Parkland Hospital, Dallas Texas, USA a.k.a. INFECTIOUS DISEASE CENTRAL!

Parkland Memorial Hospital

Parkland Memorial Hospital (Photo credit: Wikipedia)

Scanning electron micrograph of Clostridium di...

Scanning electron micrograph of Clostridium difficile bacteria from a stool sample. Obtained from the CDC Public Health Image Library. Image credit: CDC/ Lois S. Wiggs (PHIL #6260), 2004. (Photo credit: Wikipedia)

I have been holding back from spreading the word about mine and my best-friends experiences with Parkland Hospital because her treatment, which I monitor at her behest, is still on going. But sadly I must rip them a new steam hole because WE are at our wits end with their lack of direction for her care. Our dramatic saga began October 20, 2011 when she suffered a Hemorrhagic stroke as a complication of Lupus.  She also has diabetes that has been well controlled until now. You will find out why as you read on. During her stay in ICU, they discovered a small 2mm cyst in one of her kidneys. Upon her discharge from her stroke admission, she was scheduled in March 2012 for a biopsy so they could determine is it was malignant. They biopsy never took place and was rescheduled for October 2012 and in the meantime, she s NOT on any life-saving Lupus medications because they don’t want the 2mm cyst to grow without finding out if it is malignant. Now keep in mind this excuse because further down in this tale it will come up again and again! Fast-forward to October 2012, my best friend/sister has developed Pulmonary Hypertension (PH) and can’t breathe because she ISN’T on any life-saving Lupus medications because…see above excuse…this ends up being the reason for the second biopsy cancellation. Her doctor tells her it must be done in-patient because they will now want to do a Pulmonary Catheterization in addition to the kidney biopsy. He tells her to call the admissions office and schedule her check in. Now mind you, that is the doctor’s job! Not the patients! How do I know this? Because when she called to schedule her check in she was told it was the doctor’s job to set that up because they are the ones doing the procedure. Makes logic sense to me!  So, she gets to the hospital on her scheduled admission day and she is being called by radiology inquiring where she is and she is in the admissions office getting checked in. Turns out, the doctor didn’t notify anyone that the procedures were to be in-patient. She was treat very rudely by the radiology department and accused of shirking her responsibilities as a patient. She was in tears. She went back home and the procedures were not done again. She was instructed to await a call from the admissions department when she should come back to check in again. Fast-forward to November 13, 2012. She checks in, gets settled and this is when the current and continuing situation first gets out of control. She is taken for the Pulmonary Catheterization sometime between the night of the 13th and early morning of the 14th. This procedure goes well and she is back in the room upon my arrival the morning of the 14th. We are told the kidney biopsy is scheduled for Thursday November 15 but not sure what time. They place an order in the system to be NPO, which means no food or water, after her last meal on the 14th and she was in this state until almost 2pm on the 15th because they NEVER came to take her for the biopsy. I go in the hall to see if I can find her team of doctors and they are milling around trying to look important and I ask when will she either get tested or get food? One of the doctors didn’t know she had not been taken and the other ones knew but never took off the NPO order. I was livid! Her blood sugar had already began to drop and she was feeling light-headed and nausea from the lack of food and water.  Finally, around 3pm, her food arrived. Now this is where the fun really begins. The nursing staff FAILED to check her blood sugar before she started eating. They gave her all the medicines that were on hold all at once while she was eating. They had ordered PH medicine which included Tadalifil (Cialis-originally studied for pulmonary disease until they discovered the happy side-affect for men), Prednisone, and Lasix in addition to her Glyburide (diabetes med), and blood pressure medicines. ALL WITHOUT CHECKING HER BLOOD SUGAR LEVELS! she started throwing up and her blood pressure dropped dangerously low and I called for help and was repeatedly ignored by the nursing staff. I was told my nurse was on break, or with other patients. NO ONE CAME TO EVALUATE HER UNTIL I WENT DOWN TO THE NURSES STATION WITH THE TOWEL