Friday, July 17, 2009


This is one of the most heartbreaking stories I've read in a while.  

I wanted to mention it because, well, the story should get told.  I don't want to tie it into anything, but I think it runs along the same lines as the health care debate that's going on in our country.

I haven't researched much into the bill Congress is working on, or what President Obama is calling for.  I don't know what side I come down on.  

The only thing that gives me pause on the whole universal health care issue is my experience with a VA hospital.  Personally, my husband and I have great doctors, but we haven't had any reason to receive specialized or long term care in a military hospital.  However, this past winter, my grandfather had to be rushed to an emergency room due to complications from pneumonia.  Although he has his own private health insurance, he chose to go to the VA hospital in Fayetteville, North Carolina because it was the closest to his home.  

From the moment we arrived nothing went right.   

Years ago, Grandpa had to have heart surgery where one valve was replaced with a pig valve.  He was told if he ever picked up any type of infection, he'd have to see a cardiologist right away to make sure the replacement valve wasn't damaged.  Both he and my mother made this clear to the ER staff when they checked in.  It took three days before anyone told us that the Fayetteville VA doesn't have a dedicated cardiac unit.  It took almost a week to find out results from routine blood work because they don't have their own lab - they have to send out all specimens to another hospital in another town.  The hospital itself was in horrible's old, run down, dark, and I just felt dirty walking through the hallways.  The heater in Grandpa's room broke.  The radiator heater.  The whole hospital is heated with radiators.  Seriously.  Ancient college dorms and first apartments are the only buildings that should have radiator heat.  HOSPITALS SHOULD HAVE CLIMATE CONTROL.  This is a place where people need to be as comfortable as possible to get better, right?  So the radiator broke.  Grandpa was given 5 blankets to keep warm.  Of course we weren't going to stand for that...Mom made a huge fuss, as was necessary, and was able to at least get a portable heater brought in until maintenance came.  All the while we were waiting on the doctor's ok to transfer my grandfather to another hospital since the Fayetteville VA didn't have the basic equipment to do the most basic tests to check his heart.  

Let me say this again.  This hospital... The Fayetteville VA Medical Center DID NOT HAVE THE EQUIPMENT OR PERSONNEL TO DO BASIC TESTS.

AND they made us wait unnecessarily to transfer my grandfather to a hospital that could help him.

Since they could not do tests to check his heart, the doctor wanted to check Grandpa's colon.  Because Grandpa wasn't eating and complained of stomach pain.  So, he drank the gallon of solution (umm...that cleans out the colon...), but since he had a blood infection, he was constantly feverish.  Which meant the procedure couldn't be done.  I don't know whether or not the doctors realized Grandpa's infection would interfere with the colonoscopy, or if they were just hopeful they could get it done regardless.  Two days later (while we're still waiting on the transfer to another hospital) the procedure was rescheduled, and Grandpa drank another gallon of solution.  And yet again, his fever and condition prevented the test.  At this point, Grandpa had be totally cleaned out of anything in his digestive system, anything that was in there to provide nutrients...anything.  Because he wasn't eating.  He was finally put on an IV.  

Two different doctors told us two different things about his blood infection.  First we were told he had staph, a common infection in hospitals.  It's easily transferable however, so we told family members to stay home.  Only my mom, aunt, uncle, and I stayed at the hospital with Grandpa.  No one wanted to risk infecting others.  However, none of the nurses took precautions when around Grandpa.  No masks, no gowns, no sanitizing hands.  Then we were told it wasn't staph - but the doctors didn't know what the infection was.  This is when we found out they didn't have their own lab.  The doctors at the Fayetteville VA couldn't tell us what was wrong with Grandpa.  In any way.  And they weren't transferring him.  

