Saturday, August 27, 2005

This is bad - need help from anyone with NYC connections

I wish I could fast forward about two semesters.

My grandmother is in very serious trouble. She called me about two days ago in a panic with intermittent numbness in her right arm. She also had intermittent numbness in the right leg I took her over to her regular doctor. Her pressure was skyrocketing (210/83) so he gave her clonidil to bring it down. He did a VERY perfunctory neuro workup (The nurse practitioner that saw me to do my screening for this fall took about twice as long and did many more tests) and proclaimed she had no neuro symptoms and it was just a transient effect of her high pressure. His attitude towards her was dissmissive and condecending. Like a complete moron, I believed him even though my gut was telling me there was more to this. He doubled her normal dose of atenolol and sent her home with an appointment for follow up Saturday. He also scheduled an MRI for Monday afternoon.

The next morning she calls me in even more of a panic and its worse. I went over to her house. After a while we did decide to go to the emergency room. This turned out to be an all day ordeal - I will spare everyone the details since this community knows more then enough about ERs. Bottom line the cat scan showed nothing, the EKG was "ok" and her BP was 158/79 and pulse ranged between 55 and 61. They decided nothing would be done for her in the hospital over the weekend and discharged her with a Plavix perscription. They said maybe she had had a TIA. I have to agree about weekends- because when my Dad was in the hospital I observed that close to NOTHING special gets done on the weekend unless it is very urgent. My car was parked a little way away and we had to walk over to it (another mistake on my part). She was walking ok in the morning with assistance.

Last night she was dramatically worse. She can not feel her right foot so she can't move it properly. I practically had to carry her to the car and up the stairs to her house. No neuro symptoms- right. Bullshit.

I have not had assessment or patho and I am just as clueless as the next person as to how to help. It's driving me nuts.

So I need a couple of things from my nursing buddies out there:

A doctor-GP or internist that deals with geriatrics and does not suck - is not dismissive, arrogant and condescending. Competance would be a real bonus. In the Ridgewood, Queens area. Maybe I should consider a Nurse Practitioner? If you know a good one please drop me a comment.

A neurologist that meets the same criteria.

A vulcan mind meld of the assesment and patho course so I would have half a clue and not feel so fucking helpless.

5 Comments:

Blogger HypnoKitten said...

I'll link to this in the hope that someone can offer a suggestion.

-HK

3:36 PM  
Blogger Judy said...

I'm not familiar with your area, but what I'd do in your situation:

Think about EVERYONE you know in the area who has any kind of medical or nursing background. Call the ones you trust the most and ask them for referrals. If that NP who did your exam is in the area, call him/her. Explain that this is for your grandmother.

I do have one potential source of information. I know a geriatric specialist in Georgia who may have friends in NYC. Response time tends to be slow, so I hope you get a better answer before I hear from him.

5:23 PM  
Blogger Gypsybobocowgirl said...

They "think" she had a TIA? Sounds like impending stroke. CT scan, MRA of head and Carotid Duplex Scanning at the minimum. Write that down when you go in, and if they don't do at least two of the three, make them explain why.
If those are negative, you can start looking for other causes.
You have to insist...and Judy is right on finding a provider.

12:40 AM  
Blogger Nurse2B said...

Thanks, I took her for a brain MRI yesterday. The CT was negative when I took her to the ER on Friday. I will ask about the Carotid Duplex Scanning when I take her in for her follow up tomorrow. There was definitely some improvement in her walking yesterday but she is still suffering from intense nausea and her BP was 190/83.

8:08 AM  
Blogger beajerry said...

That's an odd hospital.
Mine would've admitted her, scheduled a carotid US, echocardiogram, serial cardiac enzymes, the MRI, pretty much the works.

12:06 PM  

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