So I had mentioned my dad has a new lady friend and will be moving out. She works two jobs so when she's working he putters around our house and brings her lunch between her jobs.
Well friday he was working on his motorcycle all day and left at three to go meet her. I received a phone call around 3:30 from her saying she was concerned about him, he said he was feeling dizzy and was confused. He said he hadn't eaten all day and was tired and she mentioned his left eye was bloodshot. So I tried calling him and there was no answer so i drove down to the coffee shop he hangs out at and there was eating a piece of pizza and drinking a slushee. I asked him if he was okay, yeah he replied, just needed to get some food in my stomach, I asked him if he was coming to the house then and he said yes. So I went home and waited and when he showed up I sat and talked with him for awhile and he seemed okay to me.
So I went back to work and my wife came up around 7 and said I should take him to the ER, what's going on I asked, he still just doesn't seem right to me , his speech is off and he seems confused.
So I ran back to the house and my dad was laying on his back on the porch with his eyes closed, wtf?
Dad, you okay?
Yeah, just taking a nap.
So I had him sit up to talk to him and I noticed his left eye was drooping a little, I had him squeeze my hands to check for a cva and his strength was fine, no weakness.
He did seem a little disoriented and he was searching for words.
Let's go to the hospital dad, okay if it will make you feel better he replied.
So we got to the hospital around 7:30 and they took him right in, doctor's ordered a ct scan which they did right away, then they drew blood and said they would like a urine sample, but my dad didn't have to go. So we waited, around 10:30 a nurse pops her head in the door, hey we still need that urine sample. Dad still didn't have to go, so they proceeded to make him drink water, for 2 hours, at this point it was around 1 am, they couldn't have started this at 8?
Anywho, he finally goes and we sit and wait some more, around 2:30 am the doctor comes in and says all the tests came back clean, no issues, buy this time my Dad can barely keep his eyes open because he had been up for almost 24 hours. The doctor said she would like to admit him for observation, my dad didn't want to, he said he just wanted to go home and go to bed. the doctor finally convinced him to stay. I told my dad I had to run home quick and grab a change of clothes and I will be right back, okay he said.
So it took me about 45 minutes to get back to the ER, by this time it's around 3:30 am. I walk in and ask the front desk what room my dad is in, he's still in the ER I was told.
So I go in and my dad is sitting sleeping in the chair, I asked the nurse when my dad was getting moved and she said they were waiting for the hospitalist to sign the order.
So I go back in the room and my dad wakes up and we wait, finally around 4 am, I can hear a phone conversation between the nurse and the hospitalist, the nurse is asking why the order hadn't gone through yet, the patient has been sitting here waiting for almost 9 hours, all I could hear was the nurses side of the conversation , but when she hung up she started bitching about the orders not being signed, seems there is a pissing match between the ER and the floor, at this point I look at my dad and say what do you want to do, go home he said, okey doke.
So I walked out to the nurses station and asked her to remove my dad's IV, he wants to go home, sir, his room should be ready shortly. I told her I had heard the whole conversation, by the time they actually got them in the room it would be 5 am, and all the man wants to do is sleep, you say you want him here for observation, well I'll stay up and observe him,if there is no changes, I will bring him back.
They made him sign some waivers saying he was going against doctors orders, whatever and I drove him home, put him to bed in the cabin and checked on him every hour till he woke up around 1 pm yesterday. He was back to his normal self when he awoke, but I am still questioning if what I did was right.
18 Feb ’12
coming from someone who works in an e.r. you absolutely did the right thing.
your father was going to be admitted for observation because insurance underwriters have figured out that if something catastrophic is going to happen, it will happen within 24 hours of any symptoms occurring. so your dad was going to be admitted, not because the doctor was suspicious of anything bad happening, but because not only will that admission reduce liability risk, but the hospital will also be reimbursed handsomely for an admission that would probably last about 6 hours (until 12pm or so).
you did the right thing by taking your dad to the e.r. you go to the e.r. to rule out anything catastrophic from happening, but barring that, people need to be discharged so they can go home, get some rest, eat decent nutrition, and sort out the rest of their symptoms with their family doctor.
i tell all of my patients you are the captain of your ship, and reasonable people can disagree with their doctor. you weigh all of the evidence and make a reasonable decision. if someone can't do that, you can always designate power of attorneys and advocates for them. that's how the system is supposed to work.
keep an eye on your dad. he may have just been dehydrated or hypoglycemic. hopefully, the e.r. doc told your dad to follow up with his family doctor. make sure he does that. that's the compromise a reasonable person does in lieu of a hospital admission.
ama here or pm if you have any more questions.
7 Mar ’12
Glad is wasn't a stroke. I hear stories about ER wait times all of the time (fiancee works in one.) It's really the charge nurse who's in charge. The doctors will normally see as many patients as they can if the staff can set them up in rooms/beds fast enough.
You can give us a call KVR if you want to ask any medical questions.
I hope your dad feels better soon.
8 Mar ’12
pcp to neurology consult.
did the right thing. too many men ignore odd symptoms like persistent heart burn, indigestion, not feeling well for days...and then tragedy happens. early intervention (especially when stroke is suspected) is key. limited time frame/window for certain meds.
CT scans don't pick up everything. TIA maybe. too little data.
i always tell people to acquire a copy of their med records asap from the provider/facility after receiving questionable care. i think you will be surprised by what gets documented especially after a "refusal". Info on the Lab report may also be informative (can rule out dehydration and low blood sugar for example).
And the monkey presses the button.
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