Physical Rehab, Reinvent, Retrench: Stupid Rules

January 22, 2012 at 7:25 AM (Physical Rehab) (, , , , )

Early going at rehab was all about the rules.  There was the bladder scanning every night for three days. WTF?  There were the usual annoyances about drawing blood at 5:00 am.  (“It could take six to nine tries.”  “No, I can do it.” )resulting in giant bruises (two days later), blown veins and irritation.  My vein walls were weakened by part of the chemo regimen all those years ago, and that means a simple blood draw can evolve into a painful circus.

The late husband who was in and out of hospitals for most of his life, patented the Brian Richard Flynn Guidelines for Bypassing Hospital  Stupid Rules, and I  learned most of them, and proudly execute them when able.

(thankfully this rehab place didn’t care about the two rules below anyway, but you get the idea):

For example:  Wear part or all of your own clothing rather than gowns or in addition to gowns.  The staff will freak out and tell you to stop.  Continue.  They will then freak out and tell your doctor.  If your doc is cool, they will say… “Let them wear the stuff. In their particular case the benefit outweighs risks.”  If not, then you got through three or four days of wearing clothes.

Ignore visiting hours.  Act as though you belong there.  Make sure you and the patient both show the benefit to mood, comfort, and even better vital sign results as the result of you staying.  Be polite, but firm.  Say you’re staying.  Nobody wants to call security on a devoted family member who is quiet and making no disruptions (but very well might start disrupting if not left alone)

But the thing about the bed…

I couldn’t get into it unassisted.

There are what I consider to be good rules in the hospital.  Listen and discuss and suggest with the docs and nurses.  This is a good rule.

Generally,  attempt to do what they tell you to do as far as treatment.  It makes the atmosphere less charged, and wonder of wonders makes it likely that you will have some success with the issue that brought you.  Not to mention that they are ostensibly the medical experts.  Unless you’ve gone to medical school yourself, they should know more than you do.

There’s a Stupid Rule.  Patients deemed at risk of falling *must* hit the damn call button for an assist every time they have to get out of bed or transfer one place to another.  After three days, they eased up on the daytime transfers, but never at night.  Even though it was clear to everyone that getting out of bed was no problem for me.

(I do understand that all of these rules technically serve a medical or litigation avoidance purpose.  I just think they’re dumb.  Ignoring them contributed to my sanity.)

I hate hitting the call button.  I respect the work good, competent nurses do, and if I can do something myself, I know there are patients in worse shape that they should best be spending their time on.

So I blew part of that rule off.  It’s a Stupid Rule.  I would get up out of the bed on my own at night, use the restroom whatever, and *then* hit the call button  because of the damn bed.

I’m short, and heavyset and on top of that my legs are shorter than they should be.  so the bed was too high.  They had to deflate it, and even then I could not raise my legs high enough to swing over…so they had to grab and at the right moment, put my legs back in the bed, and then re inflate it under me like some undersized waterbed.

There was some mild freaking out about this, but it did subside.

If you have a hospitalization, asses the sanity of the support staff and then after the first 24 to 48 hours categorize the rules into: 1. Agreeable  2. Don’t like ’em, but I will follow them,  recognize their value.  and 3.  Stupid and inapplicable in my case, and should be circumvented for my mental health if possible.

You’ll feel better.  Even if the staff doesn’t.  They’ll get over it.  It’s why they get paid the big bucks.

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At Regular Intervals Part I

July 18, 2006 at 11:29 AM (Hospitalization) ()

Three posts about my experience of being a “patient”

1970

I’m eight, or so in a room that has at least one other bed and three other patients, happy that my mom is there because the shots hurt. I had pain in my leg from a group of two operations that summer, and the shots are supposed to make the pain go away, yet they hurt. Mom believed I was sad or scared.

Actually I was mad. Mad at medicine that was forcing my body to experience pain in order to remove pain. I cry when I am angry, furious, enraged. But to the outside observer I am just a weepy little girl that needs to get over it. As it takes effect the nurses laugh at my high verbal explosion, a high from too much of a good thing.

The hospital doesn’t exist any more. It was known as St. Alexis back then. I am still searching for proof now, medical records, school records.

Mom was diligent about being there.
My father had just passed the bar exam and of course needed to celebrate.
So he showed up very late, very briefly, and I am told, still drunk, although he did not exhibit any obnoxiousness directly to me at that time.

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At Regular Intervals Part II

July 18, 2006 at 11:28 AM (Able Bodied Antics, Alchoholism, Doctors, Hospitalization) (, )

1975

I am thirteen. I’ve had a reasonable discussion with my physician. He makes me believe that my right foot needs to be steadied by fusing the ankle, breaking it (on purpose?) and resetting the bone so it cannot move side to side. I agree with him.

