This letter describes the medical care, responses and results given to me and my mother, regarding her treatment and lack thereof when taken to her primary care doctor, two Urgent Cares, two admissions to Hospital, and an admission to the RehabilitationHospital.  My mother’s main complaint was a migraine type headache.  After 11 days of medical care and non-care, no one knows what caused the headache, she had more complications due to the treatment and unresolved pain, we had difficulty with most of the doctors, lack of accurate diagnosis, and also difficulty twice with her discharge.  The details follow:

(1)  SATURDAY, JANUARY 23, 2010

My mother, had a headache that began on Saturday, January 23, 2010, sometime around 5pm-7pm.  Mom sat up on the edge of her bed off and on during the night trying to get relief.  She was able to talk, coherent, stated she had a headache which was pretty bad and was going to try to sleep it off.  The headache she described sounded like an intense migraine.   She took two hydrocodone.

(2)  SUNDAY, JANUARY 24, 2010

On Sunday, after taking Excedrin Migraine medication and hydrocodone, the headache was relieved for a couple hours during the early afternoon then came back with the same level of pain about 4:30pm.  I took her to the Urgent Care.  At 6:30pm, the PA at the Urgent Care said they didn’t want to treat her incase it was a stroke and to take her to the Emergency Room.  I told them last time we were there they sent us to the emergency room and told us they would call ahead so we wouldn’t have to wait, but we were still there for six hours and finally left without treatment because she was exhausted and needed to got to bed.  I asked if they would at least give her some pain medication for the headache.  The PA said they could give her a shot for the pain after a CAT Scan.  I asked how long for a CAT Scan, and the PA said it could be a while because there were people ahead of her.  I asked how long was a while - hours, minutes, what?   The PA said she couldn’t say.  I explained that the CAT Scan was useless unless done by the hospital because the hospital told us not to bring anymore of the Urgent Care tests with us next time we went, because they had to do their own tests, anyway.  I said, regardless of the test, if we stay will she get the pain medication.  The PA said it depends on what the test shows.  My mom said her head hurt too much too wait for hours for a test and treatment, she just wanted to go home and take some more migraine medication and see her doctor in the morning when his office opened.  The PA stated over and over that my mom must be treated within 24 hours of the headache if it’s a stroke, but obviously they were not listening because it had already been 24 hours by the time they saw us in the Urgent Care, where we had been waiting for several more hours.  At this Urgent Cares they did not want to give her treatment because they were worried it was a stroke.  Strokes must be treated within 24 hours of the first symptom, but migraines make the symptoms hard to see, and 24 hours had already passed by then.  They did not want to treat her and recommended going to an ER or waiting quite a while for a CAT scan with them, then probably being sent to the ER anyway.  By now, it was 7pm Sunday night, and mom just wanted to go home and get some relief from the pain and not sit in Urgent Care for a couple hours waiting for a CAT scan that they would redo anyway at the hospital.  We went home and tried more migraine meds and hydrocodone.  She slept a little bit, but the headache was still there when she got up at 4:30am.

(3)  MONDAY, JANUARY 25, 2010

We were waiting to see her primary doctor at 8am, but the doctor refused to see her, and they sent us to the ER.  She was still talking okay, coherent as she usually is but in so much pain she didn’t want to answer questions or participate in much of an assessment.  She was admitted to Hospital ER Monday 9am, the first of two times that week, for the migraine headache, which she said the pain was 10 on a scale of 1-10.  She was in such pain, and no one would treat the pain until we went to emergency at Hospital.  We spent the next two days going through misdiagnosis during this first admission.  The ER doctor was Davidson.  Davidson said it was unlikely it was a stroke and more probable a tumor from the symptoms, that she was not having any real stroke symptoms.  I agreed, she just did not seem to be having a stroke.  The Hospital did a CAT Scan during the ER intake, and gave her morphine and nausea medications.  Davidson said the CAT scan showed an old thin mass in her head and they needed an MRI to be more definitive, but his best guess was tumor.  Dr. Davidson made a specific note on her records that follow-up doctors were to speak to me and give me results from the tests and discuss treatment.  My mother was assigned to a room under the care of Dr. Le Khoa that evening.  I returned about 6pm and asked if the doctor had seen my mother yet, and whether her regular medications were being given to her.  The intake person stated the doctor had her charts so she was not sure.  I explained that my mother had complications during her heart surgery because her medications were not given and she went into withdrawal, and this especially seemed to apply to her anti-psychotic.  The intake girl said she would find the doctor and tell him.  I was also told the MRI machine was broke and it may take a long time to get her scheduled for it, because they were backed up.

