POZ Community Forums
Main Forums => Living With HIV => Topic started by: Christine on August 09, 2006, 03:43:14 pm
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In another post Moffie wrote how he takes his own meds into the hospital, so he maintains his correct schedule. I do the same thing myself. The hospital staff really gets freaked out about it, but I don't care. I have been in the hospital 6 times this year, and not once did they get my meds correctly put into the computer. That is even with my med list, plus my dosing schedule that I lay out in a chart available to them.
This past trip, as usual, and with the blessing of my doctor, took my own meds. I take them at 8am/8pm & 7am/3pm/11pm. At 9pm, the nurse comes in with my pm dose, which by the way was incorrect. And I said I already took them.
Well, you would have thought the world ended. She exclaimed that I could not do that...oh my gosh what are you doing?? Well, I was tired, and I felt like sh*t, so I told her what I was doing, and that I was going to continue doing it, and if I didn't take them myself I could be risking resistance, and a death, since they were not capable of dosing them correctly. Short little annoying woman...
I do understand that nurses are overworked, and the hospitals are usually understaffed, but we have to protect ourselves.
I would suggest talking to your doctor about it first, but take your own meds when you are in the hospital so they are correct. And if you would be to ill to do so yourself, have a friend or family member dose them for you.
Christine
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Amen, Christine. I have experienced something quite similar - dosing errors and "hospital rules" to follow with medications. I took my pills along with me and I made sure I got them when I needed, in addition to everything else that was being pumped into me. Their initial speed wobble was understandable and even to be expected when relinquishing some control for one's care - but hell if I'm giving a complete stranger carte blanche over this body. Harumph!
I strongly agree that we owe it to ourselves to be at the forefront of our own protection and care.
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That's right, Christine, this is the way to go if you're not really confident with the hospital's staff. I never really found myself in this situation, but I see your post as a very good advice. Thank you!
Val
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I've been in the hospital twice within a year. They brought the medication to me. I didn't use my own, eventhough I had it with me. Guess it depends on what hospital you are in.
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I have been in the hospital for three surgeries since being on meds. I never had a problem. Both hospitals asked that I create a med schedule for them to follow and they followed it perfectly. One time they even had me lay out all the hiv pills I took at each time of the day on a side table so there would never be any screw ups.
I supplied my own hiv meds each time.
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Hi Christine,guess I've never really thought about it so thanks for starting the thread. If Moffie posted abouthis in the past I either missed it or forgot. I'm sure there are many topics that could be revisited. I've only had 1 overnight stay at the hospital since my PML diagnosis and the staff asked my partner to bring my meds to the hospital since they not familiar with them.
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Your admitting physician can write orders that allow you to take your meds with you to the hospital and self-dose on your normal schedule, if he feels you are competent to do so. It has to be in the admitting orders, or the staff isn't going to want to allow you to self medicate.
Things happen in hospitals, such as emergencies, codes, and short-staffing, any one on which could result in your not getting your meds on time. I have self medicated as an inpatient. It makes me nervous to depend on someone else to bring me meds on schedule.
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Your admitting physician can write orders that allow you to take your meds with you to the hospital and self-dose on your normal schedule, if he feels you are competent to do so. It has to be in the admitting orders, or the staff isn't going to want to allow you to self medicate.
Things happen in hospitals, such as emergencies, codes, and short-staffing, any one on which could result in your not getting your meds on time. I have self medicated as an inpatient. It makes me nervous to depend on someone else to bring me meds on schedule.
THANK YOU whizzer - I did not know this
this site rocks
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Hi Christine,
Very good advice to our Members, honey......being proactive for our own health care and welfare is of the UTMOST importance!!
Great stuff, girl.
Love,
Zeph
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Hello Christine, it is Eldon. I must say that you did the right thing when you took your meds to the hospital. Thank God, I have never been in the hospital but is a very good example to others that we should adhere to what has been prescribed to us by our Doctors and to stay on schedule.
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I was once afraid I'd have to get off-schedule once for an outpatient procedure. I would have been much worse off if I had not been able to bring my meds to the hospital.
At the time I was taking my meds at 9a/9p. I was supposed to fast with no water for 12 hours prior to morning surgery, so I just barely got my evening dose in. I brought my morning dose with me to the hospital along with an almond-butter sandwich.
Of course the surgery ran late, so I was getting worried. As soon as I was taken back to the room and the anesthesia was wearing off, I downed the drugs and the ate what I could of the sandwich. I ended up being a few hours late, but figured it was fine, since I was pretty good about staying on schedule most of the time.
The nurses knew what I was doing because I told them ahead of time. They totally understood the dangers of missing my dose and were supportive. I felt lucky. I can only imagine being admitted to a hospital where things were not so easy. Or being admitted due to an emergency and not having my meds with me. I'd have to remember everything and be able to communicate to them. And hope they understand.
Ok, I think I need to print out a med list for my wallet! ::)
Our number-one job is living with HIV. Which sometimes involves a few additional considerations, such as these... Thanks for the great post!
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I guarantee you that 99.9999999 % of nurses will NOT know a thing about your HIV meds and how they are to be given (other than "that blue pill in the evening").
The hospital is on a "rigid" schedule, and that schedule will hardly EVER coincide with your own.
There have been times when pharmacies don't get orders, fax machines are out of paper, there are no "runners" to bring meds up from pharmacy or there aren't enough nurses to hand things out in a timely manner.
Plus, depending on how the doctor writes the order, you may get the meds at the wrong times: "Reyataz one tablet po, BID" will NOT get your medicine to you at the same time as "Reyataz one tablet po q 12 hours" (at my hospital, the former will have your meds to you at 10 am and 6pm, the latter will have your meds at 10 am and 10 pm).
