Tuesday, December 9, 2008

2 Weeks and Remembering

This time two weeks ago, I was lying in a hospital bed hooked to an IV getting a dose of dilaudid every four hours. My simple out patient procedure had turned into a nightmare and it shouldn't have.

As I look back on the events of that day, I am convinced there were things that were done, or not done by the nursing staff, to exacerbate my downfall and cause me to end up being admitted for an overnight stay.

The saga actually began before the surgery. My anesthesiologist suggested I have what is called a brachial plexus nerve block...an epidural for the arm. It was suppose to make post-op pain non-existent because my arm was to be completely numb. Sounded good to me. I was given a local numbing agent and some sedation...I remember feeling a pricking sensation in my neck and then I was in the recovery room.

Was I saying it out loud? Could they hear me? God I hoped they could. I could hear them..."just say it louder...pain, pain, pain, pain." Oh God I was in the worst pain I had ever been in and I was begging someone to hear me, to do something about it, to make it stop!

The nurse came over and asked me what was wrong. I told her I hurt...that there was horrible pain in my armpit. She told me I couldn't hurt...it was an ice pack I was feeling. I faded in and out of consciousness over the next hour all the while trying to communicate my agony when my brain allowed me to cognitive enough to do so.

Some of it is a blur but the bits and pieces I do remember are so disturbing to me I still want to cry thinking about it. At one point I was awake, again in agony, I heard another nurse summon my caretaker, "your little girl needs something" I heard her say. Again I expressed my pain..."you can't be in pain, you had the nerve block. It is the ice bag." She walked away.

In the background I heard her say, " he says there is no reason she should have pain in her armpit." I could make no sense of what was going on around me. Why wasn't she listening to me? Why didn't she believe me when I told her I hurt like I had never hurt before. Again I tried to tell her..."fine I will take this out and tell your Dr. you are being non-compliant" as she jerked the ice pack from under my arm. But I still felt as if my arm was on fire.

About 10:30 am I was moved to what is called a step-down unit. I arrived in the unit with my head in a bag dry heaving. Now I had another problem. But good news, the nurses in this unit seemed to believe I hurt...they had a clue...I could move my fingers. We all have an Ah Ha moment...THE NERVE BLOCK DID NOT WORK!

I had yet to receive anything to relieve the misery I was experiencing. But due to some protocol, the step-down unit only allows pain meds to be given by mouth and because I was dry heaving I would not be getting anything by mouth. Nothing by mouth, nothing by IV means nothing to relieve the god forsaken hell I was immersed in. By that time I was beside myself.

There were tears, begging, visualizing, Lamaze breathing...anything I could do to take myself out of my body and away from this limb that had turned on me. My poor husband could only sit and feed me ice chips...he was powerless to do anything. Friends who had expected me to be home by then were worried because they hadn't heard anything...it had all gone terribly wrong.

I remember calling my Angel to tell her what was going on. At the sound of her voice I broke into sobs...I was broken both physically and emotionally and I couldn't get anyone to help me. I couldn't understand how with today's medicine they could let me suffer like they did.

Finally around noon, my savior arrived. She was a nurse who did not normally work on that floor and was covering my nurse's lunch break. I don't know how or why she could do what she did and I don't care, but I think she saw how horrible it was for me and she said enough was enough. Before I knew it, she came in with a syringe full of phentinol and tordol and stuck it in my IV.

Within minutes I had relief. It was unbelievable. I told her I loved her and asked her to marry me! I also asked her why someone didn't do what she had done three hours earlier. She just shook her head and said, "I don't know."

It was obvious at this point that pain control was only going to be managed through IV. It was also obvious the block did not work...my arm was not numb. I was going to be admitted for pain and nausea control.

The goal was to move me from IV meds to oral meds and get me out in the morning. That didn't happen either. I could not keep the oral meds down until late in the day the next day. In the meantime, the IV meds dropped my blood pressure so low the nurse cut me off. I ended up getting 1000cc of fluid over four hours to get my blood pressure back up.

Again, what was supposed to be a simple outpatient procedure turned into a nightmare. And I don't think it had to happen. I believe if I had gotten good pain management from the beginning, in the recovery room, I would have gone home that day.

I am furious that some nurse made the decision that I did not hurt. That she decided my complaints were not to be taken seriously. I am beyond angry that she called me 'non-compliant'. No nurse should decide for his/her patient whether or not they hurt and how bad...it is the patient who should decide and the nurse who should listen.

When I saw my Dr. for my post-op and told him what had happened, that the nurse did not believe me when I told her I hurt, his response was, "she should have...that block fails in one in ten people." One in ten!

I have called the hospital and spoken with "customer service". I want to speak to her supervisor. I want answers. But more than anything, I don't want this to happen to anyone else.
Besides the personal pain involved, there is also the cost issues related to the extra time and supplies required for the overnight stay. I have insurance that will pay at 100%. I am lucky...someone else my not be.

One week from today, the hubby will be at the same hospital, on the same floor, with the same surgeon having a total shoulder replacement. They have no idea what they will be dealing with if anything like this happens to him....I am not as nice as he is and trust me....I won't stand by and watch it happen a second time!
I'll let you know how it turns out.


Epijunky said...

Oh Lucy... What a horrible experience you had. A nightmare.

As a healthcare provider I'm embarrassed. What happened to you shouldn't have.

I was worried about you when I read about you having to stay over.

I'd love to know if anything more comes out of this.

canadacole said...

This is just aweful. No one should experience such a nightmare. My mother is in healthcare and I was raised to believe in nurses as patient advocates when doctors are often too busy to listen carefully. Shame on her and her collegues for not listening to you. I don't really know you, but I'm proud of you standing up for yourself and future patients. Do write about how it turns out.

I hope you're on the mend now.

Sue Nicholson said...

This is dreadful . . . from reading your posts above I am delighted that you were able to sort this for your husband.

What an awful experience for you though. I hate the way I am sometimes treated as a whinger. Pain is the most awful thing to cope with and you should never have ended up in this situation..

I See You!