FULL OF VOMIT. I begged them to call the doctor because her color wasn’t normal, she was foaming at the mouth, and her speech was slurred. My cries for help went unanswered for 2.5 days (Thursday night, Friday, and Saturday). Finally, the doctor came in Saturday afternoon and asked her name and birthday and said she was fine but she wasn’t. His assessment was flawed because knowing your name and birthday doesn’t indicate you are in good health! He didn’t order her blood sugar checked or any of her other vitals. He said they would watch her and see if she stops throwing up and keep giving her nausea medicine to aid in this. It wasn’t until the Saturday night shift of nurses came in and I explained to them what had been going on and they determined she was in HYPOGLYCEMIC SHOCK! WTF??? Apparently, the combination of NPO and her meds caused her blood sugar to tank below 40 and it had been that way since Thursday night. After a certain point, your organs start to shut down and you start to die! The nurse immediately called the Rapid Assessment Team (R.A.T.) from ICU and after a dozen or so doses of D-50 and 2 bags of a D-10 drip, she was rushed into ICU because she was dying! She comes in for routine test and ends up almost dying! She is in ICU from the 16th of November to the day before Thanksgiving. While in ICU, she is placed on broad spectrum antibiotics (Vancomycin and Metronidazole) because her white count is high. Now mind you, Prednisone can cause this in anyone who takes it and it doesn’t mean there is any type of infection. The problem with doing this kind of protocol is it can leave you open to other infectious bacteria that may be floating around the hospital. You hear of people contracting staph infections and other stuff and this is how it is able to get in and stay in…no good bacteria is left in your system to fight off the bad sh**! Which brings me to my next point: HYGIENE AND INFECTIOUS DISEASE CONTROL. Parkland is an epic FAIL at these procedures (see articles below)! By placing her on this wide spectrum protocol, with her already compromised immune system, she contracted Clostridium difficile (klos-TRID-e-uhm dif-uh-SEEL), often called C. difficile or C. diff (http://www.mayoclinic.com/health/c-difficile/DS00736). What does this have to do with hygiene and infection control? Well, if the hospital personnel don’t wash their hands and change gloves in between patients, they can spread C Diff via fecal matter that may have gotten on their hands and gloves. Again, Parkland is an epic FAIL at these procedures! One of the main symptoms is diarrhea. Also while in the ICU, she developed a blood clot and was placed on Coumadin. We thought that is what caused all the diarrhea. The entire last week she was in she had diarrhea but no one to my knowledge inquired or mentioned C Diff could be the reason. After her discharge on November 30, 2012, she continued throughout the weekend with explosive diarrhea and she was massively dehydrated. Her temperature and blood pressure were low and she just looked horrible. We made the decision to take her to a different hospital on Monday December 3, 2012 because of her previous experience with Parkland. We decided on Presbyterian (Presby for short). We had to drive her ourselves because the Dallas Fire Department Paramedics refused to transport because we didn’t want to go to Parkland (another article coming soon). The ER staff was very helpful and rapidly assessed the situation based on my run down of events. The first thing they did was test her for C Diff. The test came back positive. They also tested her for MRSA and Staph but C Diff was the winner! They immediately placed her in ICU isolation and we had to wear hazmat gear to be in the room. Presby placed her on Vancomycin and Metronidazole via IV drip but as memory recalls, that is what Parkland placed her on and killed her good flora. Presby said those are used to treat C Diff as well as any other bacteria floating around. Presby also placed a nitroglycerin patch on her chest causing an arrhythmia and she had to have a heart echo to make sure she wasn’t having a heart attack. However, that mistake was caused by Parkland because someone placed in her prescription history she was on a nitro patch. In actuality, she uses a nitroglycerin cream on her hands to aid in circulation. COMPLETELY DIFFERENT PRODUCT! Where Presby did mess up is taking her off her heartburn medicine because they said it interfered with the blood thinner. Without her Protonix the acid built up and caused a whole other set of problems which I will get to in a moment. She was discharged from