Please help us get our friend hospitalized while avoiding Covid-19
May 15, 2020 11:05 PM Subscribe
Our friend is travelling from Edison, NJ to Chattanooga, TN to be voluntarily hospitalized. Where, near Edison, can we take her if the 11-hour car ride isn't possible?
Our friend Jill lives in Edison, NJ, lives alone and knows no one. Her health has been declining over the past two years due to a combination of un-managed diabetes, terrible IBD, high blood pressure, depression and denial. She has not seen a doctor since moving from Chattanooga five years ago.
In March she had an a sore erupt on her perineum. A telemed call got her antibiotics and painkillers, but the area will not heal, the wound continues to grow and she is in constant pain. Phone calls and facetime in the last two weeks have alarmed Jill's friends and family; due to the GI issues and the wound's location she is barely eating or drinking, has lost a tremendous amount of weight and is often confused. She refuses to go to the hospital because she is terrified of covid and the numbers in Jersey are sky high. Yesterday Jill's father facetimed with her, and she was slurring and obviously very sick. Fearing sepsis or worse, he somehow managed to get Edison EMTs to visit her apartment but she turned them away.
So Jill's father and her best friend are leaving Chattanooga tonight, driving to NJ, and bringing her directly back to Chattanooga (another hotspot, though not as bad as Edison). She knows they are coming and has agreed to be hospitalized.
We know Jill is being tremendously selfish, and that in her current mental and physical state that she lacks the judgment and motivation it takes to see this. We are all furious it has gotten to this point. Nevertheless, this is happening: two people are breaking isolation to travel to a covid hotspot to make sure she doesn't die of non-covid reasons.
The question now is, if they arrive in Edison and Jill's condition doesn't look like it can stand an 11-hour drive, which hospital in the travel route between Edison and Chattanooga should they go? All parties have been more than compliant with stay-at-home measures: Jill has been vigilant about self-isolating since the end of February, and her father and best friend have been staying at home since mid-March.
We know this is not ideal. We know it is stupid. But this is the plan currently in motion, so keep the criticism to a minimum please, and focus on the request. All parties involved are now focused on getting Jill hospitalized, and if not in Chattanooga, then somewhere close to Edison that isn't boiling with corona. Can someone suggest a hospital in an area that is reasonably close to Edison that isn't currently a covid-nightmare?
Our friend Jill lives in Edison, NJ, lives alone and knows no one. Her health has been declining over the past two years due to a combination of un-managed diabetes, terrible IBD, high blood pressure, depression and denial. She has not seen a doctor since moving from Chattanooga five years ago.
In March she had an a sore erupt on her perineum. A telemed call got her antibiotics and painkillers, but the area will not heal, the wound continues to grow and she is in constant pain. Phone calls and facetime in the last two weeks have alarmed Jill's friends and family; due to the GI issues and the wound's location she is barely eating or drinking, has lost a tremendous amount of weight and is often confused. She refuses to go to the hospital because she is terrified of covid and the numbers in Jersey are sky high. Yesterday Jill's father facetimed with her, and she was slurring and obviously very sick. Fearing sepsis or worse, he somehow managed to get Edison EMTs to visit her apartment but she turned them away.
So Jill's father and her best friend are leaving Chattanooga tonight, driving to NJ, and bringing her directly back to Chattanooga (another hotspot, though not as bad as Edison). She knows they are coming and has agreed to be hospitalized.
We know Jill is being tremendously selfish, and that in her current mental and physical state that she lacks the judgment and motivation it takes to see this. We are all furious it has gotten to this point. Nevertheless, this is happening: two people are breaking isolation to travel to a covid hotspot to make sure she doesn't die of non-covid reasons.
The question now is, if they arrive in Edison and Jill's condition doesn't look like it can stand an 11-hour drive, which hospital in the travel route between Edison and Chattanooga should they go? All parties have been more than compliant with stay-at-home measures: Jill has been vigilant about self-isolating since the end of February, and her father and best friend have been staying at home since mid-March.
We know this is not ideal. We know it is stupid. But this is the plan currently in motion, so keep the criticism to a minimum please, and focus on the request. All parties involved are now focused on getting Jill hospitalized, and if not in Chattanooga, then somewhere close to Edison that isn't boiling with corona. Can someone suggest a hospital in an area that is reasonably close to Edison that isn't currently a covid-nightmare?
Mod note: Several comments deleted. Let me make this easy: the question is "Where, near Edison, can we take her if the 11-hour car ride isn't possible?." This isn't Please Judge The Poster, or Please Judge The Sick Person, or Please Judge Metafilter (Metatalk is a place for hashing out issues). So far Penn Medical/Princeton has been suggested (in a deleted comment with metatalk complaints). If you are a person not answering the question (or using your comment to talk about other things) and your concern is that OP is calling the friend selfish, remember that written information in this format is short and doesn't include all details, but my read is that it is the unwillingness to address the health issues in the period leading up to this that is referred to, rather than a very sick person not being able to think clearly.
posted by taz (staff) at 2:12 AM on May 16, 2020 [34 favorites]
posted by taz (staff) at 2:12 AM on May 16, 2020 [34 favorites]
When my mom lived in Bethlehem, PA, she used to go to St. Luke's Hospital. The care quality always struck me as quite good. Bethlehem is about 60-90 minutes from Edison.
