Saturday, May 16, 2009

Occupational Hazard

The past few days have been one heck of a roller coaster ride of emotions for my family. I'm sure you all remember that my sister is currently in school to be a Physician’s Assistant (PA, almost done) currently she is on her next to last rotation which happens to be general surgery. On Thursday she was assisting a Gallbladder surgery by helping to do some sutures. During this process Steph came to some tough parts of the skin and when she pushed harder to get the needle through it came flying out the other side and went right through her glove into her finger. Just to get this out of the way now she was doing everything exactly that way it should be done this was just one of those accidents that happen and no one has control over.

Steph immediately stopped what she was doing and notified everyone in the ER that she had just had a needle stick. She backed away from the patient and her finger was treated and wrapped. Protocol requires that the hospital or office take blood from the patient when this happens to test for HIV and Hepatitis. Steph called me that afternoon on her way home from work to talk about this because she was so upset that it happens but at that point she wasn't worried about the test. The doctors and nurses she was working with weren't that concerned about this patient’s health because of how her records looked.

Shortly after I got off the phone with Steph the Doctor she is working with called her and told her that one of the HIV test of the patients came back positive so she needed to come back to the hospital immediately. Steph said at that point she dropped to the floor of her kitchen and immediately began to cry. She describes the feeling as being hit by a truck. Thankfully Steph's roommate and classmate walked in the door and was able to decipher some key words in the conversation Steph was trying to have with her doctor. Once Steph's roommate calmed Steph down some she had her go change and then drove her the 45 minutes back to the hospital. Steph just happened to have done her ER rotation at this same hospital so she knew the nurses and doctors that were working. They took the time to explain to Steph everything her doctor had tried to tell her over the phone. I will do my best to explain this to you all because it's an important part of this story but please remember I am not in the medical field.

There are a few different kinds of HIV test. One is the generic, if you will, test that is done when screening someone for HIV. It's a yes no kind of thing. This test came back negative on Steph's patient. When you have had a needle stick they run a second test on the patient that looks at proteins in the blood. This test is very sensitive and has a high false positive rate. This test came back positive on Steph's patient. So Steph had to go into the hospital and have the test ran on her both of which came back negative. Now according to Steph HIV will not show up until at least three weeks after you had the contact so this was not surprising. They also had to run some blood work to make sure Steph's liver was functioning so they could give her the HIV antibodies to hopefully help protect Steph. They gave Steph the first dose of these and a prescription to fill for the other doses. Now based on the test that came back positive Steph's risk of contracting HIV was 3%. While they were waiting on Steph's blood work the nurses looked up some case history that was very encouraging. Apparently no one has EVER contracted HIV from a needle stick using the type of needle Steph was so that dropped her chance to under 3% chance. Even with those figures they weren't going to take any chances. Lastly the patient had to have more blood taken to run a third HIV test that if it came back positive it would be for sure thing that the patient had it and Steph would have to have HIV test done for the rest of her life. Before Steph left the hospital they told her that the patients third test results would be back the next afternoon so she could wait to here before going to fill her prescription.

Yesterday morning about 10:30 I received a call from Steph at work and she told me everything I just told you. She seemed very calm about it and said that everyone she had talked to had had at least one experience like this and the likelihood of her getting anything even if the patient had it were very very slim so not to worry. Of course this was still all very upsetting because of the what if's. It was very hard to concentrate the rest of the day and I wanted to call and check in with Steph but I didn't.

Finally around 3:30 I broke down and called Steph. She had just got off the phone with her doctor who had called about the test results but was informed that they took 24 hrs to get back so the earliest they would know was midnight. This meant Steph had to go and get the prescriptions filled in the event the test came back positive. If she didn't have another does in her by yesterday she would have been screwed.

Steph and I made plans for her to come over to my house after I dropped the kids off with the MIL so she wouldn't have to sit at home alone. I told her I would call her when I was leaving the meeting place which I did. I could tell as soon as Steph answered the phone something more was wrong. It seems that the three different drugs she needed were not ones very many pharmacies carried. She was able to find one at a Kroger near her house, another at the Wal-mart near her house but the third was a little more difficult. No one in the Columbus area carried it except the hospitals and they can't fill prescriptions unless you are an inpatient. So Steph had to call the hospital this happen at and they ended up selling the drugs to the Kroger across the street from them so Steph could go there to have her script filled. I could tell my little sis was exhausted so I told her I would head to her house and pick her up and drive her to that hospital since it's a bit of a drive then she could come home with me and spend the night in case she reacted badly to the drugs (common side effect).

