I was still receiving non-diabetic meals and the Doctors told me that I’d have to talk with a nutritionist. When I complained about the goings on outlined above the Doctors told me it wasn’t their department. It was all quite comforting as you can imagine. Then the lady Doctor, the one I thought was a nurse, returned to harass me about my medications for pain. She was hell bent on getting me out the door and upped my morphine from 30mg to 60mg and wanted me off Percocet, and then she left. She had yet to develop much in the way of bedside manners. Apparently they don’t teach that in med school.
The urologists were still maintaining they couldn’t operate on me until three to four weeks best case. They had no interest in the fact they just flew me down, expected me to drive home and I had two bags of urine I was carrying around and a ‘perc’ in my back. Then things got really interesting, unbelievable really.
Around noon time, my daughter was out eating with my wife who had now arrived, another young Doctor, a nice fellow, came in my room. He said, “We need to talk”. Being a straightforward guy I liked this young man’s approach and said, “Okay, Doc, let’s talk”. He explained that he was there to tell me he could only be justified in keeping me one more day, maybe two, based on my condition. We went through my Montana and home story, my two urine bags, my perc and all to no avail. He said, “Mr. Kugler I understand we put you in a difficult position but ‘Administration’ is on my back and I have to get you out of here”.
Now I wasn’t mad at him, he was doing his job and being honest. But I was outraged at the system that creates such treatment. I just wanted out of their zoo. So over the next few minutes we made a deal. I said, “Doc, I’ll do you a favor. Here is what I need to get out of here. Whoever that Doctor is that is screwing with my pain med’s I need gone. She has got me on 60mg of long release morphine and I only need 30mg, its making me goofy. I need to be able to take two Percocet’s every four hours if need be”. He doesn’t blink an eye and says I got it. Then I tell him, “And Doc, I want my operation within the next ten days. You get me that and I go quietly”. He smiles and says, “Give me a couple hours”.
About an hour and a half later in walks my Urologist, who previously was telling me my operation wasn’t a priority, and says, “Good news Mr. Kugler, we moved some things around and your operation will be next Tuesday”. That was essentially a week away and I was released from the hospital and went to my daughter’s home an hour outside the city. My wife and daughter took care of me, my catheter, my perc and administered my med’s. I am a guy who doesn’t as much as take a Tylenol or Ibuprofen at home. I didn’t want these pain medications; I needed them with my condition.
I returned in a week, they replaced my ‘perc’ with a bigger hose, about the size of a garden hose and performed the operation. Quite frankly the surgical floor of the Salt Lake VA ran much better than Acute Care, whatever it is. But then there were opportunities. My urologist wanted to get my right kidney working after the surgery, a good thing for sure, and the way they did it was to put a clamp on my drain tube and force the urine through the kidney and not out into a bag. That makes sense and he set it up with instructions to try it and if there was pain, then open it, and in twelve hours try it again.
That night we tried it for the first time. Within minutes the pain came and I tried to gut it out but to no avail it wasn’t working. I called the nurse and she came and ‘opened’ the clamp. The only problem was that the pain continued. I was chasing pain all night, taking all the pain med’s I could, all for naught. When my Urologist came in the next morning to check on me, he picked up my tube, which I could not see, and says, “Oh, you had pain because the nurse didn’t open this the whole way”. Now, I felt a whole lot better.
My surgery was on Tuesday before July 4th, when Thursday came the game was to release as many patients for the long weekend as possible. My right kidney had yet to fire up, the pain was terrible and I still had two bags for kidneys. But the good Doctor explained that if I stayed in the hospital all they would do was feed me and checks on me occasionally. I decided I’d go to my daughters and come back on Monday to have the tubes removed, provided the kidney fired up. He explained to my wife and daughter how to take care of the ‘perc’ and my catheter and off we went back to my daughter’s house.
It was a tough weekend but nice to be with family. Then on Sunday afternoon I started bloating and realized my catheter was plugged and not working. The urologist had given us the hospital numbers with the admonition to call the switchboard if anything happened. About 4 PM on Sunday afternoon my wife called the switchboard and asked for urology. They would ring six different numbers and get no one. What were we to do with a plugged catheter and a patient, me, filling up?
My daughter did what any young person does today, went to the Internet and Googled just how to remove a catheter. We knew it wasn’t rocket science but it is sad that a patient would have to figure it out in that manner. What is worse, what about all the patients not blessed with a daughter and a wife to take care of them when the hospital doesn’t? That is the scary part of my story.
After release my recovery was not easy. Maybe at my age I should have figured out the risk of going off my medications cold turkey but I didn’t. And no one said a word, so, sick of being in a fog for one month I quit all medications the day after my ‘perc’ was removed. That proved to not be one of my smarter moves. I went through eleven days of hell. I had the creepy crawlies, saw large and small animals got the sweats and fevers, you name it. It was everything I’d ever read and then some. When I called the VA Doctor and told him he had a real command of the obvious, “Yep, you might be going through withdrawals”. That was it.
I feel bad for the old and young vet’s in these hospitals who can’t speak for themselves. I checked the Internet site for the hospital and found the hospital Directors name and phone, even had the extension number. I spent several years in corporate America and thought, what are the odds I would actually reach this guy with my odyssey in his hospital? I placed a call to the Director and the phone was answered by a nice young lady who was obviously the first level screen. I explained my predicament and my desire to have just 30 minutes of the Directors time over the course of the next month to review what had happened to me.
She excused herself for a brief moment and came back on the phone and said, “I’m sorry but have you discussed this with Patient Advocacy? I explained that I hadn’t since I didn’t know they existed. She explained that I would need to do that and not meet with the Director. I told her what happened to me needed to be ‘told’ directly to the big guy and she quickly and professionally transferred me to the Patient Advocacy group.
A perky young lady answered the phone, I told her my purpose and she quickly assured me she was there to help. I asked her if I should come down, write it down or just tell her. She said, “Sir, you can do whatever is good for you, we are here to serve you.” I had visions of my first night and getting my bracelet, maybe I was part of the ‘team’. I told her I’d give her a shot if she had the time for a long and painful story. She assured me that she had the time.
I started the story, got maybe five minutes in, I think we’d just arrived in Acute Care and was trying to get some pain medications when she announced she had a meeting to attend. You don’t have to be the brightest bulb in the lot to see where this was going. I said, “Miss, could I ask you a question before you go?” She assured me that would be fine. I said, “You are a Patient Advocate, right?” She answered yes, indeed she was. So I said, “Well if you are a Patient Advocate and I am a patient and we are talking … what meeting could be more important?” She was professional and all but in the end, she had to go to the meeting. She assured me that she would have the Department heads contact me immediately to resolve my complaint. That was one month ago this week and my phone remains silent.
In spite of all we went through it turned out to be a blessing. The urologist that worked on me discovered a small cancerous tumor on my other kidney. They have since performed an experimental procedure, an RF Ablation; that appears to be successful. During that procedure I received excellent care. But what I went through on entry to this facility should not happen to anyone, at anytime or in anyplace, ever. And as we all think about national health care, we best think again. My friends who go to the VA, our only national health care system in existence right now, in Chicago and Dallas and New York, have stories even today that make mine pale in comparison. And just think, we can multiply this by a thousand and create a national healthcare system for everyone.
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