solosater

Continued from my last post...

Just so you understand, I will not take blood in any form. My blood count was down to 6, my normal blood count is 14 so I had lost more than half of my blood volume and they were talking about starting me on blood and about how I was going to bleed out if they didn’t. I told them not to bother. The doctor came into my room and sat next to me. He was not my doctor but the on-call gastroenterologist. He took my hand in his and looked me dead in the eye and told me “You likely will not live through the night if we don’t give you blood.” Holding his hand and looking squarely back at him I said, “That’s ok. It’s all right if I die; it is not all right if I take blood. I will take Epoetin, I will take iron and if there is anything else you’d like to try, I’m open to discussing it but I will not take blood.” He nodded and said, “Ok then, so long as you understand.” I did.

They started me on the Epo and iron and they did a sigmoidoscopy but didn’t find anything actively bleeding and I hadn’t passed any more blood. They inserted the drain and the fluid was light pink which is normal and not red as if I were bleeding internally. Slowly over the next two nights my blood count came up to 8 and they started thinking I might just live after all. They said acute bleeding colitis apparently caused by stress. Ya think?

I really don’t remember much of that stay, I was bone tired and they had me on Morphine and Ativan in addition to the other drugs. What I do remember is having my IV changed every three hours or so because my veins kept collapsing and the nurses and techs looking scared for the first couple of days. I remember they brought in a nurse from the Pediatric ICU to find a vein the last time and after three or four tries she was able to get it in using an infrared light of some sort. They finally put in a PIC line only 24 hours before releasing me. I’m still a little ticked over that! I was allowed to wear my own pajamas though I’m not sure why and I was allowed to eat anything I wanted so that was a plus, I’d got my appetite back once the antibiotics had started working though I still was eating like a bird, I at least enjoyed it. I also remember pitching a fit after they put in the PIC line because they wouldn’t let me shower.

I’d asked the nurse to help me shower but she couldn’t right then and said she’d make sure I got a shower a little later. That was fine but then they put in the PIC line and you’re not supposed to get it wet or perhaps it’s that you aren’t supposed to stand upright or something for the first 24-48 hours (I’m a little unclear on the facts here but the outcome was the same). When I asked again about the shower she said I couldn’t have one because of the PIC line. I don’t remember exactly how that conversation went just that I told her in no uncertain terms that she was going to give me a shower or I’d have her head! I was being completely irrational I’m sure but I was itchy and oily and in need of a shower and there was no way I was not having one. She finally wrapped my arm and shoulder in plastic and helped me wash my hair and rinse off and I was appeased.

She was so cute! Late that night when the shift was changing she came in and sat down and asked if I wanted to see pictures of her pets. I was just lying in bed staring at the wall and wishing I was tired enough to sleep but without the energy to do more than stare at the wall. I was so happy to look at her dogs and cats and hear about their personalities and foibles. I know it was her way of making our little fight ok and I can’t tell you how glad I was she knew how to defuse the tension I had caused with my fit.

In fact all of the nurses and techs were fabulous (except that first one with the Foley), I can’t imagine how they do it. I think for the most part I was a good patient and easy to deal with but when you’re helpless you can’t help but be demanding; I needed help to sit up and roll over! I needed a shower every day, my hair was down to the middle of my back and I couldn’t comb it for myself, I had to have help to go to the bathroom, changing clothes or getting dressed was an ordeal. I needed help all the time! I was just one patient on the ward, there were at least 24 beds and I imagine the other patients needed similar care too.

Be nice to your nurses, they have enough to deal with without your meanness!

They kept me for 6 days that time before letting me go. I’m guessing they’d’ve liked to toss me out after four.

