Apparently this is an acceptable medical response in Fredericksburg - We don't do that here. We don't inventory a GJ tube. We don't tell physicians who order this for their patients that we do not have it in our inventory. We don't call patients whose procedures require such GJ tube that they will be unable to have it installed. We don't show patients/family how to use the jerry-rigged set-up of a GJ tube that was done on the fly. We don't follow up home health care services to see if they accept the patient's insurance. We don't notify doctors that we don't take their patient's insurance. We don't notify the patient that home health care will not be forthcoming. We don't find another home health provider that takes the patient's insurance. We don't have many patients on Medicare. (A quick look around Gastrointerologist Associates of Fredericksburg refutes that statement.)
UNTIL I point out the lack of communication is counterproductive nothing got done. It was another excruciating day of battling with Interventional Radiology at MW hospital. The intake nurse informed us that they had no GJ tubes in the hospital and asked if we brought it with us!!! Later we were dealing with people who thought that they were helping when they were not because they did not have enough information and were making assumptions that were not valid. Yes, Dr. Vaughn is treating David. Yes, Dr. Vaughn is a hematologist/oncologist. No David does not have cancer - but the IR folks plugged him into the cancer dietitian who was halfway through her "thing" before she realized that doesn't do this. When she got nowhere with the GI practice and the home healthcare company that the GI practice assured her were on board, I took David from the outpatient part of the hospital with his jerry-rigged Jtube threaded through his Gtube with colorful ports for each and a kind of twist tie holding it all together, to the GI practice and started my litany of complaints. This is because he cannot be fed through the J tube without a pump, bags and possibly a different nutrition formula that would be supplied by the phantom home health company. After about 15 minutes the perky nurse manager for the practice told me "oh We faxed everything to the company we usually use but they don't' take his kind of Medicare (I was unaware that there were different kinds of Medicare.). There is another company and they will contact you within 24 hours." OK so this is wrong on so many fronts. No apology. No offer to expedite the matter. And she was smiling. I asked to speak to her supervisor who did apologize and asked perky nurse manager to give us a timeline. I complained that their procedure was flawed and that communication was terrible. Before making an appointment for a patient to receive a device they should verify that said device was going to be available. Before placing a device into an elderly patient who is loosing weight, they should verify that follow up care was in place. I asked to speak to the Dr. Lee, the gastroenterologist who ordered the GJ tube. This is his practice and he should know about the problem. Basically he said NOT MY FAULT. I don't tell IR what to order or what to do. Eventually I asked him how many of these he does every year and he said that each doctor in their practice orders 3 - 4 a year. So not many at all. He was defensive, unapologetic and said that I can still use the G port to feed and medicate David. Meanwhile perky nurse manager said she completed all the paper work for home health care for Dr. Lee to sign and then she would fax it to the company and they would respond in 24 to 48 hours. So nothing changed, nothing was expedited. Their assembly line medicine continued to crank through the waiting room. We spent 7 hours with what should have been a 15 minute procedure in IR and an hour visit with a home healthcare nurse who delivered equipment and demonstrated its use. Katya had to come to the hospital to rescue Jeff and take him to his train so that he could get to the airport for his 6:55 flight home. Real quality time visiting in hospitals.....not.
At home I used the syringe to give David meds and breakfast about 4. The syringe tip barely fit into the port and there was a lot of resistance because the G port is attached by a 45 degree angle so the flow is somewhat hampered. I want to scream but instead had a slice of left-over pizza and two Reese mini peanut butter eggs. I have mountains of assignments and exams to grade. David is sleeping while sitting up on the couch so that he doesn't aspirate his breakfast or cause it to leak.
On the bright side the weather has improved
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