When The Phone Rings….

Everyday  a patient on the active transplant List waits for “The Phone To Ring” calling them to the hospital to receive the “Gift  of Life” in the form of an organ transplant.  For patients with Chronic Kidney Disease that do not have an identified living donor must continue to wait.  Depending upon their blood type, it can be a minimum of four to five years.  To even be considered to receive a transplant, a patient must meet several different criteria. for a kidney patient they must have reached CKD Stage 4 and thier GFR (Glomerular Filtration Rate) must be below 30. It is sad that They could not be worked up when they were Stage 3. maybe not active on the list but at least have all the testing completed. When your kidneys start declining from Stage 3 down, depending on the cause of your disease, it can continue on for a few years, a few months, or not even a month. So much depends on the overall health of the individual. I have monitored a patient with Renal failure from birth to date (21 Years) I watch them do well up until they turned 16, Then the decline started a little more quickly. In February of 2015 the patient dropped suddenly to a GFR of 15 down from 30. They were then worked up to be placed on the active list. The GFR rebounded above 15 for a few months which caused the patient to be placed on Hold till after thier 18th birthday. This caused a major issue as the patient was being seen as a Pediatric patient, and would still be able to until they were 21. The on problem was if they went down suddenly again and need to be put on Dialysis the Only Pediatric clinic was Full. The Nephrologist decided that with this problem in mind the Patient should be transferred to adult from Pediatric Nephrology. Working with the family the Doctor referred the patient to a Nephrologist at another Facility. The patient stayed listed at the Transplant center for Pediatrics. After many issues with the patients commercial insurance company the Patients listing was transferred to the Facility that the Adult Nephrologists worked with. The patient did receive thier accrued time form the when they were made active.  The family hoped and prayed to  hear the Phone Ring with the call for them to go to the hospital. When the patient had thier 21st Birthday Their GFR was still hovering around 15. Then 5 days later they ended up in the ER acutely Uremic and had to be started on Hemodialysis. Not what the patient wanted… They had prefered to do Peritoneal dialysis but thier lab was not “Bad Enough ” to justify placement of a catheter per the insurance and the Guidelines… They are now converted to PD (Peritoneal Dialysis) and doing their therapy at home. Still they wait for the “Phone to Ring”.  

Do you know of some one that is on the “list”? are you and organ donor? Is it on your Drivers License? Being a donor is not a piece of cake. You are going to have a major surgery to give  the “gift of Life” to another. Many times the Donor has more Post-op issues in the hospital than the recipient. But that is easily managed. While I have focused on Kidney Transplantation, There are other types of transplants that a living donor can offer. Liver, they remove a portion of the donors liver and graft it to the patients. The Donors liver will regenerate it self. Stem Cells, Can be a life saving gift for some patients, Bone Marrow can help Hemophiliacs. Both do not require a hospital stay for the donor. Unfortunately the Heart and Lungs come from a Cadaver. Unless you make it known that if something were to happen to you your organs would be available to be donated, It would come down to a family member to choose. Please make it know  on your position for organ donations. Help those on the list ‘ know that  they are blessed “When The Phone Rings” and it is for them to receive the Gift of Life.

What has become of our compassion and understanding in the healthcare system

Having recently visited a local ER it has become apparent to me that the medical staff of today has lost some of its compassion and the ability to listen to the patient. When the nurse that was going to start an IV was looking at the arm, they were informed that the patient was a difficult stick, the veins were deep and full of valves. It was requested not to have the IV started in the AC (bend of the elbow). The nurse only looked at a crooked vein in the AC and that was where they started the line. Last year when a person was going to have surgery the staff in the pre-op area was informed that the patient was a difficult stick and if they could not get a peripheral line in one or two sticks to put in a central line. When the anesthesiologist resident came to do their pre-op assessment the same information was passed to them. Was the patient’s request followed? No! After approximately 20 attempts in both arms and IV was established for surgery. This was done after the patient had been sedated and when surgery was over the patient was horrified to see their extremities had been used as pincushion’s. The hands were bruised the arms were bruised and the IV that was started infiltrated. A formal complaint was made to the hospital and to the surgeon and that’s as far as I know, as far as it went.

What ever happened to the patient knows their body better than the medical staff, and their rights to have procedures done per their wishes seems to be ignored. I understand that sometimes it is more important to establish IV access to be able to administer emergency medications, but to directly ignore the patient that knows their body and knows the condition of their vessels better than the nurse trying to start the IV I think is a severe lack of professionalism and borderline malpractice. I say this not as a layperson, I say this not as someone who is angry and upset. I say this as someone who has been in the medical field for 40 years, worked in the emergency room, been a paramedic on an ambulance, been a nurse in the ICU/CCU, thoracic intensive care unit, and has been trained as a hemodialysis nurse. I understand the physiology of the vessels and how to cannulated a vessel that is considered fragile and difficult. But to see the results of what I have stated above and the total disregard for the patient’s wishes horrifies me.

United States had in the past been known for having the best medical care system worldwide. Not to be political, but since the government has decided that they know how to take care of patients better than the professionals and regulated reimbursement the quality has declined. Doctors and nurses are leaving the field because it’s just too difficult to maneuver through the regulations and try to do what’s best for the patient without being sued. It used to be thought that physicians made millions of dollars a year, I spoke with my cardiologist and discovered that his practice barely broke even for the past five years because of the changes in reimbursement from Medicare and the insurance companies.

Everyone has heard of the affordable care act. It is anything but affordable, you were lied to when you were told you could keep your Dr. and your premiums would go down! Of course when you have to pass a bill before you can read it, what do you expect? You may agree with this or not. You may be able to relate to this or not. You may think I’m crazy, but my favorite saying is you’ll get over it! Next time you go to the emergency room and they come in to do a procedure and you asked them to do a specific task in a specific way like don’t start the IV in my right arm because if I’m admitted I won’t be able to eat and they started in your right AC means you can’t bend your arm and it means you’re going to eat left-handed if you can, think about this post.