After a week, a week spent talking to anyone in the hospital's administration we could, after pleading with the patient advocate, after witnessing complete incompetence, we were at our wits end.  I was so disheartened, so fed up.  One morning, Mom and I walked into Grandpa's room, and a nurse was there taking his vital signs.  He still had a fever.  He still wasn't eating.  He was wasting away in front of our eyes, and we felt totally powerless.  Later that day, around 3 pm, Mom called in the head nurse because it had been hours and no one had been in to check Grandpa's vitals.  The head nurse called in the nurse from earlier that morning to ask why no one had checked in.  She said she was busy, but she had kept to the required schedule.  I said, "But he has a blood infection.  Isn't that important to keep an eye on?"  The nurse just looked at me and said "I wasn't aware."  WASN'T AWARE?  How could my grandfather's nurse not be aware of the main reason he was sick?  She went on to say he only had a fever because he had so many blankets on him.  WHAT?  How crazy is that?  I lost it.  I had to control myself from yelling at this lady.  I told her that he had only one blanket for the past day, because thankfully the heater had been fixed at that point.  When I walked in that morning while she was checking his temperature, Grandpa only had one blanket on him.  ONE.  She sneered at me, and said, "Sweetie, you're mistaken."  SHE SAID THAT TO ME.  The nurse at the Fayetteville VAMC basically just called me a liar.  

Mom talked to the doctor one last time.  She told him that Grandpa needed to be transfered.  The doctor said the request had been put in, but no other VA hospital in the state had any open beds.  Mom said it didn't have to be a VA center, since Grandpa had other health insurance.  But apparently that's their policy.  Mom said she wasn't going to have Grandpa stay at the Fayetteville VA another night.  It had been too long, we'd been waiting because of promises that weren't getting fulfilled.  The doctor said his hands were tied.  
Mom then told him she wanted to take Grandpa home.  She'd personally take him to another hospital.  The doctor said that would be against medical advice, and since Grandpa was in such a frail state, it could be a fatal decision.  

With all of this going against us, knowing that the hospital Grandpa was in couldn't provide the care he needed, and was in fact making him worse, knowing that the doctors or administration weren't pushing another hospital to accept Grandpa's transfer, knowing that if we were to take matters into our own hands it could be tragic, Mom couldn't take it.  She threatened to sue.  She threatened to sue the nurses, the doctors, the entire hospital.  She told everyone she saw.  Within the hour, we were told a bed had opened up in the Durham VA, and Grandpa would be transfered that night.

I don't know if it was a coincidence or not (actually, I don't believe it was), but threatening legal action was the only way to get what we wanted.  What my grandfather needed.  My mom felt horrible about doing it, she wasn't proud to pull that card, but she didn't know what else to do.  

The Durham VAMC was a completely different experience.  Within a day, his blood infection was identified.  The next day he received the cardiac tests he needed.  It was confirmed that the complications from his bout of pneumonia, and then the subsequent infection from Fayetteville, did damage his replaced heart valve.  With specific IV antibiotics, the infections were cleared up, and the damage was repaired.  Grandpa was out of the Durham VA in a week.  

He's doing much better now, able to live on his own, his appetite is healthy again, and he has almost as much energy as he did before this whole ordeal.  The only lingering problem is that he has some impairment of kidney function.  Kidney damage wasn't a side effect of the blood infection or the antibiotics, but that's the only thing his doctor was sure of.  I recently had heard of a colonoscopy solution causing kidney damage, but it was for the pills that are taken with water.  However, I have my suspicions that when Grandpa drank two gallons of the prepared mixture (needlessly) within a few days, that would have something to do with it.

The only thing Grandpa has ever said about the whole thing was that he made a mistake.  He was adamant about going to the Fayetteville VA, and now he never wants to see it again.  Mom, my aunt, and uncle were upset that they let Grandpa talk them into going where he wanted to go, and not where they thought he should've.  
We don't dwell on the experience though, because Grandpa is doing so much better.

But it makes me scared for my future.  For Joe's future.  We'll more than likely be using VA hospitals.  At least I know what to expect, and I know I need to look into any facility we choose.  

That's all the worrying I want to do though - for myself and my family.  I don't want to worry about everyone else I know.  If universal health care causes more hospitals to work like the Fayetteville VA and the whole VA system, it won't be good.  I know I said the Durham VA was a great place, but I do have to mention that it works in conjunction with Duke University Hospital - a world renown hospital that's right across the street.  And really, do I need to mention the disaster of Walter Reed not that long ago?

Hopefully though, if enough people know about these kinds of mistakes and hardships, then in the future they can be corrected.  Maybe universal health care could work.


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