Need some advice? (Minneapolis, Echo: credit, loan, health insurance)

[jojo61397]

I grew up in Minneapolis. Recently my dad who lives there still fell ill. At first they said it was a blood infection, but could not find the source. Finally, he had a heart attack caused by an infected valve and was rushed to the ER at North Memorial. My dad is 69 with severe diabetes, but otherwise had a healthy heart.

He was put into ICU, my mom told the attending doctor in the ER that he had a rotten tooth, she told the ICU doctor he had a rotten tooth, and she told the ten doctor team of specialists working on my dad he had a rotten tooth. This was nearly 28 days ago. All the doctors said, nope the tooth wasn't the source. They said they suspected that the heart was infected. They needed to do a Trans-Esphogal Echocardiogram (TEE test) to see how the heart was doing. They waited and waited and waited and waited and waited, because of the "infection". Well the infection attacked his kidney's and shut them down, so they put my dad on dialysis. All ten doctors do not talk to each other. About 14 days into the whole thing, the infectious disease doctor asked my mom why they hadn't done the TEE test, and she told him that it was because of the infection in his blood, and now it's because of the kidneys shutting down. The infectious disease doctor said, well if the infection is in his heart his kidneys will continue to stop functioning.

Finally, on day 16, he had the TEE test, the doctor determined that he needed an angiogram. They did the angiogram on day 20, and then said he needed emergency open heart surgery, because the infection was on his valve. He had a valve replacement a week ago, on day 22. After the valve was replaced the cardiac surgeon determined that it was in fact the tooth that we told him about on DAY 1!, and that tooth came out on day 24.

They decided he needed a pacemaker installed, so they called my mom and told her she needed to come down to the hospital and sign the consent form. My mom is the sole breadwinner of the family and works 10 hour days owning her own business. The doctor treated her very disrespectfully and told her that she should be down at the hospital 24-7 to help care for my dad. Well, if my mom doesn't work-- the doctor doesn't get paid. The day they installed the pacemaker my sister-in-law went down the hospital. My dad is diabetic and needs to go under the for the operation-- they scheduled it at 7:30 AM, and he could not eat from 10:00 PM the night before (not that he was eating much anyway). They pushed the operation back FIVE times until it was nearly 10:00 PM when he had it. They did not feed him, did not give him even a sugar IV bag. They had my mom wait in the downstairs waiting room where they do operations for about 3 hours (for a 90 min procedure). My uncle went up and found out that they were done and he was in his room, no one came out and talked to her about the procedure. Then they went upstairs, and the technicians told her she needed to come back in the morning to hear how the pacemaker works (because dad's been loopy). My mom said, she couldn't just take off at 10:30 PM, she couldn't call her clients at that time of night and tell them not to come. She asked the attending ICU doctor why this was the case, and some other basic human anatomy questions-- the guy told her, "listen lady, you are talking to the wrong doctor."

Oh and the renal doctor told us because they waited so long to treat the infection in his heart-- dad might be on dialysis perminately. Before he got in the hospital his kidneys were functioning at 65% which is good for his age and health, now after he got into the hospital they are functioning at 8%. His GP said if they would have operated the first week on the heart valve, his kidneys would not have failed.

This whole thing happened at North Memorial Medical Center in Robinsdale. I would like to know if anyone knows of a formal complaint process, or what we need to do? My brother would like Dad moved to Unity, but it may be too late to do that.

[laura82erickson]

I have no idea what you can do about this, but I just wanted to tell you how sorry I am that your family is going through this. Illnesses are hard enough on families without added stress of unhelpful people. I'll keep your dad and family in my prayers

[JenLee]

You need to talk to a Patient Representative for the formal complaint; and also have the nurses coordinate a care conference with family and doctors present. Get Social Services involved too.

There seems to be really poor communication all the way around for some reason here. SOMEONE should have got this going a while ago and I'm not sure how your Dad fell through the cracks on this.

This is not the typical way things are done at North Memorial (or any other Twin Cities Hospital, for that matter); so a formal complaint is definitely in order. I'm sorry that your Dad seems to have jerks for doctors; as a nurse I do know some docs that have no personality but are excellent surgeons and specialists; sometimes I feel my job is to protect the patient & family from certain doctors' rude remarks.

One piece of advice I can give you is get to know the nurses and make sure they are aware of the fact that your Mom is working and can't be at the bedside 24/7. Nurses will advocate for patients and families if they are aware of family situations like this. I don't work at NMMC, but I know some nurses who do; and I've recently had a relative in North who received very good care and made accommodations for family about some things because of the health of the patients' spouse. As a nurse, I've scheduled care conferences for family on evenings and weekends and the docs were informed and had to arrange their schedules or have someone there for them.