Long story short....carry your own damn supply if at all possible. If the nurses give you shit, tell them to have the doctor to write an order..."Patient may take own HIV meds from home." And keep it at the bedside if at all possible...things get lost in the med room, trust me on this one.
I see it all the time. :o
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Thanks for all this great advice. I so love this place!
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I see it all the time. :o
Thanks John... nothing beats the voice of experience! As with everything related to our health, being proactive can make all the difference.
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I was admitted to the hospital via the ER for the first time in November of 2005 with pneumonia. My first dose of pills was understandably late but the nurse didn't bring me all 3 pills at the same time. The next morning they were on time but in the evening they left out one pill (Norvir) and I had to argue with the nurse about when I take them. The Norvir was often late for the 5 days I was there and on the last day, I waited 3 hours for my dose in the morning. The experience was very stressful and I was at the mercy of the nurses to bring me my meds. I told my HIV doc about this when I saw him after I was discharged and he recommended that I bring my own meds if I ever go again because he claims this type of thing happens all the time. You would think the care would be as good if not better in the hospital but in this case, it wasn't. I have always taken my meds on time every time on my own. Luckily there was no apparent permanent damage done from the sporadic schedule while I was in the hospital.
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I totally agree that you should bring your own meds and self-administer them if the hospital is not bringing the correct meds at the appropriate times. Hospitals are big places full of sick people with lots of different conditions. Even the best med delivery system is going to get screwed up if someone down the hall has a heart attack. I'm not sure if any disease requires the strict adherence that HIV does. We are probably best suited to monitor our own meds because we know so much about them and the nasty little virus. I'd go so far as to say that I bet the members of AM are probably better informed about our own health than the most other Americans are about their own.
Funny story about my recent trip to the ER. One Saturday night I tore my left calf muscle while dancing at a local club. Since I am not a wild dancer, I assume that "she was ready to blow." So I end up at the largest ER in Washington DC at 2AM. I'm surround by drunks, druggies and a whole Bunch of other people. When the admitting clerk asked for my info, I provides the insurance card, then game my doc's name, address & phone number. When she asked about medication, I took out this laminated card that I carry with me, it has the drugs names and dosing information of everything I take. She was really impressed that I had the info handy. Later when the doctor examined my leg, he started with "Mrs. Johnson at the admitting desk told me that I should be extra nice to you because she likes you, you have your act together." I had to laugh, because a few hours earlier as I lay in pain on the floor of the dance club realizing that I was one of the "older" patrons that night, I felt like I had was the guy who needed to get his act together.
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"Mrs. Johnson at the admitting desk told me that I should be extra nice to you because she likes you, you have your act together."
Funny story. A laminated card can be very impressive, huh? ;D
Seriously, learning that your health care is ultimate YOUR responsibilty can be very empowering.
Showing that you care that much about your health makes you a standout in a crowd of generally clueless patients ... among which the standard answers to questions are "huh?" "maybe" or "ummm.... i don't remember..." Don't take "no" for an answer if you are not getting exactly what you need as far as health care goes.
Another good reason to be proactive about our health is that we'd more likely avoid hospitals. Not only are they not healthy places for us in terms of food, getting our medications, not being able to sleep, lack of peace and quiet, etc. Staying in the hospital can actually kill a patient! Tens of thousands of U.S. hospital patients die each year from HAI -- Healthcare Associated Infections, caused by antibiotic-resistant strains of bacteria.
Healthcare–Associated Infection
Hospital-acquired and health care–related infections are an increasing threat to patient safety and health in the United States (Weinstein RA 1991; Weinstein RA 1998). In the United States, infections encountered in the hospital or a health care facility affect more than 2 million patients, cost $4.5 billion, and contribute to 88,000 deaths in hospitals annually (Malone DL et al 2002; Tasota FJ et al 1998).
Urinary tract infections are the most common, followed by pneumonias, skin and soft tissue infections, and invasive bloodstream infections. Surgical wound infections account for 20 percent to 30 percent of cases, but contribute to as many as 57 percent of extra hospital days and 42 percent of extra costs. Staphylococcus epidermidis, S. aureus, Enterococcus faecium, Enterococcus faecalis, E. coli, Enterobacter species, and P. aeruginosa are common pathogens in wound infections (Goldmann DA et al 1996; Weinstein RA 1991).
full info at: http://www.lef.org/protocols/infections/bacterial_infection_01.htm (http://www.lef.org/protocols/infections/bacterial_infection_01.htm)
Northwestern Memorial Hospital in Chicago released this information about HAIs (specifically Staph [Staphylococcus arueus]) for the year 2004:
* S.aureus was listed as a discharge diagnosis in 15% of all hospital stays – 292,045 stays/year
* Those patients with a S.aureus infection had an avg. of 3X the length of hospital stay (14.3 Days VS. 4.5 Days)
* These patients were charged three times the total charges of those patients without a A S.aureus infection ($48,824 vs. $14,141)
* HAI’s of S.aureus patients had 5X the risk of an in-hospital death
Extrapolated U.S. Data - 2004
* S.aureus stays in the hospital added 2.7 million extra days/year
* Those patients with a HAI of S.aureus cost taxpayers an additional $9.5 billion/year
* HAI of S.aureus resulted in the deaths of 12,000 patients/ year in the U.S.
Note that this refers only to Staph! The quote above that lists an estimate of 88,000 deaths per year in the U.S. due to all HAI.
Bottom line -- beware of hospitals!