Spent the Night in the ER

[rwest]

I took the city bus to the hospital for my last surgery so I wouldn’t need to get someone to drive me there in rush hour.

I had people at work telling me no way, I’ll drive you there. I told them that before the surgery I I’ll be just like I am now, but I will gladly take that ride when I get released.

Hope you made it home safely.

[LEAKYSEALS951]

glad you are done with that. hope you are back on bike soon.

[Jeff Higgins]

Originally Posted by 911boost

Glad to hear it went well!

Hopefully you are joking on the old sporty.

[astrochex]

Happy home recovery Jeff!

[Rikao4]

Originally Posted by Jeff Higgins

Yup, I am really going home tomorrow. I got discharged the day after surgery six years ago, and that was a far more invasive procedure. No problem. I'm walking short distances with the help of a walker already, and can do a couple of steps without it.
.

fantastic..
given the meds and your hx..
hopefully you didn't leave anything behind..

Rika

[pwd72s]

Happy news indeed. May you be kicking over that Sporty soon...

[Zeke]

My turn. Spent 10 hours in the ER with my wife. Turned out to be a kidney stone. For those that don't know, the doc said the pain is equivalent to child birth and not an easy one.

Attention to the pain was severely lacking. In fact, the FD paramedics had to stay there for over 2 hours because the ER could not take her in. They could do nothing and they can't just drop someone off. Besides, she was on their gurney which they needed back to get back in service. I think you can see a problems here.

By the time they let me back there when she got a bed in one of the treatment rooms, she told me she was crawling out on her hands and knees to get to another hospital. When I relayed that to the staff, things began to happen and she was comfortable enough in 3 hours after writhing in pain all that time. not to count the time at home at the sudden onset. About 4 hours of the most extreme pain I have ever witnessed. Violent shaking, vomiting, sweating, it's tough to watch that.

I'm not happy about the ER in this large somehow well respected hospital in Long Beach. An ER is the worst place on this planet. The staff was extremely nice but stretched to the max. This all went down at noon on a Sunday, not quite rush hour.

They will get a seething letter from me and the worst comments permissible on Yelp. However, I will exempt the RN's that were in attendance. Once things got going it was just a long ass waiting game with a CT scan at about the 8 hour mark that took another hour for the radiologist to get to. The stone must have been evident in the first 30 seconds of review. By now it had nearly passed into the bladder. At that point they said she could go home. Another hour until we were out the door.

Had I known what I know now, I would have given her about five shots of tequila. But there's always a possibility that something else is happening. A quick EKG right in the house on the bed ruled out a heart attack. Paramedics should be allowed to administer morphine. I was under the impression they could do that. They told me they don't have any on the emergency vehicles.

Does that sound right?

[Scott Douglas]

If they had morphine on the 'bus' they'd have druggies breaking into it every time they stopped to help someone else.
Sorry to hear your wife had to suffer like that.
I once passed a very small stone while we were visiting Sea World of all places. It was painful walking around to say the least. When I finally pissed it out I heard a small 'plop' in the urinal and there was a small round ball sitting in the bottom. A few minutes later I was feeling a lot better.

[Scott Douglas]

So Jeff or anyone else that can answer this question, in the picture Glen posted of his 'parts', if you put the 'ball' into the 'socket' can you lift the 'whole' up by just the 'socket', or will the 'ball' fall out?
Seems they could design a 'system' where the 'ball' snaps into the 'socket' with enough force to hold it under any circumstance.

Glad to hear you're back on the mend Jeff. I can't imagine having to worry about what I'm doing with my hips/legs etc. to keep something like this from happening.

[Zeke]

Originally Posted by Scott Douglas

If they had morphine on the 'bus' they'd have druggies breaking into it every time they stopped to help someone else.
Sorry to hear your wife had to suffer like that.
I once passed a very small stone while we were visiting Sea World of all places. It was painful walking around to say the least. When I finally pissed it out I heard a small 'plop' in the urinal and there was a small round ball sitting in the bottom. A few minutes later I was feeling a lot better.

That I understand. I have not witnessed much trauma. The closest thing to real trauma was when I was working a race at Talladega in '92 on a wrecker. When we pulled up the emergency crew was cutting Kyle Petty out of his car. He had broken his femur and was not happy to say the least. I heard a lot of screaming profanities. There were 8 wreckers around the track and over 16 cars disabled so we needed to pick up Mark Martin's car (the people at race control ordered the sequence of pick ups), get to the pits and get back to the back straight and get another. So I missed a lot of the drama.

My point is that in an extreme rescue operation it would seem prudent to quiet the victim. I'm also thinking of a remote rescue that needs an airlift operation in the basket all strapped in. For sure a writhing painful kidney stone is not life and death. But don't some first responders do something about intractable pain?

How about once inside the hospital? That's my main beef. What is triage for? Incidentally, my wife is trained in CERT triage, but she's no medic.

Jeff, how did this all play out with you? I know the pain was intense. I now know what 10/10 means.

