New hospital rankings 2003

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Hmmm... Cedars-Sinai--16th place. Now, granted, I had to take statistics twice in college, (oops), but a cursory glance at this here scoring table suggests that "reputational score" (or whatever they called it) is the heaviest weighted criteria, almost inappropriately so--note the reputation scores pretty much completely match the "US News score" which is what they used to determine the final ranking.

In other words, if a hospital has a good PR team, it wins. :)

(And yes I noticed that Cleveland and Mayo are at the top, so it's obviously not completely unreliable, but I'm just sayin'...)

Scott(y)
 
I'm wondering when Mayo is going to dethrone Cleveland.

Gee, Aultman isn't even listed but our other area hospital is #50 on the list. Wonder why that is? :D
 
"Good" seems to be a subjective matter to some extent, depending on your needs. Obviously, the ability to keep people alive is a "good" thing, but beyond that it seems pretty subjective:

If you are really, really scared and the "best" hospital doesn't have doctors that take the time to calm your nerves. . .is that hospital "good" for you?

If none of your family can travel out of state to support you during surgery. . .is the remote hospital the "best" hospital for you?

If you need surgery ASAP, and the best hospital in the country is booked for six weeks. . .is that the best hospital for you?

Seems like there is some wiggle room in defining "best" and "best for you". I think it is sometimes easy to get caught up in ratings and forget that there are a lot of hospitals that are great and a lot that are "good enough".

Having said that, I wanna go to Cleveland. ;)

Melissa
 
So far, Joe's found the "Best" hospitals are right near home. They kept him alive. That has been no small task!
 
Emory University in Atlanta

Emory University in Atlanta

Was 7th..Surprised me..I heard all their best doctors left and went to St. Joseph's (where I had my surgery).Rave reviews from me..NO pain, No remembering ICU..Beautiful private room and Nurses around the clock.. Maybe they are too small.:confused: Bonnie
 
Nancy sez: >>So far, Joe's found the "Best" hospitals are right near home. They kept him alive.<<

Mine just happened to be next door to the office of the doctor who made my endocarditis diagnosis--and my instructions after he saw that first (rather horrifying, apparently) echo were, "Go check in next door, go now, do not pass go, do not collect $200," etc...

Turns out Cedars isn't the worst place in the world to have a valve replaced, either.

Assuming I *had* had time to decide on a hospital and chose, say, Cleveland or something, how does one deal with long travel right after surgery like that? I was under orders not to fly or spend more than an hour in the car for several weeks...

Scott(y)
 
Improper sedation while emerging from anesthesia...

Improper sedation while emerging from anesthesia...

Granbonny sez: >>No remembering ICU.<<

ACK!! Is this a common problem? This was by far THE most traumatic part of my ordeal--I became "aware" of my surroundings almost immediately--as in, I was aware of being wheeled out of the O.R. on the gurney and into ICU. For a good four hours, probably, (as I determined by the clock on the wall that I could see witn my one eye that was half open...) I couldn't move one single muscle--not my eyelids, not my fingers, nothing. It was almost as if my body wasn't my body--I was obviously still unable to breathe on my own and so had to deal with that ventilator for probably 6+ hours. After that first four hours, I got so I could move my hands just enough to knock them against the rails of the bed--every time I'd start coughing I'd smack my hands against the bed and the nurse would say, "not yet, honey, you can't breathe yet," as if she knew from experience that the one thing I wanted more than ANYTHING at that point was that g*dd*mned weather balloon out of my stomach. I'll spare y'all the more gory details but if you're lucky enough not to remember it, that ventilator has got to be one of Satan's favorite playthings, I swear...

(And, not to scare anybody who's still pre-surgery, I've always had problems like this with anesthesia--apparently it comes from years of self-medicating (ok, whatever--recreational drug use >grin<) since college. I always tell anesthesiologists this but there is still sometimes the occasional glitch...)

Also, if this does happen, as soon as you are able to talk if you ask for a shot of Versed you'll get that lovely anterograde amnesia and won't be able to remember the ordeal anyway...

Scott(y)
 
They aren?t all in it for the rankings....

They aren?t all in it for the rankings....

I don?t think a surgeon at the Cleveland clinic would have done my surgery any differently than Dr. Propp did..... but it would have cost me at least another $50,000.00 and I would have had to travel half way across the country. Staying in-state was definitely the BEST decision for me.

Some of the very best doctors are out here in the boonies........ not for the money, fame or rankings ... but because they enjoy living here. I?d way rather see a happy, compassionate doctor who is willing to take the time to answer all my questions, etc. than see one who is ranked among ?the best? and is stressed out and in a hurry with no time to communicate with me. My surgeon came by my room every single morning. He answered any and all questions I had. He also had a cardiologist come by my room each morning.

There are a few great surgeons in the spotlight.... but there are a lot more who are not. My surgeon, Dr. John Propp and my cardiologist Dr. Bruce Andrea are two of them.
 
