Surviving hospitals

They say that one should have a good lawyer, a doctor and an accountant on one’s side. Specialised skills that are life saving.? A hospital visit is a crash course that helps one appreciate the benefit and importance of these skills, in real life.

The last few months we have been in and out of hospitals for different members of our immediate family.

Case 1: A routine surgery where the promise of being mobile and active on day 2, extended into a 8-day ‘fight for life’, can’t say anything for the next 48 hours’ scenario. A sepsis scare that snowballed out of control requiring a middle of the night emergency shift to a better equipped facility.

Case 2: A geriatric patient has a fracture on her hip,? comes back home with prosthetics after a successful surgery, develops post-op, non-related complications, goes back to the ICU with problems like fluid accumulation in the lungs and infection of the kidneys. The person’s 2nd sojourn happens before she has fully recuperated from her hip surgery - so now there are 2 independent, doctor teams that are consulting for the person at the same time.

There were a few things that we learnt during the course of navigating through these experiences

Being aware of the patient’s issues and treatment protocol

Doctors know their stuff, there is no denying that.? However, being aware of what the issue is and the current protocol being followed, will give you a sense of the gravity of the situation.?

Read up on google, check with your family GP, and reach out to some doctor friends.?

Ask your treating doctor questions - not with a view to question, but to clarify and improve your understanding. What is the next course of action that they see? When will they be repeating tests to assess progress??

Look for key words and listen to the debrief patiently, and with a lot of attention.?

More importantly, don't be reticent in asking questions.

Our extended network and some understanding, through Google, prompted us to repeatedly voice our concerns to the doctors on possibly escalating infection, which eventually accelerated the patient’s move to a different hospital with better facilities. A few hours of delay would have meant irreversible consequences.

Word of caution: Doctors these days become testy with too many self taught, ‘Google made’ doctors. So do approach these interactions with a certain level of humility,? with the intent to improve your own understanding and clarity. It is illogical to assume that one is equipped to educate doctors, but one can always understand what are the assumptions and why so.

Prepare to deal with a stretched groundforce

Once the patient has passed through the portals of the Operating theatre, then the ICU and the regular ward - they are no longer in immediate danger. This is the time when you will be dealing with a whole lot of support staff. Nurses, ward boys, Physios, Co-ordinators, Dieticians, Relation/Experience managers etc. This is a phase when the system is low on equipment and high on overworked people. Many a time, their fatigue is palpable and they seem to be functioning through sheer force of will.?

So be kind and appreciative. Treat them well.?

Hospital stays are a demanding exercise of coordination. The more help on your side, the better it is.??

In these days of largely nuclear families, we are in general, reticent to ask for, or accept offers to help - even from close relatives or friends. Rather than saying ‘ No, no, we will manage’, take a rain check and tell people you will let them know if you need anything. If you are feeling bad about taking help, just mentally commit to helping somebody out at a later point in time. It is a better model. More the options for help, the better it is.?

Be Organised and systematic

Very rarely will you find the matronly nurses of yore - stern and in control. In hospitals these days, you will find a mix of people, mostly young, with various levels of competency and involvement. Not unlike any workplace. Ask questions, keep track of what needs to be done to ensure that all necessary things are done as prescribed by the doctors, during their rounds.?

Mark what tests, interventions ( what time and when. Nebulizers for example) monitoring ( BP, Sugar, Catheter input/output, Oxygenation etc.) that your patient needs. If need be, set up alarms for yourself to follow up from time to time. Also have a process to keep your core group informed at all times (Whatsapp updates and like). This also helps keep track of the history of hospital exchanges in one place and brings someone up to speed, without wasting too much energy or time.

If? the patient was already on a course of treatment for something else, spend some time organising? the paperwork around the protocol being followed, reports etc. Similarly keep a file of updated medical insurance receipts , patient cards etc., Anybody over the age of 45 or with chronic conditions or co-morbidities will benefit to have these handy.?

These things should be easily? accessible to all concerned and not be among the best kept secrets in the family. One never knows who has to run around with it.

