My Letter to Providence Hospital

Shanna L. Pyzer

April 28, 2012

To Whom It May Concern:

Hello, I had a scheduled procedure done at Providence, Everett on February 23, 2012. I have very little experience being a patient, basically just childbirth twice. In 2009, I developed an ongoing excruciating headache on the right side of my head and face. After many doctor’s visits, trips to the ER, and imaging appointments I was diagnosed with an Internal Right Carotid Artery Dissection. I had never experienced any kind of health issues for myself before. It was a pretty traumatic time for me.

Two things have spurred me to write this letter.  About a month ago, I received my Explanation of Benefits for this procedure. My share is $3,000.00. I had been thinking of sharing my experience with the hospital and that definitely spurred me on. Then, a couple weeks ago, I was driving to work and heard a spot on the radio station that I listen to. They wanted people to call in and tell what about their job was a blessing to them. One of the callers was an employee of Providence Everett. She just gushed about what a great Christian organization it is and that it is a blessing to be a part of the ministry that Providence does. The radio host had had an experience with Providence when his wife had a heart attack last year. He also gushed about what a great experience he had at Providence and how he felt God’s presence the whole time he and his wife were there.

I caught myself thinking, “That was not at all the experience that I had there.”

I would like to share my experience.

The procedure that I had was a cerebral angiogram. I had met with the doctor in December and we got the procedure scheduled. She wanted to get a definitive answer as to whether or not I have an aneurysm on the left, rear side of my brain. She did not think that the test would show that it was one, she was hoping to rule it out.

I was not at all nervous about the procedure. This had been a long road (summer 2009-Feb 2012). I just wanted to know for sure what was going on in my head. I have been at the hospital with my grandpa and grandma numerous times for them to have cardiac angiograms and angioplasty, as well as open-heart surgeries. I have seen the videos of the arteries and the blockages and spoke with the cardiologist. I basically understood the procedure, I thought.

I received a letter in the mail about when to arrive at the hospital. I wasn’t given any instructions as to whether or not I could eat or drink, or any preparations I should make. Two nights before my procedure I got a call from a very nice nurse. She went over my instructions and reminded me to arrive at 9:30 am and told me exactly where to go. I followed these instructions exactly.

My mom and I arrived and checked in at 9:30 on the scheduled day. The front-office staff was not welcoming, nor very friendly. They were rushed and seemed scattered and were “bickering” a bit back and forth between them. I was asked to wait in the waiting area to be called back. We waited for 10-15 minutes and got called back. When I was taken into my room, the nurse informed me that I was supposed to have been all prepped and ready for the procedure by 9:30, not arrive at 9:30. Taken back a bit, I explained about the letter and the phone call that I had received. She commented that the doctors do not understand how to do the scheduling. She was very short with me. Being the easy-going person that I am, I kind of brushed it off, but made mental notes to myself. Maybe she was having a bad day and was super busy and stressed.

I got undressed and into the gown and bed. My husband showed up a bit after that. I was talking to him about how the morning had gone and little chit chat while the nurse was doing things around the room, getting things set up and all. I was in the middle of a word as she put the stethoscope on my chest and firmly said me to, “BE QUIET, I cannot hear your heartbeat when you are talking.”  She then continued to rattle on about I don’t know what because I was appalled and irritated and was thinking, “then be quiet because you surely can’t hear it while you are talking either!” I looked over at my mom and husband and they were clearly shocked as well.
She finished getting things ready and was in and out of the room.

The doctor came in and talked to me a bit about the procedure. She was very friendly and professional. They way she was talking it seemed like I was going to be going in very soon to have the angiogram done. My mom and husband grabbed all of their stuff and were waiting for me to be taken out of the room, as they were going to the waiting area. They stood for a while and waited and waited. I very nicely, asked the nurse if she knew when I was going to be taken back. She basically snapped at me that I would be taken back when it was time to be taken back. I told her that I was just asking so that my mom and husband could sit down if it was going to be a while and that the doctor made it seem like it would be soon. She then went on and on about how the doctors are not in charge of when the patients get taken and she was displaying some bitterness and resentment toward doctors. This was quite disturbing, as I am a patient, putting my health and potentially my life in this doctor’s hands. It was also quite unprofessional. So my guests sat back down and waited for me to be taken back to the angio suite.

