Sunday, April 29, 2018
Friday, April 27, 2018
Wednesday, April 18, 2018
Transition Part 11
He was running a low grade fever this morning, but because he has been diagnosed and prescribed the proper medication, and his temperature is now normal, they say, he is being released today. He will be brought to VVH with his IVs attached and with instructions for the administration of his antibiotics for 2 more days. And, No, it is not better for him to remain in the Hospital for treatment rather than in the Vermont Home, which is not a hospital. Reason given is that he will be more comfortable in his usual environment and also at less risk for pneumonia. When asked how he could have traveled by taxi, as an option this morning, or in our car, the answer was that they hadn't worked out the details at the time. When M. called for information later in the day, the nurse remarked that she had just seen her dad walking down the hall in his walker. M. said it couldn't be, so she said she'd check and came back to say, "Yes, you're right!
He says he's feeling good. I'll find out more tonight.
He says he's feeling good. I'll find out more tonight.
"Transitioning"
I was called this morning by nurse Rebecca, and told Dave is being discharged from Southwestern today. I asked how and when and she said she'd call back when the timing was set. A short time later, another call, this time from the office at Southwestern, asking when someone could pick him up at the hospital. She said his daughter had said she did not want him to go by taxi. She said Medicare pays for emergency transportation but not non-emergency transport home. Even though the distance transported is only several miles, the cost would be at least $300-$500. I told her he is a 2-person-lift and it's difficult for him to be transported in a regular car. She knew only that he was wheelchair-bound, not immobile. So she said she would notify Medicare of his condition. After more calls, she called back and said he will be transported back by ambulance, and it will be covered by insurance. Discharge is to be at 3 this afternoon.
To no one's surprise, though on admission the hospitalist said he might be there for up to 4 days, the 3-day rule prevailed. Medicare cares deeply.
To no one's surprise, though on admission the hospitalist said he might be there for up to 4 days, the 3-day rule prevailed. Medicare cares deeply.
Retort
At least Nikki Haley is reported to have "hit back." Instead of the trendy "claps back." Who needs cheerleaders at a time like this.
Talent Show
Time was when I would have hurried home to watch American Idol. Now that it's been revived, I can't seem to muster any interest in it. All the singers are capable, even good, but does the world really need another singer is all I can think of. I watched The Voice and found it at first more entertaining, but my interest is beginning to wane. More good singing, but the banality of praise piled upon praise from the judges is too wearisome to sit through. I heard that America's Got Talent is about to open its new season, and I think, please, please, no child ventriloquists. I haven't heard how last year's winner is doing in Las Vegas, but am thankful I don't have to be there, nor for the winner of the a capella Sing Off competition either. Please save me from another Pentatonix Christmas show.
Then, as I'm about to turn off the computer, I see a segment from Britain's Got Talent, and hear a singer named Calum Scott singing Dancing On My Own. I don't know if he won the competition or not, but I think he should have. From what I heard, he sounded even better than Sam Smith or Ed Sheeran.
Then, as I'm about to turn off the computer, I see a segment from Britain's Got Talent, and hear a singer named Calum Scott singing Dancing On My Own. I don't know if he won the competition or not, but I think he should have. From what I heard, he sounded even better than Sam Smith or Ed Sheeran.
Doorways
On a day near the end of summer, I walked up the few steps of the house I grew up in, and pulled open the screen door. The wooden outside door was opened, propped back against the row of windows in the old summer kitchen, so called because in the age before air conditioning or even electricity for fans, in the time the house was built, cooking during the stifling heat of summer was too much to be endured, so a little oil burner stove in a room built off the kitchen was a luxury in the homes that had anticipated the need.
There was another door, this one with glass panes at the top, that led to a small room at the bottom of a stairway and at the top of the cellar stairs. This door was always closed, else it would bang against the cellar door, which was, of course, always kept closed. The third door in that little room, also kept closed, led into the kitchen.
I walked into the kitchen as I'd done thousands upon thousands of times and found my mother and Helen in the middle room. Each was seated in their chairs in front of two of the room's doorways, my mother in her upholstered chair near the propped-back kitchen door. In all the years I lived in and visited the house, I don't recall that door ever being closed. My mother hung her pocketbook on that doorknob, against the wall, out of sight. Helen was seated in a rocking chair, in front of the closed closet door and the door to the front hallway, this door still open, as was usual in warm weather.
From the looks on their faces, they'd evidently been in deep conversation,and a serious one, not the norm for them because neither was the contemplative type. They were quiet as I entered the room, and my mother said, "We were just talking about how we got so old. It came so sudden."
If the year was 1980, and it could well have been, my mother would have turned 75 and Helen would have been approaching her 80th birthday. I suppose something about the significance of their landmark birthdays, counting down their mortality, might have triggered the nostalgia for their younger days. Or maybe they had felt a gust of late summer chill and were made aware of the approach of winter and the inevitable onset of a lasting chill.
There was another door, this one with glass panes at the top, that led to a small room at the bottom of a stairway and at the top of the cellar stairs. This door was always closed, else it would bang against the cellar door, which was, of course, always kept closed. The third door in that little room, also kept closed, led into the kitchen.
I walked into the kitchen as I'd done thousands upon thousands of times and found my mother and Helen in the middle room. Each was seated in their chairs in front of two of the room's doorways, my mother in her upholstered chair near the propped-back kitchen door. In all the years I lived in and visited the house, I don't recall that door ever being closed. My mother hung her pocketbook on that doorknob, against the wall, out of sight. Helen was seated in a rocking chair, in front of the closed closet door and the door to the front hallway, this door still open, as was usual in warm weather.
