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Monday, February 18, 2013

Home Again, Home Again, Jiggety Jig! (If only it were that easy...)

On Wednesday afternoon, Bob was discharged from the hospital. That was the first time that I saw his primary care doctor at the hospital (except once, I recognized his back, going down the hall). The first words out of the doctor's mouth were, "Let's get him home, before he catches something."

Nice to know, even the doctors think hospitals are nothing but a bed of germs....

So, the primary care doctor leaves to fill out the discharge paperwork. And the nurse comes in to take out Bob's IV's. Then she leaves. Then she comes back with the paperwork. And I say, "Um, you still need to take out the Foley catheter."

She tells me that they do not have an order to discontinue the Foley catheter. That Bob is being discharged home with that tube stuck up his penis! 

I'm thinking, What the f--?!

I say, well, this must be a mistake. So the nurse goes to get the doctor, but the doctor, like Elvis, has already left the building. So, she calls him on the phone.

When she returns to Bob's room, she says that the doctor told her that Bob was, in fact, being discharged with a Foley catheter. This, because, he has bladder retention. The doctor also says that I should take Bob to see a urologist ASAP. That Bob needs to have tests run for bladder retention and also, the urologist should scope the bladder to make sure there isn't an obstruction.

I tell you, I nearly hit the roof.

I mean, this is not some doctor/stranger----this is Bob's primary care doctor who should know better. Bob already has had neurogenic bladder testing and the urologist already knows that Bob has bladder retention and prescribed intermittent catheterization (which I already do) and on top of that, we were just at the urologist's office last week and Bob's bladder was "scoped" for obstructions at that time.

I tell the nurse all of this, but she refuses to call the doctor back. She insists that Bob has "serious bladder retention" and it would be "dangerous" to take the thing out. And the only one authorized to remove the Foley catheter, she says, is a urologist and I must take Bob to see one.

Lord almighty. I was ready to strangle that primary care doctor. And that nurse.

For one thing, I can't believe a doctor would leave an order like this, without speaking to me and Bob first.  I mean, really, would any doctor discharge a patient with a indwelling catheter and not explain/tell them about it and discuss it before discharge? What about personal choice in this matter?This is just another example of people, especially so called medical professionals, treating Bob as if he was less than human. That honestly just pisses me off. Bob has aphasia, but he is not an idiot.

And another thing. Does this doctor realize how much this is going to cost us? A completely unnecessary doctor's appointment with a $40.00 co-pay and the cost of wheelchair transport. And for what? Just to have the urologist yank the thing out. Because we were just there last week. And Bob had a full bladder exam and the urologist changed Bob's overactive bladder med and gave me a script for external condom catheters. We left that doctor's office with poor Bob soaked with urine, his wheelchair soaked with urine, because they couldn't get Bob up on the table and did the "scope" exam in his wheelchair. I had a mess on my hands when we got home. And I certainly wasn't looking forward to going through that again... I mean, give me a break.

To say the least, I was pretty livid when we left the hospital. The first thing I did when we arrived home, after I got Bob situated and comfortable, was get on the computer and google "how to remove a Foley catheter". Because, I tell you, this is one caregiver who is not afraid to take matters into her own hands.

It didn't look too hard. Except you need a special syringe to draw the fluid out of the balloon in his bladder. So, I called a friend, who is a nurse. And she said that she could stop by on Friday and yank the thing out for us.

She also said that I may want to think twice about taking it out. Because it's convenient. Especially for the caregiver.

On Thursday, I took Bob to see his Pain Management doctor. We went with that Foley catheter connected to a leg bag. And it was convenient. First time, ever, we went out and didn't spend half the time in the men's room.... but that's why I asked for the external "condom catheter" prescription from the urologist.

We had gone to see the urologist the week before because Bob's overactive bladder symptoms have changed. Used to be, he had "urge incontinence" meaning he felt like he had to pee and couldn't. Now, it seems, he's peeing every freaking 15 minutes. I kid you not. And that is driving me nuts. Especially when we go out.

After that appointment, the urologist sent a script for condom catheters to a home health agency. Who sent a nurse to our house to "teach" me how to use them. More on that, later....

Anyhow, my friend, who is a nurse, arrived on Friday and took the blasted Foley catheter out. And Bob peed just fine, 15 minutes later. And he continues to pee, every 15 minutes....

But I am glad to have him home. First time, I got a good night's sleep in a week.

A couple of people had told me to take "advantage" of Bob's time in the hospital and get myself some well deserved "respite" from 24/7 caregiving. But I tell you, I really missed him when he wasn't here. Weird that.

We see the primary care doctor this week for a follow-up. And you can bet, he's going to get a piece of my mind.


Anonymous said...

Let the doctor have it Diane, he should never have left you and Bob in that position with the catheter.

Having had 3-1/2 yrs of experience with the Foley catheter during my wife's care, there is one major concern/problem using it. Infection, particularly UTI's are prevalent when they are used for extended periods of time. There is just no way to keep bacteria from entering the urinary tract with the Foley catheter. Bob is much better off avoiding the Foley catheter if at all possible. Unfortunately for my wife, we didn't have any other choice due to her constant draining. Good luck.

Hugs, Dan

barbpolan said...

It looks as though you SHOULD be taking things into your own hands - as you have all along. Kudos to you.

J.L. Murphey said...

WTG Diane! Keep fighting for what you know is right. They placed a foley in me for six days! I had a raging bladder infection before I asked the reason for the placement and continued placement. I almost hit the roof when I was told urine retention. I've never had that problem in my life.

They pulled the foley and I proved to them I knew what I was talking about. Geez, convenient for whom? Them.

Glad Bob is home with you caring for him.

Rebecca Dutton said...

The lack of coordination among doctors is terrifying. I keep reading about a "hospitalist" who coordinates care, but I don't know anyone who has used one.