As an afterthought: something you need to realize is that your Dad wasn't taking very good care of himself before he was hospitalized: you said he was a severe diabetic, he had a rotten tooth, and his kidneys were only functioning at 65%. He's ONLY 69! I've taken care of many 70-90 year old diabetics with normal-functioning kidneys. Diabetes is a chronic disease that will affect the heart, kidneys, blood vessels, etc. if not closely monitored and controlled. A rotten tooth doesn't happen overnight and will affect diabetes; if your Dad ignored the tooth and his diabetes (and the "blood infection" he had before the heart attack), his heart couldn't have been very healthy. I'm guessing that your Dad ignored his Diabetes and this whole cascade of problems is the result.

I am sorry that your Dad is so ill; but I think you need to understand that he wasn't in such great shape to start with. Chronic diseases such as Diabetes, high blood pressure, heart disease, asthma, etc. need to be closely monitored by the person who has them, and they have to take care of themselves and make lifestyle changes.

[jojo61397]

Yes, I realize that he is not in perfect shape, but there is absolutely no reason for them to treat my mother like a second class citizen when asking questions (or pass her off to another specialist at every question), to not communicate issues with the family, not inform the family until the very last minute of any changes to his care plan, to not call even though it has been explained over and over and over again our family was not capable of 24-7 attendance in the hospital waiting room. To not acknowledge that the tooth was the culprit, even though it was addressed at the dentist office over a year ago, and the dentist said that the tooth was not covered under the insurance plan and proceeded to quote around $7000 to fix the tooth and the bridge (to a man who is retired and even though my mother works, that doesn't mean they have $7K just lying around).

And a really big point that I must make is yes, he had severe diabetes, but that does not mean that his heart was not functioning, nor were his kidneys bad enough to require dialysis. My dad did visit his PCM regularly, especially after this infection began. His diabetic numbers were within his and his PCMs goals (90-120) for several months. He had regular exams on his heart, and his heart was in really good shape considering his diabetes and other factors (I have his medical records right here), it was only in the last six weeks that his heart became a concern. Otherwise, as a part of the Accord study he had EEG and EKGs regularly and an annual TEE test.

[ozzie679]

The richest country in the world can't even take care of it's own. Maybe China will borrow us the money Shame on our country!

[JenLee]

Originally Posted by jojo61397

Yes, I realize that he is not in perfect shape, but there is absolutely no reason for them to treat my mother like a second class citizen when asking questions (or pass her off to another specialist at every question), to not communicate issues with the family, not inform the family until the very last minute of any changes to his care plan, to not call even though it has been explained over and over and over again our family was not capable of 24-7 attendance in the hospital waiting room. To not acknowledge that the tooth was the culprit, even though it was addressed at the dentist office over a year ago, and the dentist said that the tooth was not covered under the insurance plan and proceeded to quote around $7000 to fix the tooth and the bridge (to a man who is retired and even though my mother works, that doesn't mean they have $7K just lying around).

And a really big point that I must make is yes, he had severe diabetes, but that does not mean that his heart was not functioning, nor were his kidneys bad enough to require dialysis. My dad did visit his PCM regularly, especially after this infection began. His diabetic numbers were within his and his PCMs goals (90-120) for several months. He had regular exams on his heart, and his heart was in really good shape considering his diabetes and other factors (I have his medical records right here), it was only in the last six weeks that his heart became a concern. Otherwise, as a part of the Accord study he had EEG and EKGs regularly and an annual TEE test.

jojo61397, I didn't mean to come across as being judgmental or rude. I was trying to point out to you that your Dad wasn't healthy going into the hospital. Reading what you just wrote now absolutely gob-smacks me: he had a bad tooth for a year as a severe diabetic and neither the dentist nor his PCP were addressing this?

There really is no excuse for the way your family was treated by the medical team. I AM sorry about this and that is why I told you what to do to file a formal complaint. I am very serious about your Mom and brother getting to know some of your Dads' nurses and having them advocate for your family. Nurses are with your Dad 24/7; and they can update your family and give more support if they know what is going on with the family. Setting up a care conference with the docs to find out what and why this has all happened is also important. And voicing your frustrations about how things have gone and how you've been treated is necessary too.

Was/is your Dad in the ACCORD study? If so, was he in the intensive glucose control group or the standard glucose control group? Unfortunately, the intensively controlled group was found to have more heart attacks that the standard glucose control group; so they ended that part of the study in February once that data came out.

Participants in the ACCORD study were chosen because they were at especially high risk—more risk than is associated with diabetes alone—for having a heart attack, stroke, or of dying from cardiovascular disease. They had type II diabetes and have two or more other risk factors for heart disease or had been diagnosed with heart disease before entering the study.

ETA: BTW, my hubby and I are both 60 and both also have diabetes. He is disabled and has MS; I still work as a nurse; so I understand the family situation better than you think. My hubby has had abscessed teeth and a broken tooth over these past 2 years; but his dentist and doctor both made him aware of how dangerous it would be to not care for these infections. One tooth was pulled to prevent the infection from spreading (it's a back tooth and didn't need cosmetic replacement); and we are paying on a dental credit loan for the other 2 teeth - a bridge and a crown. I *really* do understand how tough it is. And I do feel for you.

