Thursday, January 17, 2013

Hospitals: Are We All Talking


Hospitals: Are We All Talking?


Elaine Waples
Elaine Headshot 11713Complications from my cancer sent me to the hospital again recently. The news that I was in trouble came unexpectedly from my oncologist’s office Thanksgiving eve, following a routine blood test. “Your liver numbers are out of whack.” My response was “Really?” as if I’d been notified that my driver’s license had expired.
I was diagnosed with a blocked bile duct and I missed the turkey and cranberry sauce. My oncologist called in a gastroenterologist, who scheduled a procedure to open the blocked duct. But my tissues were too distorted to complete the procedure, so the next day an interventional radiologist inserted a bile drain. I met him seconds before I drifted into sedation. When it was over and I was awakening, he offered me a cheery “good luck” as I rolled out the door. I never saw him again.

I returned two weeks later for a repeat of the original procedure, and this time it worked. A metal stent was implanted that propped open the duct and I was happily discharged. The next afternoon, though, I was back in the emergency department with a fever and elevated white count. A young doctor ran some tests, made some phone calls, and the staff hospitalist admitted me with pneumonia.
Over the next four days I received care from a rapidly growing list of consulting physicians: a pulmonologist, a different interventional radiologist, a partner to the first gastroenterologist and an infectious disease doctor. The hospitalist coordinated their care, monitored my progress and ordered meds and tests.
As the days moved on, the treatments, tests, antibiotics, and procedures continued. My husband and I experienced a revolving door of physicians who we met for the first time, each focused on something different. They were there for their specialized knowledge and skills: monitor the bile duct, eliminate the infection, drain the lungs. At times it felt like we were dealing with unrelated illnesses and I kept thinking, “I have cancer! Is someone connecting all this?”
The processes of hospital care are supposed to be understandable to the average patient. But I wonder if they are. Many patients expect that their care will be managed by a familiar specialist, the doctor who saw them last or their primary care physician. They may have never heard of a hospitalist or know what a consulting physician does.
We have realized that we have a strong role in making patient-centered care really work.  We asked questions of the doctors. Are you talking to my oncologist and my primary care physician? Some had puzzled looks, as if we had introduced a stunning no-brainer into the conversation. They all assured us that they had already connected directly, through the EMR, or through the hospitalist.
But we weren’t sure that was happening. We didn’t always know what they were saying and or what they were hearing. Questions got the information flowing and our conversations, both good news and bad, became more collaborative. Even so, it didn’t just happen. We had to elicit information. We had to be active advocates for my care.
I am out of the hospital now. I left with books, flowers, bottles of soap, lotions and an oxygen tank. I needed a Sherpa. I also had a pretty thorough “to do” discharge list that included a home health nurse, a therapist, pain meds and oxygen. I have since connected with my primary care doctor and my oncologist. I am vastly better, though there is a lot of treatment ahead. But at the moment, there is medical homeostasis.
I think about the experience often. My care was excellent. I was sick and in trouble, and it was the right care at the right time. The hospitalist who coordinated the care was skilled, diligent and competent. My team of consulting doctors were terrific. Left to my own devices, I probably could not have chosen more wisely.
But there was an eye-opener. The care was coordinated differently than I had imagined. I expected to see doctors I’d known before. It turns out they were involved, but with the new team in the hospital. It was clearly the right care, but much of it was, for us, out of sight, behind the curtain.
The doctors who treated me have moved on to other cases and probably never thought of me again. I owe them my deepest gratitude and I would like them to know how much better I am. I wish I could see them one more time.
But I won’t.  That’s just not how it works.

11 comments:

  1. I decided to share this because i am so glad today and happy that i am alive to see another new day and not just that but also to share the goodnews of how i survived a deadly stage 4 cholangiocarsinoma (bile duct cancer). I was told by my oncologist that she had just 6 months left to live and i was so scared to lose my wife. I was lucky to contact Dr Mrs Aleta who i told all about it and she is the nicest person i have spoken to. She recommended a herbal medicine for her which she took that cured her in less than a month. Well for more info about the medicine and cancer treatment simply reach her on aletedwin@gmail.com she can help you too. Contact her for any form of cancer too.

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  4. I GIVE ALL THANKS TO DR WILLIAMS WITH HIS HERBAL PORTION I WAS COMPLETELY CURED FROM FIBROID
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  6. MY NAME IS NITA.

