Glenn H.
Yelp
This occurred starting on Tuesday Dec 22 when my wife was having trouble breathing. I then asked that she be placed on oxygen. Wednesday, no improvement so I asked that she be placed back on her albuterol treatments. no improvement.
I was given permission to spend the night with Charlotte on Christmas Eve and spend Christmas day with her by your staff which I appreciated, but as we progressed through the day on Christmas Eve, Charlotte continued to decline, rapidly.
She became delirious, disoriented, and confused, complaining of cramps, that she was hot, that she was in pain, her respiration went to between 52-60 per minute and very shallow. she was demanding that I "take her to the hospital" and while I repeatedly assured her she was in a hospital and a good oneb she didn't understand, and continued to ask to be removed from your facility, in hindsight, I probably should have done so.
They gave my wife and additional valium beyond her scheduled three to calm her down, along with her restoril 30mg(she only receives 10mg@home) Charlotte remained in an agitated and painful state.
Everyone is wondering what is going on when I inquire about her pain medication and if she is being given anything for breakthrough pain, since being in your facility she has been on a much reduced dose compared to what she receives at home, 60 mg ER 2x30mg tid in your facility vs. 2x30mg tid at home with an allowable 7.5mg IR hourly prn, at home she averages between 90mg and 120mg or so daily, so was already partial withdrawel with the reduction while in your facility, but what I found out next is inexcusable.
Apparently, your facilities use a medication management software program, which allow medications to "drop off or fall off" the chart for administration if not re-authorized by the physician. Also, this program gives prior notification if a medication is up for re-approval which is sometimes noticed by your nurses and staff and relayed to the Dr. it is not their job to do so, and the re-authorization and continued prescribing of the medication is the Dr.s responsibility.
Well, either Dr. Modh or Dr. Patel, failed to re-authorize my wife's morphine on 12/21 one day prior to her beginning decline, and by 12/24 Charlotte was in full and complete physical withdrawel from her morphine, and I am sure you are aware how taxing and stressing this is on a reasonably healthy patient taking this for pain management would be.
But, imagine how horrible it would be to a patient who is as fragile, brittle, and weak as my wife is? she has less than 20% of a heart, multiple strokes, tias, cerebral events, already being treated in a weakened state for infection control, and prior to the 21st she was recovering, able to feed herself, able to push herself up in bed, alert, awake, and conversational, now she is none of those things, and I honestly feel had we not recognized the mistake and problem on Christmas Eve, my wife would have died on Christmas Day.
What a wonderful legacy you would have given to Me, and my, and her family and grandchildren. Such a great way to remember Christmas it would have been, but I digress.
In addition to giving her an additional non-prescribed or non-scheduled dose of Valium to relieve her agitation and anxiety, staff was ordered to give her 1mg of IV Ativan push, now between her receiving her necessary Morphine, the valium, and the Ativan, she was able to finally calm down and sleep, then until the next morning, Christmas Day when neither I nor staff was able to rouse her.
It took hours to get a Dr. on the phone to get her moved to CCU, and then staff finally did it, prior to having full approval to do so, I did appreciate that fact.
Then they figured out to give her an antagonist to counteract the diazepam and lorazepam, and guess what.... she woke right up and was alert and conversational, again, she has reduced renal and hepatic and coronary function so all of these meds were backing up and not processing through her system quickly enough, they did not use naloxone so her pain management and reversal of withdrawel remained controlled.
She was moved back downstairs, and everyone was trying to get a CT scan ordered, along with more x-rays.... again it took forever to get the Dr.s orders, and she did not receive the CT Scan until after 7 pm last night.
The X-ray results show additional pleural efflusion in the lower lobe of her left lung, and the CT scan shows more shadowing/brain damage, which I fully believe was brought on by her heightened blood pressure while in Crisis and Withdrawel caused by inattention, negligence, and useless software.
I do not blame your staff, they did everything they could, or knew how to do, but the lines of communication were FUBARed between staff and doctors, and this entire situation could have been avoided had my wife been receiving her pain medication as necessary, and the ball was dropped by Dr.s Patel and Modh. I caught these errors not staff or Doctors.