Shirley - a medical emergency

[Greg Beetham]

I'm not totally impressed David, they could have done a CAT scan right away to see what was what, to see if the pill story was the cause of the problem....hmmpf!
What if the thing had lodged before reaching the left and right fork, or what if it had partially lost integrity and large bits of it went into both lungs...
You are very lucky my friend...I reckon you should go and buy a Lotto ticket.
Greg

[David Kilpatrick]

We are not impressed either; the hospital is a very well run, lovely place with great staff but the culture is very 'passive'. Today they realised they do not have the right equipment to extract such a large pill (it appears to be almost intact) and I had to dash over to get Shirley's personal belongings as she was about to be transferred to Edinburgh Royal Infirmary - but by the time I got there, they had decided she would go tomorrow morning, so the pill spends another 24 hours in the wrong place. She has had a collapsed lung for at least five days, possibly nine days.

This is public health care, and generally it works well, but it is heavily geared to the most common conditions and routine treatments. The CAT scan is considered an expensive diagnostic tool to be used sparingly. Maybe in the US, where a charge would be made by the hospital to the patient/insurance/Medicare, a CAT scan would have been preferred to the more harmful procedure of chest X-rays - and would have located the problem on admission. But that does not happen here.

David

[Birma]

I imagine that the delay is very worrying and frustrating for you both. Best wishes to you both, and hoping that there is a speedy resolution.

[Dusty]

Any word yet? Still praying.

Dusty

[Juanito200]

David- I hope that they can lavage/ extract any and all fragments under bronchoscopy. I wish her a speedy recovery. I hate to hear that they waited so long to do a CAT scan.. It is so frustrating when the medical staff doesn't listen to you, or discount what you are saying. Here in the states I often see a whole battery of tests done for no good reason other than CYA...This is definately one time where the more expensive and higher radiation test of a CAT scan (had it been done early) would have eliminated suffering, and lessened time in hospital. I hope for a speedy recovery for Shirley. Please keep us posted. It sounds like she still has a few days in the hospital ahead.....

[David Kilpatrick]

The consultant told me the procedure took 90 minutes as the pill had broken up - instead of an estimated 5 minutes which would have been needed had they got hold of her sooner. She's going to have had at least four regular chest X-rays as well anyway. She is fine, talking, lung now cleared of fragments (to the best of a very good surgeon's ability), still collapsed. She will be in for a few days for recuperation, monitoring, physiotherapy to get lung fully opened up again.

It's very hard to be angry with the local Borders hospital as they very clearly care, and look after people well. This should not have been out of their depth, but it was. Shirley says the ward sister gave her hug when she left (Shirley is a useful patient to have around, as she always helps other patients who can't communicate or do things for themselves). Now she's in a real space-age facility with its own shopping mall. The Edinburgh nursing staff seem just as dedicated.

Never forget that all this is paid for, there is no hospital bill to follow. I do have to pay for my parking as a visitor, but the Scottish Government has announced that all charges for parking at hospitals are to be abolished. This is the same Government that provides completely free medical and personal care for the elderly. Ten years from now over 55% of the population of my region will be over 65 (including me) and I have no idea where they think the money will come from.

David

[Dusty]

I'm glad to hear everything is finally going okay.

As to the hospital bill... you already paid for it - in your taxes. When users are more than the payers, they'll just cut your benefits. They always promise they won't but they do.

Dusty

[peterottaway]

I live in a country town remarkably similar in size and in distance from its nearest major hospital as David and Shirley and I hope that their local medical administration is learning something from this. Good and timely health care are never inexpensive but cheap costs big time whether it is building standards, equipment purchases or in staffing levels and ratios.

Having spent some 30 years with the Australian federal government and dealt with many different state, local and private organizations, I am of the opinion what much more can be achieved even with what is now being spent. Many arrangements reflect past circumstances, problems and populations and their administrations more about old arrangements than they do about decent service delivery. As a cousin commented a few weeks ago at he doesn't miss his professorial office or the four P's ( Power, Patronage, Prestige and Patents).

The passive attitude that David mentioned is very common reflection in an organization that is being pressured year in and year out to do more and to change to altered circumstances without proper training and support measures. Staff and supervisors face weekly, monthly, quarterly as well as yearly reviews on costs ( less often on quality outcomes) and where changes and new services have to be implemented from existing resources. And then before the last reorganization is completed let alone bedded down the next reorganization is announced. These may look good on the lord and masters CV and to justify the size of his bonus but plays hell with service delivery.You can't do your day job, update your skills, reorganize, retrain your staff, read all the reports, attend all the meetings and collect all the new statistics required from systems that don't provide them in the format now required.

To Dusty I would add that Australia has a population of 20 million spread over an area the same as the continental USA and has a mainly public health system that costs less than 9% of GDP. I would also say that although some private companies were a good as they come, most were not. And unless forced into using them, they were not preferred for essential time or performance segments of a program. They have a different cost/ service delivery attitude which meant they were often not structured to actually deliver what was required 24/7/365.

[Greg Beetham]

Well I must say, that's a relief....finally, Shirley should recover rapidly now the scource of the irritation and blockage is gone, most of it anyway. Now we can all breathe a tad easier....

For me it's an illustration of what's wrong with the hospital system, (same here) we should be able to expect a hospital to just focus on doing hospital stuff, not being a nursing home for the aged, (should be a seperate institution) or a bureaucracy for civil servants. We really need more professional oversight/assessment/intervention on individual cases 24-7 I think.
Greg

[aster]

Shirley;

I'm happy that your health is in a more favourable state and is improving concerning the past week's unfortunate events.

David,

Thanks for keeping us updated. Must have been an exhausting ordeal.

My sympathies to the both of you and good luck!


Yildiz

[Birma]

Great to hear that Shirley is on the road to recovery.

[Dr. Harout]

Anybody care to celebrate that?
OK, rephrasing my question: anyone for a cup of drink for the good news?

[Javelin]

I only have blended scotch on hand but i'm going to get a glass now... neat. but maybe later i'll mix it and skip work in the morning

[David Kilpatrick]

Shirley has been told of all the well-wishing comments (she has a load on my Facebook as well) and she's feeling very good right now. The operation has not left her with a sore throat or difficulty talking, in fact it seems to have improved things. She will be transferred back from the mothership to the local satellite tomorrow, and have to do some sort of physio to get the lung back working properly.

David

[Juanito200]

Huzzah!