Going into this procedure, I was not anxious about the actual procedure, but I had not considered the other aspects. I was not prepared to have my bikini area shaved, as I was told that the port goes into the upper leg. I was also not prepared to be stripped naked on the narrow table, only to be covered with very narrow sheets to cover the top and bottom parts and an even narrower cloth in my private area. Another expectation that I did have was that I would be given some type of sedative to relax me during the procedure. One of the nurses said that I would be given an “I-don’t-care-what-you-do-to-me” type of medication. I was never offered this. The very nice nurse that took me to the angio suite and stayed at my head the whole time was very helpful. She was very reassuring when I was close to jumping off the table when they were taking my gown off of me.

I got through the procedure, obviously. There was a very nice man named John, I believe he is an RN, but I’m not sure. He was very kind and helpful. He is the lucky one that got to put pressure on the site where the port was put in. We chatted a bit, and I was desperately trying not to think about how naked I was, while a strange man had his hand in my crotch area for 20 plus minutes. He was very professional, though, so that helped. I spoke to him a bit about how I was treated by the other nurse. He was very kind and apologized on her behalf. He was quite aware of how uncomfortable I was feeling.

When he took me back to my room there was another nurse there waiting for me to arrive. John was explaining the site to her and how to check it and what to check for and such. She did not make eye contact, or even look at him for that matter and just mumbled incomprehensibly and was acting like she just wanted him to leave. He and I looked at each other with what I took to be skepticism. He decided to check the site before he left and felt that he needed to apply more pressure, as there were some spots that seemed to be bumpy. I thanked him for staying and taking care of it himself (even though I am a terribly modest person and the thought of having someone touch me “there” was highly unnerving). He was very gracious. He left after he felt that the spot was ok and let the nurse know how often to check it.

I, in all seriousness and legitimacy, do not understand how this lady made it through nursing school. She was so awkward. She could barely look at a person and talk to them. Half of what she said was unintelligible. She seemed nervous and not at all confident. She was an RN, I made sure to look. While giving me the discharge instructions (when I still had to lie flat for 3 more hours), she would read the paper and try to explain it to me and failed miserably. At one point my mom followed another nurse out of my room to ask about the nurse that was caring for me. She was told that she is a traveling nurse. That was definitely understandable.

I know that a lot of thought, and probably prayer went into the designing of the new facilities. It is a beautiful place. It is apparent that details were very important. Attention to details and the “little things” can really make experiences and the lack of this attention can most assuredly break experiences. Honestly, I am an easy-going person. I pride myself as being low-maintenance. I don’t like to ask for help or require people to go out of their way, or be “put out” to do things for me. I am more the “suffer in silence” type. I do not like to complain and whine. I am friendly, as I was with each person that I came in contact with that day at the hospital. I did not feel welcome. I don’t feel that there was any attempt to make me feel at ease, as I was going into a potentially life-threatening procedure. I didn’t feel prepared for the “little” (they were huge to me) details regarding the procedure; like where the port was going, being stripped naked, not having any sedative offered to me. I was not even encouraged to use the restroom before the procedure as I was going to have to lie flat for 5 hours straight. I ended up HAVING to use a bedpan, and that was a whole other experience that I care not to go into.

In the end, I was told that I do, in fact, have a small aneurysm. And I need to be rechecked in a year. This was the extent of my follow-up. As a side note; I have had a couple root canals, and each time, my endodontist called to check up on me the next day.  I was a bit surprised at the lack of follow-up after having a cerebral angiogram.

There is really a lot more that I could write, but I think you have got the picture. I just really wanted to share my story. What would I like to see done? I would LOVE to have my portion of the bill written off. I also want you to be aware of my experience and hopefully it will enable you to make sure that others don’t experience the same in the future. If you have any questions, or clarification on anything, please feel free to contact me.

Sincerely,


Shanna Pyzer

You're Putting That WHERE????????