[Jeff Higgins]

Scott, I asked the same question of my surgeon - why not some form of a "captured" ball and cup? He told me that they do, in fact, offer that solution, but only as a very last resort. He said something like "hey, you're an engineer. Let's talk failure modes. Would you rather have the ball lever itself out of the cup in such a fashion as to allow for a non-surgical reinsertion, or would you rather it rip the glue joint loose that holds the cup into your pelvic bone?" Pretty easy choice, really.

Zeke, I quite literally "feel your pain". Between my wife and I in this year alone we have had two OR stays, first to remove a cyst the size of an eight ball from one of her ovaries, and then this right hip modification for me. On top of that I have had three ER visits to pop my hip back in place, wherein they fully sedate before even trying this procedure. I'm told (by my wife) that it's quite violent. My fourth dislocation did not require transport to hospital, I'm told it was not actually all the way out.

In each and every case the pain management protocols followed by both the EMT crews and the hospital staffs were not just "inadequate", they were borderline criminally abusive. My wife had to be held overnight after having been cleared for discharge, intending to pick up pain medication from the hospital pharmacy on our way out. Well, that pharmacy closed before we could do that, so I suggested that the "care team" simply supply enough to get her through the night until I could make it to our pharmacy in the morning. Well, by golly, they "couldn't do that". So we agreed to leave her in their care overnight. Except... they still could not dispense any pain meds. They had none on hand outside of their closed pharmacy. In a hospital, for God's sake. So she spent the entire night in post op with nothing more than Tylenol, me sleeping in the chair next to her bed.

In my three trips to the ER with my dislocated hip, I was never offered anything for the pain. Hell, the second trip required driving the ambulance across a motocross track, with me in the back, to retrieve me. Average amount of time across three ER visits before they gave me anything for pain was about two hours.

This last trip to the OR (for my hip) saw me on a four hour schedule for post op pain meds. I never went less than six hours between doses. Lots of apologies, blah blah blah, but there I was. Upon discharge, they sent me home with meds (filled in the afternoon at their in hospital pharmacy), just enough for that night and the next day. They told me to contact my surgeon's office and he would fill to get me through the weekend, which would have been great, but...

This was getting late-ish on Thursday afternoon, and like I presume most surgeons, he does not hold weekend hours. So I called him first thing Friday morning, we agreed that the math shows me running out in the middle of the night on Sunday, so yes, absolutely, he called it in to my pharmacy. Thought we were good to go... The pharm app said we were...

Until it didn't, which turned out to be Saturday morning. So I called the pharmacy. They told me that my insurance (damn good insurance, by the way, negotiated for me as a retired Boeing engineer) would not allow a refill until Monday, due to something in their opioid protocols. I was free to call my surgeon and have him dispute this with the pharmacy and/or insurance provider, of course, but as explained earlier, this was now Saturday. No one in that office until Monday. So I told the pharmacy that I would simply pay out of pocket. They told me that they couldn't do that, I told them they had a prescription in hand, and I was just two days post op on a hip replacement. So the pharmacy relented, took pity on me, or whatever, and I finally got a refill late Sunday afternoon.

So, yeah, at risk of "PARFing up" my own thread, this whole pain management thing has gotten way, way out of hand. Everyone is terrified of the scrutiny applied when they prescribe opiate pain meds. I don't blame them, their very careers and livelihoods are at risk, under the watchful eyes of state and federal bureaucrats enforcing arbitrarily mandated limits. We know how to treat pain. We have for a very long time. It's time to stop pretending that OR and ER patients, who have suffered traumatic injury, are fueling this "opioid crisis". They simply are not. But, well, I guess it's easier to pick on productive, middle aged folks who have been unfortunate enough to find themselves hospitalized than it is to face the music and go after the real progenitors of this problem. And all the while people like your wife, my wife, myself, and countless others suffer some pretty severe pain, and threaten to crawl out of the ER in hopes of finding better, more urgent care. I actually said a similar thing to the staff during one of my own resent stays in the ER. It didn't have to come to this. This is absolutely unacceptable.

[Scott Douglas]

I wonder if a joint could be made that it wouldn't be able to come apart at all such that it couldn't lever out the joining pieces.
The thing that comes to my mind is like a constant velocity joint like was in an old Olds Toronado. Very interesting joint which was finely machined but would only come apart if put in the correct orientation. Blew me away that they could mass produce such a finely fitting piece as there was no slop in it when assembled.

I'm really glad I didn't need any pain meds after my quad bypass operation. I was amazed that I didn't need them.

[juanbenae]

Originally Posted by GH85Carrera

Jeff, I had my hip replaced 13 years ago. My doctor gave me list of several thing to absoultly NOT do. Of course skiing on water or snow was out.

One of the simple tasks he warned me about was a large step up, like stepping up on the tailgate of my El Camino, or climbing on a tractor, or jacked up pickup step. Crossing my legs, or sitting on the floor yoga style, with crossed legs. I have avoided all of those.

After 13 years I still will not use that leg to make the first step up into my El Camino bed. Since I have two legs, it has not been an issue.





