Thursday, May 13, 2010

A Brush with the American Medical System

My wife fell. She fell on her way into the school where she teaches. Once it became obvious that she couldn’t get up they called the local police who in turn called for an ambulance.

While waiting for the ambulance to arrive, she called me at work on her cell phone. It took me a minute or two to absorb what was happening, but once I caught on, I told her I would meet her at the hospital. I fired off an e-mail to people who needed to know I was leaving and scooted out the door.

She was on her way to Valley Hospital in Ridgewood New Jersey and I managed to arrive about a half hour after I left work. I decided to pass on the “Free Emergency Room Valet Parking” (I kid you not), found a parking space in the rather crowded lot and made my way toward the Emergency Room entrance.

On the way I’m scouting out where I can bring my car later to limit how far she has to walk since I’m figuring she’s bound to be a bit sore. Uh-huh, little did I know.

The Emergency Room’s small waiting area was completely empty. I asked the lady behind the window where I could find my wife and she directed me to room 18.

Room 18 was empty. A nurse asked if I was looking for my wife and when I answered yes, she informed me she was being X-Rayed and I should wait there. While I was waiting a hospital administration type showed up and started taking down vital information such as verifying our insurance coverage.

The very first question she asked me was what synagogue we attended and my eyes almost popped out of my head. All I could think to say was “excuse me?” Then I remembered my wife would probably say Jewish if someone asked her religion.

In the middle of this they wheeled my wife back in and I got further details on what happened. While we were talking a nurse came in and asked if my wife wanted something for pain and my wife declined.

In about fifteen minutes the doctor on call came in and informed my wife that she had broken her hip. The look on both our faces must have been classic because that was about the last thing either of us expected to hear.

Up until now the process had been sort of laid back, but now things went into high gear.

1. A series of pre-admission tests were administered including an electro-cardiogram and a blood pressure test.
2. Someone showed up to take blood.
3. Someone came in to collect another series of information related to medical history, prescriptions being taken and a whole bunch of other stuff.
4. My wife’s primary care physician was notified.
5. The nurse attached an intravenous bag
6. An orthopedic surgeon on call was recommended and accepted.
7. A hospital case worker showed up to explain the intricacies associated with Worker’s Compensation because the accident had occurred on school grounds.
8. We found out that there would probably be weeks of rehabilitation required.
9. The surgeon ordered a cat scan to better gauge the extent of the damage.
10. The cat scan was duly performed.
11. A temporary spare bed was located and my wife was transferred upstairs.
12. The nurse on duty collected another bunch of information and offered my wife something for pain which my wife declined.
13. The surgeon showed up and explained the situation and what needed to be done.
14. The surgeon put her on the operating room schedule as sort of a stand by passenger. The surgery would be performed as soon as an opening on the operating room schedule allowed but not until at least 8 hours had passed since she had eaten breakfast and my wife’s primary care physician had certified she was healthy enough for surgery. That meant sometime that evening.
15. The doctor covering for my wife’s primary care physician showed up, got the information on what happened, examined my wife and certified her as healthy enough for surgery.

By the time all of the above had transpired it was about 2 PM. Now it was simply a matter of waiting for the call to go down to the operating room. Nurses or aids popped in and out every once in a while but basically it was just wait.

Around 6:30 PM word came to bring my wife downstairs. I tagged along behind carrying assorted debris such as her clothes and pocket book. I have it on good authority that I looked just charming with her purple handbag slung over my shoulder and banging up against my purple shirt.

Outside the operating room we got information from the anesthesiologist (would you believe I spelled that right the first time? I’m impressed with myself) and the surgeon took down my cell phone number as they proceeded to kick me out for the next three hours.

I went home; let the daughters know what had happened and, along with my youngest daughter, headed back to the hospital after wolfing down a dinner of pizza. On the way we got a call from the surgeon that everything went ok and that she would be in recovery for about another 45 minutes or so.

At the hospital they directed us to the waiting room on the orthopedic floor.

When my wife arrived she was groggy and nauseous. Nurses and aids hovered around her doing what they could. Later she would tell me that she had only the vaguest recollections of that evening but she was aware that I and my daughter were there. Eventually she fell asleep and we went home until the next day.

That was actually a week ago. Since the accident occurred on school grounds it was in fact a Worker’s Compensation issue and the hospital case manager has handled just about everything.

My wife spent three nights in the hospital and then was transferred to a rehabilitation center. Worker’s Compensation has approved a two week stay. Hopefully it will take less time than that. I’m not sure what happens if she needs more time but there is also a case manager at the rehabilitation center that strikes me as very competent and up to speed on how to play the system.

To further complicate the issue my youngest daughter is graduating with her Master’s Degree at right about the end of those two weeks. My wife is adamant that she will go to that graduation. Exactly how we’re going to pull that off is a little unclear but we’ll work something out.

At the moment my wife can hobble around using a walker but spends most of the day in a wheel chair. I have no idea how she’s ever going to get to where she was. It was her right hip that she fractured and she needs that leg to drive.

The big problem at the moment is negotiating stairs and we have stairs all over the place. Our house is called a split colonial. You enter into a foyer area with what we call a playroom straight ahead with a short hallway to a powder room and the laundry room. You then go down 5 steps to the family, room where the main TV is, or up 6 steps to the living room, kitchen, dining room and exit to the deck. There are then another 7 steps to the bedrooms. Our shower is attached to our bedroom. So she has to be able to negotiate steps, but so far this hasn’t gone well.

None of the levels have everything. The main level would probably be the best center of operations as it has access to food, a convertible bed, the main computer and the outside but she would still have to negotiate up or down for the bathroom and showering and I’d probably have to get a TV in there somewhere. I also think I need additional railings on the stairs and I’m not exactly sure how to work that out.

So far, I have no complaints about the way things have been handled. This isn’t terribly surprising because we’re talking about upper middle class Bergen County here. One of the surgeon’s assistants has a child in first grade in the school where my wife teaches 2nd grade. The surgeon told me he said they had to do a good job because my wife might be his kid’s teacher next year. Two of the physical therapists at the rehabilitation center are from town and know my wife as well.

So basically we’re in good hands and, at least so far, I've been reasonably impressed with the competence of just about everyone we've encountered.

The concern is what happens from here. It’s incredible how your life can change in what amounts to a blink of an eye. It could be a lot worse so we’ll have to just plug away. More on this in the future I’m sure.

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