I was still sweating through my sheets on and off, the antibiotics were doing their thing but for some reason I would just get bad at night. During that fist week home after my second stay in the hospital I was every bit as worthless as the first time and just for fun my stepfather had pneumonia as well. My mother was working a few days a week and my stepfather and I were making more laundry than a family of 12 and she was cooking soup and running to the store for our meds and helping me shower and dress and making both of our beds most days from the mattress out. I don’t know how she did it. He was so sick that I was helping with his care after the first couple of days. He didn’t know his own name most of the time. About five days after I came home we both ended up in the ER, me because my drain was coming loose and him because he was finally convinced he didn’t have a cold (the man could lose a leg and pull a Black Knight with “It’s just a flesh wound” on you, he can’t be trusted!).

The ER doctor called my doctor and asked if he could pull my drain and got permission to do so. I was feeling much better by then but the drain had been knocked loose the day before when I went out the gate to the car for my first ride since coming home from the hospital. I would have been wagging my tail had I a tail to wag I was so eager to be out, we were going to the post office or something like that. Anyway, my mother went out the gate and I was following her through but she lost her grip on the gate and it snapped back and the latch hit me right in the drain.

For those of you who don’t know what a drain is, I’ll explain. When you have an abscess (and perhaps at other times as well?) they make a small incision, a tiny hole really and insert a tube into the cavity (There is some kind of imaging for this process but I’ve no clue what kind). The tube is apparently about a foot long (or perhaps it is cut to fit?) and lies on the bottom of the cavity and the fluid seeps into the tube and out into a receptacle. Between the tube and the receptacle there is a valve, when the receptacle is full you turn the valve off and remove the receptacle, empty it and replace it, then turn the valve back on (rather like a spigot). The valve is on a hard plastic or perhaps metal pipe about the size of a drinking straw and about the length of a toothpick, it sits about an inch from your body and makes you feel rather like the Borg. The drain is not stitched in, or at least mine was not, but just taped in place.

There are two brands of drains (or more?) and while I cannot remember which I had you don’t want that one, you want the other. There is a Blake (or Drake?) and a JP Morgan I think. One, the one I had, has a tube with tiny perforations all over it and the other has long slices running lengthwise in it. The slices and perforations serve the same purpose, to allow the fluid to drain. What happens in your body is that your body tries to close any opening, of course it does, that’s what holds us together! A great plan really but it makes removing drains (and, I’m sure, other things too) quite painful. Your body heals around and into the tube. When they pull the tube out they have to open every one of those tine “wounds” to do it. I understand the one with the long slices is way less painful as there are fewer “wounds”.

So the doctor is going to remove my drain. I asked if I should take a painkiller before he started as I had Vicodin in my purse but he didn’t think I’d need it (that sadist!). I’m lying on a gurney and he has one hand on my side and one on the drain and he yanks. Now from that moment to the next my fist flies up and just shy of contact with his face his hand catches it and by that time it’s all over but the crying.

And the swearing and the shaking.

He actually had the nerve to ask if I wanted to see it. I almost tried again! I lay there shaking hard enough to rattle the gurney and swearing like a sailor for about a half hour before I could get it together. It was completely involuntary; I couldn’t stop! It was like having Tourette’s! I was fine after that but for that half hour all I could think about was how disgusting that pain was.

I’ve said it was worse than child birth but I’ve never had a child so that may not be accurate but I really cannot imagine that child birth could be more intensely painful though it is certainly longer. It is a tearing pain unlike anything I’ve ever felt before or since it felt ten feet long and like it had knots in it. It actually made me sick to my stomach for weeks after just thinking about it and in fact is making me a little sick now. I’ll never let them put one on me again without a written promise to anesthetize me before removing it.

I’m not being funny!

After that I went down the hall to my stepfather’s room and sat with him for a while while my mom talked to her clients about rescheduling their appointments for later. He didn’t know I was there.

After that things started to get back to normal again, it was slow going but steady and we all made it through (Dan was sick for almost a month but came home after two days in the hospital).

So no, there is no such thing as Cystic Hiccups but I really did have them just the same.