My hip replacement is modular, so it can fit people of different size. The plastic insert that is the socket is about all that will wear out. The rest is titanium.

I figure if I get abducted by space aliens, they will know I am from an advanced species, with the titanium hip replacement. Of course with my luck, they will be just harvesting titanium, and remove mine and dispose of me.

Did you have a posterior or anterior?

That time I needed an extra stich..



Ya, that's my glut...


I went posterior and it was not the miserable recovery all the anterior snobs said it would be.

[Zeke]

^^^Good lord. that incision looks like it was done with a drywall saw and run over by a motorcycle.

@Higgins, thanks for the paragraphs on your experience. My plan is to pick up a couple quarts of decent tequila to have on hand. We can manage to rat hole a few pain meds for when we need them, but as everyone knows they take a bit of time. Most surgeons suggest staying ahead of the pain starting you off with 2 pills for the first dose, one each at 4-6 hours thereafter. Don't wait for the pain to come back and have to fight it. Keep it suppressed until you don't have to.

Liquor is pretty quick. Screw them if they can't handle an intoxicated patient. I don't want to see this suffering again. I will smuggle the booze if I have to. Throw me out, I don't give a rat's ass.

Yes, that same weekend thing happened to us, left the ER at 10 PM after 10 hours with a scrip called in to CVS. I asked about the hospital pharmacy and they said the same thing, closed until Monday morning. I know better, closed to the public. There is access, there has to be. I mean they are running an ICU 24/7 and need slhit all the time. They can't always know at 5PM what the night will bring.

I have learned, as has the medical profession, that big doses of acetaminophen and ibuprofen do very well. By molecular weight a Norco is 5 mg opioid and 375 mg acetaminophen. Oxy's are similar unless you go big with 10 mg.

Toradol is available in injectable solution intended for IV or IM introduction and does work. I saw that in person. They can give that stuff freely as needed. We can't get any that I know of other than slow acting tablets.
"Ketorolac Items designated as Rx can only be sold to licensed facilities or agencies".

[Tobra]

Yeah, JB that is an ugly incision.

They tell you do not cross your legs, or the ball falls out of the socket

[Jeff Higgins]

Good point regarding the weekend/after hours availability of pain meds at the hospital, Zeke. Of course they must have access 24/7/365. Traumatic injury follows no set schedule, defying even the most self important beauraucrats' authority. Imagine that.

We do reach a point, however, where it can become extremely counterproductive to even have a discussion with the attending physician or nurse regarding the effectiveness, frequency, type, or any other aspect of their "pain management". My wife, a retired nurse, tells me that they can and will flag your medical records to label you as a "drug seeker". God help you if you ever earn that distinction. Pretty much any care provider that sees that (and with modern electronic medical records that means all of them) will refuse to provide anything stronger than Tylenol or Advil, no matter how severe your pain, no matter the cause of your pain. So it's best not to argue with them.

Pain management is a vital component in the healing process. Any first year med student will tell you that. Yet here we find ourselves, with bureaucrats and politicians who have no medical training whatsoever making the rules for how doctors are allowed to approach this.

I, for one, would rather not resort to booze to control pain. That just can't be good for the healing process. We have developed far more effective means. I very much resent that the rest of us are now beholden to the abuses endemic within the lowest rungs of our society, which clueless bureaucrats and politicians use as their excuse through which they have wrested control of yet another aspect of our lives. They need to get their noses out of our health care (and not just this aspect of it) , leaving it to our actual trained professionals.

[Zeke]

^^^To make myself clear, I suggested liquor as a quick pain measure for kidney stones. Yes, I realize that I am unable to diagnose the cause of pain whatsoever. I'll leave it at that.

[Jeff Higgins]

Back on topic, today marks one week post op. I'm already getting around with no more than a cane, and I even leave that behind for most forays to the kitchen or bathroom.

I had a home health care nurse come out for an evaluation on Monday. She wondered out loud on a couple of occasions just why she was actually here. She was astounded by my progress and mobility even by then. "You got this."

My wife is soon going to demand I kick over my own damned Harley...

[Scott Douglas]

That's really good news, Jeff.

It's funny, after I had my heart surgery and was back in my room, they said a PT would be in to talk about getting me moving again. I asked what they were going to recommend, walking was the answer.

I said let's get going and started right then. Got up, grabbed the IV pole and headed for the door.

Got down the hall and one of the nurses comes running out from behind the main desk for the floor and says 'Hold on a minute while I get you another gown to close up the back.'

Guess she didn't want me flashing everyone.

I never did see a PT. Doc said they talked to the PT about it and they claimed they came and I was already walking so they decided they weren't needed.

It was kind of a pain since I had two drain tubes and a catheter in me, but I did it.

I wanted out of there. Four days was more than enough for that visit.

[Zeke]

^^^^I did 4 days in a hospital 4 years ago. If you're awake it's miserable. A lot of the problem was delays due to Covid. So I sat for a long weekend while nothing got done. Funny, there was a large seat, almost a couch and I ended up sitting over there after I disabled the alarm on the bed. Just a button. Better window view.

And no one could visit.