Thursday, February 9, 2012

Waste of Time, Resources & Added Stress to Families

Thanks to the ridiculousness of medical insurance companies my family spent most of last week both stressed & in the dark about what was going to happen with my Dad.

As I mentioned in a previous post he fell off of our friend's roof last Sunday. Well my father has Kaiser insurance but the ambulance would only take him to the nearest hospital. There are 3 hospitals in that area, 2 are about equal distance from where he was & Kaiser was the furthest away. So he went to "my" hospital (I've been in their ER & spent enough nights in it, I might as well call it mine).

While we were waiting in the ER my Mom called Kaiser to inform them that he was in the ER at this other hospital. They told her not a problem, they would coordinate with that hospital & she didn't have to worry about a thing. We were pretty impressed by the response to the phone call but we should have known it would go downhill after that.

After doing a full body CT Scan they determined that he shattered two vertebrae in his lower back (don't ask me which ones, I have no idea, never heard, not even sure my parents know which two). They said they would admit him because there was a radiology procedure that they could do the next day to help speed the healing process & reduce the immense pain that he was in.

So after he gets admitted we find out that Kaiser says they want him & they will do the procedure the next day. So the plan that night was that sometime the next day he would get transferred to Kaiser & have the procedure but he couldn't be moved until his back brace arrived which was supposed to be around noon. Well our Kaiser is pretty new & they've just started opening different departments & I know they don't do all the procedures at that hospital like they do at "my" hospital. So we weren't quite sure if he'd be transferred to our local Kaiser or somewhere else. Since I understand that hospitals operate in a different space time continuum than the rest of the world I told everyone not to expect him to be transferred until at least 3pm.

Well 3pm comes around & still nothing has happened. He didn't finally get his back brace until around 3:30pm and it was 8pm before he arrived at our Kaiser. Now the truly disgusting things begin to happen.

The EMT's that transferred him in the ambulance ask the hospital staff at Kaiser if they have a back board so they can move him onto the bed. They claim that they do not so they use what amounts to a plastic garbage bag to move him. This of course provides zero support for his back & he ends up crying out from the major pain again.

Since it's already so late that night they are told that he won't have the procedure that day, it will be the next day. Fast forward to Tuesday morning and the staff is on STRIKE!! (which they knew was going to happen that day). My mom arrives around 7am and sees what appears to be older lower management types all gathered in groups around the computers at the various nurses stations looking all lost & confused as they whisper to each other. She gets in the room & finds out that Dad had called for pain meds a while ago & had yet to get them so she calls again. They heard someone click into the room but then nothing so she goes out to find someone. They tell her oh yeah they'll be right there. After about another 30min of course she's ticked so she calls the 1-800 number & proceeds to tell the lady on the phone what's going on. She gets put on hold for a while & then the lady comes back & tells her who Dad's nurse is & that she is in the next room giving another patient some medication & she will be right there.

So more time ticks by waiting to see the doctor & find out when he's going to have this procedure done. Finally an orthopedic surgeon comes in to talk to him & tells him that well really it's up to the radiologist to determine if he's a good candidate for the procedure & that they'll have to do an MRI before they can tell. My parents said wait a minute, he had scans at the other hospital & they already told him he needed to have this procedure, didn't they have the scans? Oh, um, oh, well the doctor didn't know how to pull up scans on the computer & it took him forever to find a regular nurse (not a fill in or management) to find them.

So again another hour or so goes by & the radiologist comes in. He informs them that they won't do the procedure because they only do it on older patients with osteoporosis. If he's still having problems in 6 wks then they might consider it. WOAH!

Needless to say my Mom & Aunt are PISSSSED!! So after they find out that the complaints they are making on the phone will take days to be addressed they are overheard by a lower management person as they are talking about trying to go up to the 4th floor to find an administrator. This lady calls down an administrator for them who then takes them into an office & gets the scoop from them. Once my Aunt mentions getting the press involved (who was reporting that the staff strike was not affecting any of the patient care etc) she sends them back to Dad's room with a promise to be with them shortly.

She arrives a bit later with the Assistant Chief of Staff who finally gets the ball rolling. Turns out that the radiologist who told them that he wouldn't do the procedure, said that because he's never actually done the procedure on ANYONE! So they called in the head of Radiology from Manteca to do the procedure & expedited an MRI.

It was right around 3:45-4pm when all this happened so my husband left work early so that we could hopefully see him after the MRI, but before they started the procedure. They took him for the MRI at 4:30pm and even though we arrived just after 5pm we didn't end up seeing him until after the procedure because they took him straight over to wait for the procedure to be done.

Don't ask me the name of the procedure but basically they inserted a catheter & as they continued to do scans to monitor the progress they injected a sort of resin into his back so it would ideally fill in the vertebrae with cement.

It was about 8pm when we got the call that they were done with the procedure & everything went great. We got to see him shortly afterwards & then went home. The test of how well the procedure went would be the next day when they got him up to try & walk. If most of his pain was gone then it worked.

Everyone was greatly relieved (though the nurses went into a panic) when first thing the next morning Dad had Mom help him get up out of the bed to try to walk (an alarm went off when he got out of the bed & 3 nurses came running). He said that 80% of his pain was gone. He did so good that morning that he even got to go home later that afternoon.

He has to wear a back brace when he's up moving around but he looks so much better & he's getting around pretty well. He has to have help getting up & down right now & help getting the back brace off & on but they said that this procedure basically jumped him ahead 6 wks in the healing process.

The really frustrating thing though is that if it wasn't for the fact that Kaiser just HAD to take him from the hospital that was ready to do the procedure almost right away, to their hospital, he probably would have been home Monday night, instead of Wednesday afternoon. Seems like such a waste to me. Luckily my parents aren't supposed to have any sort of co-pay, otherwise they'd probably end up having to fight over the fact that he was only in the hospital so long because of their incompetence.

I said that it sucks that we're having to pay so much more money but I sure am glad that I am not a Kaiser patient. I just don't feel comfortable trusting my family's lives to Kaiser. When Keegan was born they were contracted with a hospital nicknamed "The Killing Fields" (the new hospital wasn't built yet). I told my husband I didn't care what we had to do but I WOULD NOT give birth at that hospital.

Even though I'm not pregnant & not planning to be having another child before this year is over (we haven't completely ruled out a 3rd but won't decide for sure til Piglet's at least a year old) we're paying even more money this year just to stay off of Kaiser. I was already scheduled to have the surgery to remove the metal plate & screws for my leg. If I would have switched to Kaiser I wouldn't have been having surgery as planned. I would have to see a whole new orthopedic surgeon & start from scratch. Plus I was still having heart problems & going to be having tests run at the end of the year & no way did I want to start all over with that. Now that I'm most likely going to have an ablation I'm even more thankful that we chose to stay where we are because Kaiser does not do that procedure here. We would have to travel to the bay area for me to have it done. With my current insurance I get to have it done at "my" hospital & they even want to keep me overnight for monitoring instead of just sending me home like Kaiser did to my sister in law (they didn't even successfully complete the ablation with her because they couldn't find the spot).

Now I realize that some people have no problems at all with Kaiser but a lot of people do. I just don't trust them & felt the need to rant about the crap that we went through. I will say that my Mom was very happy with the service & responses that she got over the phone. Just when she found out that it would take a few days for her complaints to be addressed she was not about to wait anymore. Also the Assistant Chief of Staff told her that he thought the procedure was taking place as planned when they had him transferred. He told her that if he would have known that this was going to happen he would have left him at "my" hospital & let them do the procedure on Monday.


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