cAr accident.. hospitalized

OMG! I am so, so sorry...that is awful!
Are you still in hospital or going home yet?
Ok, so anticoagulants are pretty much basic protocol for any bone fractures...scared of blood clots and the obvious complications...not sure with all of the fractures if you can get out of having them...
As for stool softeners etc...get a G.I consult in asap if you are still there.
Your body may well have shut down due to the shock of the situation and may take some time to boot up again...stick to fluids as much as possible and don't put any more in until you get something back out.
I am assuming that you are on serious painkillers as well. They may just be the culprits for the intestinal sleeiness. Once you taper off you should wake up the guts...and the pain.
Again, so sorry.
I thought that we were all bullitproof after everything that we have been through!
crap!
Sharon

I am in the middle of a pissing territory match where nobody will communicate to coordinate care. Trauma department knows nothing about J-pouches but they will not call My GI surgeon. So I try to leave a message with my surgeons answering service and she said she needs to a talk to a hospital nurse, but my nurse is not allowed to talk to anybody but the trauma team. Hope the doctor will call me back.

Later a nurse comes in and tells me they will send a nurse practitioner into talk to me. I asked "what the hell does a trauma NP know about j-pouches?". Apparently, nothing cause I have yet to see her.

Damn, so sorry! Hope your surgeon is able to speak to someone there soon. Wishing you a speedy recovery.

I belive that if you put it 'on paper' and give direct 'orders' that they then must listen to you.
I tended to use words like 'negligence' to get their attention when they would not listen to me when I was screaming very loudly!
That usually got their attention but if not...Do they have some sort of 'medical mediator'? Someone whose job it is to help the patient to communicate with the doctors?
Some hospitals have them and on occasion I have had to use them.
Some stupid orderly tried to throw me out of my bed/room (it was supposed to be my discharge day) but I was running a high fever, my BP was so low that I couldn't stand up and I was brewing an infection. The guy kept yelling at me to get out of my bed and leave. I burst into tears. I ended up calling the nursed, used the N word and then next thing I knew I had a whole lot of people worried about my fever, good health and asking if I wouldn't prefer a private room??!
You need to have someone there for you if possible...do you have someone? Do you need someone? Is there anything that we can do to help?
Maybe make a phone call for you?
Hang in there...
Sharon

Have a member of your family or you if you can get the number of the hospital administrator and register a complaint. You should get results in minutes if you use the words improper care, neglecting to listen to you, ignoring your complaints. and not allowing the right Dr. to see you since they know nothing of your circumstance. Speak with force but not rude so they know you mean business. Having been there done that it does work. Also refuse to be billed by any Dr. you have not asked to see. Ask the Dr. why he/she is there and why it pertains to your care. If you aren't happy refuse the care. I had thousands taken off my husbands bill by questioning his care. Good luck and hope you recover quickly.

Judy is spot on. The hospital should also have a risk manager (someone who tries to resolve serious problems so I would start saying things like lawsuit and malpractice and that you have a good friend who is a lawyer, etc. I hate to say this but that is what will get someone to start listening to you.

It is routine to order stool softeners and low dose molecular heparin (Lovenox) or heparin on trauma patients in our hospital.

The stool softeners are because *usually* after a trauma, you're on opiates for pain. Opiates slow the gut. Yes, as a j pouch patient you may not need softeners. It's your right to refuse them. However, I'm 24 years post surgery in less than a month, and it's possible I'd need a non-stimulant laxative to stay loose if I was on opiates. Hard to believe that some of us pouchers can be too thick, but it's true, and I'm one of them. But again, you can refuse, and honestly, they're not ordering anything out of the ordinary. It sounds like they just need to better understand your system, but even taking a few laxatives would not hurt you; it's what some do before a scope to clear out. Might be uncomfortable for you, though.

Same with the "blood thinner." I'm guessing because you're a trauma patient with no acute bleed, you're ordered heparin SQ or Lovenox SQ. Again, completely standard, especially if you're on bed rest. It's to prevent DVTs (deep vein thrombosis). Without knowing your injuries, hard to predict what issue refusing these meds would have on you, but again, it's your right to refuse the med. If your surgery is not recent, it's quite unlikely that a short run of SQ heparin would be detrimental or affect your pouch.