Dragon

solo, I was really interested in your description of the drain (I was actually interested in the whole thing but that stood out for me). We use Penrose drains at the vet clinic, in fact we put one in this morning. We use them most often on abscesses that have blown or that we've opened though sometimes we get a large wound that requires one. A Penrose drain is simply a piece of surgical tubing (the kind frat boys use to make giant slingshots out of ) cut to size and pulled through the wound so there is a piece of tubing sticking out the top and a piece sticking out the bottom of the wound. We tack it in place with a suture or two at either end. The tube itself doesn't have any openings inside the wound so it drains fluid from around the ends. We always recommend to clean the area regularly and keep the pet off of white furniture. We typically remove the drain after 3 or 4 days by cutting the sutures which hold it in and gently tugging it out. Because it has no openings to allow the body to heal into it usually comes out pretty slick and I've never seen an animal have any discomfort having it out. So solo, yours sound much cleaner but ours are much less painful. Also yours may have needed to be in quite a bit longer.
The cat we did today had been in a cat fight (he was not neutered, so that's pretty common) and had developed an abscess where he'd been bitten by another cat. Just a note, cat mouths are absolutely filthy, if you ever get bit by one clean it out with peroxide and watch it to make sure it doesn't get infected. Anyway, this abscess was allowed to fester instead of being brought to the vet to have it treated and became enormous. It filled with pus and finally burst this morning leaving a gaping hole in his shoulder. We could probe with our instruments right down to his elbow, up to his neck and across his chest quite a ways. It was a great deal of work for the vet to cut away the dead tissue and suture the good tissue back together. Quite nasty. I think his owners hadn't brought him in earlier because money was tight and they were hoping it would just sort of heal itself (as they sometimes do when they're small and open), it was quite unfortunate for them as it ended up costing probably 3 times what it would have if we treated it when it first started. I felt bad for them because of that, but they paid without even questioning and were grateful we could get them in so quickly.

marius

Wow, solosater. What a story! Always amazed at what we managed to survive. Glad you made it through all that and I found it all quite interesting! Wanted to ask, will you NEVER take blood? Have a friend who is a med tech and for her surgeries she gives her own blood ahead of time for them to use. She doesn't want foreign anti-bodies (or something like that) running around in her blood.

I'll tell my surgery story someday, not nearly as interesting as yours, but there are things I didn't understand and still don't. Maybe nurse Robin will be able to explain. It was thirty years ago so am sure things have changed.

Meanwhile, gee Dragon, what an awful surgery for that cat. Yikes! Do you assist with surgeries? I've always thought that would be cool. Probably missed my calling and should have been a pathologist. One time some chiropractic students let me meet their cadaver whom they affectionately called, Ziggy Porsche. I got to hold the brain, cut into it and actually found some tiny thing they'd been looking for. Got to hold the lungs and they had calcium deposits the size of small grapes. It was a born-again experience or something. I mean, the man's body was no different from dead animals you see on the road, meaning that whatever had animated that body was GONE! I could have stayed there all day poking around but they had work to do so I had to leave. Yep, think I missed my calling.

Robindcr8l

Solo, I about the drains. I had to laugh when you said there is one called a JP Morgan drain! I think JP Morgan was some wealthy entrepeneur or something. It's actually a JP drain (stands for Jackson Pratt) and we see them quite often. They are frequently used after elective surgeries to prevent hematomas or fluid collections at the site. They are usually pulled after about 3 days, and my patients always say it hurts when they come out, but not like the pain you describe with your drain. It's kind of shocking how hard you have to pull to get one of those drains out, though. I always thought they would just kind of slide out easily, but not so. I can see why it hurts.

Dragon, we also use penrose drains on people, but they would be for a more superficial type of abscess, not a deep abdominal abscess like Solo described. The penrose drain is perfectly smooth, so comes out very easily and with little or no pain, like you said with animals. We also use penrose drains as tourniquettes for starting IVs! They are multi-purpose.

