My Doctor Made A Home Visit Today

[Avalon1849]

I had not been outside my apartment since April of last year - I fell in the parking lot and the rescue squad got me back inside. But then I went to the ER day-before-yesterday. The ER doctor mentioned getting home health care. But my doctor would need to approve it and he would need to see me hence his visit today. I last saw him in March last year.

He told me that he thought that I'd be alot worse off when he saw me today. But he was honest with me that I'll probably be going into a nursing home before the end  of the year. It has been getting harder and harder to get around even with the walker. 

I have a bad right leg. I've had cellulitis in it several times; I was hospitalized twice for it. But now I have a "leaky leg". I've had it for months. It itches and I've been scratching sometimes so much that it bleeds. He said that could cause an infection. I do have an ointment to rub on it.

The reason I went to the ER was because of the foot pain. Like walking on gravel; burning sensation. Different from the diabetic toe pain. The pill I take for that will not help with this other. This new problem only came about a week ago..  So he's giving me another prescription.

My doctor isn't sure what home health care could do for me except maybe check up on my "leaky leg". But he is going to consult with the ER doctor who recommended it.

My doctor said that he'll return in two weeks.

[numerito]

Sorry to hear about your recent health problems, @Avalon1849, but I am glad that you finally saw a doctor. I hope the medicine he prescribed will work on your walking-on-gravel foot pain. Take extra good care of your “leaky leg” to avoid an infection. 

Hang on in there!

[Avalon1849]

Thanks numerito!

[numerito]

Check your inbox, @Avalon1849

[OneFinger]

So glad you're getting good healthcare. I believe we've posted before our common problem with mobility. Mine is very slowly getting better but it remains a major concern. Made the mistake this week of sitting on the couch and was stuck there for an hour before finding the strength / hand holds to get up.

So great you've got a Dr. willing to come to you. Hope things get better.

 

[unicorn]

There is far too little information in your posting to be able to advise you regarding home health. ER physicians are usually the bottom of the barrel within the physician community (for the most part), and I take little stock in what they say. Their job is mainly just figuring out which doctor can actually take care of the patient's problem (and they don't always even get that right). Your primary care physician is in the best position to determine whether you'll benefit from home health care. If you can't make it to your physician's office, then a home visiting RN would probably be appropriate. 

[nycman]

1 hour ago, unicorn said:

ER physicians are usually the bottom of the barrel within the physician community (for the most part), and I take little stock in what they say. Their job is mainly just figuring out which doctor can actually take care of the patient's problem (and they don't always even get that right).

What a biased, stupid, and ill informed comment. 

The world has passed you by I'm afraid...or you work in a shitty time-warped hospital that's providing care circa 1974. 

Either way, I feel pity for you. 

[unicorn]

11 hours ago, nycman said:

What a biased, stupid, and ill informed comment. 

The world has passed you by I'm afraid...or you work in a shitty time-warped hospital that's providing care circa 1974. 

Either way, I feel pity for you. 

There are three hospitals within easy driving distance from my office. Some are better than others, but I often roll my eyes regardless of which ER it is. Similarly in other places I've worked with other hospitals. Skilled ER doctors are few and far between. ER medicine attracts physicians who lack commitment. That's the nature of the specialty. FWIW, most of my colleagues are of the same opinion. We talk about this often. Emergency medicine is a specialty in which nothing is really done other than passing the problem to someone else--for the most part. 

Edited April 1, 2019 by unicorn

[nycman]

9 hours ago, unicorn said:

ER medicine attracts physicians who lack commitment. 

And faggots are too swishy to make good CEOs....

And women are bad drivers.....And blacks are to......and Mexicans are to....and Asians are to....

Can we stop with the ridiculously broad generalizations already?

I’m sorry that you seem to have been exposed to crappy and poorly trained emergency physicians, but painting the whole specialty with your broad based biased opinions just makes your look out of touch with the reality of the modern medical community. 

For the record....you should see the shit your “brilliant colleagues” send to the emergency department when they're too lazy, stupid, and/or money hungry to deal with it in their pristine offices.

Late at night and you want to sleep?....”send them to the ER!”

You've already pumped them full of useless antibiotics, steroids and narcotics and don’t know what else to do?....”send them to the ER!”

The patient’s insurance ran out and they can no longer afford to pay your bills?....”send them to the ER!”.

The elderly patient comes to your office and stinks because they haven’t bathed in a over month?....”send them to the ER!”

Of course, the very fact that you use the term “ER” tells me you're still practicing medicine like it’s the mid-1970’s.

Times have changed. Don’t like the “ER Docs” at you local hospitals?....campaign with the hospital CEO to shell out the bucks it costs to staff the place appropriately with tell trained board certified emergency physicians. If your hospital thinks of it’s “ER” as a loser and staffs it with loser “ER Docs”....then you’ve created a perpetually self fulfilling  prophesy. You have no one to blame but yourself and your own medical staff for accepting such mediocrity. Great emergency physicians abound. Maybe they’re just not attracted to practicing in a hostile work environment with your crappy medical staff....ever think of that?

 

Emergency Medicne......”Any patient, any time, anywhere.”....no other specialty comes even close. 

Edited April 1, 2019 by nycman

[RA1]

Both unicorn and nycman are correct.  Call your doctor and the first thing their recording says is, if this is an emergency, go to the ER.   OTOH, once in the ER likely the docs will do exactly what unicorn suggests.  Try to stabilize the patient, inform the attending (your doc) and call for help if things go awry.  

Unfortunately the modern practice of medicine is too much aligned with the bottom line.  Hospitals are taking over and controlling docs and the practice of medicine.  We already are only too aware of the influence of big pharmacy, insurance and the feds in general.  

Regardless of how and whether we have significant health reform in the US, we do not have enough docs and other medicos.  Cheap Rx and universal pay for health care will not solve the current problems. 

Best regards,

RA1

[unicorn]

The only time I send someone to the ER is when they need something done there that I can't do myself (such as immediate labs, Chest X-ray, etc.). When patients go to the ER themselves, they almost always seem to end up with a CT scan and get sent home on a Z-pak. Documented are crazy exams which they never actually do (i.e. a person comes in complaining of ear pain, and an abdominal and neurological exam are documented, but not an ear exam), and differentials written by computers which are both ridiculous and never really explored (like, no, elephantiasis is not in the differential of that 80 year-old who came in with swollen feet, and if you really considered a DVT or PE, why didn't you even order a D-dimer??). When I ask patients "Did he actually check your reflexes when you came in for an earache?", they usually say no even when the exam is documented. And why order a strep test in the dude with a sore throat and a cough who clearly has a simple cold, if you're going to ignore the negative strep test and send the patient home with a Z-pack anyway?