Under the knife and out again

News bulletin:
Carolyn had a bilateral simple mastectomy this afternoon.  The doctor also removed 5 lymph node specimens closest to the identified tumor in her right breast.  Two tissue samples were frozen and sent to the lab.  The results were negative for cancer.  The doctor wants to see the complete pathology lab report for all submitted tissue before giving a conclusive prognosis but she seemed positive about this afternoon's surgery.

Carolyn is resting as comfortably as can be expected given the assault to her body.  She is sore and slightly nauseous but dozing off from time to time as the anesthesia slowly works out of her system.  She looked a bit like Smurf Grandma when she came out of surgery due to the blue dye used to identify the optimal surgery target but already by 9:00 this evening, her normal color was returning.

The doctor was optimistic about discharging Carolyn Friday afternoon if she continues to improve at her current pace and if the doctor is convinced she can get adequate care for her wounds and fluid drainage.

News behind the news:
Since Carolyn has now had 4 major surgeries in the past 10 years, all at Kaiser, we feel we're becoming somewhat expert at evaluating their systems.  This time it appeared to me that they were continuing to find ways to improve and continuing to fail. For example, there were 4 separate times Carolyn was interviewed as part of the "admitting" process, 5 if you count the pre-op surgical consultation.  There was an interview in the Peri-Operating Medical clinic by a hospital based internist, a billing and fiscal responsibility interview by an admitting clerk, a workup by an RN in the Pre-Op staging area, and a mini-workup by an RN on the nursing floor where Carolyn was placed to begin her healing process.  Each person collected some unique information but they also collected duplicate and redundant information making us wonder if any of the information is really coordinated between departments.

Another example.  As Carolyn left the Pre-Op staging area to be wheeled into the Operating Room, we were given a card indicating what we could expect to see in the OR waiting room.  Similar to the flight monitors in airports, a patient monitor in the waiting room indicates by a code each person scheduled for surgery today.  A color code and legend then indicates where the patient is in the system: pre-op, surgery, recovery, discharged, etc.  Only problem is that Carolyn's coded listing still showed her in the pre-op area 2 hours after we had seen her enter surgery.  And there was no indication why.  We didn't know whether is was a delay with Carolyn or some other patient, or even the whole OR system.  And no one offered to tell us how long the delay might be.   In this case trying harder just didn't help.