I work in a trauma/neuro/medical/surgical ICU, and neither of these things are out if the ordinary. However, if you're uncomfortable with the treatments, I'd just cont to ask them to hold meds til you can clarify with your surgeon their preferences. But I can guarantee that if you're years out, they likely will not have an issue with a short run of SQ heparin, as heparin has quite a short half life, and likely will not affect your pouch in the slightest. And a DVT or a pulmonary embolism would necessitate a heparin infusion and long acting blood thinners eventually, and be way more dangerous to you than a week of injections to prevent them from happening.

Just my two cents.

Le, you just can't catch a break! So sorry this happened.

I agree with Rachel. When you are a trauma patient the focus is on acute measures to preserve your life and future function. Plus, you have pre-existing spinal and neurological issues that are a priority. Whether you have a colon or not does not factor in much. Still, it would be nice to have your GI surgeon weigh in. You probably have done this, but have you requested a GI consult in regard to your surgical history?

Jan

I was able to work with them and agreed to take laxative, remembering that it did not damage my pouch when I took it for my pouchoscopy. Success! I have been able to go small amounts since last night three times. Was able to stand//shimmy to portable commode this a.m. with PT.

Wonderful news!
Keep up the good work!
Now, how long do they say that you are in for? How much time will it take to heal up and go back to being autonomous?
Sharon

Variety of responses.... Could be 6-10 weeks.

I have a filter and leg pumps. Just concerned about blood thinners, since UC manifests itself in other ways. Have heard nothing back in regards to coordinating my care with my other specialists. Nor have t hey given me a valid reason. Therefore, I conclude this is all ego based.

Sorry to hear about this. About 2 months ago one of my coworkers was in a similar type accident, cut off on I-95 and car slammed into concrete jersey barrier, her head hit windshield knocking her unconscious, and when she came to she was in hospital with broken wrist and ankle. The ankle continues to swell two months later and they are injecting it with cortisone. The wrist has not healed properly, a bone density scan has been ordered and she may be facing surgery. Our office mostly deals with car accidents so it is somewhat ironic for her to be on that receiving end.

Regarding coordinated care I can echo the other posts that state the squeaky wheel gets oil. However the coordination of care has to be communicated in the right way such as questioning the use of meds without consulting specialists on your J Pouch and related issues with it. Once these things are documented in the records then the consult has to happen.

FYI, uC is associated with clotting disorders (higher tendency to clot), so I would worry more about potential clots than bleeding. It is unclear to me why your providers have not communicated your need for them as a trauma patient. I have been on anticoagulants when needed. They should not affect your pouch adversely.

Jan

Of course they have warned me of DVT, but I was unaware that UC is associated with clotting. Seems too me it's associated with just bleeding, so I really was afraid to thin my blood and develop other problems. I was ad emitted 2years ago with pulmonary embolism and received a filter in my right hip area. The .nurse last night stated "I'm surprised they didn't take that out" I didn't ask her, but why would they take it out?

They rarely remove them in our patients, but do sometimes. There's mounting evidence they aren't as benign as once thought. This has some good info.

http://pulmccm.org/2013/cardio...emoved-jama-int-med/

That was some accident! I'm glad you survived and are questioning your treatment. Even if they are correct in what they are doing and/or medications it is your body!

After my first surgery my blood pressure was low. It was 90/50 or so and the nurses kept trying to give me my high blood pressure medication - because it was ordered. I refused it saying my BP didn't need to go lower! It took several days to get this corrected. I never did need to go back on it and am 4 years post surgery!

We just are not normal. Our colons factored into more aspects of our health than just for it's primary function. They call it our second brain...

I hope you are feeling much better. 6-8 weeks is a long time to be hospitalized. It sounds like you were lucky to come out of the accident alive

Good luck!!!

I have been in the hospital and SNF for a full month, but I AM FINALLY GOING HOME TODAY!

This accident has been a major setback for me and very expensive endeavor with having to buy a new car (who knows when I will ever be able to drive again), loss wages, deductibles, medical equipment rental, PT, and providing airfare and living expenses to a friend to take care of me 24/7.

I know that my personal injury claim will eventually reward me handsomely, but darn it.... none of this was in my plans moving forward from my 2year recovery of my J-pouch.

Congratulations on your homecoming! Its about time!
Glad to hear that someone is coming to take care of you while you recuperate.
Keep us posted on how it goes...Are you still casted? How are you feeling?
Sharon

Finally out I hope the insurance company doesn't add to your stress!

Thanks for updating us. I hope your recovery goes well.