I can picture the kind of drain solo had, but have never had to remove one. An abdominal abscess like that is a medical emergency. Solo was probably septic throughout her whole system, and that can lead to multi-system organ failure and death. So that's why the hospital admission and the concerned staff around her. I think it's amazing that solo had that abscess growing as long as she did. I always think an abscess must hurt very bad. I think about how much a little zit can hurt sometimes, so imagine a huge pus-filled abscess somewhere in your body?! I get people with spinal cord abscesses and think that must be excruciating! It sounds like you responded quickly and well to treatment, Solo, so thank goodness for that!

Marius, how interesting that you got to play with a cadaver. I remember going to the gross anatomy lab (they really did call it that) during nursing school and seeing the cadavers. A couple people passed out. (I'm sorry, but give me a break! Drama queens!) I thought it would be kind of disturbing, but,in fact, it was just as interesting as you describe. They don't seem like real people in a way, because there is no life left in them and they are not really recognizable. I, too, could have been a pathologist, but not a coroner. Think about the remains those coroners have to autopsy, how stinky they must be. I am very sensitive to smells. Anyway, after my field trip to the anatomy lab, I decided to donate my body to science upon death. Someone may as well get some use out of it, and then they cremate your remains for free! It will help science, and save my boy some money!

marius

My surgery: exploratory turned to complete hysterectomy, age 25, thirty years ago. Here are things I still don't understand. Perhaps our resident nurse, Robin, can shed light. What I don't understand is why I wasn't better prepared for the recovery process. Before surgery I was given something to read and all I remember is what wasn't in the brochure, which as I recall is that the brochure talked more about before and during surgery than after.

I had a painful orange-sized cyst on one ovary, and apparently had had many ovarian cysts that popped and oozed or whatever they do, for quite a few years. Day after surgery the nurse set me in a chair. I began to fall forward but was so drugged or ???, that I couldn't alert the nurse, much less move to prevent floor meeting my face. She caught me just in time, but I was terrified. Then after rescue, more scary thoughts, "I can't sit in a chair by myself???" Then there was the constant question, "Have you passed gas?" That was a personal thing to ask. I didn't understand why they cared. Finally a nurse told me I had to eat to pass gas. So I ate because they were all so focused on gas. THEN ... shuffling down the hall with my buddy, the I.V., it happened. All I can say is that I would not have called that "passing gas." It was mortifying as others were in the hall and it was not a silent process. I felt hurt and angry, "Why didn't anyone TELL me it would be like this?"

About a week later I thought to take a walk around our apartment complex. My fastest pace was the "old-person shuffle." I wondered what had gone wrong in surgery, wondered if I'd be disabled like that the rest of my life. Finally a neighbor told me that recovery from major surgery takes a long time. It did? How was I to know? Then, about a month after surgery, hair began to fall out. One brush stroke and I'd have to empty the brush. It kept happening. Sheer terror. Called the doctors office and they said, as if no big deal at all, "Hair loss after major surgery is common." It is??? I lost half my hair volume. It never grew back. But, there is a silver lining: my hair had been way too thick and difficult to manage, so loss turned into a relief. : )

I wonder if people are better prepared for recovery experiences today. In fairness to medical team, back then I had undiagnosed panic/anxiety, depression issues. It's possible I was told what to expect, but still don't think I was. And, maybe it's impossible for medical people to know how each person's recovery will go, so best to say nothing?

marius

And Robin, spouse also has donated his body. After a year of using it to practice medical procedures, they cremate and send remains back to family. They also provide $600 to a funeral home or church if you want to have a memorial service. I think that's great of him, of you, but for some reason have not followed suit ... yet. : ) Also, funny - did not know about "gross anatomy." I thought it was fascinating. I'd go again if anyone ever invited me.

Dragon

marius, I very rarely get to assist in surgeries. I am a Veterinary Office Assistant (basically a receptionist). The AHT's (Animal Health Technolagists) get to assist with surgery. Occasionally I do get to do a little assisting and it's always incredibly interesting. I remember my first year there I got to help hold a calf's intestines in while the doctor prepared him for surgery. I told my friends (who are all engineers) about how neat it was and they were all grossed out by it. Guess we all ended up where we should be .

