Here are a few slides from her CT scan on the day she was injured. These were taken at the Medical Center in Bowling Green. Pretty obvious to the untrained eye it is broken.
This image on the left is the top of her C2, viewed from above which displays the front where the C1 rests on top of the little point of bone that allows head movement. To the right is the visible crack as viewed from the side.
Next in the left image is the same bone farther down where the ring that surrounds the spinal cord is visible. The rear of the bone appears intact. The right image is of the same area a little more to the center of the spine.
So, the cardiologist says that three episodes in two and a half years is not significant enough to warrant going on a maintenance medication. That is encouraging. He says it isn't life-threatening and when the vest comes off he'll want her to get an echocardiogram, which is a technical way of saying heart ultrasound. We have that appointment for the first week of April. With any luck, she'll be out of the halo long before then.
Back to the NP of neurosurgery. She profusely apologized for the wrong and/or lack of information we received. She explained that she'd wear the halo for 12 weeks, regardless of what anyone else told her because they won't even look at healing until 12 weeks. The first visit is just to find out if she is still in alignment and to tighten the head bolts. She's not looking forward to that. The same thing will happen at eight weeks. Only at the 12-week visit will they actually do a CT scan to check for healing. If it is not sufficiently healed, they will determine if it is healing and will continue the halo for another month or she will be evaluated for surgery. I'm not really happy about her having to suffer for 3 months only to find out she would still have to have surgery anyway.
I'm still debating on whether to have my wife call the patient advocate over this whole affair. The ER nurses and the attending doctors were fine. They kept her comfortable and the pain manageable. However, the on-call neurosurgeon was another story. He seemed impaired as if sleep-deprived when he arrived at 2:30 AM to install the halo-vest. He kept referring to events that would take place in the future as tomorrow when he really meant in a few hours. I asked for clarification since I was definitely sleep-deprived and going on 20+ hours without sleep myself. This appeared to agitate him for some reason. Another sign of sleep deprivation and unprofessionalism.
Then as he was attempting to get the vest situated and he commented that it was crooked. Jan heard him say it, too! So, if the foundation is not correct, what does that do for the rest of the construction? Any contractor will tell you it won't work out well. So, now the bars are being installed by Dr. Crooked. After getting three bars installed, the fourth was at such an acute angle it wouldn't connect to the halo around her head. When I pointed out he could loosen another axis to get the additional working room, he said, "Who's the expert here?" Despite my usual smart-aleck self, I kept my mouth shut but certainly wanted to reply, "I don't know. Maybe we should page one!"
The points she should make to the patient advocate are as follows:
1) Her head is rotated 20-30 degrees clockwise from forward
2) They did not shave the posterior halo screw sites, difficult to clean
3) Gave us no guidance on pin care, didn't tell us to clean them or how
4) The vest was put on crooked and the doctor that did it acknowledged it
5) They have little or no concern for the person being traumatically put through this
I've always heard good things about Bilkmore but my faith is greatly shaken in the medical profession in general.
This image on the left is the top of her C2, viewed from above which displays the front where the C1 rests on top of the little point of bone that allows head movement. To the right is the visible crack as viewed from the side.
Next in the left image is the same bone farther down where the ring that surrounds the spinal cord is visible. The rear of the bone appears intact. The right image is of the same area a little more to the center of the spine.
The nurse practitioner finally called us back on Dec 29th while we were at the cardiologist's office. My wife had an episode of PSVT (paroxysmal supraventricular tachycardia) in early December. She had a heartbeat of 160 bps for more than an hour with a BP of over 200. She originally had that appointment for Dec 15th at noon. Unfortunately, we missed that one due to still being in the ER at Bilkmore with her new headgear.
So, the cardiologist says that three episodes in two and a half years is not significant enough to warrant going on a maintenance medication. That is encouraging. He says it isn't life-threatening and when the vest comes off he'll want her to get an echocardiogram, which is a technical way of saying heart ultrasound. We have that appointment for the first week of April. With any luck, she'll be out of the halo long before then.
Back to the NP of neurosurgery. She profusely apologized for the wrong and/or lack of information we received. She explained that she'd wear the halo for 12 weeks, regardless of what anyone else told her because they won't even look at healing until 12 weeks. The first visit is just to find out if she is still in alignment and to tighten the head bolts. She's not looking forward to that. The same thing will happen at eight weeks. Only at the 12-week visit will they actually do a CT scan to check for healing. If it is not sufficiently healed, they will determine if it is healing and will continue the halo for another month or she will be evaluated for surgery. I'm not really happy about her having to suffer for 3 months only to find out she would still have to have surgery anyway.
I'm still debating on whether to have my wife call the patient advocate over this whole affair. The ER nurses and the attending doctors were fine. They kept her comfortable and the pain manageable. However, the on-call neurosurgeon was another story. He seemed impaired as if sleep-deprived when he arrived at 2:30 AM to install the halo-vest. He kept referring to events that would take place in the future as tomorrow when he really meant in a few hours. I asked for clarification since I was definitely sleep-deprived and going on 20+ hours without sleep myself. This appeared to agitate him for some reason. Another sign of sleep deprivation and unprofessionalism.
Then as he was attempting to get the vest situated and he commented that it was crooked. Jan heard him say it, too! So, if the foundation is not correct, what does that do for the rest of the construction? Any contractor will tell you it won't work out well. So, now the bars are being installed by Dr. Crooked. After getting three bars installed, the fourth was at such an acute angle it wouldn't connect to the halo around her head. When I pointed out he could loosen another axis to get the additional working room, he said, "Who's the expert here?" Despite my usual smart-aleck self, I kept my mouth shut but certainly wanted to reply, "I don't know. Maybe we should page one!"
The points she should make to the patient advocate are as follows:
1) Her head is rotated 20-30 degrees clockwise from forward
2) They did not shave the posterior halo screw sites, difficult to clean
3) Gave us no guidance on pin care, didn't tell us to clean them or how
4) The vest was put on crooked and the doctor that did it acknowledged it
5) They have little or no concern for the person being traumatically put through this
I've always heard good things about Bilkmore but my faith is greatly shaken in the medical profession in general.
The guy who saw her may not have been a regular neurologist. He may have been a resident specializing in Neurology. That would explain the sleep deprivation. As crazy as it sounds residents and interns on hospital rotations are REQUIRED to work 36 hour shifts. Yes, 36 hours. There is a room where they get to take naps, but I doubt those naps come at regular intervals or last a decent duration.
ReplyDeleteIt should be criminal. Anyone without sleep for that long is impaired. He acted like he was impaired. Short, unprofessional and antagonistic.
ReplyDelete