Once we finally made it to the Kroger we went straight to the Pharmacy. The very nice girl behind the counter had some trouble understanding that they hospital didn't call the prescription in for Steph but sold the drugs to them so they could then fill the prescription Steph had in her hands. It took about 10 minutes to get that straightened out. Once she did Steph explained to her that the prescription she had was for a full does but that per the hospital she was only to have a 24 hour supply filled at first. The girl wasn't sure about this so she took it to the pharmacist who was a very mean cruel woman, but you will see why soon. The pharmacist argued with us that the hospital sold her 18 pills and that was what she had to give to Steph even though the prescription Steph was holding said to only fill a 24 hour dose at first. After what seemed like an eternity of arguing with this woman she finally said she would do it.

Steph and I decided to wander around the store since they said it would only be about 10 minutes. Five minutes into that they pages Steph back to the pharmacy. As we were walking up the pharmacist came out and around the counter, she walked up to Steph and said

“You do need all 18 pills because your blood work came back positive!"

I am pretty sure at that moment I gasped very loudly and yelled WHAT??? Steph on the other hand instantly began sobbing and almost passed out. It was a good thing I happen to be standing behind her to catch her. Through allot of tear Steph started yelling at this lady and telling her that when she was in the ER they told her the test was negative. I was trying to be the calm one and eventually got Steph to call the hospital back and talk to the nurse that set all of this up for her. That awesome nurse checked Steph's files twice and confirmed that Steph's results were negative. At this point the nurse becomes enraged because Pharmacist do not have the authority to give a patient a diagnosis because they are not certified to do that. The nurse was also upset because when she called to have the drugs transferred the only reason she gave as to why was because of a deep needle stick, never did she say anything about anyone’s blood work or test results.

Steph got off the phone with the nurse and told the pharmacists that no her test results were negative and she just needs the 4 pills. The pharmacist didn't argue this time and filled the script right there. I think total this process took about 10 minutes but it was truly the longest 10 minutes of my life and I can't begin to imagine what it felt like for Steph. Steph didn't say much as we checked out and walked to the car but shortly after getting in the car the shock of the situation wore off and Steph became very upset and rightfully so. She had just had a pharmacist tell her that she was HIV positive which was a downright lie! On top of that she told Steph this in front of about 6 to 10 people that were waiting to pick up their prescriptions. Throw in the way in which she told Steph and I think this all equals a law suit.

After all the craziness of the day I stopped and got us some dinner at Chipotle and then we came back to the house and watched Braveheart with Dave. Steph had never seen this movie and its Dave’s favorite so it seemed like a good time. Thankfully it is a bit of a longer movie so by the time it was over Steph was tired and went up to Emma's room to sleep.

I had to work this morning which meant a 6am wake up call. It also happened to be the same time that Steph needed to take more pills so I got her up. She came downstairs took her medicine while I was getting ready for work. When I walked out to the living room she informed me that at 2:39am her doctor texted to her to say that the patients test came back negative so she didn't need to take anymore of the pills. It also means that Steph doesn't have to worry about anything for the time being.

During one of the conversations Steph and I had the past few days she made the comment to me that she knows this is a risk of being in the medical field and she is ok with that risk she just wished that her first needle stick didn't come with the positive HIV test. What I think is that while she is bound to have more in the future maybe she was lucky and got the big scare one out of the way but who knows. What I do know is that I love my little sis and I am so thankfully that this scare is behind us.


Missy said...

Praise the Lord she is okay! How scary for her & you all! I am so glad she is okay though! And what an ignorant pharmacist - I think I would have to call and talk to the manager of the store or pharmacy.

Tiffany McCallen said...

Holy crap that's an unbelievable story!!! Poor Steph. I can't fathom how tough her week must have been. I'm so glad it has a happy ending though. What a wonderful reminder to celebrate family...

Jen said...

Yikes! How totally scary for her. I am glad things are ok. . .

Lindsay said...

Wow that is so scary!!!! I'm glad that Steph is ok......