Image via WikipediaDoctors in Disarray: When you're in the hospital, you get a bunch of specialists who look at your problem(s) from the perspectives of their various disciplines, and of course that should be a good thing. I suppose that often, it is. But not always. One problem is that the specialists don't always communicate well with each other, and sometimes they work at cross purposes. We now have at least three, maybe four, different doctors writing orders in my mother's chart, and even though we now have a hospitalist on the case, there are still other guys ordering stuff that is inconsistent with the approach that the hospitalist is taking, or wants to take. My mother went into the hospital walking and talking, coughing a lot, and mildly confused. That was Sunday. As of last night, she was unable to stand up, much less walk. She was terribly disoriented, and had no short-term memory. Her speech was very slurred, nearly incoherent. She was keeping her eyes closed most of the time, even when awake, and could not explain why. She wasn't eating or drinking, and the nursing staff seemed unaware of that, or unconcerned about it, until I repeatedly brought it to their attention. They kept musing about a "pureed diet" order, ignoring the fact that she is refusing to swallow anything. They had unhooked her IV fluids, because she was moving around so much. Yesterday, she was still being given a medication for sedation (Ativan) that was clearly making her mental status worse. I think I finally got the attention of enough of the doctors, yesterday afternoon, to make sure she will get no more Ativan. And the IV was hooked up again when I left, last night.
The various tests so far haven't shown anything that would be an obvious cause of her delirium (the rapid-onset confusion). The doctors have various ideas, but it's all really tentative. Maybe it's metabolic, maybe it's her meds, maybe it's several things that have acted together to cause problems in mental functioning.
Today we'll see if she clears up any.
1 comments:
If your mother is having a bad reaction to one medication they should try another. What works well for many does not work well for everybody. Good thing you are are taking the overview. What do other people do? Let us know if you find a good way to supervise medical care if you can't be there.
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