Robin, you ar right about autopsy stink. I have been there for several post mortems at the clinic and there is just nothing that smells like that. In fact there have beena few times when I've walked back into the clinic after lunch, taken one whiff and said to myself 'Somebody did an autopsy back here.' It's funny how when you work in a medical environment you start cataloging smells in your brain whether you mean to or not. We will often walk into an exam room and just know that they were treating bad ears, or doing an anal gland expression. And Parvo puppies have such a distinctive stink you can almost make a diagnosis of that alone!

solosater

Yeah well when you say Jackson Pratt it all comes back to me, JP Morgan is part of JP Morgan Chase like in Chase bank but I do believe they have diversified into lots of other things as well. My drain was in for five days I think it may have been as long as a week.

Marius, I was under the impression that I would slowly recover and be mostly back to "normal" after six months and that was true. I would think that with the advent of Medical Malpractice Suits the industry has likely put more effort into letting the patient know what to expect and being way nicer about it too. I don't mean to say that doctors and their staff would knowingly keep a patient in the dark but I find a lot of surgeons do not think about things like that, I wonder if it was just an over site, a sad one that shouldn't have happened but still just an over site.

I've never been to collage and certainly never got to sit in on a gross anatomy course but my family does own a slaughter house and mammals are very alike under the skin and many a farm animal suffers from similar structural trouble to that of people, we've seen herniated discs and other spinal issues, heart valves that may have been causing trouble and all sorts of interesting and smelly things you don't want to associate with your food. I also have looked online for information about canine anatomy and found course notes and pictures of an autopsy of a dog and a cat, gross but very interesting and still no smellavision so all good.

Dragon, I've never had a cat, really more of a dog person, but a friend had a cat we all called the cat with no neck. I was never sure what caused it and they never got it taken care of but the cat survived with this giant hole in its neck very much like you described here. I felt awful for that cat and would have at the very least paid to have him put down but it was not my choice. I think thats just mean. Is there a quick cleaning method you could share for cleaning a pet's wounds? Would the same plan you offered for humans work for our pets as well? And I promise not to sue!

solosater

marius, no I would never take blood for any reason, there are so many safer options and so many terrible things that could happen because of taking blood that it doesn't make since for me to do so.

They have cell savers (a machine that basically collects any spilled blood and recirculates it so you actually lose very little) in surgical settings. In surgeries that are particularly bloody like liver surgery they can use a cauterizing scalpel that seals the wound as it cuts to minimize blood lose. And there are medications (like Epoitin) that raise your blood volume even before you lose any.

In emergency situations the most important thing is to stop the bleeding and to raise the volume, even in trauma situations a skilled doctor can do without blood and most would likely prefer that if they were on the table; blood is dirty, dirty stuff!

Thats the logical argument, there are other reasons too.

Robindcr8l

Marius, I do think that they are probably better now than 25 years ago about informing patients what to expect, but also think that it's such an individual thing, that they are maybe reluctant to go into too much detail. I had shoulder surgery back in April. Basically prepared me that my arm would be completely immobile for 2 weeks, then 4 more weeks of passive range of motion only, then active range after that. Well, all that immobility and passive movement only, made me think that the less I moved it, the better. So here I am, a nurse, and wasn't very compliant with my post-op passive range of motion exercises, thinking rest was the best thing. No one bothered to tell me that by not moving the arm I would get "frozen shoulder". I don't know if they just assumed a broader knowledge base than I had, just because I am a nurse, or if they really just don't educate ANYONE very well. I think it's the latter, unfortunately, because the therapists didn't know I was a nurse until I told them. Anyway, here I am 6 months later with a severely compromised shoulder...much worse than pre-op. And I blame much of this on me being underinformed.