(4)  TUESDAY, JANUARY 26, 2010

My father and I arrived around 12 noon to see my mother and check on her condition.  I was told she was getting an MRI.  I came back about 6:30PM to find that my mother never received the MRI, but instead was sent for a Carotid Artery Ultrasound Tuesday late morning, but she was being prepared for the MRI then.  I stayed and accompanied my mother for the MRI because she was very nervous since she had a bad reaction in the past to dye during a test.  The hospital did two MRIs Tuesday evening about 9pm, one with dye and one without.  I never saw or spoke to her assigned doctor while she was there.  My mom said she was told that if the MRI didn’t show something definitive, then they were going to send her home.  I asked if a technician was going to be available to read the results, and was told they were very backed up so it was unlikely it would happen that night.  I left.  The MRIs were Tuesday night at 9pm, and my mother called to say she had been discharged about 11pm Tuesday evening without my ever speaking with a doctor regarding results or lack thereof.  I asked my mother if they told her the results of the MRIs.  She said she couldn’t remember if they did.  Mom has mild dementia and did not remember seeing a doctor prior to discharge, or remember what the doctor might have said when he discharged her.  My mother was permitted to sign herself out.  When I picked my mother up, I was given a prescription of cholesterol medication, nothing for pain, a handful of print outs with everything from how to prevent colds, to strokes, to flu shots, etc. and instructions to follow up with a primary care doctor or Urgent Care if headache comes back.  I asked what caused the headache.  The nurses did not know.  I asked to speak to a doctor.  A doctor was not available.  I emphasized that I needed to know what happened and why, and what the follow up treatment would be.  The nurses said they understood that the problem was caused by an old stroke becoming irritated.  Nothing was said about a newer stroke.  They said it was an old stroke site that was irritated and inflamed and causing problems and my mother was discharged.  I questioned the result saying how could a old stroke suddenly cause this problem but the nurses said they were unable to comment or help. 

(5)  WEDNESDAY, JANUARY 27, 2010

The headache continues through the night building force and pain and becomes unbearable again Wednesday around 5pm. 

