Navigating Your Way Through the Medical Records

 This area cannot be emphasized enough as to its' importance!  We learned the hard way just how important it is.  

Here's the biggest thing that we learned by trial and error.  If it saves just one of you from making the same mistake, it's worth Moms' time as well as mine to explain it to you.

Being Moms' POA for Healtcare, involves a lot of things.  We learn something new with every trip to the E.R., hospital or Care Conference at a facility.  Initially, I would carry all of these records around with me as we made our way to the next stop on this trip.  But, almost everytime I offered to share them with medical people or staff, I was told that they really didn't need to see them.  WRONG!

Getting these records is a feat within itself.  You can take all of the notes that you want while in some of these places, but having the actual records of what the Doctors, Therapists, ect. are writing is an almost fool proof way to avoid problems down the road later.  We started acquring Moms' records when she started becoming, what we now call, a 'Frequent Flier'.  We never knew when we would be getting a call that she had once again injured something and sometimes, we would hear from her via our phone calls if something was just not right.  Listen to your family members when they tell you these things.  You may have staff at facilities telling you otherwise, but most of the time, the patient knows when something is not right.

We were able to obtain most of the records by my phone calls or visits to the offices and facilities as well as our explaination that we were moving Mom to Wisconsin.  It took us over 4 months to realize that trying to take care of her long distance was just not going to work.  We are extremely lucky in that we own our own business and were able to have at least one of us go to her when the phone rang.  I have no idea how people do this when they have to work for someone else.  It would be almost impossible.  Another thing that needs to be looked at when it comes to family leave for medical care of your parents.

Most of the facilities would have us fill out a form that would require a copy of the POA Healtcare legal paperwork in order to get the records.  Since Mom was unable to go on her own and obtain these, having the legal paperwork is paramount to your being able to obtain them.  I've also now started to request her complete chart, labs, x-ray results, ect. as part of her discharge from hospitals.  So far, I've been able to leave with them on dismissal day except for one hospital in Waukesha that requires you to fill out a form and then wait up to 4 weeks for them to be sent to you.  They are also currently trying to charge us for them.  It was interesting to note that even with the advent of electronic medical records, facilities cannot exchange those records with each other due to all of them having different software.  So, where exactly is all of that money going that was slated for this project?

We thought that Mom was having another TIA episode at her facility in Waukesha.  The ambulance was called after we evaluated her ourselves and she was admitted to the hospital for 2 days.  There was no evidence via the CAT scan and MRI of another stroke and it was chalked up to a TIA.  All of us had a little red flag going up in our heads that we were missing something.  Twelve hours later, we would finally realize what that was.  And, that was only due to our taking the time to go over the medical records and lab results from the last 5 years on her.

Twelve hours after her dismissal, we received a call from the Dir. of Nursing at midnight.  We've now gotten used to carrying my cell phone with me at all times due to all of the phone calls we have gotten over the last 6 months concerning Mom.  It still sets your heart spinning when the phone rings in the middle of the night.

Mom had gotten up and gone to the restroom.  Once again she had fallen.  Call button was within reach and she will be the first one to tell you that she 'probably won't push the button'.  This time, she broke her femur.  In four places.  Brittle bones and ambulation do not go well together when you have balance issues.  We were lucky in that I still had all of the medical records in my vehicle and I happened to grab them on the way into the E.R.  I was still trying to see if someone would take the time to at least look at the darn things, since we were still missing puzzle pieces when it came to Mom and how some of these things were happening.

We were also very lucky in that the same E.R. doctor was on duty that had taken care of her just 2 days earlier.  As they were once again doing labs and x-rays, one of the E.R. techs mentioned that her sodium was low.  A lightbulb went off in my head as I realized that low sodium mimics stroke symptoms and I wondered what her levels were in the past.  As I was going through all of these records looking for lab results, I started seeing low sodium levels from as far back as 5 years ago.  I pointed this out to the E.R. tech, who in turn told the E.R. Doctor.  When we got the lab results back again for confirmation, we had a very big answer as to why Mom would have these episodes of confusion and lack of comprehension.  We are now wondering if all of the 'mini TIA's' we thought she had had these past few years were really low sodium issues.  Many times, she would just work her way through the episodes and not tell any of us what was going on.  Another side effect of her independent personality as well as her desire to stay in her independent apartment.  Add in the fact that many years ago, she had read somewhere that a low salt, no fat, no sugar diet could help those with high blood pressure and this was all starting to make some sense.  We all get stubborn as we age.  I know that I have!  If you are dealing with older parents, it's easy to shrug off some of their ways of doing things just to keep the peace.  We did that for many years until it became quite obvious that her diet was also jeopardizing her health.  Respect for your parents is one thing.  Letting them continue to do things their way to the point of becoming hazardous is another.  Unfortuately, it's very tough to take that step and try to find a solution that will make everyone happy.  Another lesson learned for us.

Bottom line is, if I had not had all of these records, we would have never known of the sodium issues.  Mom is now on salt pills.  And, the sodium levels are coming up.  She's also become more alert and does not get as confused anymore.  At least for now.  She tells us that she feels like she can 'make sense of things again'.  She also tells us that she's glad she didn't try the 2 tablespoons of cinnamon a day to lower the blood pressure.  It's one of the many things she heard via her circle of friends would work.  She hates cinnamon!  Take the time to talk to your parents.  Listen to what they are talking about with their friends.  Almost all of them are trying to figure out ways to avoid going to the doctors.  A lot of them are now learning that all of the new meds out there also have lots of side effects.  Thus, they try and avoid all of it.  While this will be fine for them for a while, eventually, it will also earn them that 'Frequent Flier' badge when it comes to playing catch up.  Mom has a great sense of humor.  When we told her of her new designation, she wondered if that also meant that she would be earning frequent flier miles.  This, from a woman that would not drive her car more than 2,000 miles a year.  Don't forget to laugh when you are in these situations.  Sometimes, that's the best medicine for everyone.

Have a great week!