leaving hospital Ama its BAD!

[Cello]

I'm thinking about you, Charris. Sounds like you found your voice in this unthinkable situation and are right on top of it.

While you're so focused on her, make sure YOU'RE staying well hydrated yourself. You don't want to wind up in the ER yourself.

With you in spirit.

 

[brooklyngirl]

Wow, what a terrible situation. Charris- you're doing a great job being an advocate for her, but I'll echo the sentiment to make sure you're getting in enough fluids and protein so you don't drop. Good luck!

 

[Spiky Bugger]

I don't know if this would work, but...
Tell Simpson he's a genius...that of COURSE it's getting better;
So much better in fact that she'd like go home tomorrow.
(The goal would be to get him to sign the discharge order because leaving AMA may mean she becomes financially responsible and Medicaid won't pay.)

Then get her to a hospital...ACROSS TOWN...at a hospital where he does not have privileges and get her to someone less cavalier.

Have you called Medicaid to talk about her options?

 

[SHales]

^^^^THIS^^^^ I don't know about Az, but here, if you are a Medicaid recipient and leave AMA, you are responsible for the bill. Handle this carefully. Sorry to add one more thing to your plate but you need to be aware.

 

[Larra]

Glad you're not leaving AMA. Looks like a lot of bruising, which would make sense with his explanation about having to pull the stomach out incision he usually doesn't use and lots of tugging involved. If that's all it is, it may look worse than it really is and just be slow oozing and not a major bleed that would require surgical exploration. The scan should tell the story, because if there is a collection of blood (hematoma) it will show up on the scan.

I'm more worried about her throwing up blood. Is that getting any better? I hope so. Hopefully, this is also just a slow ooze from all the cutting and stapling of the VSG.

Most importantly, are her vital signs ok? that would be my biggest concern.

Keep on documenting everything. Hopefully you won't need the documentation in the future, but you never know.

 

[Charris]

Dr.Er convinced Dr. S to do a MRI and it was good. DR. Er believes the bruising is from the tugging and pulling then changing directions when he couldn't get it out on the left switching and pulling it out the other direction. She was able to get some rest and had not needed extra nausea meds since around noon. They will ro blood work again in the morning to check the white count. They gave her saulmedral yesterday for itching and think her white count could be high due to that. Her heart rate was elevated from 106 yesterday to 133 today. Her bp was down from 178/9? Yesterday to 133/90. She's made progress. He is actually saying depending on blood work/white count she can go home tomorrow. Which is fine because no dr wanted to accept someone's mess today. If she happens to go to an er after being released tomorrow they can't refuse to treat her whereas if she goes AMA things could get sticky. Never know he may say we pressured him to release her. After his behavior over the last 2 days I just don't know where his mind is. But as long as she's not getting worse or still throwing up blood we WILL LET HIM BELIEVE THAT HE IS THE MAN....

 

[Charris]

,

I pray your cousin is safe and all is well. I'm sorry to say but I wouldn't trust Dr S. To ck my BP let alone do surgery. 6 months ago he was trolling OH for band patients, he himself was stating that if a bandster had a problem he would go in, UN-buckle the band then go back later and rebuckle. Seriously? Then he started promoting the sleeve. As a surgeon this man SCARES ME.
http://www.outpatientsurgery.net/su...8-million-for-gastric-banding-death--01-24-11

WOW

 

[ProteinSnob]

@Charris Any updates? Hoping all of this gets better before your first day back at work...

 

[Elizabeth N.]

I pray your cousin is safe and all is well. I'm sorry to say but I wouldn't trust Dr S. To ck my BP let alone do surgery. 6 months ago he was trolling OH for band patients, he himself was stating that if a bandster had a problem he would go in, UN-buckle the band then go back later and rebuckle. Seriously? Then he started promoting the sleeve. As a surgeon this man SCARES ME.
http://www.outpatientsurgery.net/su...8-million-for-gastric-banding-death--01-24-11

I remember that. In my uneducated personal opinion, this man is a menace.

