Wednesday, July 1, 2009

An Ode to the Morass

Man you can do a lot of medical stuff at home these days. We came home from the hospital, yesterday, June 30. We came home with the promise of being able to continue the IV antibiotics Marty has been on in the hospital for another 20 days, at home, done by yours truly and his trusty gang of caregivers.

We actually started home Monday but sort of got caught up in the medical delivery, insurance, Medicare milieu. Almost all hospitals today have case managers or Social Workers (my daughter, Erin is a Social Worker, employed by the way), and these good folks go around all day trying to get you out of the hospital and coordinating the myriad of events that sometime must take place to get you home.

In our case this involved finding the right antibiotic, the equipment with which to administer the antibiotic and the home care nurse who would train Larry and gang to administer the antibiotic via the handy dandy little PICC line which was installed (surely there's a better word) Monday. It just got too complicated to do in one day. First we had to discuss with all of Marty's insurers who was going to pay and how much. The end result, no one was paying very much. Fancy that. Then we had to find someone who could actually provide the compound antibiotic, Merrem, the compound part being a complicating factor. So, we decided to just stay Monday night, have the antibiotic at the hospital one more day and retry homeward bound on Tuesday.

Tuesday it worked. Marty's drug plan still wasn't paying for the meds (donut hole you know, if you don't you will when you hit 65) but we found the antibiotic and the case manager lined up the home health nurse to do the training.

As complicated as all of this is -- it worked. Just as promised the company from the DFW area brought medicine and supplies (we are now the proud owners of an IV pole) and the home health nurse showed up right on time. We went through about an hour of training, most of the time spent on sanitary procedures, and I can now, if you ever need me to, can hook up an IV to you in about 30 minutes flat. I don't charge by the minute, it's a flat rate.

I am forever amazed how out of the bureaucratic maze that medical care can be that every thing ever comes together. When we got home everything had been lined up and people really followed through from the medicine to the training. Now that doesn't take care of the financial end of this, but once you say, "I'll pay", people bring all kinds of things to your house.

The nurse training us is from Germany and has a, German accent, fancy that. She is extremely competent and I've been a little afraid to screw up lest I be chastised. We gave the first dose under her watchful eyes; "don't touch that, hold that there, don't pull that, make sure that's clean". Hygiene, sterile conditions are a big deal. We got through the first dose easily and the 2nd dose was scheduled at 1 a.m.. The German nurse came back, she was still a little intimidating, though nice. This dose also went well though Marty kept moving her arm and it took 2 hours to infuse so it was a very late night.

Anyway, all of this is really an ode to the competency of people we often don't think are going to be competent. We think the people in administrative health care are going to reach and strain for mediocrity because we hear so many horror tales. I've seen that up close and personal too. But, it's not always that way, sometimes, most times given the right support, these folks will deliver and perform and out of the medical morass things take shape and good work happens. This was a pleasant experience, or at least as pleasant as it gets.

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