(6)  THURSDAY, JANUARY 28, 2010

We go to Urgent Care again, this time another one, as instructed as soon as they opened, 8am.  Urgent Care did not want to treat her because they thought it might be a stroke, but when I told them I had the instructions in my hand that sent me to them, they gave her a shot of morphine and nausea medication then told me if the headache continued, I needed to take her back to the ER.  Two hours later, 11am, the headache had not subsided at all, and we were back again in emergency room at Hospital, for the same headache problem.  She was given anti-nausea medication Zofram, dilaudid, and a steroid, and twenty minutes later Decadron for the rapid heart beat.  The ER doctor was Ruiz.  I also asked for Davidson since he was the doctor who treated her two days before.  Davidson showed up and I told him she was discharged without me ever speaking to a doctor and here we were back again for the same thing.  Davidson said he placed specific orders on his papers for Dr. Le Khoa about filling me in, and he was going to address that right away and left.  Dr. Ruiz again tells me the headache is not due to a stroke.  But Ruiz claims it’s just high blood pressure and acted like they were going to send her home.  I questioned that diagnosis, saying she had not taken her blood pressure medicine for five days due to nausea from the headache and perhaps that was why her blood pressure was high plus pain can cause it to be high and she was in severe untreated pain for days.  The doctor said maybe, but it could be the headache cause, too.  I argued that her blood pressure was fine when the headache began and only occurred after coming to the hospital the second time within two days.  Ruiz said it could also be dehydration causing the rapid heart beat and started an IV.  I was very frustrated now, and I called Senior Dimensions insurance and left a message for her last Case Worker.  By this time, Dr. Ruiz had made several guesses including “temporal arteritis” which seemed to match the symptoms well, and they gave her a steroid as treatment.  I was told after that, her blood sugar was high and maybe that was causing the headache along with the high blood pressure.   I argued that high blood sugar occurs when you get steroids so how could that be the problem, because she didn‘t have high blood sugar when the headache occurred.  At 2pm, we were still in the ER, and Ruiz was ordering EKGs for her rapid heartbeat.  About 2:20pm, my mother is given lebatalol (a diuretic for blood pressure).  About 2:30pm, I received a call from Kitty with Senior Dimensions and I explained I did not want Dr. LeKhoa taking care of my mother if she was admitted and was told due to her insurance I may not be able to change doctors and I did not want my mother discharged again without my speaking with a doctor.  Kitty said they would have a wheelchair delivered to our home, plus there were other doctors available so that was not a problem.  Then at 3pm Dr. Ruiz asked me “what I wanted them to do?”  This floored me.  I was there because I didn’t know what to do.  I said, “Pretty simple, no discharge until they can have me manage the pain myself without trips to Urgent Care or the ER everyday.”  More EKGs followed, a cardizem (to lower blood pressure and slow heart rate) shot and drip for heart beat to slow, plus more nausea and pain medication for the extreme headache that was still continuing.  Headache continued on a scale of 10, but at least my mother was at least resting between medications.  At 5:30pm, a blood thinner was added, more pain and nausea medications were given, and another EKG at 5:45pm.  At 6pm, Dr. Corona appeared and said he was an HPN doctor.  He said this was just a migraine, not a stroke or anything else and to stop bringing her to ER for headache treatment.  In the records, Dr. Corona said he was going to state it was a migraine headache, and place a history with instructions in her record and I needed to get a copy of it for further care.  I told him she still has a headache.  He said if the headache continues, take the history with me to the Urgent Care or our primary care doctor and tell them to treat it, and if they refused, ask for a supervisor because HPN did not like them sending her to the ER for just a headache, and he guaranteed they would do something.  I said, okay and he left.  A few minutes later he came back and said he had read the chart and she did have a stroke, after all, in fact two of them.  At this time, her headache was still continuing at a 10 in pain.  Dr. Corona said the results of the tests actually showed she had an old stroke (we already knew that) and also a new smaller stroke within the last few weeks, but those were not causing the headache.  At this time, I was told she was also having irregular heart rhythms and small heart attacks, continued high blood pressure and high blood sugar (most of this probably as a result of not being able to take any of her medications for several days due to nausea and puking from the headache, and the steroid shot).  His guess was possibly “temporal arteritis” and they would need a biopsy.  I told him she had an iodine allergy, and he said, then the biopsy is out, but they could still treat it the same even without a biopsy.  A few minutes later I was told they were going to admit her to a room.

