Ileus Hospitalization

We took DH to the emergency room Wednesday morning. After being up all night with severe upper abdominal pain, he became nauseaus and was sweating bullets to boot. I thought he might be having a heart attack, or his hiatal hernia surgery he had done a few years ago came undone, or he had gallstones.

He spent 9 1/2 hours in the ER. They did an x-ray and blood work. He had a high white count. They sent him for a CT. He had a "slow small intestine". They call it an Ileus. They needed to watch him to see if it turned into a blockage. They admitted him...but it took forever to get a bed.

HE was allowed No food or water. They started an IV. They did regular blood work. Thursday he was still on no food, no water. But was feeling better. His potassium and calcium were low so they gave him those. They did another x-ray to see where things were and apparently they had started to slowly but surely move along. He was told they would start him on clear liquids in the morning and soft foods like soup and pudding in the afternoon.

So I get to the hospital at 10 am on Friday morning and he hadn't seen a Dr. since he coincidentally ran into his Primary Care Physician coming out of x-ray at 9 am the day before. No one could tell us who was covering for his doctor or when someone might be in to check on him or at the very least give him the OK for some clear liquids.

He was about ready to discharge himself. I went to the Nurse Station and asked, I informed them they were about to lose a patient. They said they'd look into it. an hour later his nurse comes in and we ask her about it, Dan tells her he was leaving in 65 minutes, whether they discharge him or not. she'd said she'd check. Another hour goes by and nothing. So i went and called his PCP, got the answering service since it was a holiday and they are closed for the holiday and explained to her that one if their patients was admitted Wednesday and hadn't seen the covering physician yet, has been on no food and water for 3 days, I had asked at the nurse's station and the his nurse who the covering doctor was, when we might see him, when he might be allowed at least some clear liquid and they couldn't' answer a thing. I go back to his room. And then I go back down to the nurse's station, who informs me they just received a call from his PCP, they were now looking for his covering doctor. Of course you are, because I JUST got off the phone. I CALLED his PCP! You are going to lose a patient in 5 minutes, he's packing as we speak. The covering Dr. doesn't do rounds till late afternoon. Well then I guess he'll have one less patient to see. As I am leaving she asks which nurse covers my husband, the covering Dr. is calling in, my husband's nurse happens to be there and picks up.

All over the hospital are signs posted for this CONDITION H. H for HELP. That if you feel you are not receiving quality care, you can dial this number and a team of people will arrive to assess the situation and assist in getting your patient help. Needless to say, this IS NOT confidence inspiring. Anyhow, the Unit Nurse Coordinator shows up...she says her name is Nurse COMFORT...makes me wonder if it's a code name like "Paging Dr. STRONG to room #2B19" just means they need some really strong people in that room ASAP to help restrain a patient??? Anyway she offers her apologies in the lack of communication, it's busy....They were trying to reach the covering DR all morning, they can't help it if he doesn't answer his pages. I said we understand he is low priority, it's not life or death, but some simple straight answers would have averted this entire situation. At first I was irritated but OK, I told her I have no interest in listening to excuses, she says in a snotty tone "these aren't excuses Ma'am...these are the facts...." OMG BULLSHIT...NOTHING was being done UNTIL I CALLED HIS PCP. He asked his nurse this morning she had no answers. I went to the Nurse's station two hours ago..they couldn't even tell me who his covering doctor was! THE ONLY REASON they were on the phone with him 10 minutes ago was because I CALLED HIS PCP! I was so irate, Dan got up stepped between the nurse and me, and was like I'm staying. I'm OK .Everything is OK. Your OK. He hugged me but I was so peeved I pushed him away and walked out. I was absolutely FUMING. I was totally ready to go toe to toe with Nurse Comfort.

When I got back he had coffee, a carton of milkshake crap, cream of broccoli soup, a tapioca pudding and a Jell-O. A while later they offered him toast and his nurse filled out all his paperwork so when the Dr. Late Bird got around to doing his rounds his discharge would be quicker. We sat in the room for another 4 1/2 hours waiting on the Dr. His nurse came in and was so apologetic...I don't have a problem with any of the nurses, except Nurse Comfort, she better keep her distance from me. I told her I've had two babies at that hospital, my glalbladder out, Dan's hiatal hernia surgery and we've never run into this kind of problem before, I understand he's a low priority case however, my daughter has epilepsy and if i ever get this kind of treatment in her care all Hell will break loose.

Almost 5 pm Dr. Late Bird meanders in, doesn't check Dan over at all, doesn't listen to his gut nothing...just asks how are you feeling? Nauseaus? Pain? No...I was told you wouldn't be released until tomorrow but if your feeling up to it I'll release you now. Any questions? Yeah how about his low potassium...is it the cause of the Ileus or a result of the Ileus. I doubt it's the cause, lots of people come in here with low potassium doesn't mean they'll get an Ileus (OK I know I am not a Dr., I know I shouldn't get my medical advice online but go to medline and look up Ileus and you'll see this....

Paralytic ileus, also called pseudo-obstruction, is one of the major causes of intestinal obstruction in infants and children. Causes of paralytic ileus may include:

Chemical, electrolyte, or mineral disturbances (such as decreased potassium levels)

So it was caused by the Ileus? It was probably caused by the Spirolactone (his high blood pressure medicine).

From Medline about Ileus:
Possible Complications
Complications may include or may lead to:
Electrolyte imbalances

From the FDA site on Spironolactone:

Indications and Usage for Spironolactone

Hypokalemia
For the treatment of patients with hypokalemia when other measures are considered inappropriate or inadequate. Spironolactone tablets are also indicated for the prophylaxis of hypokalemia in patients taking digitalis when other measures are considered inadequate or inappropriate.

(hypokalemia is low potassium in the blood)

Therefore when you go down to WARNINGS:

Warnings
Potassium supplementation: Potassium supplementation, either in the form of medication or as a diet rich in potassium, should not ordinarily be given in association with Spironolactone therapy.
Excessive potassium intake may cause hyperkalemia in patients receiving Spironolactone (see PRECAUTIONS: General). Spironolactone should not be administered concurrently with other potassium-sparing diuretics. Spironolactone, when used with ACE inhibitors or indomethacin, even in the presence of a diuretic, has been associated with severe hyperkalemia. Extreme caution should be exercised when Spironolactone is given concomitantly with these drugs.

Hyperkalemia is excessive levels of ptassium in teh blood, which can lead to cardiac arrest, like he isn't a cardiac arrest awaitign ot happen already?! @@I'm beginning to wonder if they just pulled a Janitor aside to pose as a Dr. to get us out of there?!