed him to know that I needed narcotic pain medication the day of surgery and throughout the night. He agreed. After surgery I wasn't feeling any pain. I was so pleased he'd honored our agreement. For a brief period of time I thought this would be the easiest pain free surgery I'd ever experienced. Little did I know excruciating pain was just around the corner waiting. I have interstitial cystitis. After an hour or more of  irritation from the catheter,  my bladder was going into powerfully painful spasms every few seconds. I was reduced to moaning from this unanticipated source of pain. I realized I neglected to inform my Surgeon that I have Interstitial Cystitis. This meant we had no plan to treat the symptoms of this disease when it appeared after surgery.

3. When you are in the role of the patient, neither the nursing staff or physicians want you to be the one to diagnose yourself or tell them how to treat you. It took me a while to realize this. Once I did, I asked the staff to consult with my Urologist who treated me for interstitial cystitis.Thankfully, I had his phone number in my iPhone, which came in handy earlier in the day. I don't know whether he was called or not. It took the staff approximately four hours to find the right cocktail of medication to quell the most painful bladder spasms I'd experienced in my lifetime. It was a bitter reminder to me that no matter how well I tried to plan things for all contingencies, things won't always go the way you anticipate, before, during or after a surgical procedure.

4. From that point on my pain level was kept under very good control with one exception. At night I began to feel my pain level rise to a very uncomfortable level. I called the nursing staff to my room and asked if something was wrong since my pain was coming back. They checked my medical records. Apparently, I didn't receive a dose of pain medication that was due. We'd gone a few hours past that point, so my pain from the surgery returned.  It was another reminder that I was in the care of a system that was not perfect. Mistakes that cause pain and suffering will occur.

5. My IV bag ran out. The nurse came in to shut the alarm off. I thought she'd changed the bag, but she got busy and never came back. This error was noticed on shift change an hour or two after the bag was empty.Thankfully this wasn't antibiotics or some other vitally important medication.

A short time later I began complaining that I was feeling bloated, and that I had to urinate but couldn't.  I was told this was a normal experience when you have a catheter. After the pain kept intensifying and I kept complaining about feeling bloated, the nurse noticed my catheter bag was empty. I don't know why this happened, but the physician they called decided I was dehydrated. I couldn't help but wonder if that happened because my IV of fluids stopped flowing hours ago.

Feeling bloated and in pain they told me they were going to push additional fluids into me (causing me additional bloating and pain) and then have me walk around the unit. (causing greater levels of pain) I wouldn't have minded any of those plans if I believed they'd work. For me this was another example of how you lose control of your body once you enter a hospital. After they pushed more fluids into me though my IV and had me walk around the unit, I was told me to lay in bed while they continued to push additional fluid into me. They expected my catheter bag to fill up with urine. Unfortunately for me, not a single drop of urine came through the catheter.

Finally I had enough. My pain level was now through the roof. They'd lost my good will and co-operation. I insisted they take a different course of action. They must have called the on call physician   because what they did next required physician approval. A nurse came into my room and pulled out the catheter. Immediately, I went to the bathroom. I was surprised how easily I could urinate. The bloating and pain were now in the past. I felt relief. I was now in control of  how and when I could urinate. Slowly more of my body functions were returning. As I was recovering from surgery I was lessening my dependence on others, machines or medical devices and medication for my care and comfort.

6. Now that I was able to urinate on my own I knew I could be discharged the next day. Since I have a ninety minute drive to get home. I asked for a dose of medication right before I left. I thought that would keep me pain free until I arrived at home. The staff was kind enough to call in all the prescriptions I needed to my pharmacy so they'd be ready to pick up as soon as we arrived at home. We didn't know that a public event was occurring in San Francisco that day. Exits to the City were closed. It took us ninety minutes to get out of San Francisco. By the time we hit the highway, my bladder spasms returned with a vengeance.We had another ninety minutes to drive before we'd get to our local pharmacy.

By the time we arrived home I was bone weary. I hadn't slept in thirty six hours. As a result of  bladder spasms my clothing was soaked with urine. As I stepped into my house to change, my wife went to pick up my medications. I wondered if I'd made the biggest mistake of my life by going into a hospital so far away from home.

I'm now the proud owner of a AMS 700 penile implant. In six weeks I'll find out if this devise works and whether it will restore my sex life. I feel blessed and amazed we have a medical system that has the skill, talent and ability to make procedures like this possible. I feel grateful to my Surgeon, my Anesthesiologist, and all those involved in performing my surgery. I'm also grateful to the entire nursing staff for caring for me, taking my pain seriously and providing me with the outstanding care that enabled me to leave the hospital after a one night stay. That said, I added six more reasons why I hate being a patient in the hospital.

Rick Redner & Brenda Redner are the authors of: I Left My Prostate in San Francisco-Where's Yours?