 

[Charris]

Glad you're not leaving AMA. Looks like a lot of bruising, which would make sense with his explanation about having to pull the stomach out incision he usually doesn't use and lots of tugging involved. If that's all it is, it may look worse than it really is and just be slow oozing and not a major bleed that would require surgical exploration. The scan should tell the story, because if there is a collection of blood (hematoma) it will show up on the scan.

I'm more worried about her throwing up blood. Is that getting any better? I hope so. Hopefully, this is also just a slow ooze from all the cutting and stapling of the VSG.

Most importantly, are her vital signs ok? that would be my biggest concern.

Keep on documenting everything. Hopefully you won't need the documentation in the future, but you never know.

just got a call from the hospital saying that she has to have an emergency blood transfusion her blood count is really low. so my question is wouldnt that mean she's actively losing blood? To go from normal to extremely low wouldn't that mean she has active bleed somewhere?

 

[SHales]

just got a call from the hospital saying that she has to have an emergency blood transfusion her blood count is really low. so my question is wouldnt that mean she's actively losing blood? To go from normal to extremely low wouldn't that mean she has active bleed somewhere?

Yep

 

[Elizabeth N.]

just got a call from the hospital saying that she has to have an emergency blood transfusion her blood count is really low. so my question is wouldnt that mean she's actively losing blood? To go from normal to extremely low wouldn't that mean she has active bleed somewhere?

Of COURSE she has an active bleed. Shit, I feel so helpless. I have no idea how to get another surgeon with a goddamned clue on board when the patient is stuck on Medicaid. Please please please, get on the Medicaid hotline and get an advocate involved. Her life is in danger with these morons.

 

[Charris]

DR S PARTNER CAME IN AND FINALLY TOLD THE FREAKING TRUTH. SHE IS BLEEDING INSIDE BUT AT A SLOW RATE. THEIR RESOULTION IS GIVE HER THE TRANSFUSION AND THEY HOPE THAT IT WILL STOP THE BLEEDING!!!!!! THAT DOESNT MAKE SENCE TO ME. SOMEONE WITH MEDICAL KNOWLEDGE PLEASE HELP ME UNDERSTAND THIS CONCEPT??? If you have a leak inside slow or fast how is putting more substance in to leak out going to stop the leak? in my mind that just means she will have more to leak out like the other did?? He is making it seem like a fix a flat type fix he said to avoid going back in. They will check her counts every 4 hours and if she is still loosing go back in. Please help me understand if that is an appropriate option to this leak..

 

[Charris]

Of COURSE she has an active bleed. Shit, I feel so helpless. I have no idea how to get another surgeon with a goddamned clue on board when the patient is stuck on Medicaid. Please please please, get on the Medicaid hotline and get an advocate involved. Her life is in danger with these morons.

I FEEL HELPLESS ALSO. I CANT BELIEVE SOMEONE IS BEING SO CARELESS WITH A 24 YEAR OLD WHO OTHER THAN OBESE HAD NO MEDICAL PROBLEMS. NO OTHER SURGEON WILL TOUCH HER. I CALLED EVERY BARIATRIC DOCTOR IN AZ. SO THE BEST WE CAN PRAY FOR IS HER TO MAKE IT AND EVENTUALLY BE RELEASED SO WE CAN CALL 911 AND HAVE AN AMBULANCE TAKE HER TO A TRAUMA ER WHERE THEY WOULD HAVE TO TREAT HER.... sorry for yelling just realized i was in cap lock

 

[ProteinSnob]

OK, I think I found the wording for patient rights at Maryvale: http://www.abrazohealth.com/patients/patient_rights.aspx
I'm also wondering if she has rights under EMTALA to be transferred to a critical care unit which would give her access to the higher level of comprehensive care that she needs: http://www.ascensionhealth.org/index.php?option=com_content&view=article&id=146&Itemid=172