more on the hospital visit(s)

[Guest guest]

Thanks so much to all of you for all the love and support you have shown me.

I did go to the hospital today and spent two hours reading my chart. I got

names, places, and times to add to my complaint. I'm going to copy and paste

in the very long, detailed letter I am sending to the hospital. I also talked

to the CFO at the hospital and he is going to relay my story to the nursing

supervisor. She was off today but he promised she will contact me. He said he

had thought their ER was getting better. I told him that with the exception of

this one doctor, the ER was great. I told him that my complaint did not center

at all around the four hours it took them to get me to the treatment room. I

understand that sometimes there are just many more serious patients than usual.

Anyway, I have now had my say with names and everything, so I feel much

better. Oh, I also discovered that my horrible 'nervous' reaction was caused

by the reglan and not toradol. According to my chart, I was only given reglan

on the hospital floor even though the nurse said it was for pain and nausea.

Here's the letter I wrote. WARNING it is long!

B. Weston

1410 Hayden St.

Athens, AL 35611

November 11, 2002

Athens-Limestone Hospital

700 West Market St.

P.O. Box 999

Athens, AL 35611

ATTN: Philip E. Dotson, administrator

Dear Mr. Dotson,

After reviewing my charts from my last three admissions to Athens hospital, I

have more information in regard to my complaints indicated in my two previous

letters.

Below is a chronological list of the events that took place:

10-16-02

admitted under Dr. Boone's care with a diagnosis of abdominal pain

Dr. Boone's orders

Morphine 5 mg IV every two hours as needed for pain

Phenergan 25 mg IV every 4 hours as needed for nausea

10-17-02

10:45 a.m. Dr. Boone's orders

discontinue the Morphine (at my request)

Demerol 25-50 mg IV every 2 hours as needed for pain

10-18-02

7:55 a.m.

B. DeFoe, LPN, charted the following note

" abdomen tender, constantly c/o nausea but requesting graham crackers after

meds given IV, denies emesis "

I'd like to offer my explanation. Once I have had a day or two of no food and

my stomach has rested, I reach a point that the nausea is made worse by having

an empty stomach. At that point, something light with carbohydrates helps

combat the nausea. It is obvious that Ms. DeFoe has very little experience with

the different types of nausea. I know my stomach and I know when I am ready for

something more than liquids. Just because I can tolerate graham crackers does

not mean that I am not still having nausea!

8:00 a.m. Dr. Boone's orders

Lortab 5 1-2 tablets every 4 hours as needed for pain

(IV Demerol and Phenergan were NOT discontinued)

1:30 p.m.

B. DeFoe, LPN, gave me 1 Lortab 5 in response to my request for medication for

pain and nausea. I was told the IV medication had been discontinued.

2:41 p.m.

C. Pack, RN, gave me IV Demerol and Phenergan only after I insisted that the

Lortab was not controlling the pain and that I knew Dr. Boone had not

discontinued the IV meds.

6:48 p.m.

R. Farley, LPN, gave me a Phenergan suppository and 1 Lortab 5 for pain. I was

told I could not have IV medication. Ms. Farley caused me great pain upon

inserting the suppository - something no other nurse has ever done.

10-30-02

admitted under Dr. Boone's care with a diagnosis of abdominal pain

Dr. Boone's orders

Demerol 25 mg every two hours as needed for pain

Phenergan 25 mg IV every 4 hours as needed for nausea

10-31-02

10:00 a.m. Dr. Boone's orders

Lortab 5 1-2 tablets every 4 hours as needed for pain

(IV Demerol and Phenergan were NOT discontinued)

1:20 p.m.

C. , RN, gave me 2 Lortab 5 in response to my request for pain and

nausea. I told her I also needed something for nausea. She said, " your doctor

wrote the order for oral medication so I know he wanted you to try it. "

8:30 p.m. (actually 9:22 p.m.)

R. Farley, LPN, charts the following

" pt states " I do not want any lorcet, I want demerol and phenergan, the lortab

does not work " c/o having to wait for pain med. Pt states " I am in pain " pt

shows no grimace of pain on face at this time "

I had been asking for medication for pain and nausea for over 1 hours when Ms.

Farley came into my room with a pill. I had just finished throwing up. I

assumed she had a Lortab in response to my request for pain/nausea med., so I

blew up at her. She told me she had my routine med, not pain med. I immediately

apologized profusely for losing my temper. I told her I was really in pain and

very nauseated and that waiting over 1 hours for medication was not

acceptable. Her response to me was, " Well, just wait. It's going to get worse

if they don't start treating us better. All the nurses are going to quit. " By

the way, I may not have had a grimace on my face but there were tears in my

eyes when I told her I really needed something for pain and nausea. Next time,

I'll be sure to add a grimace! Additionally, Ms. Farley charts that the

interchange took place at 8:30 p.m. but she charts that the routine med

(Plaquenil) was given at 9:22 p.m. The interchange took place at the same time

I was given the Plaquenil, which was approximately 9:22 p.m., not 8:30 p.m.

11-8-02

8:00 p.m. arrived at emergency room with acute abdominal pain and nausea

threw up twice while waiting to be brought to a treatment room

11-9-02

12:00 a.m. brought to treatment room

Jean , RN, immediately hooked up IV fluids via my PICC line

I repeatedly asked for medication for pain and nausea but Dr. refused to

give me anything until she got my lab work back.