(7)  FRIDAY, JANUARY 29, 2010

At this time, Mom has been in the Hospital since Monday morning, with a short discharge Wednesday, and re-admitted Thursday.  The prognosis so far, as I’ve been told is:  a severe headache that is not from a tumor or an old stroke or a newer stroke but rather may be from high blood pressure instigated with inflammation due to temporal arteritis, and the symptoms seemed to match that diagnosis.  I was told that these temporal arteritis headaches are very severe, more than migraine pain, and could last several days, weeks or months while treatment is conducted.  One of the side conditions is loss of vision, and mom is partially blind now with limited dull vision that comes and goes.  I was told that treatment is steroids to relieve the condition and pain medication to dull pain.  The vision may or may not return.  The more prominent issue with the doctors at this time is her heart.  Dr. Vlara, an assistant to Dr. Sheller (heart specialist), said she needs a heart test to determine her heart condition, an angioplasty which is a minor surgery but may lead to a bigger surgery depending on what they find.  I am told that Dr. Villaluza is her primary care doctor and he is internal medicine.  I am told she is currently on a heparin (for thinning blood, blood clots) and cardizem drip for the heart.   I am told Dr. Tufail is in charge of her headache.  I tell Nurse Lisa I would really like to speak to someone who is taking care of the head problem, since this is going on the fifth day and no one seems to be addressing it and my mother claims the headache pain is still continuing.  At about 10:30am, Granadosin RN with United Health Care discussed getting a wheelchair for us, again (her primary care said he placed an order but nothing came of it, and the hospital said the doctor placed an order during her first admission, but we never heard anything else).  She said my mother had turned it down, and that mom needed rehab.  I pointed to the big sign on the wall above my mother’s bed, which I had placed there, stating mom says “no” to everything and to ask me because I make those decisions.  I told her yes on both.  (Notation:  As of today, we still have no wheelchair.)  Around 11am, Tufail shows up and goes on and on about my mother having a very bad heart and repeated small heart attacks and the necessity of an angioplasty probably followed by either a pacemaker, bypass or shunt depending on the results of the test.  I explain my mother is allergic to dye, but he says they can give her something for the dye allergy and she can still take the dye test.  I express my concern about her age and condition, but he says the test is necessary to take care of the bad heart, and should be done as soon as possible, and due to the small heart attacks she is having, they need a decision about life support, yes or no.  His accent is very strong at times, and neither my mother nor I could understand everything he said without him repeating it several times.  I said I had to discuss it with my mom and dad first.  I talked to mom, called dad, and went to the nurses station where he was waiting to say yes for the test.  Dr. Tufail made a call right after that and appeared to be discussing set up for the test.  I asked him to call me when they had scheduled it so I could be here, and I wanted to talk to the heart doctor before the test and surgery.  That evening I read that dilaudid can cause heart arrhythmias and I was more confused wondering if the medication had caused a complication with the heart beats rather than really needing heart surgery since it the heart problem seemed to occur after my mother received the dilaudid.

(8)  SATURDAY, JANUARY 30, 2010

My father and I spent a sleepless night worrying about the angioplasty test and subsequent surgery which we were sure she may not survive and sending updates to the family and calling everyone, only to discover that there was not going to be any tests now.  Supposedly, according to my mother, Dr. Sheller talked to my mother after I left that evening and said there was not going to be any surgery, because she was stabilizing fine and didn’t need it.  At this time, I was noticing a new level of confusion and disorientation in my mother.  She seemed 80% worse mentally and not better than when I brought her in, and yet, she was being discharged to rehab.  Since I was greatly confused now, I asked several people what the hierarchy was for me to speak to someone about making the doctors discuss with me what was going on, and going over her chart with me.  Someone sent Charge Nurse McKenzie to speak to me.  I explained that six doctors have treated my mother for a variety of things in the past days and I was still in the dark, not knowing what was happening and I’d like someone to go over the records, tests, results, treatment and prognosis with me.  McKenzie stated that Dr. Sheller said no surgery, mom’s heart stabilized and he had in fact signed off on her chart and was no longer treating her.  I asked what was being done about the headache, which was the reason we were there.  She said she had nothing to report on that.  I said I had requested several times that I speak with a neurologists.  The nurse said Tufail said she wasn’t seeing another neurologists, since it’s just a headache.  My mother was still on a heparin and cardizem drip.  My mother’s blood pressure at 11:20AM is 123/69.  I said, I guess I need to talk to a case worker then.   I called and left a message for the case manager.  I leave the hospital at 11:30am, and wait for a call back all day.

