Wednesday, September 30, 2009

Getting sicker

Due to unexpected setbacks, my father's condition has been mired by more complications. 

Dad went in for minor surgery to have a cyst lanced. It was then the doctor realized there was a much deeper infection spreading through his body. Not surprisingly, Dad became infected with MRSA while staying as a patient in the hospital. This super bug is often hospital acquired and penicillin resistant.  The staff required Dad to wear hand mitts to prevent him from pulling out his IV drip of Vancomycin. A low-grade fever meant he had to spend additional time in the hospital. 

There is a grain of irony to this dramatic turn of events given that I have spent many months working on a MRSA prevention online project, immersed in the topic and visualization of the infection. 

PROCEED with CAUTION: The next turn of events could be described as grisly in nature.  Do not continue reading if you are sensitive to visually graphic content. 

Dad had a peaceful final evening at the hospital. He seemed to be improving. But, just hours after being readmitted to his nursing home, Dad appeared agitated over dinner. They call it sundowning. 

When escorted to the bathroom by a nurse, Dad ripped the catheter out of his penis. Blood went everywhere. It was worse than a fishing accident. The look of horror on the faces of the nursing staff spoke volumes as they left his bathroom. I am still shaken from what was relayed to me by my family over the phone.

When I saw Dad last, we found him strapped to an arm chair.  His swollen bare feet dangled from his chair. He was wearing somebody else's dirty clothes; but he was communicative.  He recognized us. 

His goals at the hospital: to allow care and not to hit.

I was touched with a sense of tenderness for Dad, maybe in ways I could never express before he became ill, all the time focusing on his beautiful hands to give me for sense of comfort and continuity.

6 comments:

Medawar said...

See:
http://www.dailymail.co.uk/health/article-1218666/Chemical-cosh-given-dementia-patients.html

This is infuriating: the issue was raised, several years ago, with regard to specialist geriatric wards and nursing homes, and eradicated from there in the UK as very definitely not best practice. But any senile patients on general medical or surgical wards, or ones that the staff think are senile, are evidently still at risk.

However, at least in the UK there's a national newspaper willing to expose and kick the medical profession's backside for doing this.

Perhaps automation of medical care will effect an improvement, as AI physicians could be programmed to obey Asimov's three laws rather than the humanistic substitute for the Hippocratic Oath now employed by many medical schools.

Medawar's best wishes to you and your Dad, perhaps Medawar's uncle knew what he was doing when he returned to being a National Rowing Coach after a four way bypass operation.

Medawar said...

MRSA is not an insoluble problem: Bedford Hospital did a lot by making day surgery patients have a shower first: this measure had been dropped because "it implied that patients were dirty" well, everything from outside the hospital is dirty in surgical terms.

They also benefited from a South African surgeon pointing out that it was pretty pointless getting visitors to rub their hands with alcohol gel, if their shoes went untreated.

If you enter a farrowing shed on a pig farm, you have to tread on a disinfectant mat. Why not when entering a hospital ward?

Bedford hospital managed eight straight months without an MRSA infection and with very few C-diffs, this is in stark contrast to certain other establishments in the region, such as Hinchingbroke, which has a truly terrible record.

Generally speaking, the primary source of infection in any hospital sits behind a big desk marked "manager" and makes policies on cleaning contracts and so on, that lead to certain places never, ever, being cleaned, whilst others on the checklist are scrubbed several times a day.

The Tory party has just said that if they get elected, NHS trusts and other public services will need written permission from the Chief Secretary to the Treasury before they can pay their executives more than the Prime Minister's salary. Many managers now face the appalling prospect of having to live on £180,000 or less per annum!

Medawar thinks this policy was actually prompted by a computer analyst with the Youth Justice Board who was getting £340,000 pa despite only working a four day week, and was also getting his air fares paid, between London and Newcastle each weekend, which was why he didn't want to work Fridays. When Medawar read this story, for some reason, the words "tip" and "iceberg" came into his mind.

Medawar said...

You are not alone in articulating this peculiar kind of grief:

http://www.dailymail.co.uk/health/article-1222548/John-Suchet-grief-discovering-wife-Bonnie-Alzheimers-guilt-putting-care.html

This gentlemen, John Suchet, is an ITN newsreader and the brother of the actor, David Suchet.

Kat Gregory said...

Thanks for sharing, Medawar.

Medawar said...

See:
http://news.bbc.co.uk/1/hi/health/8356423.stm

Medawar really did think this was sorted out a few years ago. Evidently, either a false impression was given at the time, or the medics obeyed for a little while until no-one was looking and went back to killing patients to make life easier.

Anyway, this is definitely wrong and there is now authoritative scientific advice that using anti-psychotics on dementia patients can kill.

Kat Gregory said...

This link really blew me away. Thanks.