I also think that surgery, and treatment, and care, and education vary geographically. When I worked as a nurse in New York, healthcare was much different than here in Boise. Patients are treated much more like princesses here, and there is huge competition between facilities because in this smaller community, there are basically only 2 hospitals to choose from. If you have a bad experience at one, you will go to the other one for the rest of your life, then badmouth the first one to everyone you know. So they are very focused on customer service and customer recovery. In NY, you're just glad to get clean sheets and a shared bathroom.

Solo, I understand your point about not accepting blood under any circumstances, but as a nurse, I would not want to discourage someone from getting a transfusion if they truly need one. You were young and otherwise healthy and able to recover from your anemia fairly quickly. Not everyone is in that same situation. I am here to tell you that a blood transfusion can hasten someone's recovery ten-fold if they are anemic. Someone with a blood count of 6 who only gets epoeitin will likely take weeks and weeks and weeks to recover, when a blood transfusion would have them up and around by the next day. There are risks, of course, which is why patients and doctors have to weigh the risks and benefits before making the decision or recommendation. But having worked for the Red Cross collecting blood and blood products for 6 years, and having worked in hospitals administering them, I would personally take one if I needed it. I respect your views, but just worry that someone might read this and get it in their heads that they should NEVER have a transfusion, when each situation is individual. I say, educate yourselves and talk to your doctors before making any healthcare decisions.

Dragon

solo, abscesses are not uncommon on cats, especially the ones that like to scrap. If you see it right away you can clean the wound pretty much like you would a humans and treat it with something like polysporin. The problem is they're often under a load of fur and are hard to see. A lot of them get missed then close up and start growing a nice load of pus. Some will burst quite quickly and then you can clean them out and use a wound ointment on them (though it's best to at least contact a vet because they can close up and start all over again and may need antibiotics). The one we had today was one of the biggest I've ever seen and they said the abscess (before it broke) was enormous.

Robin, your story about your shoulder reminded me of my mom's issues with her shoulder. A few years ago she fell and broke her collarbone. She was rushed to the hospital where they told her they almost never pin or plate a collarbone break, they just heal back together. Well my mom's collarbone was rather more shattered than simply broken and it was very painful, not to mention the fact that her right shoulder was now quite a bit closer to her centerline than it was supposed to be. Not only did none of her shirts fit anymore (a minor concern) but now her muscles through her shoulder and back didn't really line up properly and caused her a lot of discomfort. Her bones were not healing back together and every time she was jostled she had terrible pain. Finally after a year she was referred to an Orthepedic surgeon who told her if he'd seen her the day it happened he'd have had her in surgery right away and pinned the bones together. She had that done and has almost all her range of motion back and has very little pain. So the moral is, if you ever break your collarbone insist on seeing an Orthepedic Surgeon right away - don't let them tell you no cause he's the one who can tell you if you should be pinned or not. That's not to say ER docs don't know what they're doing. I have great respect for them, but it isn't their specialty so it isn't out of the question to bring in a specialist and get his opinion.

solosater

No, I'm not a physician and would not ever want someone to follow my beliefs or opinions blindly and I hope everyone here knows that. Taking blood could certainly be lumped in with any other daily medical practice and I'm sure that some may see benefits in doing so, as I said the arguments I mentioned are purely the logical ones; there are others. But we all make those decisions for ourselves and as far as I am concerned there is no good reason to do it and plenty reasons to avoid it.

I will say this, I think in a lot of situations the medical establishment tends toward the fastest fix whether that is the best fix or not. I think a great many doctors lean on the ability to give blood as a crutch for skill where they should be finding better ways.

How many of you would pick up a toothbrush at a second hand shop or yard sale or for that matter even borrow a friend's or family member's? Sure it's easy and convenient but is it the best choice? Are you likely to catch a cold? The flu? Or even just cooties? How much more so the blood running in someone else's veins? Even with all the testing that is done and the regulations, tainted blood does find its way into the supply and I cannot see how risking an infection is a good idea when a person is already down.

solosater

Dragon, my stepfather nearly died because the ER kept sending him home. He went in three times and was convinced to go home and take more pain medication after he had knee surgery. Final I got upset and told him to get back to the ER and refuse to leave until they take a proper look at him and run some tests! He's not a wimp, if he can't handle the pain there is something wrong!