2:40 a.m. given Reglan and Toradol for pain and nausea (this was 6 hours and 40

minutes after I initially arrived at the emergency room and 2 hours and 40

minutes after I began begging for something for pain and nausea)

Dr. indicated that they would probably need to admit me because my blood

counts were low. I told Dr. that I thought Dr. Boone was out of town but

that I had just been referred to Dr. Noel the previous Thursday. Also, Dr. Noel

took care of me on a previous admission when Dr. Boone had to go out of town.

I felt somewhat anxious/nervous after being given the medication but was able

to fall asleep after about an hour.

4:30 a.m. The nurse came in to tell me that I was being admitted to room 319

under the care of Dr. Hassan because Dr. Boone was out of town. I didn't bother

asking if they had even contacted Dr. Noel.

6:00 a.m. I asked for something for pain and nausea. I was told that there was

nothing ordered. I told the nurse that even at home I take Lortab and Phenergan

on a regular basis and that I needed something for pain and nausea. She simply

said she was sorry.

8:30 a.m. I again asked for something for pain and nausea and was told that

there was nothing ordered. C. , RN, said Dr. Hassan would want to see

me first, so I'd just have to wait. I told her the same thing I had told the

3rd shift nurse, that even at home I take Lortab and Phenergan on a regular

basis and that I needed something for pain and nausea. She just ignored my

request.

11:30 a.m. My mother called and I was near tears from the pain. She immediately

called the head nurse, Beverly. Beverly told my mother there was definitely

something ordered for pain and nausea and that she would see to it that I was

given medication.

11:40 a.m. Carol , RN, gave me IV medication, which she said was for

pain and nausea. However, upon reading my chart, there was no order for pain

medication. There was only an order for Reglan 10 mg IV every 6 hours as

needed. The chart also showed that I was given only Reglan.

Shortly after being given the medication, I was hit with the most horrible

nervous/anxious feeling. My nausea was much improved but the pain was not

diminished at all. I decided to get up and take a shower in hopes it would take

my mind off the pain and the horrible jittery feeling I was having. It didn't

help and I literally paced the floor until being discharged from the hospital.

12:30 p.m. I told Carol , RN, that the medication had made me feel

really weird. I told her it was a very horrible nervous sort of feeling, like I

could not quit moving. She simply said to tell Dr. Hassan when he came in.

2:00 p.m. Dr. Hassan came in and told me my labs were better so he was sending

me home. I told him about my reaction to the medication and asked him to please

give me something to counteract the effect. He simply said it wasn't indicated

in my case. I said, " Can't you please just give me something like a mild dose

of Valium or something? This is really a horrible nervous feeling. " He just

said no he wouldn't and that I wouldn't be nervous when I got home. I was

slightly better at home, but the effects of the medication did not completely

wear off until around 7:00 p.m.

I originally thought my 'nervous' reaction was to the toradol. However, upon

reading my chart today, it seems I was not given toradol except in the

emergency room. I assume my reaction was to the reglan, despite the fact that I

have had lower doses of Reglan orally many times in the past with no ill

effects. When I looked up Reglan on the Internet, my reaction was described to

a tea.

From Healthsquare.com

" Especially in older people, Reglan may produce tardive dyskinesia, a syndrome

of jerky or writhing involuntary movements, particularly of the tongue, face,

mouth, or jaw. In children and adults under 30, Reglan may cause involuntary

movements of the arms and legs, and sometimes loud or labored breathing,

usually in the first day or two of treatment.

Reglan may cause intense restlessness with associated symptoms such as anxiety,

agitation, foot-tapping, pacing, inability to sit still, jitteriness, and

insomnia. "

I am not exactly an 'older' person at the age of 41 but my body may react as

that of an older person because of all the assaults it has been through since

July. All I know is that it was a very miserable several hours. Not only was I

in pain and not provided any medication for pain relief, I had to deal with

horrible anxiety and restlessness as well.

I think that admitting a patient with acute abdominal pain but no order for

pain medication is absolutely cruel. Especially given the fact that the patient

has been on narcotic pain medication on an almost daily basis for several

months. I am sure that some may think that I am simply a drug seeker. However,

if one will take the time to review my quite extensive medical history (and not

just from Athens hospital) it will be discovered that I have had many incidents

of elevated pancreas and liver enzymes along with my episodes of pain. Yes, I

have also had many incidents of the same pain with normal enzymes. However, the

pain feels the same to me. You might also note that prior to July 2002, I had

many months with no emergency room visits or admissions due to abdominal pain.

Additionally, I feel simply ignoring the fact that I was having an obvious

reaction to the medication I was given was just another example of cruelty.

Surely, there must have been something that would have eased the reaction to

the medication. Maybe even just Benadryl would have helped.

Other than the nurses indicated in this letter, I received exemplary care from

most of the remainder of the nurses on the floor. The nurses in your emergency

room have always been superb. With the exception of Dr. , each doctor I

have seen in the emergency room is also superb.

Unless these situations can be dealt with appropriately, I will either go to

Huntsville or Birmingham when hospital care is warranted in the future. Under

no circumstances will I ever go to the Athens emergency room when Dr. is

the physician on duty.

Sincerely,

B. Weston