Tuesday, February 15, 2011

Do Not Be Alarmed

Years ago, when a person was subjected to a serious illness, injury, or extreme medical care, they kept that person in the hospital, which was staffed with people who knew what they were doing. Various tubes might be attached to the patient, and various things might ooze from the patient, but those were all taken care of by doctors and nurses. Mostly nurses. But the point was most medical care was tended to by medical professionals.

Nowdays, though, hospitals prefer to "release" patients to their homes "where they can be more comfortable" much earlier. This allows patients to recover from whatever happened to them in a comfortable home setting. It also happens to keep costs down but that's just coincidental. It does mean that patients with serious holes and tubes and needs are often cared for by family members or, in some cases, by the patient themselves.

In order to give the patients, caregivers, and the hospital's attorneys a fighting chance, patients are wheeled to the door of the hospital carrying lots of "discharge instructions." These instructions can go on for pages and pages and can get very specific. Generally, though, most of the bulleted items in the instructions fit in to one or both of two categories:
  1. Things to do that are normally done by a nurse, and
  2. Things you can't say we didn't warn you about.
A third category is of reasons you should NOT visit, call, or otherwise disturb the medical professionals. For example, you may see a line like this:
When you [do a regular activity], you may notice blood coming from your [body part which does not normally produce blood]. Do not be alarmed.
I've been compliant with all kinds of medical directions, and I have followed printed instructions to do all kinds of unusual and most unnatural things to myself, but I'm afraid this is one directive with which I can not comply. When I see blood come out of certain parts of me, I find that alarming.

I'm sure they created these instructions to reduce emergency room trips and late night calls saying "I'm bleeding from my [very important body part]!!". I get that. But it's still alarming. At this point it wouldn't surprise me at all to see instructions like:
At times, your [important body part] may detach itself and fall down your pant leg. This is normal. Simply apply antibiotic gel and reattach using the paper tape supplied in your post-operative kit.
At the end, of course, are always a list of conditions under which you should call. For example, one sheet says I should call if I experience a fever over 101 degrees F or if I have "excessive bleeding". The temperature is an example of a nice, concrete indicator I can use to determine if I should call. If the thermometer gets to an exact temperature, I call. Indicators like "excessive bleeding", however, are more open to interpretation. I don't like seeing blood come out of any part of me, so my threshold for what I consider "excessive" is probably lower than that of the average doctor or nurse. This morning when I first saw blood coming out of my [body part from which I don't expect to see blood], I considered that 100% excessive, I became quite alarmed, and I wanted to call.

Fortunately I have a follow-up appointment later this morning so I can tell them about it then.

I wonder what it would take to get a siren for the top of Sarah's car?

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