Cowboys/anesthesiologists

Cowboys/anesthesiologists

Hey Scott,

I woke up while I was still in the OR room too... but there was no tube in my throat and my hands were not tied. The first thing I remember is people standing over me talking about my blood pressure. I couldn?t see them... just hear them. The next thing I remember is being very cold and telling the nurse so. I remember watching her get blankets out of an oven kinda thing in the wall and putting over me. The worst problem I had for the first few hours is that I was sooooo incredibly thirsty. The next one was a few hours after the surgery when they decided they needed to take an x-ray... they rolled me over on my side and slid the x-ray thingie under me.... Ouchie, ouchie, ouchie.

But then I missed the joys of playing with *recreational* drugs. :p Oh yeah, and my surgery was out here in the boonies........ my anesthesiologist was a cowboy. :D I?m sure that helped more than anything! He was a great guy too.

Dang, I'm beginning to feel like I should write them all a thank you note or something.
 
Rain sez: >>The worst problem I had for the first few hours is that I was sooooo incredibly thirsty.<<

ACK! I remember that too... And they wouldn't give me anything to drink. A couple of ice chips to suck on every few minutes but that was it.

>>Dang, I'm beginning to feel like I should write them all a thank you note or someting.<<

I actually did write all my nurses (and surgeons) thank you notes. It's not like I was a *difficult* patient or anything, I was just not havin' this new conservative approach being taken by some hospitals to painkillers. (I guess after my recreational drugs comment this is not surprising, LOL...) After that whole six hours of the breathing tube and not being given anything for pain (because they thought I was out cold all that time), the first two words out of my mouth were, "Pain. Killers." This cute little nurse smiles sweetly at me, gets something, and pushes it into my PICC line. "This is Toradol," she says brightly. "It won't make you drowsy." Well. Toradol is like Aleve--and as far as I'm concerned, not at all appropriate given the ordeal I've just been through. So I stare her down. "What? Drowsy? It's not like I'm getting ready to DRIVE out of here or anything..." I can tell she knows where this is going. "And in fact, right now I would LOVE to be drowsy! Nearly unconscious if you can manage it. What I would like, is a nice, strong, opiate-based narcotic that with any luck will make me incapable of speech for at least the next 45 minutes." She agrees immediately, probably having pegged me as a problem child she'd RATHER couldn't speak, and returns with another syringe of something and pushes it into my line. There it is, that painkiller buzz I've been craving for the last six hours... "What was that?" "Dilaudid." "How much?" "3.5 cc. Why?" "Just curious."

I found out that after that, for the rest of my stay, the surgeon ordered that very dose of that drug every 4 hours, "as needed." >snicker< Some nurses were agreeable, and just brought it in when I called. Others wanted to play that "pain scale" game--"is it better or worse than last time, do you think you could skip this one, etc..." One nurse asked me the second time (on her first night) "Oh dear, are you in pain already again honey?" "Not really, no, but it's been four hours since the last time and I'm entitled. Doctor's orders. I've seen my chart." She didn't argue and after that, she brought it like clockwork. :)

Sometimes you gotta train these people.

Anyway, the all did get thank you notes from me. As did one of the assisting surgeons, who is the same age as me who came to my room a couple of days later said, "I just wanted to see what you looked like awake."

Scott(y)
 
My hospital ranks #14 in the country and #1 in Michigan.
Interestingly though they have done far more heart surgeries than any hospital in the top 50.
Five thousand more than the Cleveland Clinic!
I'm from Cleveland and could have gone there for my surgery since we still have a lot of family there.
My nephew and his wife worked there for many years.
He did kidney dialysis and she was a surgical nurse in the heart section.
But I think my hospital was just great and if I ever have to do it again I'll go right back there.
 
Hi Scott-

Just reading your posts re: the ICU and all the attending stuff.

You are so right. You were FAR too alert in the ICU. Most people are so drugged up, they hardly remember anything about this experience. Unless you have to be on the ventilator for a longer time than normal, it would be just a passing memory. Being on the ventilator for 6 hours, isn't unusual at all. Many people have to be on it far longer. My husband has had 3 valve surgeries, and he's one of the unlucky ones who doesn't easily rouse after being anesthetized, so he remained on the vent for quite a while. But he was asleep for most of it. Bonnie was on dream street and doesn't remember a thing. Our friend and Moderator, Ross, may be the vent CHAMP.

But for those who are facing surgery, the ventilator is very, very necessary. You cannot breathe on your own right after surgery until all the surgery stuff leaves your system. Without the vent, you would be in serious trouble. Every hospital wants to wean the patient off the vent as soon as possible, because being able to draw deep breaths is so important to clearing your lungs. It just has to be done in a safe manner.

If people have any concerns about being on the vent, they should speak to the surgeon about it. Knowing why it is necessary helps a lot in feeling better about the experience.

