Remain Relevant in Changing Times

Going in the hospital? Better learn the language

A kind nurse rolled me out of the hospital yesterday, eternally grateful to be headed home after several days of tests and treatments. I'm on the mend again, feeling much better and smarter all at the same time. I went in speaking only English. I came out bi-lingual, fully understanding medi-speak. I hope you don't have to use this, but just in case, I want to share with you the most relevant language being used in a modern hospital.

Hat: you'll never want to wear one of these one your head. It's what they call  the little plastic  bowls they put in the toilet before asking you to  "collect" your own  "elimination."

Temporary discomfort: if told you "might experience a little temporary discomfort" you're in trouble. It really means, "This is going to hurt like hell but you'll get over it in a few days."

Hot stick: you don't want one of these. It means a "special IV technician" is about to take a harmless looking needle with wings and stick it way deep into a vein, thrusting it in an out while your entire body burns. Just before you pass out, the technician will cheerily announce, "OK, I think I've found one that works!" Resist the urge to respond, "Are you sure? I once went on an archeological dig that wasn't this comprehensive or time consuming."

We're trying to isolate the problem: this is what doctors say when they don't agree with one another on your diagnosis. One of mine thought I had Crohn's Disease. Another was sure my problem was e.coli. After a rousing game of "Rock, Paper, Scissors" they concluded they were both right.

Nutrition: this used to be called "food service." In recognition of the fact that few people would call it food, lawyers are now requiring hospitals to stick with the simplest, most objective term. After all, everything on the tray does, in fact, have some kind of nutrition in it. (Except for the shredded iceberg lettuce with low fat dressing.)

Blood products: Adding the word "products" is apparently supposed to give blood transfusions more of a consumer feel, almost like you're getting something you've shopped for. When these products are delivered right to your bedside, they also come with multiple nurses, who check one another's  ability to match the names and numbers on your arm band with what is printed on the bad of blood (which, btw, isn't red so much as it's maroon). When you see the intensity on their faces while they read, it makes you very nervous and grateful all at the same time.

Vital signs: these are things that must be checked every 12 minutes, day and night, especially when you're sleeping. For some reason, vital signs cannot be checked at the same time you're being given medicine or food. It's a whole separate procedure that also can be done only with all the lights on.

My favorite word is discharge because it means you're headed home. At this point, you receive all kinds of paper work that essentially says "here's how you take care of yourself." They slip in several paragraphs that note that if your insurance company doesn't pay the bill, you have to give the blood back or they'll come to your house and do an instant "walletectomy."

I'm certain this language will keep evolving, so I encourage you to share what you have learned from your own personal experience.  We have to do our parts to remain relevant as patients because, believe me, you don't want to be an irrelevant patient!

Viewing relevance from a hospital bed

Relevance, I've learned, looks pretty different from a hospital bed. I'm lying in one now in room 619 at Kennestone Hospital in Marietta, GA, where I've spent the past four days being tested up the wazoo. I came in through the emergency room on Sunday, which is my preferred method (you get serviced faster that way and who doesn't like a little drama?).

A number of issues had me here, the most serious being the rapid increase of my creatine, which measures kidney function. My transplanted kidney was starting to poop out on me.

I certainly couldn't afford a lose a second transplant. I've run out of sisters. Lucky for me, Dr. Robert Jansen from Georgia Kidney Associates, has been on the case. First the good news... I'll be fine.

Meanwhile, I've noticed some interesting changes since my last extended visit here five years ago. The lovely hospital gown I was offered first thing wasn't the solid institutional blue of years past. Instead, it has "Hospital Property" stamped all over it. Is this to ensure I don't get it confused with my personal identical gown brought from home? Or is it a reminder of who's really the boss here? For the record, I never thought it was me. I've always assumed it was the insurance company.

For instance, yesterday I was taken to a mysterious cavernous part of the building for a colonoscopy and endoscopy (and from the way I felt later, apparently another oscopy they failed to mention). The doctor asked me if I wanted to be put to sleep for the procedure. I told him anyone who was getting ready to put a tube up my butt better have drugs or some very strong chardonnay. Then I probed (before he did), "Why would you ask?" He said, "Because it will cost your insurance company more if I do it that way. Some people prefer to just put up with the temporary discomfort."

Not this somebody. I didn't care what the insurance company thought about any of this. But it was a real "ah ha" moment for me. Insurance companies, for better or worse, are becoming more and more relevant to our everyday lives, requiring decisions that previously didn't even merit consideration.

Another thing that has struck me is how technology drives so much of the healthcare system now. Everything here beeps, rings or hums. Every person, from the surgeons to the cleaning crew, have cell phones attached as closely as vital organs and they ring constantly (the phones, not the organs). Information flies around wirelessly and yet, as far as I can tell, most of these systems don't talk to one another very well. I still had to answer the same questions 10 times. Maybe they're really just trying to determine my memory skills.

There are several channels on the internal TV system showing educational shows about various medical procedures. That's fine, but what would be even better - and more relevant - would be if I could go to the web site and just download these episodes into my iPod.  Few things are more comforting than having an articulate doctor right there in the palm of your hand gently explain something (on demand, no less).

And while they're at it, a few links to blogs and web sites about specific procedures would be good too. Right now, WellStar (Kennestone's parent) has some great information on its web site that's strictly text based, but they need to take things up a notch.

Hey, we impatient patients are sitting here with laptops picking up the wifi connection. Why not send us to pre-selected links? It might keep us busy enough to lay off the "call nurse" button for a while.