Stories

Cristina from Texas

After surgery, her mother left the hospital ill-informed about possible complications and returned with a dangerous blood clot.

Cristina

Although Cristina Sanchez has moved to another town in Texas, she still has roots in her family’s hometown of San Marcos, a half hour south and west of Austin. San Marcos is where Cristina and her brother and sister were raised by Maria and Humberto Sanchez, who worked hard to parent the children together even after they divorced. And though Maria moved to Austin once the kids were grown to work as a letter carrier, she moved back to San Marcos after a back injury forced her to retire on disability.

Cristina chuckles at the way she describes Maria: "She’s nice and friendly, a very good-natured person -- and she’s a very bad poker player! But she loves to play cards and visit with her friends." One Thursday night in March 2011, Maria played cards until very late at a friend’s home. As she left in the dark, Maria slipped on a step and fell, breaking the bones in her right leg above the ankle.

At a hospital in San Marcos, doctors performed surgery to repair the damage. "She got a metal plate and bar put in her leg," Cristina says. "She was there until Sunday and saw a couple of doctors and maybe seven nurses, different people each time. When she was about to be discharged, the hospital gave her an order for a walker, a prescription for pain medication and told her to keep her leg elevated. Mom remembers discussing that with the nurse and the nurse seeing how she was sitting, in the chair with her leg elevated straight out."

Maria had not been home long when the leg began to bother her, says Cristina: "She noticed that her leg was getting swollen, she was feeling a lot of pressure in it and it was getting hot." After about two weeks, the condition had become so severe that Maria went to the hospital. "She got admitted and at first people were telling her it was probably no big deal," Cristina says. "Then one nurse said to her, ‘Well, you haven’t been taking your medication, have you?’ My mother asked her, ‘What medication?’ And the nurse said, ‘the Coumadin’" — a trade name for warfarin, a medication given to prevent blood clots. "So my mother said to the nurse, ‘I wasn’t given any.'"

Then, Cristina says, the nurse had another question. "She said to my mother, ‘You don’t sit like that all the time, do you, with your leg elevated and straight?" My mother replied that yes, that was how she had been sitting. And the nurse said, ‘No, no!’ She told my mother she needed to lie down at times, stretched out, and that she needed to be moving her toes a little, regularly, to make the blood flow. None of her doctors or nurses ever mentioned this at discharge. It really bothered my mom that they had seen her sitting like that in the hospital after the surgery and hadn’t explained to her what else to do, or what to do differently, when she got home."

Cristina said the nurse told her mother she might have a blood clot, and cautioned her, "This is a big deal. Don’t let them send you home without making sure everything is okay." At the family’s insistence, Maria was given an MRI scan; the scan detected a blood clot in her hip. To be sure the clot didn’t break loose and move to another part of Maria’s body — a potentially life-threatening situation — doctors kept Maria in the hospital for observation for three days.

The second time she was discharged, Cristina says, Maria was sent home with Coumadin to take orally. She also was given a faster-acting blood thinner, in the form of injections she was to give herself in her stomach, and was told to follow up with a doctor after a few days. Cristina says that again, the discharge instructions didn’t prepare Maria for what occurred: The shots in her stomach were causing pain, lumps and bruising.

Maria called the hospital seeking advice, Cristina says, "and the hospital told her the doctor can’t call her back because he wasn’t her doctor, he was just the hospital doctor when she came in." In desperation, Maria contacted an acquaintance who is a pharmacist, who urged her to stop taking the shots and go to an urgent care facility. A doctor there approved her staying on the Coumadin but dropping the shots, and the side effects from the injections soon subsided.

But the fallout from the clot and treatment still linger, Cristina says. In late June 2011, a small cut on Maria’s hand would not stop bleeding, so she went to the emergency room to get stitches. "When she got to the hospital," Cristina says, "the doctor there said he thought her blood was too thin — but to address it, she needs to go to another doctor..."

"My mother doesn’t really get angry about it," Cristina says. "She takes everything with the attitude of, ‘Oh well, they’re just doing their best.’ But I was angry. When they sent her home the first time, they gave her incorrect information about care and neglected to give her information and medication to guard against blood clots. And then after that, when they sent her home with the shots, she had such a hard time again getting help and information. She doesn't want to get her doctors in trouble, but she would like for people to know what happened with her, to raise awareness of situations like hers. She hasn’t gotten the care she should have."