Monday, April 17, 2017

PSA: If you must go to the Emergency Room

While Mr C and I were on vacation in Ohio this past week, I had to take my MIL to the Emergency Room. She had been sick for nine days, unable to retain fluids or food. She had suspected it was her new medication within days of starting it. She had called her Doctor. She had just told him the new medication didn't seem to be working. He told her to keep taking it, give it a chance. She did NOT tell him of all the "side effects" she was having!
By the ninth day of her illness, we had been there about four days. We had not been hovering over her, but going elsewhere to let her rest, and checking on her mornings and nights. The evening of the eighth day, her great grand daughter ratted her out: Granny is sleeping in the floor! (Granny had fainted!) She was still not convinced she needed to call her Doctor back.
I "googled" the name of her new medication and its side effects. It was a long list.
EVERY. Single. Symptom. my MIL was experiencing was on that list... along with some she wasn't. I called her prescribing Doctor's office and spoke to his nurse. Her Doctor was out of town, and she recommended that I take my MIL to the Emergency Room at once for evaluation.
 Here is where my Public Service Announcement starts. When you take someone to the emergency room, take a moment or five and bag up ALL of the prescriptions your patient is on. I had only taken the one we were personally convinced was the problem. MIL was so sick and dehydrated, she couldn't begin to remember the medications she was taking- which are very few! I see my MIL a few times a year- I have no IDEA what she takes on a daily basis. But you will need to know. Take the containers they are issued in- it has recommended dosage as well as the strength of the dose.
I can understand where the ER Doctor was coming from- I offered to show him the loose pills she had in her daily dosage box. "There are hundreds of millions of medications out there! I couldn't POSSIBLY recognize them by their shapes and colors!", he snapped at me.
MIL kept trying to gloss over her symptoms. In the ER, you don't gloss over your symptoms. Don't exaggerate... but be honest. Just because you haven't vomited in three hours (probably because you haven't eaten in twenty-six hours!) when you have been vomiting after every meal or drink for nine days... does not mean your vomiting is "better". Because you urinated twice last night, and actually had urine output doesn't mean you don't tell the Doctor you haven't been ABLE to pee for three days!
Doc grumbled that we were giving conflicting information. Before you go to the ER, take a few minutes to DOCUMENT symptoms. He couldn't understand why she thought she was feeling much better one day in the midst of this- which would mean it was NOT caused by the medication- and I reminded her, I had found a dose on the counter where she had MEANT to take it, but had not. (She missed a dose.)
The Doctor went to call the nurse who had recommended we take MIL to the ER, to find out what MIL was supposed to be taking, and snarked as he left the room, "People come in here with inaccurate, conflicting, and incomplete information, and expect us to make life and death decisions about their care!"
While his attitude stunk, I can see his point.
Here is a list of things I SHOULD have taken to the ER.
A list of EVERY  DOCTOR the patient is seeing. Their General Practitioner, Cardiologist, Diabetic care doctor... ANY Doctor the patient is seeing. You need their names, specialty, and their phone number if you have it.
ALL of the MEDICATION the patient is prescribed, in its original container.
ALL of the Herbal Supplements and/ or vitamins the patient takes. 
An official form of IDENTIFICATION for the patient. If the patient is unable to respond coherently, be sure you know their birthdate and year of birth.
Insurance cards. 
Bottle of water for your own and patients hydration.
Change for vending machines to keep up your strength for the duration of the wait.
A sweater or small blanket for the patient. (When you are ill, waiting rooms can feel like refrigerators.)
A Notepad and pencil or pen... I used my cell phone, but cells are often not allowed  in the ER. (You will want to document what is said about future care for the patient. I kept note of MIL's blood pressure, temperature, and blood counts as tests were run. My notepad was a quicker reference than their computer system in comparing old and new readings. It was handy for noting the names of both the snarky and the above and beyond duty caregivers. I plan to send Thank You notes to the staff members who deserve recognition.
 MIL was admitted. She was severely dehydrated, and had low/ borderline blood count, which required a transfusion during her stay.  Two nights and three days of professional care, and she was able to return home... on her 84th birthday! The staff Doctor agreed, after observation, it was the new medication. She is off of that for good!