Part II — Lessons Learned From My Recent Hospitalization

Part I concluded with my Saturday night arrival at the emergency room at Cedars-Sinai Medical Center, where I was immediately seated in a wheelchair and brought straight into a small room with a bed and lots of electronic equipment.  My palms were sweaty and my heart raced.

The nurse assigned to help me proved efficient at her job.  She wasted no time taking my vital signs, inserting an IV line into my left arm, and hooking me up to a device to monitor my vital signs (including my oxygen saturation level, which is the amount of oxygen being carried throughout my body in my blood.)  My blood pressure was lower than normal (a common sign indicating I was dehydrated,) but my heart was pounding from the stress I was feeling.  I asked for a glass of water, and received water and apple juice.  Several vials of my blood were drawn to run tests, and the wait for the results began.  Lisa sat with me, watching everything going on and answering questions on my behalf.  If I’d been expected to answer for myself, I don’t know what I would have said given how badly I felt physically and the state my nervousness.

Lesson #1 — If you must go to the hospital, go with someone who is familiar with you and your health, and who will stay beside you until your diagnosis is determined and your plan of care designed and implemented.

Lisa spent ten hours with me in the emergency room at Los Robles Medical Center when I was diagnosed with my stroke in November 2011.  When the clock reached 5 a.m. I was finally assigned a hospital room.  I hoped we weren’t in for a similar scenario at Cedars-Sinai.

About an hour after my blood was drawn, a doctor came in to speak with us and examine me.  She explained my white blood count was very high, indicating a serious infection.  She ordered a chest X-ray and a urine culture, convinced the likely culprit was either pneumonia or a urinary tract infection.  Immediately an antibiotic called Zosyn was placed in my IV line, as well as a solution to begin hydrating my body.   My diagnosis surprised me, because I wasn’t coughing and I had no unusual sensation when I urinated.  Then Lisa reminded me when I was diagnosed with shingles at 98, the small rash I developed cleared in one week.  My internist told me it was the mildest case of shingles she ever saw, and attributed that to my strong immune system (due primarily to a vigorous exercise program I followed the last fifty years.)  Just another reason everyone should incorporate regular exercise into their lifestyle, in my opinion.

When all my test results were in, the urinary tract infection won the award as the cause of my feeling so terrible.  My diagnosis was reached in just a couple of hours.  Amazing!  I was told I’d be admitted to the hospital that night, and by 10 p.m. I was in my room.  Thankful not to be forced to spend the entire night in the emergency room, I was wheeled to my room with Lisa accompanying me.

Once in my room, I met my nurse and her clinical partner.  My nurse spoke with Lisa about my usual medications.  I still lacked any appetite and felt blah, but felt relieved by a diagnosis that seemed to be not too serious.  My admitting doctor came into the hospital at 10:30 that evening to examine me, something that astounded me.  On a Saturday night, a doctor is paged with a new patient just admitted, and he comes to the hospital to see me?  When I suffered my stroke and was admitted on Thanksgiving night 2011, it seemed all the regular doctors were on holiday vacation.  One of the benefits of a large hospital like Cedars-Sinai is regardless of the day a patient is admitted, there is ample qualified staff covering whatever day of the week it happens to be.

I was labeled a fall risk, and the bed alarm was activated on my bed.  Never having seen a contraption like this before, I learned the hard way that just by swinging my legs over the side of my bed, a loud alarm would sound, sending the hospital staff running.  Given my independent nature, I detested this restriction on my mobility and continued to set off the alarm until Lisa told me to accept the fact I could get out of bed only by summoning help first.  I was not happy, and let Lisa know it.  She took it in stride, emphasizing I wasn’t steady enough on my own two feet and the bed alarm was for my own good.  I knew Lisa was right, but I still complained about feeling trapped.

Lesson #2 — If you happen to be labeled a fall risk in the hospital, take it seriously (for your own safety.)  There’s a good reason, as much as I hate to admit it, that hospital bed alarms exist.

