The day before yesterday I spoke with my mom’s managing physician before her second surgery and he made it absolutely clear to me that it was very unlikely that Kaiser would see fit to send my mom to a skilled nursing facility when I brought up my concerns about her coming home too fast. I may have mentioned that this second surgery would most likely have been avoided if she had stayed another day or two in their care or went to a rehab center for a few days. He made it very clear to me that Kaiser isn’t responsible for what happens to patients after they’ve been discharged. It is of no concern of theirs if the home they’re being returned to is a safe healing environment or if the people caring for them are in any way qualified or able to care for a post-op patient with needs such as: commode monitoring and emptying, physical therapy exercises, med control, bandage changing and wound care.
He told me that Kaiser has strict PT criteria and when the patient reaches them they are discharged and if I don’t like it I can blame congress for it.
It was an icy conversation. I was already upset that Kaiser, this time around, has not been keeping me informed about decisions for her care. I did not get unpleasant with him, no raised voice, no direct accusations, but I did respond with a “we’ll see” when he said they’d probably send her home two or three days after her surgery.
The doctor did not speak to me again. The nurses did not tell me that the plan for her had changed completely. My mom told me herself but she was hallucinating off and on all day yesterday so I couldn’t be sure.
Some things I’d like to note:
The physical therapist my mom originally worked with (after the first surgery) was taken off her case and she got a new physical therapist.
The doctor I spoke with who was so sure my mom wouldn’t qualify for a stay at a rehab facility has been replaced with a new doctor who actually called me this morning with an update on their plans for her rehab which include a stay at a rehab facility and the assurance that Kaiser feels they should take my mom’s recover “very slowly”.
The surgeon who performed the first surgery was contrite during the pre-op visit. He seemed extra gentle with my mom and not at all dismissive of my questions (as he somewhat was the first time around) and though he never visited my mom after the first surgery he has already visited her twice this time and yesterday said to my mom “I’m sorry, this shouldn’t have happened”. She says she responded with “No, it shouldn’t have.” Go mom!
The physical therapist who paid a visit to our house the day after her discharge did not think her excruciating pain and inability to walk to the bathroom was worthy of note or consultation with her surgeon. The surgeons believe that she had already dislocated her new hip the day before because of my mom’s description of the level of pain she was in. This should have been a red flag to the PT guy. But all he did was lecture me on administering pills to my mom correctly. Fucker.
So, as of today, I know for sure they’re going to keep her at Kaiser for another day or two and then they will move her to a skilled nursing facility. They didn’t tell me how long they think she’ll be at the nursing home but I’m sure it will be the shortest time possible because that’s how Kaiser likes to do things. I think this 180° change in their approach to her care is due (probably) to two factors: they have come to realize that my mom is in worse shape than they originally supposed and I rocked the boat and made it plenty clear that I hold Kaiser responsible for her needing this second surgery. All I can say is suddenly they’re being very cautious of her recovery.
I’m still angry with Kaiser. I absolutely hold Kaiser responsible for my mom needing this much more complicated second surgery. But I feel loads better now that they seem eager to make things right and see that my mom recovers in a manner that is safe and appropriate.
My mom is a trooper. Truly such a trooper. She has so many fears (at clinical anxiety level, like me) but she just keeps bouncing back from those fears with new eagerness to recover well so she can come home to her dog and her textile art projects, and to us.
My mom lets me take pictures of her in the hospital. Indulging me in my macabre fascination with medical equipment and hospitals is definitely not something all mom’s would do.
My mom never loses her sense of humor. Her humor is almost as dark as my own.
She says her leg feels “right” this time, that it didn’t feel quite right after the first surgery.* So she feels optimistic that her recovery is going to go better.
She’s not fighting me on my strong feeling that she needs to go to a nursing facility if her insurance allows. Two years ago she fought me so hard I caved and it was really rough on me to have her home and not yet even completely sure how to change her colostomy bag. This time she’s totally on board. It’s probably because the level of pain she felt when she broke her femur on Tuesday was so tremendous she is scared to have a repeat of anything going wrong at home.
I’m just about to go visit her. This has been a gnarly three weeks for us here and I’m ready for everything to go well now instead of falling apart. The car is fixed (for $$), Chick’s ear seems to be healing so it seems possible she won’t need surgery, my mom’s dog Rosie who got hurt during the whole EMT visitation is barely limping now, Max’s toe is still infected but he’s soaking it so I think that will heal soon.
My phone is continuing to break down. Payday is today and I have a little bit of money that I made from Sugar and Pith that I can transfer to our account so hopefully I can replace it because I’m so tired of having to work around the part of my screen that no longer responds to touch. Maybe that sounds unimportant but it just had to break down when I needed to be able to text my brother and sister frequently with reports on our mom’s sitch.
But the main good thing is that things do appear to be calming down and getting fixed. I’m not sick to my stomach with anxiety today. It’s not so hot out. It’s still tomato and summer squash season, and fall is just around the corner. ** Although I failed to stay sober through all this hospital stuff, I will be soon be ditching the beer again for tonic and mega-lime with no gin.
Thank you to all of you who have been following our misadventures, offering thoughts of healing for my mom, and emotional support for me. You are absolutely wonderful and your reaching out has been so helpful. xoxo
Update: It’s 3 minutes after I published this post and my mom’s dog started throwing up, so maybe I spoke too soon. Holy fucking hell.
*That would have been incredibly useful information to share with her PT and her doctor right away.
**Which sometimes means hotter weather than summer here in our county. So fingers crossed we get a real crisp fall this year. We’ve had several cool grey mornings this week and that’s been heavenly.