It turns out blood tests apparently showed she was low in potassium and her kidney function was a little "off." Multiple other tests, including an EKG and X-rays, were apparently OK. I examined Patient A. at her residence the following day.
Unfortunately, she knew very little about what happened in the ER. I learned about her low potassium and other tests from the staff member who went with her. When I asked what instructions she was given about her medications, taking extra potassium, and the actual written reports of her blood potassium and kidney test (I wanted to compare them to her previous test results) the ER apparently told the staff to "follow-up with your family doctor tomorrow."
I can't tell you how frustrating it is as a physician to be given so little information, yet be responsible for the patient's care. I needed to know so many things: What tests were done in the ER, what were the results, what were the conclusions, what treatment did she receive while there and what instructions was she given when she went home. ERs often don't send more than a photocopy of a preprinted instruction sheet home with patients and a few added instructions in difficult-to-read handwriting.
So what can you do to be sure that you not only understand what happened in the ER, but be sure you get the best follow-up care, too.
Bring all your health information with you. Your health history is the most important tool the ER physician has to help make the most accurate diagnosis. Carry an emergency health information card in your wallet along with your insurance card at all times. If you have started to collect your medical test results and consultations reports, bring them as well. This information may be vital to your diagnosis and care.
If you have nothing prepared or ready, then at the very least bring all your current medications (include over-the-counter ones such as ibuprofen) in their prescription bottles. A review of all your medications will give the ER doctor an important snapshot of the severity of your health conditions and how to treat you.
Bring a health buddy with you. No one, especially seniors, should go it alone in the ER. A health buddy can help give the medical history if you are too sick, take notes, ask questions, and assure that discharge instructions are followed. The nuns first taught me many years ago the importance of having someone accompany the patient into the examination room and stay by the bedside at all times. They call their health buddies "guardian angels."
Ask questions. As I have written before about asking questions and speaking up during a doctor visit: "If you don't ask, they won't tell. If you don't tell, they won't ask." Researchers have shown that if patients don't speak up and ask, often doctors will assume patients understand or do not want to know.
On the other hand, doctors can't know all that you are experiencing, so you need to speak up and tell all. Communication is a two-way street. Both patient and doctor need to provide the free flow of information. Questions should include what medications you should resume at home and which new ones should you take, what symptoms should prompt a visit back to the ER, and when to follow up with your family doctor.