[jojo61397]

Originally Posted by JenLee

jojo61397, I didn't mean to come across as being judgmental or rude. I was trying to point out to you that your Dad wasn't healthy going into the hospital. Reading what you just wrote now absolutely gob-smacks me: he had a bad tooth for a year as a severe diabetic and neither the dentist nor his PCP were addressing this?

There really is no excuse for the way your family was treated by the medical team. I AM sorry about this and that is why I told you what to do to file a formal complaint. I am very serious about your Mom and brother getting to know some of your Dads' nurses and having them advocate for your family. Nurses are with your Dad 24/7; and they can update your family and give more support if they know what is going on with the family. Setting up a care conference with the docs to find out what and why this has all happened is also important. And voicing your frustrations about how things have gone and how you've been treated is necessary too.

Was/is your Dad in the ACCORD study? If so, was he in the intensive glucose control group or the standard glucose control group? Unfortunately, the intensively controlled group was found to have more heart attacks that the standard glucose control group; so they ended that part of the study in February once that data came out.

Participants in the ACCORD study were chosen because they were at especially high risk—more risk than is associated with diabetes alone—for having a heart attack, stroke, or of dying from cardiovascular disease. They had type II diabetes and have two or more other risk factors for heart disease or had been diagnosed with heart disease before entering the study.

ETA: BTW, my hubby and I are both 60 and both also have diabetes. He is disabled and has MS; I still work as a nurse; so I understand the family situation better than you think. My hubby has had abscessed teeth and a broken tooth over these past 2 years; but his dentist and doctor both made him aware of how dangerous it would be to not care for these infections. One tooth was pulled to prevent the infection from spreading (it's a back tooth and didn't need cosmetic replacement); and we are paying on a dental credit loan for the other 2 teeth - a bridge and a crown. I *really* do understand how tough it is. And I do feel for you.

Sorry just hits close to home... Yeah we are encouraging him to find a new PCM/PCP. And my parents can't afford dental insurance, my mom's insurance is over $700 a month, which is ridiculous, she's 60 and in perfect health-- absolutely no medications or problems.

He is in the intensive group, which was disbanded.

[JenLee]

He is in the intensive group, which was disbanded.

It was disbanded because review of the data showed that "the medical treatment strategy of intensively reducing blood sugar below current clinical guidelines caused harm in these especially high-risk patients with type 2 diabetes."

The price your mom pays for health insurance is disgusting.

This is the richest country in the world and we have a healthcare system where we pay huge corporations obscene amounts of money but we aren't able to get decent health care when we get sick.

[golfgal]

Originally Posted by JenLee

It was disbanded because review of the data showed that "the medical treatment strategy of intensively reducing blood sugar below current clinical guidelines caused harm in these especially high-risk patients with type 2 diabetes."

The price your mom pays for health insurance is disgusting.

This is the richest country in the world and we have a healthcare system where we pay huge corporations obscene amounts of money but we aren't able to get decent health care when we get sick.

Ok, wait a minute, yes, this is an extreme case of things gone bad but you can't judge all medical care by this one case. Sorry but we have EXCELLENT medical care in the US and even more specifically MN. Try going to a Dr in pretty much any other country in the world and you are in for an eye opener.

WHile I am not discounting what the OP is saying, we are only hearing ONE side of the story. I am sure there is more going on here that we don't know about. Yes there are bad doctors and things do happen but for the most part this case is NOT typical.

As for her insurance premiums, what is the story behind those, is she paying for an individual plan? Again, there is a lot more to this story.

[jojo61397]

My mom is self employed, she has never had a medical issue. I have lived in Germany for two years, we had private insurance through the military PLUS universal health care, it was AMAZING. If we could have the health system the Germans use in the US, it would be phenomenal.

My son has autism, we are under TRICARE (which is the military HMO). My father is just one example of health care failing Americans, my son is another. My health insurance caps necessary therapy at $2500 a month. We live in rural ND, in order to get this therapy in ND it would cost us nearly $12000, almost $10000 out of pocket for the first session, then nearly $1200 a month out of pocket each successive month until he is 8 years old, he is four. This would be over a quarter of our income. Not to mention that for every specialist we have had to travel out of state to see, which not only is expensive because there is a flat $.50 a mile anywhere, which in no way covers wear and tear on your car, it doesn't cover gas. We have been out state 5 times since my son was diagnosed (we live in ND). My husband has had to take a job in VA. My husband has earned a bronze star from his service in Iraq, he was on a career path to make Col and maybe even Brigadire General (this is not a wife bragging-- I spent 5 years in, I know a fast burner). With this job in VA, he will lucky not to retire a major, so that my son can get adaquate health care. My husband and I have both served 11 years and 5 years respectfully, and America can't take care of my son. Insurances solution for when my son is a teen-- institutionalize him, and BTW that's not covered EITHER, because you make over the income cap to get SSI.

So please don't tell me America's health care system is broken.