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Things I've noticed while visiting the ICU

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Re: Things I've noticed while visiting the ICU

#31

Post by ch4s3 »

virgildotcodes wrote: post #19
questime wrote: post #7

Earlier quoted context omitted.

Because of demographics this is a problem we will have to confront regardless - do you think medicare/medicaid spending will become 80% of government spending?

Maybe with higher taxes and a reallocation of defense spending we’d be able to sustain a more humane society for longer. Is it indefinitely sustainable? Not sure. I don’t know if it’s as easy as just extrapolating from recent trends because there may be countless unknowns from biomedical advances to climate destabilized societies to being turned into biological batteries for our machine overlords in the next few cent…

Having medicare operate under a fee for service model will never be sustainable in the long run. We already spend $ 755 B on Medicare, which is roughly equivalent to the DoD's $ 767 B, and Medicare is notoriously wasteful[1][2].

[1] https://www.healthaffairs.org/do/10.1377/hpb20220506.432025/

[2] https://vbidcenter.org/wp-content/uploads/2021/10/jama_shran...

Re: Things I've noticed while visiting the ICU

#32

Post by copperx »

georgeg23 wrote: post #9

The hallucinations sound like a side effect from lorazepam (Ativan) -- something hospitals give almost everyone but is a hardcore drug. Consider asking nurses to stop administering it after you do your own research. https://www.webmd.com/drugs/2/drug-6685/ativan-oral/details#... ).

It's hard to pin it down to a single drug. Having had both my grandmother (80) and mother (60) in the ICU, and both got hallucinations without Ativan. It could be so many things:

* The aftermentioned lack of sound sleep

* Anesthesia

* Painkillers

In the case of my grandmother, hallucinations and incoherence lasted about three months after she was home. My mother's lasted about 2-3 weeks. It was scary. They both eventually recovered. But it is true that nobody in the hospital bats an eye when acute dementia-like symptoms are mentioned. "It's normal," they say.

Re: Things I've noticed while visiting the ICU

#33

Post by possiblydrunk »

From personal experience, one of the most frustrating things about the ICU (if you're there for any anything beyond a day) is dealing with the variability in the availability, skills, and temperaments of the nurses on duty. The 'right' nurse can make a huge difference in how fast the patient recovers and how difficult the stay is.

Re: Things I've noticed while visiting the ICU

#34

Post by notacoward »

Mezzie wrote: post #17
anjc wrote: post #4

> the next time you have trouble booking a surgeon or even a gastroenterologist, you can remember that America’s supply of surgeons and gastroenterologists is being disproportionately used by the AARP crowd. What a horrible sentiment.

What's terrible about it? I'm a younger (34) person with substantial healthcare needs (I have MS). Everything is always oriented towards the old, and I also pay taxes that are used to support them while getting nothing in return despite having similar needs.

> I also pay taxes

Do you really get nothing? And who is paying for whose care? You mention taxes, but they've probably been paying taxes even longer. And why do you think health care is a strict quid pro quo anyway? Some of us believe care should be allocated where it's needed, not where it's paid for. Put another way: why is it a problem that they are getting care? Isn't it that you aren't? This doesn't have to be a zero-sum game. If you feel that you're in competition with someone else for care, the problem is pretty clearly that there aren't enough providing it.

Saying others have less right to health care is pretty terrible no matter which way the finger points.

Re: Things I've noticed while visiting the ICU

#35

Post by cactus2093 »

a_shovel wrote: post #21

I don't have much personal experience with hospitals, but there's a trend I've noticed across several articles now where the medical system is characterized by an unpredictable and frequent alternation between extreme competence and extreme incompetence. The author's dad was being seen by a variety of highly trained specialists all working to treat him, but "people need to sleep" seems to be a recent discovery in the…

From reading the abstract you are completely mischaracterizing this study.

For the average person healthy food usually means food with fewer calories and more micro-nutrients, like eating more broccoli and less white bread.

This study is about malnourished patients who need more calories than they can even digest from an average meal so they need specialized high-calorie foods that are customized for their own metabolism. It's essentially exactly the opposite of what "healthy food" means in any other context.

So it has nothing to do with any narrative about cost cutting and the quality of ingredients used in hospital cafeterias.

