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ferlew | 22:50 Sat 30th Nov 2013 | Body & Soul
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How much are we entitled to know?
Found out yesterday that Mr F has broken ribs from the procedure to remove part of lung.
The Docs/Nurses on the ward have not mentioned it at all. It would have helped to know why he was in so much pain.
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PP, I think you will find ferlew has a right to know all information re her OH. I hope you can get some decent pain relief for him soon , take care.
You may be right, Peter but in some situations the next of kin needs to be made familiar with all the details.....I was with my Mum who had Alzheimer's and MrG who didn't.....in both hospital and GP surgery.
A good doctor knows what should be done and how to do it...if they care.
only if she has POA (health and welfare)
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I have mentioned before, MrF has Alzheimers PP. I was there at his consultation. VATS was what was discussed, and consented to.
Please understand, we just would have been pleased to know why he was in so much pain . We are not member of the Litiginous society. (sp)
Not always, Bednobs....I never had POA over MrG but I was included in everything and sometimes when he was absent...if it helped and was the right thing to do.
that is the legal position. The common sense position is of course, different! :)
oops sorry about that
missed it completely.

VATS - sorry I thought they had done a rib splitting thoracotomy

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VATS was on the menu, for some reason they did the full op, as yet we have no idea why.
2nd second sorry I thought this was listed under 'Law'
2nd oops
When the hospital gave himself back to me he wasn't in any state to take in anything they were saying so they addressed me. Sorry Mr F hasn't been treated very well, but just take solace in the fact you have got him home and you have the appropriate medication to make him feel more comfortable, being cross isn't going to get Mr F better any quicker and that's the priority now.
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To clarify, we are not moaning about the change of op......just about the lack of info about why he had so much pain.
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Ta Sherra, I will get him thro' this.

Night all, I am shattered xxx
Night Ferlew, x
Dear ferlew,
Great sympathy for your situation. I wish you and Mr F all the very best.
Don't know about your legal right to know but morally, humanely and for correct aftercare both of you should have been talked through the details with the why's and wherefores explained.
I thought Mr F's GP should receive details and Mr F copied. Request more info and advice from GP by pre-arranged 'phone conversation or home visit if necessary.
Paracetamol useless in this situation - shame on you bedknobs. GP to advise on pain-killing and monitor effects. Maybe codeine/paracetamol combination pill (codramamol, I think it's called) or the sodium salt of morpine. Latter sounds scary but is a non-addictive weak form - often given after hip replacement.
You are right to avoid litigation - you would (wrongly) lose in today's political climate and just increase the stress and anxiety on you both.
With my very best wishes to both,
Love,
SIQ
ferlew....an odd story.

Do you mean "broken rib" (accidental) OR do you mean a "resected rib" (planned)
VATS doesn't require a rib removal, usually, but if exposure was compromised, then the removal would be justified.

Would i tell the patient or relative?.....no idea.....it wouldn't be the first thing that would come to mind.

Pain relief........opening the chest may sound dramatic, but it is less painful than opening the stomach, having a tooth out or having a baby.
Paracetamol is the usual painkilller in such situations, although patient's response to pain killers vary.

Who told you about the "broken rib?"
Ooops! didn't answer your question:

As the wife, you have every right............but do you need to know the details of the operation?
Sqad I think that depends on the person...from the people who want to know every little thing and feel better when they do, to the people who get freaked out by the detail and don't even really want to know enough to give informed consent. I know in the "olden days" surgeons generally thought that patients didn't need to know...but hey things change.
The important bit I think from ferlew's post is not really IMO the "why" of the pain but the fact that there was more pain than there should have been, especially in when the patient has dementia and therefore might not be so able to express their need for analgesia.
I speak bith as a professional and a reli.
woofy

\\\\\Sqad I think that depends on the person...from the people who want to know every little thing and feel better when they do, to the people who get freaked out by the detail and don't even really want to know enough to give informed consent\\\\

It does, it does, but how does the doctor know which is which and how they will respond?
The types that say "Go on Doc give it to me straight" are the ones's quite often, who just keel over when one does "give it to one straight."

I just hadn't the time and nor did my juniors to have a "proforma" for all types of individuals, so we all had a set routine for everybody and if we got it wrong, as we often did, then so be it.

As for the pain....perhaps the medical staff do not know why he is in such pain......this is often the case.....and indeed ARE they in such pain.
Well Sqad, rightly or wrongly, now the expectations of knowing who wants to know what are higher.
I know a tiny bit about pain management and the first step is if a patient says they are in pain or behaves as though they are in pain, then whatever their mental state, the practitioner must believe that the person is feeling pain and to act accordingly. That doesn't necessarily mean spiralling up to mega doses of pain relief, but it does mean doing something. My personal experience of pain management both as reli and professional, is that many (most) doctors and nurses, even excellent ones are not good at pain management. Its not that long ago that it was believed that babies and young children didn't feel pain like older children and adults do.
the problem is though woofy, in an ideal world if someone who was exhibiting pain behaviour, you might start with paracetamol, assess the effect, then go up, assess those effects and so on. Unfortunately on a busy ward, it would take an exceptional nurse to 1) spot the patient might be in pain and 2) have the time to give pain killers, assess the effcts then do something else. when i was working as a nurse i probably would have made that a priority, because i was exceptional. Unfortunately my experience as a patient tells me that nurses don't have time any more to do what would have been so simple "in my day". I also worry that ferlew says he was "offered" paracetamol, not "given". It makes me think he may have refused it, therefore it may well have been assumed he wasn't in pain

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