Mom, with all the facts in front of her is incredibly afraid that losing flexibility in the right foot will be worse for me in the long run. She cancels the sugery.

I actually fly into a rage and take her by the shoulders and *shake her.* How dare she decide what’s best for *my* foot!

She is stunned and actually afraid of me. I back down on the physical stuff but still take the (in hindsight ridiculous) position that at the ripe old age of thirteen, I am the one who gets to decide. I am left in my room to listen to another war of words between my father and my mother.

“Well, I agree with you, it’s probably a lousy idea, but you’ve got the kid *set* on it now, and once she’s set up for something…you see how nuts it is! But it’s a fact now. Now, we have to do it.”

With my father’s comfortingly lukewarm endorsement, I had that surgery.

Sometime during that stay, he also felt the need to show up completely wasted, loud, f*cked up during evening visiting hours, demanding to see me, terrorizing the candy stripers. “Where’s my daughter!!!!!!” The candy striper he yelled at came in later, after he was gone and gave me cookies and juice. I was profoundly ashamed . After all, if I was not a patient there, the werewolf would not have brought his chaos to them.

I had a horrible reaction to the general anesthetic that was used back then. So for 8 hours I was so puke o matic that I wasn’t aware that my right leg was killing me. Once the pain in that leg increased enough to register, I avoided the pain meds for as long as I could…did the white knuckle thing with my hands on the rails until 4:00 am. I remembered that last time the nurses had laughed at my rapid fire manic talking after I took stuff. So I was going to hold out. I was sweating and shaking by the time I buzzed the nurse for a painkiller.

Then Wednesday morning arrived. My orthopedic surgeon breezed in after a cheery round of golf, no doubt with some of his and my father’s mutual acquaintances, part of the Charming Drunks Who Thought They Ran Things Network.

“Well, and how are *we* today?”

I looked at him, cocked a brow and said, “I don’t know how *you* are, but I feel like SH!T!”

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At Regular Intervals Part III

July 18, 2006 at 11:25 AM (cancer, Hospital Staff Lunacy, Hospitalization, illness) (, , , )

1991

Friday, Valentines day. Lovers’ Day.

At about 2:00 my physician informed me that I had Hodgkin’s disease, a cancer of the lymph nodes.

Stage 3b which was basically one stage away from, ‘Get your affairs in order.’ They felt very strongly that it was important that my chemotherapy begin the following Tuesday. (Until, of course, it was determined that my insurance would not allow me to be treated there. Then, a three week wait for record transfer to a hospital *twenty minutes west on a city bus* was the best way to proceed.)

Out they went. In came my husband. For the next 45 minutes we talked about what this would probably be like. I tried to maintain a look of calm, as much for myself as for him. I had told him the night before that it was fine for him to go to Texas to visit his sister since we had both made plans to go. But my inside self was crazed with fear and begging him to *see that,* understand that, and stay behind, for me. 45 minutes after I was diagnosed he left for the airport, on that night that I was told that I too, might die young. My Mom and stepfather left also, shortly afterwards.

Discernment eluded both of us that day. He never understood that I wished him to stay and I never knew until much later that he wept during the entire flight down to and the whole visit was full of tears for him. “What will happen to her,” I am told that he wept often and wondered.

And the records nightmare after he and I returned home:

The hospital that I was *diagnosed* at first told me that my chemo abosolutely *had* to start the following Tuesday, due to the late stage of my cancer. Couldn’t wait. Had to rush in there and save my life, after all.

But magically the next day, they didn’t think it was so urgent. They did not want to treat me because they did not have a contract with my private insurer. But, there was another nifty hospital *five minutes by car* away, that *did* have a great cancer center as well, and a contract with my insurance carrier.

So I was slated to get my care there.

Slight problem. The doctors at the new hospital wouldn’t proceed without reviewing my medical records from the old hospital, specifically all the minutiae in the biopsy report itself.

This was just before the digital revolution began…so records were still on microfiche or in hard folders.

I called Hospital One *every day*

Records Toad at Hospital One: “Well, can’t you come and get them?”

Me, in bed technically terminally ill on the phone: “Actually no. I’m unable to get out of bed, and if you’ll check the chart, my husband has a serious immune system illness as well, and right now *he’s quite feverish and has a case of bronchits* so he won’t be LEAVING THE HOUSE RIGHT NOW!”

Records Toad at Hospital One:

“I don’t understand why your’re so upset.”

“Because I want you to give the records to a courier have the courier *walk outside* get on City Bus # [whatever the bus was] ride ten minutes west, get off the damn bus walk into the [Cool Hospital Beloved By My Insurer] and *give the biopsy results to the right person, NOW!”

Records Toad at Hospital One: I’ll have to talk to [xfdkdfijge]. And they hung up.

That went on for *three weeks* before I actually began the chemotherapy that saved my life.

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