carhoch
Pearl Clutcher
Be yourself everybody else is already taken
Posts: 3,028
Location: We’re RV’s so It change all the time .
Jun 28, 2014 21:46:39 GMT
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Post by carhoch on Aug 17, 2014 0:18:24 GMT
It seems like people are kicked out of the hospital these days before the doctors are ready to let them go. I remember 28 years ago when I had my son by C-section and they wanted to send me home one and a half days later. My doctor refused so I got the extra day. My mom remembered how most women stayed in the hospital up to a week after a regular delivery! About 35 years ago I was in the hospital 5 days with a kidney stone. Now they rarely admit you ~ just give you pain meds and send you on your way home to pass it.
When can you remember being in the hospital for more days than they would ever allow now? And I had a c-section 22 year ago in Switzerland and i stay 10 day in hospital it was the norm at that time .
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Post by scrapmaven on Aug 17, 2014 0:36:15 GMT
As a frequent flyer in the hospital, my doctors constantly weigh the risk of infection vs. the risk of going home too soon. Another big surgery is upcoming and many people would be oupatient, but I will be inpatient for a few days. In my case my doctors can do a bit more w/me due to good insurance. I wish everyone could be treated w/such care. That brings us back to the vicious cycle about healthcare in the USA and how to improve it. Dh and I often ask what we'd do if we didn't have our particular insurance plan? I wish I had answers.
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Post by Zee on Aug 17, 2014 0:38:40 GMT
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Post by mirabelleswalker on Aug 17, 2014 0:41:31 GMT
In 1988 I had appendicitis (not a rupture). I was admitted to the ED on Sunday, surgery on Monday, discharged on Friday. Now it's same-day. When I had my tubes tied it was supposed to be outpatient, but I had some complications and ended up staying in the hospital. I was out very early the next day, though.
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Post by SunnySmile on Aug 17, 2014 0:45:36 GMT
I was in Japan for my appedectomy and I was in for about 3 weeks. Not kidding! I was hit by a truck the following year (off my bicycle) and I was in for 2 weeks. That is just normal for there. A C section is a month's stay. No questions asked. Wow! Amazing length of times! having never had a C-section, I don't really know the recovery rates, but I would think I would be crawling the walls to get out of there way before a month was up! On the other hand, maybe hospitals there are more restful than they are here.
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Nanner
Drama Llama
Posts: 5,987
Jun 25, 2014 23:13:23 GMT
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Post by Nanner on Aug 17, 2014 1:07:06 GMT
My kids are 27 and 23. Back then, here, they let you go home on the third day, not counting the day of delivery. So both of my kids were born on Wednesdays and we went home the following Saturdays.
After gallbladder surgery 27 years ago, I was kept in hospital for a full week. Yes, things sure were different!
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maurchclt
Pearl Clutcher
Posts: 3,646
Jul 4, 2014 16:53:27 GMT
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Post by maurchclt on Aug 17, 2014 1:17:46 GMT
For whatever reason I can't get the quote button to work, but, the idea that a DOUBLE MASTECTOMY is done on as an outpatient is beyond belief.
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Post by keknj on Aug 17, 2014 1:18:10 GMT
My kids are 11 and 8, I had C-sections with both and was in 4 days for each. I was lucky both times and had a room to myself. I took advantage of the help for baby care and did rest. I can't imagine being in for a month tho, I would have been climbing the walls.
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Post by casswithsass on Aug 17, 2014 1:20:34 GMT
When I had my fourth son 30+ years ago, the doctor heard I had three little ones at home. He told me to stay an extra day and "rest up," so I was in the hospital four or five nights. I had a liver transplant four years ago and spent six nights in the hospital. I was ready to go though. they had the physical and occupational therapists in there, and they were surprised I could get around so well. Survived both stays!
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akathy
What's For Dinner?
Still peaing from Podunk!
Posts: 4,546
Location: North Dakota
Jun 25, 2014 22:56:55 GMT
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Post by akathy on Aug 17, 2014 1:20:51 GMT
For whatever reason I can't get the quote button to work, but, the idea that a DOUBLE MASTECTOMY is done on as an outpatient is beyond belief. I know, we were all STUNNED and it was about 10 years ago.