Re: Things I've noticed while visiting the ICU

#36

Post by chiefalchemist »

When when one of my parents had a stroke years ago, we spent a week in the ICU. It was a special ICU for stroke victims. The care and staff were exceptional. We were lucky such an ICU was in our area.

On the other hand, subsequent hospital visits (non-ICU) were a cluster fuck. Noise, lights on, nurses constantly waking my parent up, could-care-less doctors, etc. And getting healthy enough to be transferred to an extended care facility was a shit show. It's was like the hospital but worse. Both experience seemed to have little to do with health and recovery.

My point is, the article author is in for a shock once his dad gets out of the ICU and into the "general population". I can't imagine that's going to be better than the ICU. I hope I'm mistaken.

My take away from this experience is:

1) Make choices that maximize your health the best you can.

2) If you can, be rich - like fuck you money rich. The kind of rich where your "general population" hospital experience will be like being in the ICU.

Re: Things I've noticed while visiting the ICU

#37

Post by warner25 »

> There’s no sense of a scientific method, reasoning from first principles, or even reasoning from similar cases though. It’s all shooting in the dark, and most of the time I felt like I could have done just as good a job on these longterm issues...

This articulates very well what I've usually felt when dealing with doctors. It's like the story of a programmer finding that his code outputs 5 when it should be 4, and then adding...

    if(return_value == 5):
        return_value = 4
...to fix it, and being satisfied. What I want is something like in the television show House. The main character is unhinged and anti-social and takes extreme risks, but at least he demonstrates curiosity to really figure out and understand the root of what's going on. To be fair, I don't actually think that doctors lack curiosity or are incapable of doing this, the medical system as it's set up just doesn't allow it. For chronic issues, I've usually figured them out for myself, as a layperson, by persistently keeping track of things, searching the web, reading, and experimenting over months and years.

Re: Things I've noticed while visiting the ICU

#38

Post by neonate »

voz_ wrote: post #8
questime wrote: post #5

It's politically toxic to discuss but a ton of money goes to keeping people not dead (not really alive either). You could give a lot more people medicare/medicaid if we let a 90 yr old with dementia/diatebetes/etc. pass with dignity.

I don't think its politically toxic, but rather, extremely humane that we care for our elderly. The real unfortunate part is that we, in the working class, have to make due with sharing slices of the pie so more money can go to our exploiters and owners - especially in the US, we are such a wealthy nation, and yet here we are bickering around who deserves care based on age. Sad.

We don't care for our elderly. We fear death.

If our society really cared for the elderly, they would be integrated and respected, not segregated and shunned. We do the latter because we fear age, sickness, and death. Fear isn't caring.

Re: Things I've noticed while visiting the ICU

#39

Post by Wonnk13 »

For context see my comment here https://news.ycombinator.com/item?id=33625584#33647770

One thing that this article touches on, but I think needs to be emphasized even more is that the stark reality is that the only advocate for the patient is the patient themselves, or perhaps a caretaker.

The burden is on me to ask questions about fertility and sperm banking because my oncologist is well... an oncologist not a fertility expert. I have to ensure that every department is communicating with every other department.

Hospitals and physicians are fantastic at solving discrete issues, but the bigger picture is often lost in the chaos. I can do it as a technically adept 34 year old, it's horrifying to think about how someone closer to 80 goes about it.

Re: Things I've noticed while visiting the ICU

#40

Post by notacoward »

gopher_space wrote: post #30
anjc wrote: post #4

> the next time you have trouble booking a surgeon or even a gastroenterologist, you can remember that America’s supply of surgeons and gastroenterologists is being disproportionately used by the AARP crowd. What a horrible sentiment.

It’s painfully easy to start thinking in numbers when you’re paying six thousand a month to warehouse your grandmother’s body. The number of tests people want to run on someone we all hope dies tomorrow is insane.

Funny, I pay even more than you mention to support my own mother in relative comfort in a nursing home, and I don't find it "painfully easy" to think that way at all. I certainly don't hope she dies tomorrow. You might want to reconsider saying such things in public.

Note: my mother, not my grandmother, and I have lived that ordeal for several years. Some interaction is still possible, but recognition has been beyond her for a while. As long as she seems to take some pleasure in her surroundings, no matter how dim or muted the signs, you won't catch me framing my thoughts about her in terms of dollars I could save.

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