Also, the ice chips when you are very thirsty: If you were to drink fluid during this period of time, it would make you sick to your stomach and there is the possibility of aspirating stomach contents into your lungs, not to mention the pain of vomiting right after surgery, and the strain that would put on a surgical incision. So fluids are witheld and introduced very slowly. In addition some of the pain meds can cause nausea.

That's why ice chips are used and not too many of them.

There are good reasons for all of this.

Fortunately for most, ICU lasts for a short time, and things move ahead at a pretty fast clip once you get out of there.
 
Heck Dilaudid made me nauseated and the ice chips produced the ralph reaction anyway. Our stomach's aren't ready for anything after surgery. In fact, I don't think they even function for quite a while afterwards.
 
Traveling after surgery

Traveling after surgery

Someone asked about how you manage the trip home if you have surgery halfway across the country. I live in Mississippi and had my surgery at Mayo in MN. I was in ICU for 3 days on the vent, but only remember brief parts of that. Got out after 6 days and stayed at the motel for another 3 days to build up a little strength. Then I flew home with one stop in St. Louis, then an hour and a half drive from the airport to my home. I wasn't doing the driving, of course! I had a wheelchair at the airports, but other than than just the usual trip. It was exhausting, but I was on an andrenylin high, so I managed. My husband was traveling with me and my brother flew over from England to be there for the surgery. Mayo and Rochester are all organized to accommodate out-of-towners so the motels have special rates and accommodations and there's all sorts of shuttle services and healthy menues in restaurants, etc. The place just falls all over itself trying to make it easy on you. Really truly amazing.

Joyce
 
Seven hour drive

Seven hour drive

And you know what my surgeon said when I told him I was sure I might die of thirst?!! ?How about some kool aid?. Grrrrrrrr........ On second thought maybe I?ll scratch him a quick ?thank you? on the back of a kool aid package. :p

I had a little different attitude about the whole deal with the meds.... I wanted to take the least amount of drugs possible. From the very beginning I asked the nurses what every pill was, what every drop they were putting in my line was, etc. They were even giving me meds to make me hungry?! I stopped taking the ?hungry pills?, sleeping pills, and about 90% of the pain pills right off the bat. I wasn?t in a lot of pain... only when I decided to roll over or get out of bed. And I swear the pain meds kept me awake at night. :eek:

When you live out here in the boonies, the nearest hosptal that does heart surgery is still a 7 1/2 hour drive. We started home on day five. I have to admit I almost had to beg Dr. Propp to get him to approve. No, not almost .. I did... I begged. :p I?d have stayed another day or two or what ever he wanted, but I had a six year old daughter at home crying for her Mom.. I needed to get home to her. It took some real effort to convince him (the surgeon) that my Ford Explorer was a car of comfort and spending the next two days driving over mountain passes wouldn?t bother me. :p It really wasn?t all that bad. We even drove around Colorado Springs looking at puppies for my daughter on the way. We arrived in Durango the next day just in time for my appointment with Dr. Andrea.... he thought I looked and sounded wonderful. One more hour and I was home! YEA! I had a six year old daughter waiting for me on the front step when we drove up the drive. That was a happy moment. The next one was finally having some Mexican food........ you ever notice they don?t serve Mexican food in hospitals?! Beans, cheese, salsa, sour cream, tortillas, hot peppers..... the good stuff. :( Noooooo....... they send in fish, cooked carrots or maybe oatmeal ...with a hugry pill on the side. :rolleyes:

P.S. Bonnie, I had a private room too. I think all the rooms on the ?cardiac floor? were private... but I'm not sure.
 
Scott,

Scott,

My surgery was 20 years ago........................I woke up during my surgery..............I could hear everything going on! It seemed like forever, but I am sure it wasn't long. My surgery was nine hours long and I believe that they maintain you at various levels of unconsciousness during the surgery. Apparently they weren't giving me enough anesthesia at that moment. I was so scared that I started with tacycardia, I heard them comment that I was in -------something fib and then I went back under. I was so afraid of hearing that saw(which I didn't). This incident nearly scared me to death!

From what I understand it is more common than you would think!
 
Thanks Gisele!:rolleyes:

My husband read in the paper yesterday about a lawsuit that is pending where a woman was given the paralytic drug and never received the anesthesia. She was aware and could feel her whole surgery but couldn't do anything about it. What a nightmare for her!

Betty(bvdr)
 
OMG!

OMG!

That poor woman................I couldn't feel anything at least, I also couldn't move a muscle. I tried to alert them that I could hear them but I was totally paralyzed. This really scared me. In fact I told my husband about it and they sent the shrink in to talk to me about it afterwards. I guess it didn't scar me for life as I have had multiple surgeries since and this was never an issue for me. I never worried about it happening again, and in fact it never did! Thank goodness!
 

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