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maurchclt
Pearl Clutcher
Posts: 3,646
Jul 4, 2014 16:53:27 GMT
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Post by maurchclt on Aug 17, 2014 1:30:14 GMT
For whatever reason I can't get the quote button to work, but, the idea that a DOUBLE MASTECTOMY is done on as an outpatient is beyond belief. I know, we were all STUNNED and it was about 10 years ago. This is so WRONG on so many levels, physical, emotional, I don't even know where to begin. Please tell me she is ok now.
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Deleted
Posts: 0
Oct 9, 2024 18:16:11 GMT
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Post by Deleted on Aug 17, 2014 1:50:29 GMT
When I was 19 yrs old I was living/working in Germany and had an ectopic pregnancy. Even though I went to the American ER on the military base, they didn't have a doctor there to do the surgery so they sent me to the German hospital. They removed my right tube and I spent the next 7 days in the hospital.
I was ready to go home on day 2 but they kept me there for a week...I was sooooo bored (especially since all I had was European TV to watch).
5 years ago I had a total knee reconstruction and they sent me home as soon as the anthesia wore off.
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akathy
What's For Dinner?
Still peaing from Podunk!
Posts: 4,546
Location: North Dakota
Jun 25, 2014 22:56:55 GMT
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Post by akathy on Aug 17, 2014 1:53:48 GMT
I know, we were all STUNNED and it was about 10 years ago. This is so WRONG on so many levels, physical, emotional, I don't even know where to begin. Please tell me she is ok now. She is. She's fine. Went through chemo afterwards and has been cancer free ever since.
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Deleted
Posts: 0
Oct 9, 2024 18:16:11 GMT
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Post by Deleted on Aug 17, 2014 1:55:12 GMT
I was in Japan for my appedectomy and I was in for about 3 weeks. Not kidding! I was hit by a truck the following year (off my bicycle) and I was in for 2 weeks. That is just normal for there. A C section is a month's stay. No questions asked. Wow! Amazing length of times! having never had a C-section, I don't really know the recovery rates, but I would think I would be crawling the walls to get out of there way before a month was up! On the other hand, maybe hospitals there are more restful than they are here.Hospitals are all about getting rest. Lots and lots of rest. DS was in for 2 or 3 weeks with pneumonia and we were going home for Christmas. They finally discharged him like 3 weeks after admission and we left the following day. That was a nightmare.
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maurchclt
Pearl Clutcher
Posts: 3,646
Jul 4, 2014 16:53:27 GMT
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Post by maurchclt on Aug 17, 2014 1:57:14 GMT
This is so WRONG on so many levels, physical, emotional, I don't even know where to begin. Please tell me she is ok now. She is. She's fine. Went through chemo afterwards and has been cancer free ever since. Thanks for the good news!!! She is a survivor!!!
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Post by stampinbetsy on Aug 17, 2014 3:10:50 GMT
I had my second child late in the day, like 11:40pm I didn't even get all finished up with the rest of it ( nice way to put that huh ) until after midnight, got put in a room with a bed so I could sleep at around 1am. But that counted as a day and the '2nd' day after release time was not even 32 hours after the birth. It seemed like a whirlwind to me at the time. I kind of had the same experience with DD - she was born at 10:32 p.m. on a Thursday night. I didn't get into a room until about 2:00 a.m. We went home Saturday morning. So I was probably discharged 36 hours after giving birth. DS may be facing surgery this winter, and I have no doubt they will try to get him out of the hospital as soon as possible. Although he tends to not cooperate. He spent 11 days in the hospital after surgery as a baby, and a couple of years ago had surgery that was supposed to be day surgery. He ended up getting admitted for the night, mainly because he was having a hard time waking up and his oxygen saturation was low. That, coupled with the fact that his surgery was about 3 hours late getting started, got him admitted.
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Post by rst on Aug 17, 2014 3:32:28 GMT
My 2nd son was born at 6 pm after about 20 minutes labor. We were discharged the following morning at 11. So less than 18 hours hospital stay. But in that case, I was totally ok with it. I was fine, he was fine, and everyone was happier at home.
