Saturday, 27 May 2017

A Few Thought on our Medical System and my Late Dad

This blog of mine has such a negative tone running through it.  Perhaps at my age I've become a curmudgeon and find myself irritated by most and critical of everything.  I really don't believe I'm have such a negative outlook on life but I am finding it harder and harder to find "professionals" who care and live up to their title or companies that take pride in producing well manufactured products and stand behind them with a realistic warranty.

This fast paced life often has us trapped.  Job stress, climbing the payroll ladder, road rage, mounting bills, stay-cations, increasing taxation and over-regulation.  Fast food, tethered to a cell phone or pager, internet tracking your interests & "Likes" - spam, GPS, telemarketers.  House prices that skyrocket 15 - 20% in a year.  Student loans that will take a lifetime to pay back.  CEOs make more money in one week than you earn in a year.  A hockey goalie makes more money protecting a goal than a soldier protecting your country.  Go figure.

Do we care about anything anymore -except how to make more money?  The hell with the customer; the hell with the product we foist upon them.  Make it cheaper but not less expensive.  Planned obsolescence!!  If it breaks -Great!  They'll have to buy another.  Chase that unreachable stock market carrot dangling in front of your nose -more, more, more - always more!

In pursuit of, and the worship of the Mighty Dollar!!

I've been away from this blog for a while due to the death of my father.  His life spanned good 92 years on this earth having grown up with silent movies, bi-planes the wonder of black & white television to having traveled in jet aircraft, watched man walk on the moon, even utilized the internet. He even survived WWII, having slept in the snow and survived on supper stolen from a dog's bowl.

Still his last days should have run out more smoothly than they did.

About two years ago he went to an optometrist to get new glasses as he was a voracious reader -books were his primary joy in life.  The optometrist detected the presence of glaucoma and a forming cataract which, by my dad's account, did not interfere with his enjoyment of books.  He began receiving treatment for the glaucoma and was booked to have cataract surgery.  As he loved to read, I urged him to get the cataract surgery.

By all accounts, the surgery was botched.  He followed post-op instructions yet his vision was less clear after the cataract surgery.  The eye looked different - something looked 'off center' for lack of a better term.  Follow-up had the doctor 'hem and haw' -never acknowledging a problem -yet he would get comments "what's wrong with your eye".

He could see less well and therefore decided to postpone surgery for the other eye.

Now two years later, he is still living alone in the country home -self reliant, only with lunch brought in by a 'meals on wheels' type of organization.

He calls me up on my birthday and we have a nice long chat.  Two weeks later my wife answers the phone to hear him gasping for air.  No longer driving, he asks her to take him to his doctor.  On arrival, my wife finds him in severe distress, still gasping for air so she calls for an ambulance. (In my wheelchair, I'd only slow my wife down during this emergency!)

He's admitted in a local hospital (only the second time in his life)  and they determine by his symptoms that he has pneumonia.  He's placed on antibiotics and sent for X-rays, CAT-scan etc.  He is left on a hallway stretcher for an extended period of time -waiting.  He cannot get anyone's attention to take him to the washroom to relieve himself - so he has no choice but to urinate on the stretcher.  Nurse sees that a 92 year old man has peed himself; must be incontinent at his age -so he is catheterized so as to avoid any further accidents the staff may have to clean up.

Scans show that he probably has some congestive heart failure - fluid built up around the lungs and heart making his breathing difficult.  They drain the fluid, put him on diuretics and oxygen.  But Pneumonia??

He hates that catheter irritating his insides and sure enough he comes down with a urinary tract infection (UTI).  But not just any UTI - he has an ESBL (Extended Spectrum Beta Lactamase -producer) which is a "superbug".  He now finds himself in an isolation ward with others -apparently the hospital has a 'super-bug' outbreak.  More antibiotics!!

I cannot obtain much information on his condition, treatment or prognosis.  Nurses can't say much, doctors don't return calls.  At a so called family meeting, I can't get any useful information.  While I worked some 34 years as a Microbiology Medical Technologist, I just can't get any useful, information.  Doctor tells me that they don't culture respiratory samples as "they are of no use -always mixed cultures".  Analyzing those sorts of specimens was part of my job for those 34 years, and if they are mixed, it is more a function of poor collection by the doctors and nurses and not the Lab Technologists analysis.  How are they certain the infection is bacterial and not fungal or viral?

To make a long, sad tale shorter, he was discharged after almost two months in the hospital.  He was a different person who came out than who went in -and he knew it.  "What the hell did they do to me in there?"  he would ask.  He felt totally drugged and in those two months his eyesight deteriorated until he was virtually blind.  Still he was being treated for glaucoma.  My understanding was that treatment was to prevent/slow down the progression of glaucoma to prevent blindness.  The why continue to treat a blind man?? (Is there a legitimate reason??)

On discharge we were instructed by his doctor to obtain a weight scale and weigh him daily (presumably to measure water retention?) -never made clear.  And we were to measure his urinary output each day which we did so diligently -keeping a record.  But in the end, nobody wanted the information we were instructed to collect!

Still catheterized he continued to be tormented by "that stick" stuck up his penis.  We tried to have the catheter removed but they gave him four hours off the catheter in which time he had to urinate.  Without drinking sufficient fluids, he was unable to urinate.  Back in went the catheter for now his problem was no longer deemed to be incontinence but rather retention.

He went into the hospital as my dad and came out someone else.  Gaunt and pale, a few days of home cooking had him looking better.  Still he drifted;  he could talk about world history and provide accurate events with dates or speak with friends and relatives clearly and concisely but then babble nonsense - all the while asking "what did the hospital do to me?"

Each morning I wake and listen to for his voice, a cough -something to let me know he is still with us on this earth.  I hear his gravely voice and for the time being, am relieved....

He lasted another month with us.  Now, unable to see at all his circadian rhythm was messed up -waking up and asking for breakfast at 2:00 am.  He was fidgety -continually fussing with blankets and other items before him.
With bilateral pain developing it appeared he had re-acquired a urinary tract infection (UTI).  Was it something new or was he sent home with the ESBL superbug still in his system?  Another ambulance was called and he left home for the final time.  Readmitted he continued to decline until he was moved into palliative care.  My wife and I went to see him in the hospital on Christmas day.  Unresponsive in an isolation room, we said our goodbyes.  A doctor called on Boxing Day around 2:00 in the afternoon to let me know that the 'old soldier' had passed.  And so it goes....

Was his decline typical?  The hospital would have us believe so.  However, having worked in one for some 34 years, I believe a hospital is no place for a sick person.

From his misdiagnosis of incontinence-  to the empiric treatment of a possible pneumonia without knowing what the pathogen was or it's sensitivity to the antibiotics used -I feel the system failed him.  The acquisition of a hospital 'Superbug' (a noscomial infection) to continued treatment of a blind man for glaucoma.  Keeping family members 'out of the loop' -inquiring family seemed to be a nuisance.

Was a 92 year old man of lesser worth than a young person?  That 92 year old man was my father and he meant the world to me!  And now he is gone....

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