It's 6:30 a.m. there at the moment, and Information probably isn't open yet, but you may want to call ahead to see how hard they're being hit. 1-866-STLUKES.
posted by Sheydem-tants at 3:28 AM on May 16, 2020
It's 6:30 a.m. there at the moment, and Information probably isn't open yet, but you may want to call ahead to see how hard they're being hit. 1-866-STLUKES.
posted by Sheydem-tants at 3:28 AM on May 16, 2020
My mom who lives in North Jersey told me that Overlook in Summit is the non-covid hospital for the area. Probably about 30 minutes or so from Edison.
posted by ellebee at 5:27 AM on May 16, 2020
posted by ellebee at 5:27 AM on May 16, 2020
I think triage from local support resources could help you locate hospitals, so you could use 211.org, which is available in every state and likely can help make referrals to hospitals. For example, NJ 2-1-1 also has a helpline where you can speak to a healthcare professional at 1-800-962-1253.
posted by katra at 8:27 AM on May 16, 2020 [1 favorite]
posted by katra at 8:27 AM on May 16, 2020 [1 favorite]
Looking at google maps: two main routes, one goes down 95 and then over to 66 at Washington. The other goes over to Allentown, PA, and then over to I 81 which goes to Chattanooga. Harrisburg appears to be fairly hard hit. Looking at those routes along with this map Charlottesville, VA, is about halfway to Chattanooga, although slightly off route. However, it has the University of Virginia Hospital, a major topnotch hospital and the Charlottesville area does not appear to have have a lot of cases.
posted by mareli at 8:30 AM on May 16, 2020 [1 favorite]
posted by mareli at 8:30 AM on May 16, 2020 [1 favorite]
One thing to be aware of, if she ends up going to a non-local hospital, is that her insurer may refuse to pay for treatment. Or more specifically, they'll probably pay until she is stabilized, but not while she awaits "placement" for post-hospital care. (I am assuming, based on the apparent severity of what's described here, that she would not be discharged home -- or even if discharged home/to family, she would at least need a visiting nurse and/or home health aides for a period of time.) Discharge planning begins immediately on admission, but it's a lot harder to get placement if you are not a resident of the region; I have seen people who are medically ready for discharge languish for weeks pending placement.
Being prepared with a list of hospitals en route is a good idea, but if you are deciding between Hospital A and Hospital B, take a quick gander at her insurer's website if you can, to avoid the horror of an unexpected bill.
posted by basalganglia at 8:49 AM on May 16, 2020 [13 favorites]
Being prepared with a list of hospitals en route is a good idea, but if you are deciding between Hospital A and Hospital B, take a quick gander at her insurer's website if you can, to avoid the horror of an unexpected bill.
posted by basalganglia at 8:49 AM on May 16, 2020 [13 favorites]
The best hospital that is *closest* to her is Robert Wood Johnson University Hospital in New Brunswick. Note NEW BRUNSWICK, not their Rahway location.
The best hospital overall would be Morristown Medical Center but that's significantly further away. It is a sister hospital to Overlook but much larger and about 15 minutes from one another.
posted by dancinglamb at 9:25 AM on May 16, 2020 [1 favorite]
The best hospital overall would be Morristown Medical Center but that's significantly further away. It is a sister hospital to Overlook but much larger and about 15 minutes from one another.
posted by dancinglamb at 9:25 AM on May 16, 2020 [1 favorite]
Assuming that you come the most direct way, down through Virginia, possible stops are:
Inova Fairfax Hospital Center in Northern VA (very good!) if you are in the DC area (avoid DC itself, northern VA is a hotspot but hospitals aren't being stressed at all AFAIK) and
University of Virginia Hospital in Charlottesville (possibly the best hospital in VA, not a hotspot).
Unfortunately, after those two you are pretty much in the middle of nowhere with NOTHING but tiny rural hospitals until you get to Knoxville (University of Tennessee hospital is here, but you might as well drive on another 45 min to Chattanooga).
Chi Memorial is the considered the best place in Chattanooga. Personally, I didn't find it great but I'm more used to bigger, wealthier cities. They say that they have COVID patients well isolated.
Covid is hitting Chattanooga's minority communities hard, and I unfortunately expect it to get much worse as Tennessee is now opening after quarantine.
I wish your friend luck and healing.
posted by mkuhnell at 11:20 AM on May 16, 2020
Inova Fairfax Hospital Center in Northern VA (very good!) if you are in the DC area (avoid DC itself, northern VA is a hotspot but hospitals aren't being stressed at all AFAIK) and
University of Virginia Hospital in Charlottesville (possibly the best hospital in VA, not a hotspot).