They finally found several blood clots in his leg, admitted him and put a filter in his leg. If he hadn't insisted they would have sent him home again without looking farther that their own noses. I imagine they were glad he didn't give up as they'd have had a lawsuit on their hand had he died because they wouldn't look.

I've spent rather a lot of time in the local ERs and I have to say that the majority of the time I have good experiences and leave feeling well cared for but there have been times when I've left to go to a different ER too!

I was accused of drug seeking at the first ER I went to on the night I had my drain pulled. It was sliding out and I (not having a real understanding of how the drain worked at that point) thought it was going to fall out and leave me with a bleeding hole in my side! The nurse said it was fine without even lifting the bandage to look and had the doctor sign my release forms without even coming in the door. I was so upset by the way I was being treated I had a panic attack and my chest started tightening, I got short of breath and nearly passed out. I'd never had that kind of panic attack before and thought I was having a heart attack. When the doctor came back in to see me he said, "I could do a chest workup but you'll be here all day and we still won't give you any drugs."

That was like five days after my release from the very same hospital after all that infection and blood loss (I've been spelling loss wrong for some reason:-P), I was not a happy camper! I stood up and walked out the door without a backward glance and my mother drove me to the next ER. (Then went to get my stepfather too.)

I waited a day or two but then called Nancy Queen the Nurse Manager for the hospital and told her all about the situation and then at her suggestion wrote to the head of the ER department too. She was great and assured me that there was no mention of drug seeking on my record there, though I believe they must just not write it in that way for "legal" reasons.

I've been back to that same ER many times since and will go there in the future too if I need to; they are the closest. But I won't ever not get treated when I need it. I really believe that in ER medicine they kinda' see it as their job to get you to go home; if they can get you to go home then you probably don't have a real emergency. I don't know that that is written down anywhere but it certainly is an attitude I've come across a few times. I can see how that could start but it's a sad thing that people who are in need have to fight so hard to get help.

solosater

Robin, are the JP and the Drake/Blake drains just different brands or are they used in different situations too? I know you are likely not walking talking and typing medical dictionary and encyclopedia but thought you might know.

I need to know if I can demand the JP (or the other though I'm pretty sure I had the other) the next time! NEVER AGAIN!!!

Robindcr8l

Solo, they are different drains, and I believe used for different situations. You could always inquire if, God forbid, you ever needed another drain. But the JP drain has very small tubing, and I've not seen it used for infection, just for post-op drainage, which is typically very thin. It has a bulb at the end of it, which we pin to the patien'ts gown. You squeeze the bulb, then close the drain, so the bulb stays depressed. It creates a suction that way, and typically, on someone who has a LOT of post-op drainage, we might drain like 75cc in a shift, but more common would be about 30cc. That amount will decrease over a few days and when it is less than 10cc we pull the drain.

The other drain types that I've seen used for abdominal abscesses have larger tubing, so would be able to collect the thicker drainage that would come from an abscess. They are usually to gravity, although I have seen them hooked up to low suction before, too. I actually haven't heard the name Drake or Blake for the drains, but I am pretty sure of what kind of drain you're talking about. There are other drains, too, like after knee surgery a lot of docs will put in a hemovac or a constavac. Some of them have to be drained and reinfused into the patient, to prevent blood loss. (similar to a cell saver, but this is post-op when the patient is on the surgical floor. Cell savers are used during the surgery itself.)