Several people seem to be reading my earlier post as saying that a reason for early dishcarges is to avoid hospital borne infection and disruption -- not what I was trying to convey (though I'd have to say that statistics I've seen suggest that hospital acquired infection is by no means rare) -- I was just saying that those are factors that make being at home far preferable for a good recovery-- provided that you have a good environment and adequate supports in place at home. I agree that hospitals are about evaluation and monitoring, not recovery in today's systems.
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Post by JustCallMeMommy on Aug 17, 2014 4:22:03 GMT
I think a lot of doctors in this area are a little more conservative. When I had my gallbladder out, they kept me for 23 hours (costs apparently rise drastically at the day mark). I appreciated being able to recuperate overnight, though I might have driven the nurses nuts with my requests for gingerale and jello. I hadn't eaten without pain for months, and I was in hog heaven.
When Ali was born, I think the doctor purposely waited until after midnight to deliver so that I would get an extra day. I went in on Friday afternoon, she was born in the wee hours Saturday morning, and I checked out Monday morning.
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Post by PNWMom on Aug 17, 2014 8:30:59 GMT
I am a nurse working specifically in discharge planning. While it is true that some patients have funding that works on a DRG basis, that is not true for many funding sources (lots of private insurances). Our utilization management department communicates with the insurance companies on a usually daily basis, sending them updated clinical information to request for another day, etc of inpatient status for patient. Sometimes they pre-auth for like 4-5 days for a particular surgery. Any time after that, and we need to send new clinical updates to justify why we are keeping the patient longer. For most of the patients I work with, the criteria for discharge is having their pain controlled on pills (not needing IV meds); mobilizing safely (using a walker/wheelchair/crutches if needed), and have stable vital signs/lab values. There are always other things like having drains removed or learning wound care, but once you CAN go home....you go home.
And....I had bilateral mastectomies, a sentinel node biopsy and tissue expander placement done last year and went home less than 18 hours later with four drains in place. I was fine at home, and much more comfortable than I would have been had I stayed in the hospital longer. When I went back to actually have breast implants and reconstruction done with fat grafts and liposuction, I went home right after surgery. Same thing with nipple reconstruction surgery.
I know from long experience that there are lots dangerous bugs in the hospital (MRSA, VRE, MDRE, etc), and patients are much less likely to get contaminated with them when they are OUTside of the hospital.
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Post by cade387 on Aug 17, 2014 12:07:26 GMT
We have hospital receipts from my Aunt's delivery in 1944, my delivery in1979 and my first son's delivery in 2011. All were natural births. My Grandma stayed in for 14 days in 1944, my mom stayed for 5 days in 1979 (but was in L&D for 2 days prior), and with my son I was there for 2 days. One of the OBs in the practice was all set to send me home after one day even though I had stitches and was still having issues with bleeding.
With my second son (2013), we got to the hospital at 6pm on a Saturday and had the baby at 7:59pm. He ended up in the NICU because I never really transitioned (delivered in 8 minutes) so while they discharged me on Monday night, that was when my son got out of the NICU so they let me stay in our room with only a nurse for him and I was in more of a hotel status. I thought that was really great.
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mallie
Pearl Clutcher
Posts: 3,253
Jul 3, 2014 18:13:13 GMT
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Post by mallie on Aug 17, 2014 12:33:53 GMT
I am a nurse working specifically in discharge planning. While it is true that some patients have funding that works on a DRG basis, that is not true for many funding sources (lots of private insurances). Our utilization management department communicates with the insurance companies on a usually daily basis, sending them updated clinical information to request for another day, etc of inpatient status for patient. Sometimes they pre-auth for like 4-5 days for a particular surgery. Any time after that, and we need to send new clinical updates to justify why we are keeping the patient longer. For most of the patients I work with, the criteria for discharge is having their pain controlled on pills (not needing IV meds); mobilizing safely (using a walker/wheelchair/crutches if needed), and have stable vital signs/lab values. There are always other things like having drains removed or learning wound care, but once you CAN go home....you go home. And....I had bilateral mastectomies, a sentinel node biopsy and tissue expander placement done last year and went home less than 18 hours later with four drains in place. I was fine at home, and much more comfortable than I would have been had I stayed in the hospital longer. When I went back to actually have breast implants and reconstruction done with fat grafts and liposuction, I went home right after surgery. Same thing with nipple reconstruction surgery. Who took care of you at home? Or did you take care of yourself?