An improved understanding of the situation along with some organisation creates a sense of control and comfort when the need arises.

Navigating through the rough and tumble of Insurance

Insurance all said and done is an epic of fine print. Most of us sign up and automatically pay premiums when it comes due. Reviewing? the policy, bonuses accrued before hitting the auto renew - maybe a good practice. Circumstances change, needs change and? the insurance policy has to live up to these changes. There are a lot of options that are available today, deliberate and choose what works for you best. Switch, if you think something else makes better sense. Understand the features of your policy, your eligibility etc. Sound out your insurance agent as soon as you know that a hospital stay seems likely.

Having a good insurance agent in your corner is worth its weight in gold. An? agent who is running a reasonable business and has some standing with the service provider phenomenally helps. Be prepared to negotiate tooth and nail and relish it. My sense is that insurance companies listen to a sound argument and are willing to concede some ground if it is logical.?

Go through the final bill carefully ( if you have been organized it helps). There will be a lot of items and bills towards medicines, special visits, patient support material (Oxygen, leg warmers, special beds etc).? When the patient is in the hospital, no one really notices these things, but keeping track? and a detailed review of the bill can help you spot and fix any oversight. Reducing an additional day’s charges for a special bed with warmers can save your 4000 Rs. While it may all seem meaningless, keep all your records clean. - even if you don’t foresee a return to the hospital in the immediate future.?

All is well, we are heading back home

This is the time you want to throw in the towel and think we are back home. We are done. But there are still some stops to cover.?

Once the date of your discharge is visible on the horizon, start getting ready to get back to normality. Leverage your network to identify service providers for the multitude of things that you may need. Beds, consumables, special equipment, nursing services etc. Scout for alternatives in terms of service providers, negotiate and plan for backups.?

Now you will see a lot of expense trickle in that will amount to a fair stream. There is nothing to regret but there is no harm in trying to manage it well.

Put the word out, you never know who can help. My cousin’s wife’s colleague helped us sound out some good contacts because his mother had gone through a similar patch recently. Somebody else gave us a reference to source consumables at wholesale.??

Be aware when the current treatment protocol needs to stop or change. In the case of senior patients you also need to be cognizant of when to bring back or re-align pre-surgical protocols that have been temporarily stopped or changed during the course of the hospital stay. Before you leave, check with the doctors on what to look out for in terms of post-op events or red flags. Breathlessness, lack of sleep, acute or? chronic pain, vomiting, low grade fever, shivers, patient not engaging well etc. More often than not, we have a tendency to logicalize, because somewhere in our minds,? we don’t anticipate anything serious, or, really don’t want to contemplate the possibility of going back to the hospital again. It helps to be objective and listen intently to the patient’s issues and err on the side of caution.?

‘What took you so long’ is not something you want to hear after all the effort and trouble you have already taken.

Be gentle but firm in ensuring that they do the prescribed exercises etc along with their medicines. Have a routine and stick to it as much as possible. Alternate therapy could? help the patient in terms of pain management and building a positive frame of mind. It could be homeopathy, healing, prayers etc. Whatever the patient believes in, and you can support with. Goes without saying that there should be no conflict with the core method of treatment currently in force. Now is the time when you can call on the earlier offers to help that you haven’t encashed yet. If somebody can step in to take care of them - their friends, your friends.. It will provide both the patient and you a change of scene and a welcome breather.

While rightfully so, we are in a hurry? to get back to the safe haven and familiarity of our own routines. But, these things are at best unpredictable. Being calm and objective will go a long way in dealing with the situation deftly. For all those closely involved, the intensity and fatigue could be cathartic and help build new perspectives. Even reframe their approach to life and living.? Healing could happen in more than one dimension and some learnings in life leave us with more than one meaning.?

As the Serenity Prayer goes, we should have the wisdom to know the difference between what we can and cannot control, but, be willing to understand and push the boundaries, where you can.

#health #wellness #selfhelp #DIY