Presby after 5 days and placed on the same antibiotic for 10 days and told to follow-up with her primary care physician. Her primary care physician, through Parkland, STILL hasn’t returned that call. So, I took her to my doctor at St. Paul. He prescribed another 21 days of Vancomycin. You have to get it compounded into a liquid which isn’t cheap. Parkland doesn’t do that! We followed the instructions to the letter never missing a dose. We finished the antibiotics around the 19th of January 2013 but her diarrhea never really subsided. We continued to go to all her follow-up appointments and finally on the 22nd of January 2013, the doctors placed her on her Lupus medication because the cyst had not grown since first discovered on 2011. They placed her on Cellcept, which is an organ anti-rejection drug also used for Lupus patients to suppress their immune system. They said it would take two weeks for her body to adjust and one of the symptoms would be diarrhea. We read the instructions and all the information we could find so we would be prepared if anything seemed abnormal beyond the listed side affects. Her heartburn was increasing and in addition to the already existing loose bowel, her stomach was bloating and very hard. We figured it was part of the side affects. Little did we know the C Diff had never went away and the Cellcept caused it to multiply worse than ever. On January 29, 2013, we were at one of her follow-up appointments and she began to cough up blood. I called for help and the doctor who came quickly determined she needed to be taken to the ER. I rushed her downstairs to the ER and they got her in pretty quickly and the next thing I know, they are giving her a blood transfusion! I’m watching her fail before my eyes as they rapidly work to reverse the blood thinner in her system and stop the bleed causing her current crisis. Come to find out being off the Protonix caused a major acid build up that caused her esophagus to be burned and bleed and the C Diff ha caused an Ileus Blockage! Ileus Blockage you say? Presby incorrectly took her off the Protonix because they incorrectly thought it would interfere with her blood thinner. They placed her on Pepcid which actually contributed to her current crisis.  Fast-forward to today February 10, 2013. She has been in the hospital since January 29, 2013 and the C Diff has not subsided. They have kept her on same antibiotic protocol (Vancomycin and Metronidazole) but it isn’t clearing it up.  After a bit of research, I found out Vancomycin is standard to treat C Diff but Metronidazole IS NOT FDA APPROVED FOR USE IN TREATING C DIFF! No wonder the infection isn’t clearing up! However, there is one procedure that can be done to cure her 100% called Fecal Bacteriotherapy (http://en.wikipedia.org/wiki/Fecal_bacteriotherapy). Parkland will not allow it to be done because they say it isn’t within their standard of care! Yes, they said, “their standard of care”! I laughed out loud at the hypocrisy of that statement! But it gets funnier: They informed me I could do the procedure myself at home! YES PEOPLE,  YOU READ IT CORRECTLY – AT HOME! So, this is Parkland’s standard of care? They refuse to do a life saving procedure because it is not within their standard of care but I can do it at home? Not only is that insulting but I’m pretty sure it violates some kind of health code rules and if it doesn’t, it should! Handling fecal matter should only be done in a controlled, sterile environment. Maybe not Parkland because its sterile classification is lacking after all. If this infection isn’t cleared up she can die. Now, they are wanting to send her home with this infectious disease still running rampant in her system. I question the competence of all the doctors on staff here because just last night, February 9, 2013, she had to have another blood transfusion. As the doctor put it, she is seriously sick and her bone marrow has stopped producing red blood cells. BUT SHE IS READY TO BE SENT HOME??? REALLY??? I am praying someone picks up this story and can offer us some kind of help. She needs to get rid of this infectious contagion and soon. She doesn’t need to be released as long she is still symptomatic (diarrhea). Her vitals are stable but fluctuate so rapidly, it is hard to keep an even level for very long. Yet, they want to send her home. I have filed complaints with the hospital itself and The Joint Commission.  We are still waiting on someone to respond. I will keep fighting for her and praying she gets the help she needs. If anyone reading this can lend a hand, please let me know as soon as you can. Thank you all!