If you remember, back in the summer of 2009 I had an Right Internal Carotid Artery Dissection. I had several MRIs and CT scans, both, with and without dye :). In the images of these most wonderful and EXPEN$IVE scans was found what may be an aneurysm in the anterior left of my very beautiful and packed-full brain.
My neurologist was not totally convinced that it was an angiogram so I was referred to a brilliant neurosurgeon back in 2010. Well, when I got to that appointment the discs containing the imaging results of the CT and MRIs was completely blank. Grrrrrr...... Sooooo..... Jeremy and I got to sit an listen to this neurosurgeon tell us how brilliant and experienced he is..... s.n.o.r.e.......... He assured me that when he did receive the imaging he would call and discuss it with me. So, I waited .....and waited ...............................and waited....... And he never called. (Sounds like an orthopedic sports medicine doctor that also never called when he said he would.)
Anyway, In December I was referred to another neurosurgeon who also was not convinced that what they saw on the imaging was an aneurysm. Soooo...... she scheduled me for a cerebral angiogram. I am very familiar with cardio angiograms, as several family members have had them. I was pretty excited to get a definitive answer and figure out where to go once we knew for sure one way or the other.
I was not at all nervous about the procedure.

My motto is "When it is my time to go, I will go; no matter where I am and what I am doing."

I knew that the procedure involved having a catheter put in my upper leg so that a scope could be inserting and that it would go up to my neck, they would insert dye and get images of the veins in my neck and head. This being the case I wanted to make sure that I was adequately depilator-ied. I used my VEET awesomeness to remove unwanted hair in the general area of my upper legs and shave the lower portions. I didn't concern myself with my feet, thinking that I would wear socks the whole time. (HA!)

My mom and I got to the hospital, checked in, waited, got taken back to the room, I got COMPLETELY undressed (anyone that knows me knows how much I detest being naked and exposed), then one of the nurses said that I would have to be shaved in my bikini area for the catheter to be put in.......WHAT??????..... my "bikini" area (hahahahahahah....as if I would EVER wear a bikini) is NOT part of my upper leg!!!!!!! I assured her that I had already taken care of the area, so of course she had to check. Ugh! She approved. She, then, TAKES OFF MY SOCKS!!! NOOOOOO...... I didn't take off the peeling polish and make my toes pretty....... 

Note to self: do not go to the hospital without all of the proper preparations, no matter what you are going in to have done.

Then the doctor comes in to explain the procedure---never mentioning that I would receive any kind of sedative-type medication. I would be fully awake and participating. Oh Yay!

One of the nurses did say that I would receive a dose of I-Don't-Care-What-You-Are-Doing-To-Me-I'm-In-My-Happy-Place-Type medication. Whew! (I never got any of that. Just some lidocaine to numb the area.)

p.s. The nurses that I dealt with yesterday had a 50% chance of being nice nurses. There are some Doosies at Providence Colby, let me tell ya!

Finally, a very nice nurse came to wheel my bed into the "Angio Suite", assuring me that everything would be great. Entering the sweet I was greeted with some nice 70's disco music playing and lots of plasma screens, which would later televise my vitals. I met a lovely man, named John, who would later get to know me a little better than most.

WHAT I DID NOT ANTICIPATE..........

Once I scooted onto the table, I was completely DISROBED.....Um........ WHY ARE YOU MAKING ME LIE ON A TABLE WITH A ONLY VERY NARROW BLANKET???? OH.... a narrow blanket over the top 1/3 of me and the bottom 1/3 of me with a very narrower strip of gauze over the middle 1/3 of me........I AM FEELING VERY UNCOMFORTABLE.... oh and now I need to peeeeeeeeeeee.......... I remembered that the doctor had said it would take about an hour. Can I hold it that long???? Oh no...... after that I have to lie flat for 4 hours........ What am I going to do????? I can't ask to go to the bathroom now...I'm on a table naked. Ok..... please please please don't do anything that makes me pee uncontrollably......now is a very good time to practice my kagles..... 

The procedure was a little uncomfortable at times....the putting in of the catheter....the bursts of dye that made my head feel like it was on fire...one section at a time. But, no big deal....especially once I presumed that it was safe to say that there were no clots being pushed up to my brain, causing a stroke. (this was one of the risks)

When it was all said and done....however..... my good friend John (previously mentioned) got the job of putting pressure on my GROIN AREA (guess what......that is my "bikini" are in disguise!!!!!) for 20 minutes after the angiogram was done. Yah! I am laying practically fully exposed on a table and a strange man in holding his hand in my yoohooo area for 20 minutes. a.w.e.s.o.m.e. Of course, he was very apologetic and friendly and professional about it. BUT STILL. I just wanted to be covered up and my back was killing me and my right knee really needed to be bent. 20 minutes later, after a very nice bonding time with John, I got my gown put back on me and covered with nice warm blankies and rolled back to my room. Ahhhhhhhhh................

