Disgusted with ped, hospital, and cost of healthcare!

[Pea-n-Me]

Not being confrontational-but what does this mean, I truly don't know because from my point of view all that was done after we arrived in his room was what I mentioned. Is it because they have staff ready to jump in in case of an issue that may arise?

Not confrontational at all...

There are a lot of things that can go wrong after a procedure like that, which is why most patients are hospitalized and monitored overnight. Although fairly rare, things like bleeding from sites, loss of pulses to limbs (if used for catheter access), allergic reactions to dye or medications, retroperitoneal bleeds, fluid volume overload, acute thrombosis, dissection or tears in cardiac tissue, stroke, arrythmias, pericardial effusion or tamponade, and even death, can occur. So what to you is

all that was done for him was check his temp and blood pressure a few times-he was discharged by noon the following day

is actually a whole lot more. There are standards of care which are determined to be necessary after these procedures in order to quickly detect and treat any potential problems. If it was as simple as you say, anyone could do it. A cardiac nurse in a post procedure unit in a hospital doing procedures like this is very well prepared to detect and report any problems so they can be dealt with quickly in order to prevent further problems. "Checking vital signs" looks like simply taking a pulse, respirations, temperature and oxygen saturation. When in fact the nurse is continually assessing all different bodily systems when he or she talks to the patient, checks surgical areas, listens to heart tones, even when monitoring BP (you can hear a pulsus paradoxus when there is an effusion, it's often the earliest warning sign of a major problem), watching the heart's rythm on an advanced cardiac monitoring system (again, early warning signs of trouble can be detected by a skilled nurse), monitoring lab results, urine output, restlessness, pain, anxiety, etc, are also being assessed, and in pediatrics it's not just in the patient, but the parent as well. (It's more than I can fully capture here at this hour of the night.)

Additionally, care is planned individually for every patient. There's patient/family teaching in hospital related to the procedure and there's patient/family teaching prior to discharge. What activity level is post procedure, what medications and fluids are, what's going to happen next, what to call nurse for, how long to stay in bed, and why; what to watch for at home, when to call back for problems, who to call, what medications are and what they're for and what to know when taking them, and on and on. Any special instructions related to prior health and follow up, etc.

And oh yes, all of this and more needs to be documented completely and accurately.

And as I mentioned, these procedures are only done in specialty hospitals who are allowed to do the procedures because they have specialized equipment and staff. The procedure itself involves pediatric cardiac interventionalists and numerous other staff in the procedural and recovery rooms. They use advanced technology, including fluoroscopy and other radiological equipment. Lots of medications are used, generally, including anasthetics and analgesics. And there's lots of monitoring and electronic documentation that goes on there which, again, is quite complicated.

So my point was that this type of procedure cannot compare to a simple medical overnight admission for constipation, see what I mean?

Here are a few relevant articles if you want to learn more.

http://content.onlinejacc.org/cgi/content/full/32/5/1433

http://circ.ahajournals.org/cgi/content/full/97/6/609

http://nursing.uchc.edu/unit_manuals/intensive_care/docs/Post-Cardiac Intervention Procedures.pdf

http://www.enotes.com/nursing-encyclopedia/cardiac-catheterization

 

[JVL1018]

Not confrontational at all...


So my point was that this type of procedure cannot compare to a simple medical overnight admission for constipation, see what I mean?

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I do! LOL Thanks for all the info!

 

[marymouse]

OP, I feel your pain. We dealt with constipation issues for 4 years with the ped just telling us to give her miralax or another stool softner.
Changed doctors and she sent us to a pediactric GI. He was wonderful.

Basically even if she wasn't withholding in the beginning, she probably is now because it hurts. She has to push so hard because the stool builds up and becomes hard and the urge finally over comes the fright.

Our GI said we had to clean her out completely and start from scratch. Milk and molasses enemas were what he prescribed. I can't remember how much but we did 2 12 hours apart. Then a suppository the next day, then onto the Miralax again. She was on the Miralax for about 3 years before we weaned her off and she is doing well now at 12.

I would look for a Pediactri GI that liked kids. This one sounds like a crabby one.

 

[Tracy041500]

Instead of Miralax, try Flax seed. Its a natural laxative. You can mix it in anything. Also they have flaxseed oil and you can put 1tsp in juice,or yogurt.

 

[Pea-n-Me]

Another important point is that the child has to be "taught to go when they get the urge to go". Otherwise, they lose the urge and it becomes a viscious cycle. Challenging? Absolutely. If the child is worried about odor when in school or out in public, an odor eliminator might help. They are sold in drugstores and natural food stores.

 

[wvjules]

Instead of Miralax, try Flax seed. Its a natural laxative. You can mix it in anything. Also they have flaxseed oil and you can put 1tsp in juice,or yogurt.

Sorry but in severe cases like the OP, Flaxseed won't do the trick. Sure, add it if you want but do not cut out the Miralax in favor of Flax.

 

[The Mystery Machine]

Instead of Miralax, try Flax seed. Its a natural laxative. You can mix it in anything. Also they have flaxseed oil and you can put 1tsp in juice,or yogurt.

Another one to chime in and say while it sounds nice in theory, it does not work.

I remember the days of giving my dd mineral oil before they handed out the Miralax....pure torture.

 

[donnajon]

DD10 just went through this. She had her gall bladder removed when she was 8 and about six month later she started having abdominal pain again. I think the local pediatric GI thought she was faking it and told me that it takes the body a year and a half to figure out what to do once the gall bladder has been removed. Yea, right. I took her to another doctor two hours away. He put her on a special diet which helps 90% of his patient but didn't help her. So he did an endoscopy and colonoscopy and found out she had a pound of hardened stool lodged up near her appendix. Because it was so high, we had to go the Miralax and Ex-lax route. She was taking four large capfuls of prescription Miralax and six ExLax per day in addition to four tbsp of Mineral Oil. He said because of the size, it might take about six months for it to go away. And it took almost exactly six months! She would describe her pain as a 9.5 to a 10. Now she is finally pain free. She has been off the Miralax and ExLax for about a month and we follow up again in another month. He wants her to poop three times daily, which she does (She likes to quote him as saying "A poop a day keeps the doctor away.") She is still pain free and feeling better than she has in a year and a half. I'm just glad I didn't listen to the local doctor. Imagine how large that mass would have become if I had listened to him and just let her be in pain for a year and a half!

Also, you may be able to negotiate with your hospital to cut your bill. Tell them your insurance paid X amount and you only think you should pay whatever. Some hospital will do this. It certainly can't hurt to ask. The worst they can do is say no.