Here are some tips:
Q: Where should I start?
A: Find out about the hospitals in your area. Find out what services are offered, which doctors are on staff, what insurance plans are generally accepted, what success ratings they have for particular surgeries and what their nursing personnel is like. Try to find the hospital that best fits your needs and goals.
Q: How do I choose a hospital?
A: Mostly it depends on where your doctor is on staff and these days with managed care, it depends on your insurance coverage.
Q: Don’t all hospitals provide the same care?
A: In my father’s particular case, no. He had a 5 graft bypass heart surgery in Visalia and was discharged three days after his surgery. His HMO plan stated that this was the normal course of a hospital stay. Unfortunately, after he came to Southern California to stay with me about 2 weeks after his surgery, he had to be readmitted to another local hospital. I have since found out that this hospital kept a 5 graft bypass heart surgery patient in for a minimum of 1 week.
Q: Why did your father have to be readmitted to the hospital?
A: Apparently, he was dehydrated and malnourished from not eating after his surgery. His appetite and ability to eat diminished to almost nothing and forcing him to eat only made him throw up. I have since found out that anesthesia and medication will decrease appetite and taste so it is helpful to continue the intravenous nutrition for a while following surgery. Other friends of mine have related similar stories regarding being discharged from the hospital in a short period of time then having to be readmitted to rehydrate.
Q: Is your father okay now?
A: No. His heart did not hold up well and he passed away soon after coming home. The lack of adequate nutrition for those initial two weeks led to a starvation condition, causing the body to break down. His condition was further complicated by internal bleeding which was hard to control since his clotting ability stopped functioning normally due to significant blood loss and break down caused by the starvation.
Q: Couldn’t you tell if he was bleeding?
A: Not while he was at home. His bowel movements had slowed down to a crawl. His first bowel movement following the surgery was about 10 days later and was black. Because he was on iron supplements, I assumed this caused the black color of his fecal matter even though old blood can do the same. He was sleeping a lot and did not want to do much of anything, but this was explained by the hospital staff to be normal following major heart surgery.
Q: What finally led to getting him back to a hospital?
A: Although his eating was getting better and he was taking in more food, he was getting weaker and finally collapsed while walking complaining of stomach pain. It turns out he had internal bleeding which became very hard to control. The ulcers he had turned out to be quite deep and it was estimated that he probably had these ulcers for a long time.
Q: Since he has been in the hospital, what are some of your recommendations for a better experience?
A: Find a doctor with whom you can communicate easily and makes things understandable to you. It is helpful to have the doctor line up a team in the anticipation of future needs, particularly for a critical care patient. Coordination of the entire team, including family visits, spiritual counseling and nursing care, is important to establish. Focusing only on the clinical, bodily functions is not enough. Be sure that the team is aware of the human side of nurturing. Don’t be afraid to ask questions if you don’t understand. See if there are written materials available to help you. There are books available to the general public explaining medical conditions in easy to understand terms and pictures. Don’t let medical personnel create a hopeless picture. Insist that they talk in hopeful terms even if death is imminent. Norman Cousins describes this well in his book, Head First: The Biology of Hope.