Unfortunately, after those two you are pretty much in the middle of nowhere with NOTHING but tiny rural hospitals until you get to Knoxville (University of Tennessee hospital is here, but you might as well drive on another 45 min to Chattanooga).
Chi Memorial is the considered the best place in Chattanooga. Personally, I didn't find it great but I'm more used to bigger, wealthier cities. They say that they have COVID patients well isolated.
Covid is hitting Chattanooga's minority communities hard, and I unfortunately expect it to get much worse as Tennessee is now opening after quarantine.
I wish your friend luck and healing.
posted by mkuhnell at 11:20 AM on May 16, 2020
The confusion and slurring could be from sepsis from the open wound, complicated by dehydration. Either is life-threatening. She needs to go to the nearest equipped hospital, not across the country, or even Philadelphia. Is there nobody local to her who can help?
Arriving by ambulance gets her immediate attention by clinicians, which might not happen if she walks in.
posted by citygirl at 12:37 PM on May 16, 2020 [17 favorites]
Arriving by ambulance gets her immediate attention by clinicians, which might not happen if she walks in.
posted by citygirl at 12:37 PM on May 16, 2020 [17 favorites]
I am a nurse, though not your nurse and obviously not assessing your friend in person. That said, I know from experience that sacral/perineal wounds can go downhill real fast, and a multi-hour car ride from NJ to TN is only going to make matters worse. I would advise her father and friend to take her straight to Robert Wood Johnson Hospital in New Brunswick, which is by far the closest hospital to her house, and then plan to stay in her apartment until her discharge plan is finalized. Covid risk in the hospital is real, but the absolute worst covid clusters are in skilled nursing facilities, and if the wound is as extensive as you are describing she may need skilled care afterward. (Also, speaking as a former skilled nursing facility nurse, you don’t want to be in one of those facilities with a sacral wound). Having family around who can advocate for her to return home and help to coordinate home care logistics would be huge.
posted by ActionPopulated at 11:06 PM on May 16, 2020 [2 favorites]
posted by ActionPopulated at 11:06 PM on May 16, 2020 [2 favorites]
Mod note: From the OP:
Upon arriving at her apartment in Edison, Jill's father and best friend immediately saw there was no way she could handle the drive back. They called EMTs, who immediately transported her to JFK Medical Center where she was admitted. She is alone there now as the hospital would not allow her father or her friend in, due to covid protocol. Which is ironic, because covid is currently the least of Jill's worries.posted by taz (staff) at 4:21 AM on May 17, 2020 [8 favorites]
It ended up being a good call that Jill's father and friend left Chattanooga when they did, because we are all certain Jill would have died alone in her apartment otherwise. She was so weak she couldn't get to the door, and she was barely coherent. Her vitals were a mess and she was severely dehydrated. The perianal abscess will be addressed, and in the following days arrangements will be made to get her transferred to Chattanooga.
This whole thing is so frustrating and horrible, especially for Jill's family. Thank you, Taz, for recognizing what I failed to originally articulate. Jill is a warm, brilliant and giving woman who is loved and respected by so many people. But like so many in our circle, she has mental and physical ailments that she rationalizes or ignores. A few of us embrace antidepressants and can empathize with the apathy and inertia that blocks one's ability to even acknowledge depression's presence, but to add all of the physical ailments on top of that and STILL refuse to go to a doctor, leads to the collective internal rant //***you have insurance so why won't you just make an appointment, you NEED a primary care physician, you're smart and you know this and literally ALL your family and friends have taken you aside privately and fucking BEGGED you to go to a doctor, you're so goddamned smart why won't you do this thing you know you need to do, well yeah depression makes it easier to not do this thing ... lather, rinse, repeat over many years. And that's why 'selfish' was flung out there. The worst-case scenario we all feared would happen has actually happened and now you've dragged other people into being the responsible adult for you, and it all might have been avoided if you had originally just done the thing. But depression is why you didn't. So two people who love you had to haul ass all night to save yours. Because you never would get a doctor. No, we don't feel you are deliberately selfish. It may be wrong to characterize your inaction as selfish, but here we are. And we won't say these things aloud, because you don't need to hear anyone rehashing the ways this situation might have been avoided because you'll only hear "the ways you screwed up." Depression is an illness whose voice is louder than anyone's, including your own and all those who care.***//
Don't know if your or your sick friend need to hear this to feel any better but perianal wounds are rediculously common in people whose mental health starts to affect physical health. I reviewed coding for level 1 trauma centers in phila and at times it felt like every other admission was a perianal wound that went too far. Please don't allow it to become a source of shame or embarassment.
posted by WeekendJen at 8:01 AM on May 17, 2020 [3 favorites]
posted by WeekendJen at 8:01 AM on May 17, 2020 [3 favorites]
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posted by needs more cowbell at 2:08 AM on May 16, 2020