Medical Procedure Scheduling Question

[mom31257]

Is it common for a procedure to be put off a couple days even when there is risk of a dangerous outcome? 

My friend's husband had a large kidney stone lodged in pretty tightly, so he needed to have a laser break it up. He went to the ER on Monday evening very late. They scheduled the procedure for Wednesday afternoon. He wasn't supposed to drink much at all because the kidney was very swollen and they didn't want it to burst. 

If your kidney is potentially going to burst, how is that not an emergency procedure that is taken care of in the ER? I'm trying to figure out if this is normal or just the local hospital. I'm concerned it it is just the local place's policies. 

[vonfirmath]

55 minutes ago, mom31257 said:

Is it common for a procedure to be put off a couple days even when there is risk of a dangerous outcome? 

My friend's husband had a large kidney stone lodged in pretty tightly, so he needed to have a laser break it up. He went to the ER on Monday evening very late. They scheduled the procedure for Wednesday afternoon. He wasn't supposed to drink much at all because the kidney was very swollen and they didn't want it to burst. 

If your kidney is potentially going to burst, how is that not an emergency procedure that is taken care of in the ER? I'm trying to figure out if this is normal or just the local hospital. I'm concerned it it is just the local place's policies. 

Depending on the load of a hospital, etc. Yes I hear many stories like this. People who should have been treated immediately having to go days (or sometimes months) for an appointment with the proper person to do it.

 

[itsheresomewhere]

Sadly, common now.  

[Jean in Newcastle]

Not at all common in my metropolitan area on the West Coast.  I'm sure that this varies widely by region. 

[Kassia]

Wow, that is horrifying and scary to go to the ER and be told to wait that long for something so urgent.  😞 

[Mrs Tiggywinkle]

Does the local hospital have urology and is capable of breaking it up? Our hospital doesn’t have either so anyone who needs it that urgently is transferred someplace else, but right now no place locally has beds available for transfers.  If it isn’t 100% urgent things are getting scheduled for outpatient procedures.

[Pawz4me]

All I know is from navigating my own health issues, walking the cancer journey with DH, and what I read on the large cancer board I belong to. And that is -- Sometimes there is a delay in a legitimately time sensitive matter. Often it relates to staffing or equipment/machine availability or getting insurance approval. But more often than not it seems that there's a misunderstanding between how urgent a doctor truly thinks a condition is versus the patient's understanding of how urgent the condition is.

[itsheresomewhere]

A friend has been having issues with extremely low iron/internal bleeding.  She needs an urgent appointment with a gastroenterologist.  She has been waiting since the beginning of July for an appointment ( end of this month was the earliest after calling several).   So the solution after passing out a few times is for her to go weekly for iron infusions until then. 

[cjzimmer1]

Long before COVID, unless you were actually dying on the spot, then yes surgery was scheduled later rather than "right now".  What I've learned is my understanding of "emergency" and medical personnel definition of "emergency" are two entirely different worlds.

[KidsHappen]

I went to the hospital with an active internal bleed on 3/8. My hemoglobin had dropped to five between the time I checked in and just a few hours later. They did admit me to the hospital for a few days for tests and a transfusion but then sent me home and I did not have my surgery until two weeks later. It was a close decision between keeping me in the hospital and doing surgery as soon as possible or letting me go home and doing some of the tests on an outpatient basis and scheduling the surgery based on the results. But I can tell you that the entire two weeks that I was at home I was scared to death that I could bleed out. 

I have been in near death experiences a few times and I can tell you that when a doctor says that if things continue the way they are you could die it is not necessarily what they consider an emergency. A doctor considers it an emergency if you are actively in the process of dying say in the next hour or so. I once went to the emergency room and they took me back as soon as they saw me without me even having to say a word and I still spent hours in the emergency room before they decided that I needed to go straight to the OR. Luckily I remember very little of that.

So unfortunately, no not that uncommon and I think that it is just going to get worse especially in some fields like maternal medicine.

 

[mom31257]

5 hours ago, Mrs Tiggywinkle said:

Does the local hospital have urology and is capable of breaking it up? Our hospital doesn’t have either so anyone who needs it that urgently is transferred someplace else, but right now no place locally has beds available for transfers.  If it isn’t 100% urgent things are getting scheduled for outpatient procedures.

He had the procedure two days later at the same hospital but as an outpatient procedure. 

[Brittany1116]

My friend's dad was in 5 days last month for the same thing and it was days between discovery and procedure. 

Editing for clarity...

He waited a few days for procedure and was in hospital total of 5 days. I don't believe he waited 4 or 5 days.

Edited August 12, 2022 by Brittany1116

[katilac]

The mere possibility of something dangerous happening doesn't always mean it's an emergency situation, or that it's best treated immediately. Imaging to see more precisely what was going on and treating the pain were needed emergency actions, but not necessarily removing the stone. 

They probably did not think a kidney rupture was at all likely, but of course they have to mention things that might happen, what to look for, and how to minimize the possibility. 

They likely gauged the risks and felt that having a planned surgery was the best choice. Laser removal of kidney stones is minimally invasive, but it's still surgery and you are under general anesthesia. Same-day surgery is set up much better for it than than late-night ER, and that's really how you want it to happen, if at all possible. You want the doctor who routinely does hundreds of these procedures to do it, in the place that is optimally  set up to do it. 

So, while I do think some people have to wait too long to be treated for certain things, I don't think this case necessarily falls under that. In general, ERs are set up well to treat the pain and manage the immediate situation, to see what's going on with kidney stone size and placement and if emergency removal is needed, and outpatient surgeries are set up well to handle the majority that are not emergencies.