(9)  SUNDAY, JANUARY 31, 2010

At about 8:30am, Dr. Tufail calls me to say my mom is being discharged from the hospital and sent to rehab today, and then she’ll be able to come home in about 3-4 days.  In the meantime, she is being moved to the fourth floor to await transport to rehab at about 12 noon.   I told Tufail I was in the hospital at that moment and on my way up, and I’d talk to him directly.  I went directly up, and Tufail was sitting at the nurses station.  I said to him, I’ll be right back, I’m just going to check in my mother.  I checked with my mother, for all of one to two minutes, and went back to the nurses station.  Tufail had left.  At 9:55am, I asked the nurse if I could at least get a list of my mother’s current medications before she was transferred since the doctor just kept ducking me and wouldn’t speak to me directly.  She said she could not give me a copy of the medication list, but she could read it off to me.  I scribbled as fast as I could and she said them rather fast.  I had her repeat a couple of them and asked for spellings, and received only a list of names with no amounts or times to take them.  I spoke with Yvonne, the United Health Care case worker, and complained, but was told I need to take it up with her new case worker, since my mother was being discharged from Hospital.  I was told I’d have a new case manager at Rehab.  At 10:57am, my mother was moved to room 429B but the room had a strong vibration which caused my mother and I to become nauseated (we both have Meniere’s).  I told the attendant we could not place her in that room or we both would be vomiting.  My mother was moved down the hall to a room without the vibrations.  I told the nurse I had to leave and would meet my mother at the rehab center, and to keep an eye on her because she was not oriented and would pull out her IV.  Nurse on duty, Sam; CNA Angela; charge nurse Jim.  At 11:30am, Yvonne calls to say my mother will be moved to Rehab at 1pm to room 329A.  The nurse tells me my mother has pulled out her IVs and catheter.

I said, I’m not surprised, that’s why I was suppose to tell you when I was leaving and why I warned you she might do that.  The nurse apologized, but really – I’m beginning to feel like it just doesn’t matter anymore because nothing said prevents it.  At 2pm, my mother had been relocated to Rehab.  I proceeded to provide intake and other information to the respiration nurse, and  Health Care Power of Attorney papers, etc. to the charge nurse, and taped up my mother’s room signs again.  The signs alert medical personnel that my mother is not in charge of making decisions and is not permitted to discharge herself or say “no” to health care decisions, that they should call me.

MONDAY-WEDNESDAY, FEBRUARY 1, 2010

Care at Rehab begins and continues through Friday, February 5, 2010.  The first three days of care under Dr. Fisher and the health care professionals, aids and rehab assistants was very pleasing.  I have absolutely no complaints whatsoever regarding Dr. Fisher or the attendants who cared for my mother, or the facility itself.  Dr. Fisher went so far as to call me at home and discuss my mother’s care and rehab.  Over Sunday and Monday, I was greatly worried because my mother’s mental comprehension seemed gone and she just drifted and mumbled - sometimes not even recognizing me and fumbling constantly with her fingers, and talking to herself and person’s who were not there.  By Tuesday the nurses were telling me she was having periods of time where she was lucid.  By Wednesday my mother was fairly clear and almost back to normal, like she was before the originating headache on Saturday, January 23.

WEDNESDAY, FEBRUARY 3, 2010

On Wednesday, I spoke with Dr. Fisher in person at the rehab, and he asked what the hospital had told me about my mother coming to the rehab center.  I said, I was told she would be there for 3-to-4 days, and probably be released on Thursday to go home.  Dr. Fisher asked what I would want my mother to be able to do in preparation of that happening.  I said, be pain free from the headache specifically and have a plan for me to treat it if it returned, and for my mother to be eating like she should.  I also commented that she was eating real well again, so that point was accomplished.  Dr. Fisher said, then I see no reason why she should not be able to go home tomorrow as was indicated.  My mother was delighted and I was delighted.  I clarified, so if my mother eats a good amount of dinner tonight and breakfast in the morning, she can go home with us tomorrow.  Dr. Fisher said, yes, but my associate Dr. Ollie will have to be the one to sign off on that because I’m off for a couple days, so it will be after your mother sees the doctor tomorrow.  My mother and I were excited and discussed her coming home the next day.  Since we did not see Dr. Fisher until around 3pm in the afternoon, we assumed it would be noon or after before she was released the next day.