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Post by PNWMom on Aug 17, 2014 21:50:17 GMT
I am a nurse working specifically in discharge planning. While it is true that some patients have funding that works on a DRG basis, that is not true for many funding sources (lots of private insurances). Our utilization management department communicates with the insurance companies on a usually daily basis, sending them updated clinical information to request for another day, etc of inpatient status for patient. Sometimes they pre-auth for like 4-5 days for a particular surgery. Any time after that, and we need to send new clinical updates to justify why we are keeping the patient longer. For most of the patients I work with, the criteria for discharge is having their pain controlled on pills (not needing IV meds); mobilizing safely (using a walker/wheelchair/crutches if needed), and have stable vital signs/lab values. There are always other things like having drains removed or learning wound care, but once you CAN go home....you go home. And....I had bilateral mastectomies, a sentinel node biopsy and tissue expander placement done last year and went home less than 18 hours later with four drains in place. I was fine at home, and much more comfortable than I would have been had I stayed in the hospital longer. When I went back to actually have breast implants and reconstruction done with fat grafts and liposuction, I went home right after surgery. Same thing with nipple reconstruction surgery. Who took care of you at home? Or did you take care of yourself? I really didn't need help at home. I did have some family come up to see me, but that was very much because THEY needed to see ME, rather than me actually needing assistance. My husband took 2 days off from work while my family was here, but went back to work as soon as they left.
I had held off on telling my mom that I had cancer until 2 days before my surgery, so my sister drove her up to Seattle to see me the day I came home from the hospital. They stayed here for I think two days. My mom really needed to wrap her mind around things and SEE me to know that I was OK. There was a huge emotional component surrounding my first surgery, since the whole cancer diagnosis was so new. One of the hardest things of all was waiting those 22 days to tell my mom I had cancer. She has serious depression issues and I am by far her primary emotional supporter, and I wanted to have a lot of concrete info to give her, not just a vague cancer diagnosis.
Cancer surgeries were my first ever experience with pain. Before this, I had never so much as sprained an ankle or had stitches. As it turns out, boob surgery is not terribly painful. And, it does not involve your abs much (other than the later liposuction for fat grafting), so it is not terribly painful to get from point A to B or to sit up. I just had to be careful about moving my arms around, since it was the upper chest muscles that had been cut through.
I was able to take care of stripping my drains and getting in and out of bed and all of that on my own. I planned ahead and had a chair in my bedroom to make it easier to climb into my very high platform bed, and bought easy to cook meals from Trader Joes. I was very aware that my family needed to feel....needed, so I let my husband help me keep track of my drain output (had them in for 2 weeks!!), and labeled my different meds in plain English so he could get them for me (antibiotic, muscle spasm med, pain med, etc).
With my later surgeries (reconstruction and nipple reconstruction), my husband took off the day of surgery, but went right back to work the next day.
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Post by Dori~Mama~Bear on Aug 17, 2014 22:01:59 GMT
In 2005 when I had my hysterectomy I was suppose to be in the hospital 3 days and actually stayed 4 days because after surgery I was so numb from the epidural I couldn't feel my legs. I was out of surgery in the early afternoon and it was the next evening by the time I could feel my legs again. they were so numb and felt like your tongue after Novocaine shots. the doctor wanted me to walk that night but the nurse called him back and said she is not gettting out of bed with them that numb. So it made me 1 day behind in the routine recovery schedule.
When I had my oldest 2 babies I stayed in the hospital 3 days. when I had my youngest baby I was in the hospital 1 week before I had her (she was early). I had her on Saturday, had my tubes tied late Sunday night and went home on Monday. she stayed for 6 weeks even though she was 12 weeks early.