Lisa spent the first night at the hospital with me, attempting to sleep on a cot in my room.  As my Durable Power of Attorney for Healthcare, she insisted on staying until my condition began to improve.  Good thing she stayed.  It wasn’t for the sleep, as neither of us got any.  But my stress turned into anxiety, and that caused my heartbeat to fall out of its regular rhythm.  Atrial fibrillation, a common condition in seniors where the heartbeat isn’t properly regulated by the heart, is something I experienced last spring.  It was corrected when my internist prescribed a medication called Digoxin, but it wasn’t working now.  My pulse, normally in the 60-70 range per minute, jumped up to 115-125.  Atrial fibrillation can increase the likelihood of a stroke, so my Digoxin dose was doubled when Lisa saw what was happening and found my nurse (who paged my doctor, who approved the medication change.)

My second day in the hospital was uneventful.  I started feeling a bit better.  After watching the Clippers whip the Lakers, Lisa called it a day and headed home for some sleep.  I resigned myself to staying in bed accompanied by that blasted bed alarm.  I was bored.  I couldn’t sleep.  I wanted to go home.  Lisa called that evening to say she’s be back the next morning.  She slept soundly that Sunday night.  I stared at all the little electronic lights attached to the medical equipment throughout my room.  I was angry I had developed an infection.  I didn’t even know how it happened.  I was stuck in the hospital, a good one, but I was still trapped.

The next day (Monday) when Lisa arrived, she spoke to my nurse about my condition, medications, and doctor’s assessment.  I couldn’t understand half of the language they spoke.  Combined with being hard of hearing, Lisa had to translate for me once her conversation with my nurse ended.  My white blood count was falling, a sign my infection was being killed by the antibiotic in my system.  But my atrial fibrillation had my doctor concerned enough that I had to spend another night in my captive hospital bed.  I thought about tying several bed sheets together and lowering myself outside my fifth floor window to the street, but gave up the thought when I thought I might actually succeed.  Where would I go in a hospital gown with slippers but no wallet?  I didn’t want to end up being mistaken for Keith Richards.  Most definitely not.

Lesson #3 — Don’t try to escape from a hospital when you’re a patient.  Sorry, but there’s no alternative but to stay the duration.

My third night (Monday) in the hospital was grim.  Still unable to sleep.  Too much anxiety thinking about my irregular heartbeat.  Too much noise in the hallway.  Lisa left after dinner, trying to cheer me up by saying I’d hopefully be discharged tomorrow.  Small consolation when you’re trapped.  She had her comfortable bed and Bob waiting at home.  I had a bed alarm and needles in my arms.  My mind raced and I longed to be back at home in my own comfortable room, with Bob and Lisa in the next room, able to come and assist me if I needed them.

On Tuesday morning a physician assistant visited me and told me I would be discharged that afternoon.  My infection was minor now, and my heart rate had stabilized.  When Lisa called that morning to check in, I told her the good news.  She promised to be at Cedars-Sinai at 2 p.m. to take me home.  What joy!  I ate my breakfast (which wasn’t too bad) and waited for Lisa.  I wanted out.

A little before 2 p.m. Lisa arrived, with a change of clothes and my wheelchair from my stroke recovery days.  Ready to bolt out the door once I dressed, Lisa had to reel me in, explaining we needed to see my nurse for my discharge instructions.

Lesson #4 — Discharge instructions are important and should be understood thoroughly before leaving any hospital.  Ideally, a patient should have someone with them who is willing to read these instructions and understand them before you head out the door.

I had no interest in my discharge instructions, but Lisa did.  She read, she asked, she asked again.  The nurse had to call my physician assistant for clarification on a couple of items, but once that was done, we were headed back home.  Where my reclining chair waited for me.  I could hardly wait to stretch out.

Next:  Part III — Post-discharge care.

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