Have I mentioned I was not allowed any food or liquid since midnight the night before? Oh and that I am clearly an addict of the drug caffeine????? Soooo.... the headache was hitting and the caffeine did not come quickly enough. But it did come, in the form of an iced latte with a straw that I had to drink lying flat with my head turned. Sweet Jeremy....Thank you so much!!!!!!!!!!!!

Headache was progressing, pee urgency was progressing. I had 4 hours to lie flat. What was I going to do???????? While Jeremy was out getting my coffee, my good friend and I think we may be dating now, John came back to check the "site" and detected an embolism forming, so he needed to put pressure on for a bit longer. Oh goodie! John (and his wife) is from San Diego, loves Mexican food. He is outdoorsy, likes to hike. He highly recommends visiting New Mexico, as it is very eclectic in the area of art, and has the BEST mexican food. He also has a lovely sense of humor and a love for the veins and functions of the brain. :) On a side note: When John checked on me, he noticed the very WEIRD and AWKWARD nurse so he took the initiative to check me and pressurize me to save me from her having to do it... Thank you, John!!!!! I really did appreciate that!

After lying on my back, flat, for 2 hours or so, I couldn't take it anymore. I DESPISE relying on other people. A bit of independent pridefulness, I suppose. BUT......I had to pee, my head was killing me and I was thirsty. NOT a good combination. I gave in to the use of the bed pan. What? did she just say bed pan???? Yes she did. Guess what????? I might as well have just said, hey...how about I just lie here and pee in this here bed and then you take the top layer of sheets off and let's hope that the in-between layer is, in fact, waterproof. Because that is basically what happened. And waterproof it was! Thank you nurse, I am sorry I can't remember your name, but you were really nice and funny and sarcastic and I liked you a lot! And you provided me with my first ever bed pan experience.

Water please.....from a straw from the side of my head. Thank you, Chelsea!!!!!!! Oops next time, please don't drip water down my face. :)

My headache just kept getting worse then the nausea hit. I really don't want to puke lying flat on my back, waiting for a nice healing clot to form on my artery in my groin area. Can I please get some med for it? Yes I can! Whew....... I love Phenergan!!!!!!!! Insert into IV......good night!!!!! Two solid hours of  drug-induced sleep. Thank you!

From then on, it was uneventful. I sat up, got in a chair for a bit, got dressed, walked to (and used) the bathroom and back and got wheeled out to my car. 

The moral of the story. Anytime you have ANY procedure scheduled...... get rid of as much hair as possible.......make sure your toes are polished........sneak a little nip of coffee as early in the morning as possible to avoid the caffeine headache that is inevitable.   Maybe it is time to wean myself off of it.

(Oh...and... I do have a very small 1.9mm aneurysm. I will have another CT scan in a year.)

Thank you so much, mommy for taking care of me and being here for me!!!!!!!!!!!!!!!

My Sweet Ride ---insert sarcastic smile---

Things I hate about the 1992 Ford Ranger:
1. The seat belt holder thing is WAY too high so it practically cuts across my chin.
2. The inside door handle on the passenger side is broken, so I have to put the truck in neutral, engage the E-brake and get out so that Benjamin can climb across to get out at school in the mornings. (Pretty annoying. You would understand this if you take your kids to school in the mornings.)
3. The E-brake doesn't just disengage when you pull the lever. You have to put your foot under the brake, pull the lever and use your foot to pull the brake all the way up.
4. I can't roll down the driver's side window. Very annoying.
5. I am not sure how much gas I can put on, because at some point it is too much and then I will have a leak.
6. Gagging on my pride. (Which includes praying against the green-eyed monster that rears its ugly head with every glimpse of a beautiful Volvo, GMC, Toyota, Honda........you get the idea.)

Things I like about the 1992 Ford Ranger:
1. No payments.
2. We can put money that would have gone to the car payment toward paying off the other car. (And we better, because if I am driving this beauty for no reason....... you get the idea.)
3. The heater works.
4. It doesn't look too bad.
5. The radio works. (And....helloooo there is a casette tape player!)
6. The seats are kind of comfy.
7. It is a super cab.
8. It runs.
9. It isn't super loud.
10. Jeremy took off the metal rack.

