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April 13, 2001
A long road to recovery
Heart attack and stroke test the health-care system.
CYNTHIA RAMSAY SPECIAL TO THE JEWISH BULLETIN
It began on a Sunday: "We were supposed to be going out for
lunch. [Karl] said he didn't feel well and the next thing I knew
... he just collapsed. I thought he had fainted. I didn't think
he had had a heart attack. He came 'round and we went out for lunch,"
said Carol Taussig, describing her husband Karl's heart attack.
It was Nov. 5 and, within two weeks, the Taussigs' lives would change
drastically.
Karl Taussig has been very active in the Jewish and general communities.
He has been on several different committees in the Jewish community.
He is a past president of the Jewish Community Centre of Greater
Vancouver (JCC) and a past president of the Jewish National Fund.
He has been on the board of Beth Israel synagogue twice and he has
held positions on various committees at Vancouver city hall. He
and his wife are active members of Beth Israel.
Karl, 75, has an eight-year history of coronary heart disease, but
it was only in the summer of 1999 that he was diagnosed as needing
medication to maintain his health. In addition, Karl changed to
a low-cholesterol diet and joined the Healthy Heart program at the
JCC, which he attended once his name on the waiting list came up.
The program, which combines education and exercise to try and improve
participants' cardio health, complemented the other physical activities
in which Karl was engaged: walking, cycling, swimming, racquetball
and tennis.
"I'd cycle regularly up to the centre, up to the synagogue
or wherever I wanted to go," said Karl. "But I wasn't
entirely satisfied with my response to all my activities. I used
to have pains in my upper arms, which was eventually recognized
as being my version of angina."
After his collapse Nov. 5, Karl's family doctor recommended that
Karl report to the emergency room at Vancouver General Hospital,
which he did the evening of Monday, Nov. 6. The tests he underwent
showed that he had suffered a heart attack the previous day and
that the damage was severe. The hospital wanted Karl to undergo
a quintuple bypass and a valve repair operation - he was scheduled
for surgery Thursday, Nov. 9. He remained in the hospital that week.
The surgery was scheduled for 4 p.m. Karl was prepped for the operation,
and the surgeon, anesthetist and other operating room personnel
were ready to perform their task. But, as 4 p.m. passed and there
was no nurse available who could look after Karl after the operation,
the procedure was cancelled. He was sent home, after rescheduling
the operation for the next week.
"I wouldn't take him home at first because I was worried that
he wouldn't get back in," said Carol. "I took him home
only after Karl was sure he had another date."
After a quiet but nervewracking week at home, Karl underwent surgery.
"He woke up [after the procedure] and he was blowing kisses
to everybody. He was fine, except that he couldn't talk - he had
all these tubes in him," said Carol, a high school teacher
in the Delta school district. "But then I went to school Monday
morning and, at 6 a.m., he had a stroke. I didn't phone [the hospital]
till about 7:30, but nobody [from the hospital] phoned to tell me
or give me any information," said Carol, holding back tears.
"They did nothing for seven hours. They didn't tell us anything.
But there is a drug that, if you have a stroke, and you use it immediately,
it's supposed to help. They couldn't use it because Karl was already
on heart medication," she said. Ultimately, the hospital took
a scan of Karl's heart.
"It revealed, they told me, he had a slight stroke. In actual
fact, he had a major stroke," said Carol. She lamented that
this information wasn't shared with them until much later - after
Karl had been moved from VGH to the G.F. Strong Rehabilitation Centre.
"Also, we had no idea that a stroke is a side-effect of having
heart surgery, and we had never been informed about that,"
continued Carol. When the stroke happened, she said, "We all
thought he had died."
The day after the stroke, on Nov. 21, Karl was transferred from
the cardiac care unit (CCU) - where Carol said the care provided
was "excellent" - to the ward - where, she said, "nightmare
time started." She explained that there is constant monitoring
of patients and one-on-one care in the CCU whereas in the ward,
less intensive care is provided.
"He just had a stroke, he was completely helpless and he was
[in a hospital room] at the far end. I arrived, he was alone, he
had cords around his neck, everything had fallen on the floor. There
was nobody around and he was far too out of it to be able even to
pull a cord. And I went berserk. They moved him to a room nearer
to the [nurses] station because he had to be watched," related
Carol emotionally.
In the ward, Karl developed pneumonia and needed to have his lungs
suctioned so that he could breathe more easily. Again, said the
Taussigs, this is a common occurrence after heart surgery, but they
were not warned of the possibility.