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5 thoughts on “Parkland Hospital, Dallas Texas, USA a.k.a. INFECTIOUS DISEASE CENTRAL!

    • I did contact the reporter who has been following Parkland and he gave me a hotline number to Centers for Medicare and Medicaid Services (CMS). They opened a case because I was able to give dates, times, and photo evidence of all their shenanigans! I hope the investigation has a positive result.

  1. For what it’s worth, you should know that Vancomycin and Metronidazole are the standard therapy for C. diff; however, oral Vanco and Metro added to IV are more effective than just IV Vanco and Metro alone for treating C. diff because the bug has not necessarily invaded the body, but instead maybe just confined in the gut lumen producing toxins absorbed byt the body where IV antibiotics are ineffective in reaching, via the blood and lymph vessels.

    Rather than trying fecal infusions via nasogastric tube feeds (which many hospitals are understandably still reluctant to try due to its unsavory nature), you could tell your friend to constantly take acidophilus and eat yogurt to replenish normal bacterial gut flora wiped out by the antibiotics because Vanco and Metro (Flagyl) not only kill C. diff, it also kills all the good bacterial flora in the gut, causing a void in which C. diff can continue to thrive in. (This is why the New England Journal did the study with fecal infusions after antibiotic therapy because normal gut flora from things like feces is supposed to inhibit the spread of C. diff.)

    It is likely your friend acquired the C. diff infection at the hospital because it is a hospital-acquired infection, not normally seen in the community. I don’t believe she got it from Vanco or Metro, but instead, for her kidney biopsy, the doctors probably used a penicillin-based antibiotic for prophylaxis that probably wiped out the normal bacterial flora in her gut, allowing the C. diff acquired at Parkland to flourish in the void of her unprotected intestines.

    Please note, however, your friend’s continuing diarrhea may not be from C. diff (it may be though, I don’t know), but a lab test will confirm if C. diff is still a problem. Diarrhea will still remain a problem so long as her normal gut flora is disrupted by any antibiotics. Normal bacteria flora is necessary for normal digestion, so your friend needs to try to replenish her normal gut flora (via fecal infusions to the intestines, yogurt, acidophilus pills, or what not.)

    • The antibiotic given, according to my research, was not approved for use for C Diff by the FDA. It only listed Vancomycin. What I have learned over the years with pharmaceuticals are often used by medical professionals in an experimental capacity and if it works for one person, they incorrectly assume it can be used for all. Because of her Lupus, her body wasn’t absorbing any of the treatments and you have to aggressively treat any infections for Lupus patients. My issue with the fecal bacteriotherapy came in when they said it “isn’t in their standard of care” yet I could do it at home. I found it insulting and down-right contrary to the Hippocratic Oath taken by these so-called medical professionals. I was also told by these same “professionals” that probiotics were ineffective. But I have since found out, and subsequently proven them wrong, that one specific probiotic called Saccharomyces Boulardii, has been proven to cure people of the C Diff. I purchased it and began giving it to her one week ago and not only has her diarrhea subsided, but all her blood work is coming back normal for the first time in months! A hospitals “standard of care” should include whatever means necessary to cure a patient! They should not EVER refuse to treat a patient. But what I am also finding is a lot of passing the buck because her insurance has not kicked in. We have actually been told by these “medical professionals” that when it does, her standard of care will improve! HOW DARE THEY! People become indigent for all kinds of reasons and none of them have to do with being lazy, or suffering from addiction, etc. She lost her job due to corporate greed and her illness came on by no fault of her own. So, where as I appreciate you trying to give them the benefit of the doubt, they do not and will never deserve it.

  2. Attention anyone suffering from Clostridium difficile (klos-TRID-e-uhm dif-uh-SEEL) or C-Diff or any gastrointestinal disasters…. | karensunhumbleopinion

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