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Post by swtpeasmom on Aug 17, 2014 23:49:50 GMT
I had my appendix out in kindergarten. I am pretty sure I was there at least a week, but I don't remember. But back then, it was kind of major abdominal surgery, and I still have the big ol' scar to prove it. These days, as long as it's not infected and doesn't rupture, I think that might be a laproscopic procedure. In and out in a day or two, I'd imagine. Unless someone here has had their appendix out recently and knows differently. I had my appendix out about 16 years ago - it was slowly 'rupturing', and they performed emergency laproscopic surgery. I have 3 small scars. It was about 1am that I had the surgery, and was there an additional 2 nights. Luckily, all went well.
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scorpeao
Pearl Clutcher
Posts: 4,521
Location: NorCal USA
Jun 25, 2014 21:04:54 GMT
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Post by scorpeao on Aug 18, 2014 0:00:11 GMT
Three years ago my sister had a blood clot in her brain. She spent a week in the ICU and another week on the floors. By the second week she was crying because she wanted to go home so bad.
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Deleted
Posts: 0
Oct 9, 2024 18:16:11 GMT
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Post by Deleted on Aug 18, 2014 0:03:44 GMT
My 78 year old dad had a kidney removed about three weeks ago. Surgery was on Monday and he was released on Thursday. He did fine so I guess it was ok.
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Post by BuckeyeSandy on Aug 18, 2014 2:09:01 GMT
Hospitals are paid by DRG coding, has nothing to do with infection rates of the facilities, disrupted sleep etc. It's based on a standard rate of time to treat a particular group of diseases/illness, etc. Unless there are comorbidities or something occurs to prolong a stay, you get X amount of time and if you stay longer the hospital absorbs the cost. So, they want you out in the time specified for pay. Sounds cruel,but it really is how it is. It's not personal. Watch your bills carefully if you ever go to the ER and they want to keep you over night... You may THINK you were admitted, you were in a bed on a ward, etc... but coding wise, you were never admitted. Depending, it may have been "cheaper for you" if you were admitted to the hospital, rather than "watched over night." Me? I wanted out of there so much, I was ready to leave as soon as the "attending" said he was going to discharge me. I HATE hospitals, never can get sleep, and if I do, then someone is there wanting more blood or something.
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melissa
Pearl Clutcher
Posts: 3,912
Jun 25, 2014 20:45:00 GMT
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Post by melissa on Aug 18, 2014 2:22:17 GMT
The pendulum has swung back moderately from the days of drive through deliveries and drive through mastectomies.
My bilateral mastectomy was 8 years ago. I couldn't wait to get out of there. The afternoon after my 4 hour surgery (I had other surgeries under the same anesthesia), I asked to get up and go for a walk. The nurse laughed at me and told me that if I could get up, she would take out the Foley and let me go for a walk. Yeah.. I also had abdominal surgery and could not physically get up myself. Still, I begged to go home after 2 days. It was enough. There was much I could not do when I got home, but I couldn't do those things for many more days, so another day or two in the hospital would not have helped. Hmm.. might have even been the third day that I went home.
Anyway, LOS (length of stay) today is based on actual data, not just random historical decisions. And, of course, money is involved in those decisions as well. It's always a risk/benefit issue.
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Post by pierkiss on Aug 18, 2014 2:39:05 GMT
I had my daughter in 09 via csection. I stayed in the hospital for 5 days. I had my son via csection in '10, and stayed 4 days. Had my other son in '13, and stayed for 4 days again.
I had my gallbladder out in '11, and that was outpatient surgery. I remember the nurse "encouraging" me to stop throwing up afterwards so that they wouldn't have to admit me for the night.
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Post by AussieMeg on Aug 18, 2014 3:30:31 GMT
I had my fist child in 1997 in a public hospital. I stayed from Sunday to Wednesday. My second child was born in 2004, and when the doctor came to see me later on the day that I gave birth, he said "So, you ready to go home today?" I was like "Ah, no, I think I'd like at least one night here" - it had been been 7 years since my DD was born and I really wanted bit of a refresher on breast feeding etc. Even private hospitals try to get you out ASAP these days.
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