More than once during their interview with the Bulletin,
the Taussigs spoke of the lack of information provided to them at
various stages of their ordeal. One problem they pointed to was
that, once a patient is admitted to the hospital, the family doctor
has nothing to do with the process. Another problem, they said,
was a shortage of staff at the hospital.
"The nurses work incredibly long hours; 12-hour shifts, which,
because they're short of staff, is very hard on them," said
Carol. "They seem to find families, particularly caring families
who are so anxious, as we were, they find us a nuisance. They found
us intimidating. But had we not been there, and been intimidating,
I'm not sure what would have happened to Karl."
Despite the fact that Karl has three grown children living in Vancouver
who helped with his recovery, Carol had to hire care people to come
into the hospital to stay with Karl at night and turn him occasionally.
"We were so tired. We just couldn't spend all day and night
with him," she said.
On Dec. 13, Karl was moved from VGH to G.F. Strong. The rehabilitation
centre would only accept him as a patient if his feeding tubes were
removed and replaced with a peg-like apparatus. Karl's tubes were
taken out Dec. 7 and replaced Dec. 9 with the peg. When his younger
daughter questioned the attending physician about the fact that
her father had gone 48 hours without food, she said the doctor's
response was that "It isn't harmful to go without food, you
just lose weight."
The Taussigs chose G.F. Strong because it's held in high regard
in the community.
"It has an excellent reputation," said Karl. "It
processes patients [who have] extreme difficulties, such as stroke
patients and spinal injury patients, very rapidly through its program
and sends them home."
Karl's rehab "team" included a nurse, social worker, physiotherapist,
occupational therapist, speech language pathologist and a psychologist.
"They taught him all of the basics and spent a great deal of
time with him," said Carol.
However, perhaps as a result of the timing of Karl's arrival - right
at Christmas time - the Taussigs found that, at G.F. Strong, as
at VGH, they had to "complain a lot" in order for certain
things to get done.
"I found that, when I wrote notes ... then there was an immediate
response. I think, due to the shortage of nurses, once again, oral
communication was not as effective," said Carol. "They
[the nurses] are worked off their feet.... The shortage is everywhere
and with respect to programming, if somebody [on staff] is sick,
there is no one to replace them."
Both Carol and Karl expressed concern over RADs, reduced activity
days - days on which hospitals operate on a reduced basis in order
to stay within their budgets.
"For patients who are so incapacitated, as many of these [patients
at G.F. Strong] are, I think these days are questionable,"
said Carol.
On Friday, March 16, Karl was finally well enough to return home.
A social worker and a care team visited the Taussigs and determined
how much care Karl would require. The home support services consist
of four hours a day general help with dressing, meals and some light
physical activity, such as walking. These services are paid for
mainly by the government - the cost to patients varies according
to the amount of care they need and their income level.
If the Taussigs feel that Karl needs more help, they either have
to convince the government of that need or pay for the services
themselves. Carol works 6 a.m. to 6 p.m. five days a week, therefore
Karl is left to his own devices for much of the day. While Karl
is up and walking around, one of the main concerns is that, as a
result of his stroke, he has lost much of the feeling in his left
side. He could burn or cut himself on his left-hand side and not
know about it. In order to help remedy this situation, he needs
physiotherapy and he is currently on the waiting list at G.F. Strong
for treatment on an outpatient basis. A private physiotherapist
can cost as much as $200 a day. So, the Taussigs wait.
Luckily, Karl is over 65 years old and the medications he is using
are covered by Pharmacare (the province's drug insurance program).
This means that the Taussigs only have to pay for the dispensing
fees of the nine prescription medications Karl is on (up to a $200
annual maximum) - one recent trip to the drugstore amounted to about
$275, said Carol.
For B.C. residents who are under 65 years old and not considered
low-income earners, there is an $800 annual deductible for Pharmacare,
after which the program picks up 70 per cent of the cost of any
eligible benefit items. Once the individal or family has spent $2,000,
Pharmacare covers 100 per cent of any further costs.
The Taussigs have been told that Karl's recovery could take up to
two years. Carol said she is living one day at a time. Karl admitted
that he was having difficulty accepting the changes in himself and
in his lifestyle.
"I realize that there are many aspects of which I should be
duly appreciative because it all could have turned out so much worse,
and my condition was so much worse at the start, and I've witnessed
a lot of improvement in the four months since it happened. But it
still leaves me very depressed and worried about how it's all going
to turn out in the end," said Karl.
Both Carol and Karl said they have received many offers of support.
If there is a silver lining to their experience, they said it is
the "blessing of the kindness of friends, family and community."
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