Tuesday, August 07, 2007

Turbulence

Another day that didn't go at all the way I had hoped or anticipated. This morning, just as Brett and I were getting ready to head to Conley (home of Atlanta's scenic Mount Trashmore!) to pick up comics at the FedEx Freight hub, Kim called to tell me that the hospital was trying to dump Dad into a nursing home sixty miles from Rome.

I had feared that this was what Dr. Naguszewski had in mind when he painted this rosy picture of Dad's rehabilitation and recovery; when everyone else was painting a bleak picture, he described Dad talking, walking with the aid of a walker, and enjoying a reasonable quality of life. He told us how he and the neurological team were prepared to work with Dad on therapy, including aggressive treatment with Aricept and other medications; how they'd try physical therapy to see if there was any improvement; and how Dad certainly wouldn't be moved anywhere until he was ready.

At the time we found out that they were talking to nursing homes about this, Dad had not seen a therapist at all since Thursday afternoon; he had been given no Aricept or any other medication targeting his stroke and its related damage; and he has only been on what I refer to as "physical maintenance" medication (antibiotics, blood pressure medication, insulin), along with his peg-tube feeding and a little bit of Depacon (which he's been on since Monday of last week).

I don't know if the hospital is trying to get Dad out of here right now because it makes their numbers look good (hey, another positive outcome for a stroke patient!) or because they're worried about the fact that he sat here for two days in a neurological ward specializing in strokes before it occurred to them to do any testing to see if just possibly he'd had a stroke on Sunday night. Two days with no proactive treatment for a stroke in a facility that advertises itself as in the top 10% of the nation's stroke centers.

Tomorrow I need to talk to a medical malpractice attorney to see if there's any legal action that can be taken to keep Dad in the hospital, to ensure that he gets appropriate treatment, and to block such dumping. But now, I'm just sitting here running interference, trying to throw up any road block I can to prevent them from moving him.

I asked for a second neurological consultation because I simply don't have any confidence in Dr. Naguszewski's opinion; he made it clear that he will not consider quality of life in the development of any plan for Dad, regardless of Dad's living will. He also seems to make a lot of promises that he has no intention of keeping. Right now, we've asked for a second opinion from Dr. Glass, another Rome neurologist; originally, they thought they wouldn't be able to get him in to see Dad until Thursday, but now they've asked for him to come by tomorrow morning (I just found that out a few minutes ago).

I also have asked for a meeting with all of Dad's doctors to try to get some coordinated information; so far, I'm getting bits and pieces, and I feel like I'm in a medical version of "the blind men and the elephant." No one seems to be actively communicating with each other, and no one seems to have any interest in a plan to determine Dad's prognosis prior to dumping him.

Dr. Jester was bluntly honest today: "Either we can move him to a nursing home or you can order that we strictly interpret his living will and we can withhold all treatment and wait for him to die."

I'm feeling so out of my league on all of this, but I'm not willing to quit fighting for the right thing for Dad.

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