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  7. I am Shelley from Los Angeles,California, I want to testify on how i got cured from fibroid, I have suffered from fibroid since the 2011 with so mush pain,that i have to spend so mush money getting pain relief in the hospital, and I have visited several doctor ,but all to no avail, my world was gradually coming to an end because of the pin during my menstrual period until i saw a post in a health forum about a herbal Dr Williams who use herbal portion in curing people from different kind of diseases including fibroid, at first i doubted if it we be able to shrink the 9cm large fibroid in my womb, but i decided to give it a try, when i contacted this herbal doctor via his email, he prepared a herbal portion and sent it to me via courier service, when i received this herbal medicine, he gave me step by step instructions on how to apply it, when i applied it as instructed, i was completely free from fibroid just for 1 months of usage,i we recommend this to all my friend family in the world today who still suffering from fibroid you can contact him through his email on drwilliams098675@gmail.com for help.

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  8. "Dear dr williams, your herb has saved my life and my sanity. I was scared, and had been seeing numerous specialists and almost all of the straight away told me I had to remove my uterus because of my large fibroid. Can you believe this? To top it all up, none of those doctors had answered my simple questions on the subject. I was so scared that I would not be able to have a baby as surgery seemed like the only choice then. Your product had dramatically allayed my fears. I have read many other guides on the subject of fibroids and i think dr williams herb is yours offers and the only true and lasting solution to fibroid. I am a walking living proof of that claim. It has been 3 months since I implemented dr williams herbal portion, and I am now completely clear of fibroids and I am sure I am on my way to become a mother. I also feel very healthy and vibrant. Thank god for your work and support dr williams, for more information about his herb you can also contact his email address drwilliams098675@gmail.com

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  9. With Dr Williams herb i was completely free from fibroid.You are an amazing doctor.Matching diagnosises aside, I just want to be your friend. Lol You inspire me on a feminist level. On an intelligence level. you are a good man doing so much for mankind, level.Thank you for being you.For keeping a lot of us off the ledge of diving into sugary. For reminding us that we aren’t a fucking statistic or a status, we are still PEOPLE. With brains and personalities and jobs and lives.I’ve only been diagnosed for so many years now with fibroid, and the roller coaster of emotions is all too real.I’m sure I speak for everyone here when I say thank you. From the deepest part of my soul. THANK YOU.You give us all an indescribable level of comfort and absurdness in sharing our diagnoses and, almost a green light to continue to celebrate our lives,for you always been there.For every jerk who throws you hate, there are hundreds of us thanking the universe for you.for more information about Dr Williams product you can email him on drwillliams098675@gmail.com

    ReplyDelete
  10. I GIVE ALL THANKS TO DR WILLIAMS WITH HIS HERBAL PORTION I WAS COMPLETELY CURED FROM FIBROID
    I can’t believe this. A great testimony that i must share to all fibroid patient in the world. i never believed that their could be any complete cure for fibroid with out going for surgery ,i saw people’s testimony on blog sites and Facebook page of how Dr Williams prepare herbal cure for different king of disease,and with the help of his herb they where able to shrink there fibroid naturally. i had to try it too and you can,t believe that in just few weeks i started using it all my pains stop gradually . Right now i want to tell you all that i just give birth to a baby boy last month,and on thin now i have not had any pain, and i have just went for text last week and the doctor confirmed that there is no trace of any fibroid in my system . Glory be to God for leading me to this great Dr Williams I am so happy as i am sharing this testimony. My advice to you all who thinks that their is no herbal cure for fibroid that is Not true ,just contact him and get cure from his email drwilliams098675@gmail.com and you will be free and free forever, Try it and you will not regret it because it truly works. i hope to see your testimony soon.

    ReplyDelete
  11. I felt so awful when I was diagnosed with fibroid . I felt like my life was ruined since surgery was the only solution. Upon all of my constant research, I stumbled upon Dr Williams blog and articles of his good work that have been published. YOU ARE AMAZING. You have given me hope. This fibroid have cause me so mush pain that my life was deteriorating.Dr Williams You are so courageous and I don’t know if I’ve ever looked up to someone so much. Being famous for writing is my dream and I also have always wanted to make a difference in the world somehow. You are doing both and I think its the deepest thing ever. The world needs people like you to end the fibroid stigma. Never stop being you and thank you for being a voice for us all,you can also email him on drwilliams098675@gmail.com for his product.

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