From the looks on their faces, they'd evidently been in deep conversation,and a serious one, not the norm for them because neither was the contemplative type. They were quiet as I entered the room, and my mother said, "We were just talking about how we got so old. It came so sudden."
If the year was 1980, and it could well have been, my mother would have turned 75 and Helen would have been approaching her 80th birthday. I suppose something about the significance of their landmark birthdays, counting down their mortality, might have triggered the nostalgia for their younger days. Or maybe they had felt a gust of late summer chill and were made aware of the approach of winter and the inevitable onset of a lasting chill.
Call of nature unanswered?
If you go into a store or restaurant, ask to use the restroom and are denied the code, why would you, or how could you, sit in that place for an extended period of time, even refusing to leave when asked, and remain there long enough to be escorted out by police? Never mind, don't answer or even attempt to come up with a reason.Some things are 100% not open to discussion. So I confide this thought only to you, O Blog, in the anonymity of things unread.
Wonder what that means...
Has anyone ever seen him laugh? Or even smile, for that matter, anything not resembling a smirk?
Friday, April 13, 2018
Who Cares.
I've received 2 calls, so far, from medical offices asking if I'd scheduled follow-up visits, which I had not. I mean, enough is enough. So I asked, at the second call, why I was being asked. I didn't say hounded or anything. The caller said that it was insurance company, that if I ended up back in the hospital, they "would be in a whole lot of trouble."
I have come to understand that the Medicare Readmission Program team cares deeply about my health.
I must add that the local hospital now makes it very clear indeed, on Form CRM-018SAM, exactly what the patient's status is. The form, called Medicare Outpatient Observation Notice, newly revised, as of 6/15/17, lets the patients know that being told they're being "admitted," doesn't mean they're being "admitted," not really. That's Medicare language. If you've ever wondered why so many patients are discharged from the hospital by the third day, not counting the day of discharge, it's because any longer admissions could result in increased financial obligations on the part of Medicare. So if you know of any elderly patients being retained in hospital for more than the 3 days' admission, they are in serious medical trouble.
On the other hand, judging from experience, it seems that hospitals are willing, and even eager, to "admit" patients for up to the 3 days threshold, even if the patient is not eager to be there.
Last year, when Patient D. was conveyed to ER by ambulance for a fall that stunned him and lacerated his head, he was transferred from St. Mary's to Samaritan for admission. He was assigned therapists and given referrals to choose an in-patient facility for an unspecified period of time. Then, unexpectedly, was told he was being discharged to home, and if he was there longer than the third day, he would be responsible for hospital charges, estimated at $2,000 per day. Patient could appeal, but if appeal was denied, charges would be owed. However, at the time, the packet of literature in the patient's room said otherwise, that those charges would not be patient's responsibility. After denial of appeal, despite several phone calls from various family members, a letter with attached (evidently defunct) hospital policy submitted to Medicare resulted apparently in no cost to patient for the "extended visit day." So now the hospital has a new form to cover any such circumstance.
A minor win, but if patient D had been admitted for 3 days, nursing home costs would have been covered, so Medicare wins bigger.
I have come to understand that the Medicare Readmission Program team cares deeply about my health.
I must add that the local hospital now makes it very clear indeed, on Form CRM-018SAM, exactly what the patient's status is. The form, called Medicare Outpatient Observation Notice, newly revised, as of 6/15/17, lets the patients know that being told they're being "admitted," doesn't mean they're being "admitted," not really. That's Medicare language. If you've ever wondered why so many patients are discharged from the hospital by the third day, not counting the day of discharge, it's because any longer admissions could result in increased financial obligations on the part of Medicare. So if you know of any elderly patients being retained in hospital for more than the 3 days' admission, they are in serious medical trouble.
On the other hand, judging from experience, it seems that hospitals are willing, and even eager, to "admit" patients for up to the 3 days threshold, even if the patient is not eager to be there.
Last year, when Patient D. was conveyed to ER by ambulance for a fall that stunned him and lacerated his head, he was transferred from St. Mary's to Samaritan for admission. He was assigned therapists and given referrals to choose an in-patient facility for an unspecified period of time. Then, unexpectedly, was told he was being discharged to home, and if he was there longer than the third day, he would be responsible for hospital charges, estimated at $2,000 per day. Patient could appeal, but if appeal was denied, charges would be owed. However, at the time, the packet of literature in the patient's room said otherwise, that those charges would not be patient's responsibility. After denial of appeal, despite several phone calls from various family members, a letter with attached (evidently defunct) hospital policy submitted to Medicare resulted apparently in no cost to patient for the "extended visit day." So now the hospital has a new form to cover any such circumstance.
A minor win, but if patient D had been admitted for 3 days, nursing home costs would have been covered, so Medicare wins bigger.
Thursday, April 12, 2018
TKR #!
Before I'm not saying who these knees belonged to, but the knees in the bottom picture are before surgery. The "subject" is standing upright with knees as close together as possible. The subject found it very painful to walk, and oddly enough even more painful to stand. Subject would no longer wear skirts or shorts out of embarrassment. Orthopedist said he could fix the knee and straighten the leg, and he did. A few days in the hospital, 1 week PT at home, and then drove to 6 more weeks of welcomed physical therapy, and no pain to date. Knees may not be things of beauty, but they allow subject to ride a stationary bike and walk several miles, pain free. Want the name of a really good orthopedist?Thursday, April 5, 2018
cappedThe Lottery Redux: "Ethical and Religious Directives for Catholic Hea...
cappedThe Lottery Redux: "Ethical and Religious Directives for Catholic Hea...: "A person has a moral obligation to use ordinary or proportionate means of preserving his or her life. Proportionate means are tho...
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