My mom's local hematologist team just called me bc mom's platelets are very low again even on a high dose of steroid. The medicine they ordered for her is still going through the insurance approval process but even if it were to come in tomorrow it will take at least a week to have any effect. So they want her to go back to the big city hospital tomorrow so she can get an IV/IG infusion.
The local team doesn't have admitting privileges there. A nurse navigator had made the initial outreach to the local doc. So I'm going to call her in the morning to see if we can bypass the ER. Where they had treated her for 8 days for this two weeks ago and had taken the initiative to facilitate the hand-off to the local team I'm hoping they will treat it as a referred admission rather than an ER admit (I don't know the correct terminology). She does have a gerontologist with this same hospital (in the burbs) and I was thinking perhaps he could facilitate the admission.
I don't think her pcp has admitting priveleges there but I will check that too. His office just doesn't pick up their phone until 10:30...🙄
Any other suggestions and/or verbiage I should be using?
So upsetting, I'm just glad she's not in any distress.. Sucks so bad, we've had a good couple days and she's been in a decent head space.
Can you update me a bit here.
Last I can find was just in February with Mom have procedure for her collapsed lung and her chest tube not draining.
She seemed also otherwise very much weakening in general. IF I recall she is 80?
I am uncertain what at the present moment the medical team is TREATING here, and what the underlying disease process is, exactly, and the prognosis.
Has ANYONE, medical team, you, mom, her gerontologist spoken with mom and family about hospice?
Does mom still wish to do aggressive treatment?
If she DOES do aggressive treatment, what is the chances of any improvement?
Just exactly what issues are there with her insurance? Is this an advantage plan that isn't allowing outside practioners and hospital? Or is the Medicare refusing treatment?
Can you update me a bit as to age, wish for aggressive treatment, underlying disease, prognosis?
I know you are here a lot and I SHOULD remember, but 82, and can't remember what I had for breakfast 10 minutes ago!
While in hospital for the chest tube etc they diagnosed her with ITP Idiopathic Thrombocytopenic Purpura in which the platelets are attacked by their own antibodies (how rude!). Her local hematologist agreed to follow so we wouldn't have to drive to the city weekly for labs. They were to taper her prednisone and see if other meds were indicated.
However it seems the local can't or won't pivot quickly enough to different meds etc. thus they have handed her back to the city ER as a bridge. The city isn't formally following her so they won't do a direct admit.
Her Promacta medication has been approved as of today but it takes time to "kick in". I am unsure as to why they can't handle in IV/IG infusion as Leonnie pointed out they don't take long. They said they would have to order it. My guess is that they don't want to front the payment for it and it would, take too long for her Medicare advantage (united health) to approve. They (UC) actually haven't been too bad with regard to all her stuff.
Anyway, it has been decided we are going to the ER as soon as dad gets home from his scheduled ecco cardiogram! (7 appointments this week between them). They called ahead to let them know we are coming so hopefully that speeds things up.
The good news, she is taking this well, from what I read it is a disease that can be managed. She's not in any pain or distress just in danger of spontaneous bleeding. Cool right?
Like Daughter said, if hospitalization is required, you should be able to check in directly at the Admissions desk rather than go thru the ER. That's been the case with a doctor ordered hospital admission for both dh and myself in the past,
Good luck and Godspeed.
The city hospital is the best, but they are not formally following her so she has to go thru the ER. But the know she is coming. If my dad would just get home from his appointment with the car ughhh. She's ready to go!