Why Are the Right Things So Difficult?

I know that I need to eat healthier, and less. I need to workout more, which usually means being at the gym by 5am. Reading my Bible is a necessity.
I Love, I mean LOVE, to eat. I do not eat in moderation (CLEARLY). I don't want to eat in moderation. But I need to. It is SO hard to put the fork down when there is cake around. I don't want to stop after I have had 5 double stuf oreos dipped in milk. There are few things more satisfying than a happy full belly! I mean really! But, if I want to get rid of this excess weight (aka FAT) that I am carrying around, I have to change my thinking on this. "Nothing tastes as good as thin feels." Right? I wouldn't KNOW!!!!! But I want to find out!
It is just so dang hard to do the right thing!!!!!
I feel so much better every time that I make it to the gym and workout. Why do I skip days (that sometimes turn into weeks and months)???? Why??? Why can't I make myself remember that feeling of strength and accomplishment and vibrancy when I finally decide to stop playing the "snooze-button" game and turn the alarm off? 
Working out and going to church are very similar. They are always the right thing to do, but sometimes you just want to stay in bed. But once you have gone to church or finished a workout you never regret it!
I am on a journey to lose at least 30 of these excess fat pounds by the time I turn 40 in March. I have been logging my food and exercise at http://www.loseit.com/ . It is a really cool site/App for you smart phone. But when I got on the scale after 2 weeks, it had not moved anywhere but UP!!!! Grrrrrr!!!! But I will not give up. I will keep on doing the next right (even though difficult) thing, just because I know it is what I need to do!

What I Feel vs. What I Know....(today, at least)

O God,

I feel so depleted.

I feel empty.

I feel as though I am withered.

I feel that if this is all there is, what is the point.

I feel alone.

I feel forgotten.

I feel like walking away.

But,

I KNOW that you are my sustenance.

I KNOW that when I am empty YOU fill me.

I KNOW that you are the LIVING WATER to replenish me.

I KNOW that there is a PRIZE and I must press on toward the goal.

I KNOW that YOU are my EVER-PRESENT HELP IN TIME OF NEED.

I KNOW that YOU love me with an EVERLASTING LOVE.

I KNOW there is nowhere I can go that is hidden from YOU.

and

My HOPE is in YOU!

Kindapping, Circuses, and Vampires, Oh MY!

So, this has been a great couple of months of reading for me! I took an online summer class, which started of the roll. I read this great book about a 14 year old boy that began a 40 year journey of Schizophrenia. It was such a great read and very insightful into the world of mental ilness.
I also read:
 The Stranger Beside Me, by Ann Rule. This was the story of Ted Bundy, serial killer. Fascinating!
There were a couple other books for the class that I merely got through to write papers!
After the class was over, the fun began!!!!!!! The first book that I read FOR ENJOYMENT was:
 I super loved this book!!!! Such a great love story and who knew what went on behind the scenes of the circus...OH MY GOODNESS!!!!!!!! I haven't seen the movie yet, and I am not sure why! I need to get on that!
Next up......
I saw the movie before I read the book and I was not disappointed with either! I had heard about this book like 2 years ago and have wanted to read it. Finally got to it and I loved it so much! Each character evokes such strong emotions!
After this, I turned back to non-fiction for:
This tragic book is just seriously heartbreaking!!!! This woman grew up under horrible conditions under unthinkable circumstances. She does get rescued but has a long road of recovery to walk. My heart was broken when I finished because I just really want for her to know Jesus. I am praying for her!!!!
After this I took a little break from reading, as I tend to get consumed with it.
AND....I went on a girls weekend in September with 2 friends. One friend convinced me to watch the 3 Twilight movies, which I have sworn NEVER to watch and especially NEVER to read the books. Not because I have anything against vampires and werewolves, but because I knew I would get SUCKED in. Well.... I did. In a big way!
 
Right away in the first movie I was hooked. I knew that I was going to have to read all of the books to get all of the details! And I did. It took me approximately 10 days to read 2,490 pages of wonderfulness!!!!! I will blog more about this later, it is brewing in my mind!!!!
The next book that I will be taking on is this 800 page novel:
I will let you know!!!