I thinkyou are probably right about the attitude in ERs, although I think that attitude comes from a variety of causes. Although you were not drug seeking, they get plenty of people whoARE drug-seeking in ERs, and I'm sure it taints one's perspective after awhile, until we all seem like addicts to them. Also, insurance and medicare regulations have made it so that it takes an act of God to admit someone to a hospital anymore. So they are trained with the attitude of moving the patient through the system as efficiently as possible. As the charge nurse on my floor, I go to a staffing meeting every shift where all the charge nurses meet and determine where the nursing needs are and who will float where. The ER charge comes in and will say things like "we have 28 patients, and I only know of one admit for telemetry. " The supervisor will say, "What about the guy who came in with paralysis?" and the ER nurse will say, "We cured him." and everyone will laugh. Thing is, there are people who come in with paralysis who aren't really paralyzed, it's just a psych disorder. But makes you wonder for the person who comes in with paralysis and they assume it's psych and send him home. 2 days later he's back only this time the paralysis is spread higher and more severe and they finally realized they missed that spinal cord abscess. It's scary for sure!

Dragon

In Canada we don't have the worries about insurance to be admitted to the hospital. Our ER's are always overrun though. I suspect they would try to move everyone through quickly or try to determie if they can go home because a lot of people go to the ER with things that don't require emergency care. I suspect they see a lot of people with the sniffles who don't think to go to their family doctor or a walk in clinic instead.

solosater

I agree fully with your thoughts. I believe most people in the industry do care and want to help the sick and injured but I also think many are not equipped to see the real from the imagined and are going on gut or even based on their own feelings at a particular time. I don't know that that can be prevented entirely but I wish it could. I have several people close to me who would perhaps seem less emergent than they actually are due to their personality or history.

My stepfather will always seem less sick than he is; he's like a dog who hides his illness for protection. My brother will always look like he's seeking drugs because he gets terribly nervous in hospitals and looks like a street person most of the time. I personally will joke around with the staff even when I'm at death's door so I may seem like I'm not really sick or like an attention seeker.

Even regular, non emergency health care is hard to get on a personal level, likely due to the medical insurance companies and the laws and rules governing the industry.

My mother was recently made to switch doctors and even most of her specialists because her insurance no longer covered her doctors. Her new endocrinologist wants her to wait two hours after breakfast before eating anything else. My mother has been trying to follow that but is having real trouble as she has been eating only an apple for breakfast. I asked her if her doctor knew what she ate for breakfast and of course she didn't. Her doctor is most likely used to treating diabetics who eat pancakes for breakfast as many diabetics don't eat well. My mother assumes that her doctor is treating HER while it is likely her doctor is treating A DIABETIC. The doctor has fifteen minutes to get to know her and treat her before she needs to see another patient; there is no way she could know that my mother has successfully treated her own diabetes by controlling her diet for over thirty years.

None of that should prevent us from getting the care we need but unfortunately it often does.

We bear some responsibility as well; we have to keep trying when we know we are not getting the doctors and nurses to really see us. Perhaps that should be a given but it's not and we can whine about it and stay sick or we can make them see us and get our needs met. I've found with most doctors if you get their attention and really make them see you they don't ever miss you again.

solosater

Thanks for the info on the drains Robin.

I forgot until you mentioned it that we depressed the reservoir before attaching it to the valve. I believe there was both suction and gravity in play with my drain.

marius

This medical talk has been most educational to me. Here's what I wonder: why hospitals, etc. are short-staffed when there are constantly ads in the classifieds for nurses, etc. Are there not enough doctors, nurses, or are the medical establishments so pinched they can't afford to hire as many as needed? I don't get it.

I've been hearing forever about the heavy patient loads given to nurses and my brain say, "Just hire enough people already! Problem solved." From my puny perspective, medical costs are so outrageous that is seems there "should" be plenty of money to hire enough staff.

solosater

As to why it is in the medical field I haven't a clue but I see it a lot in customer service of many fields. I think it's that the companies are trying to only have as many people on as needed but they project those numbers from previous years and months and are often wrong. I see it mostly at discount stores like Ross or Walmart and grocery stores but in call rooms you can't SEE it; I've experienced it on the other end though.

It isn't easy to get people in on their day off. I worked for Eye Masters about ten years ago and my manager always had plenty of people on to carry the load, if we happened to have a slow day and there were too many of us she'd ask if anyone wanted to go home. I think that is a way better way to handle it.