May 26, 2025

From Farm to Straw

Today we honored those who made the ultimate sacrifice for our freedom by spending time with our loved ones enjoying our freedoms. Our kids picked the strawberries my in-laws grew on their farm and there were plenty to blend into the smoothies for Mom as she celebrates one week free from hospitalization (again) and continues to persevere on what is to be a 3-month liquid diet as she awaits another surgery, this time at the larger hospital.

This week I have plenty of thoughts for you on seeking a diagnosis and an effective treatment plan when the plan is not yet clear. For Dad a few years ago he felt very low energy with discomfort in his chest. He believed he had COVID until my mom thought something wasn’t right and had him call his PCP. His PCP thankfully diagnosed him over the phone based on what he was telling her and called an ambulance for him as she strongly suspected he had had a heart attack the day before. She was right. His diagnosis was straight forward and he underwent a quadruple bypass surgery very soon after that.

With Mom’s first hospitalization in recent years she also received a clear cellulitis diagnosis (a skin infection) and shortly after that an amazing provider from Infectious Disease at the small hospital became involved and a month of treatment with antibiotics ensued which cured the infection, but ended up impacting her kidney function. When she was hospitalized a second time about two years later she entered through the ED at the small hospital emergently by ambulance with a severe hernia and extreme pain which turned out to be a full bowel obstruction both of which led to emergent surgery.

Hospital Hints: In the ED a provider (sometimes a nurse practitioner or a physician’s assistant) will triage your loved one and, once determined to be stable enough, you will then wait (sometimes for hours) to be seen by the ED docs. Then if your loved one needs surgery they will typically be assigned to the service of a Surgical Team. When communicating with the hospital staff you will want to ask to speak with the Surgical Team which includes all of the residents and attending physicians on that Surgical Team and could include a nurse practitioner or physician’s assistant. If you continuously ask for the Medical Team (as I did) you will be incorrect if the surgeons and surgical residents are the ones overseeing your loved one’s care. Also, a special tip from me, no matter how many times your loved one has been readmitted, don’t be dismissive with the ED docs because you’re waiting for the surgical team because you believe that’s who you need and that the ED docs won’t be doing anything anyway. You never know what they are noticing and finding.

In Mom’s case over months in and out of the small hospital, the teams passed her from one to the other. What you as an advocate can best hope for is one consistent treatment team to follow your loved one until treatment is complete or they can be discharged to a lower level of care. Consults with GI or Nutrition or other specialties can be extremely helpful, but passing the patient repeatedly back and forth from the Surgical Team to the GI Team to the Internal Medicine/Hospitalists for observation can be very confusing for the patient, the patient’s support system, and the overall treatment plan.