THURSDAY, FEBRUARY 4, 2010

My father and I traveled to the Rehab to pick my mother up at 12:30pm.  We were told the doctor had not been by yet.  We waited for several hours until about 2:30pm, and I told the nurse I had to take my father home but I could come back.  She said the doctor was in the building if I wanted to wait, but they had said that several times already and my father also has dementia and needed to return home.  I told the nurse just call me when the doctor comes and I’ll come back and pick my mother up then.  At this time, I was assuming it wouldn’t be much longer.  At 4:00pm, I had not heard from the nurse, so I called the Rehab.  The nurse told me the doctor was with my mother at that time.  I told her, good, then I’ll call back after she finishes and signs the discharge.  I called back half an hour later.  The nurse said, the doctor was still with my mother and hold on and I could talk to the doctor.  I was on hold for about 20 minutes then someone hung up on me.  I waited an hour and called back, and Michelle said the doctor tried to call me and couldn’t get me.  I said, “Bullshit.  I’ve been sitting on this phone for hours waiting for you to call me.  If the doctor called it would show in my call history on my phone and it doesn’t show any recent calls at all.”  Michelle continued to emphasize the doctor claimed to have called me and could not get hold of me.  I finally said, whatever, can I come pick up my mother.  Michelle said the doctor gave her a verbal discharge but not a written one.  I told Michelle that lining up a sitter repeatedly for my baby that has seizures is difficult and I needed to know a specific time for when I could come pick up my mother tonight.  Michelle said she didn’t know.  I said, then I’ll be there at 8am tomorrow morning and you need to get whatever it is you need from the doctor to make that happen.  I don’t lie to my mother, and we all told her she was coming home today.  Now my dad is upset, and my mother is upset, and they both have dementia and you are making this all exceedingly difficult for me.  So go in and tell my mother right now that I will come first thing in the morning to get her, and that the doctor made a mistake by not signing the discharge, because I don’t want her crying all night over this.  Then I asked, she is coming home tomorrow, right!?!  And Michelle said yes, and that she would tell my mother she was going home tomorrow not tonight.

FRIDAY, FEBRUARY 5, 2010

I decide to double check before I drive all the way to the rehab.  I call at 8:20am and speak to Michelle, who says, we now have to wait until the doctor comes in again, and she doesn’t know when that might be, and yes, it could be as late as yesterday.  I said, call the doctor and get this taken care of because I am picking up my mother today and not tonight.  I am not waiting all day long for the doctor to get her act together and make my mother and father think I lied to both of them again.  Enough is enough.  My mother is coming home with me this morning.  Michelle said she couldn’t get hold of the doctor, she had tried.  I asked to speak with the Case Manager Anna, and was told Anna would not be in until 9am.  I asked to be placed through to a supervisor.  I was then connected to a line that said, this mailbox has not been set up *beep*.  I left a message anyway.  I then called Courtney at Senior Dimensions and expressed my disbelief and frustration over the doctors I had been encountering.  I explained I was going to pick up my mother despite the doctors ineptness and how could I get her discharge instructions and prescriptions.  We discussed several options including a written complaint.  I sat back to wait for Anna to call.  As of 9:45am no one had called me.  I called Senior Dimensions back and spoke to Karen.  Karen suggested several options including making an urgent appointment with my mother’s primary care doctor or any physician available who could access what I needed online.  I tried and was told by Southwest Medical it could not happen.  I asked for a supervisor at Southwest Medical as I had been instructed to do, and was told no supervisor was available.  I was then placed on hold for a “lead” named Marissa instead of a supervisor.  I was on hold a while, and then Marissa said she had to speak directly with the primary care doctor before attempting to get me an appointment.  I explained that we had been directed to call them by Senior Dimensions, who said any doctor would do, and there shouldn’t be a pending reason to get the primary care doctor's approval, just give us an appointment with anyone because all we needed was a follow up visit for her release from Rehab with follow up instructions online for their access.  I was told she would call me back.  I waited an hour, and then I called Senior Dimensions again at 10:45am when no one had called back, and this time spoke to George.  I told George that I was on my way to pick up my mother and the rest of the situation, he asked me to hold while he attempted to call the primary care doctor's office.  I was on hold with him from 10:45am to 11:15am, and he was unable to speak with anyone.  I told George it was always like that.  I never called the primary care doctor office without being placed on hold for 15 minutes or more and sometimes up to 45 minutes, at which time I would give up and hang up.   And you could not get appointments by phone unless they were months away.   I asked George if he could see where my frustration was coming from when Senior Dimensions and the doctors kept telling me to line up an urgent appointment with my mother’s primary care doctor.  George called the Rehab to see if he could secure the paperwork for me there.  He said he was unable to speak to anyone he requested but to ask for Anita the supervisor whom he had not spoke with, Anna the case worker who would not speak with him, Michelle the charge nurse who verified what I said about the discharge problems, or Chad the Director of Nursing.  I said, I see, you were not even able to speak to any of them but you want me to try again there.  No problem, I can’t keep beating this, I’m just going to pick up my mother and then I’ll stand at the front door of a doctor’s office and scream until someone sees my mother.  At 12:30pm, my father and I went to the Rehab.  At this time, I had received a call back from the primary care doctor office who left a message, and when I responded to the number they gave me, I was on hold for 15 minutes and just hung up.  My father and I arrived at the Rehab.  I asked the charge nurse if my mother’s discharge was ready, and she said no.  I said, I’m here to take her home now, can you provide a wheelchair to the door or do I need to get her walker.  She said they would get a wheelchair but I should wait for the discharge papers.  I said, Really!  Wait a few minutes or wait several hours like yesterday?  Michelle said she didn’t know.  I said, I’m taking my mother home now not in several hours.  You’ve had all morning to get things ready.  I dressed my mother.  I asked if the nurse wanted to remove the IV access plug or should I?  A nurse removed it.  We started out and Dr. Ollie came up and asked if I could wait 45 minutes for the discharge papers.  I said, okay, you got 45 minutes but when it looks like it’s turning into 2-3 hours again, I’m out of here.  Dr. Ollie said I need to understand they have emergencies and they take priority.  I said, Every hour in the past 24 hours was an emergency?  She said, yes, there are emergencies and your mother was not a priority.  I said, I don’t have a problem with that, I have a problem with people being mean and teasing my mother about coming home, don’t say it if you can’t accommodate it.  People with dementia do not understand that type of meanness but you should.  You got 45 minutes.  I was given the paperwork 20 minutes later and we left.  At 1:00pm, we were nearly home when Anna called me, and asked if we could talk about the problem.  I told her I was driving and unable to talk.  She asked if we could talk later.  I said, No, I think I’ve given you enough time to talk and you didn’t respond.  Anna said she was on the floor at the Rehab and couldn’t call me. I said, No problem, because we have nothing to discuss now.  I consider it over.  Call ended.  I turned the new prescriptions in to Walgreens.  Settled my mother at home, and found she had another headache, about 6/10 scale.  I gave her medication and she laid down.  In the evening after she went to bed, she muttered loudly for several hours, twice she got up and undressed and tried to go outside, once she was hunting a cigarette on the floor that was not there.  I put her back to bed each time. She got up about six more times to go to the bathroom.

SATURDAY, FEBRUARY 6, 2010

When I called Walgreens to pick up the prescriptions I found that urgent care doctors and hospital doctors had written prescriptions not covered by my mother's insurance, and they were unable to give prior-authorization which was required for the scripts, and that could only be done by her primary care doctor.  Lovely, just fucking lovely.  Back to the drawing board for any prescriptions I needed including stronger pain meds for the headache.