I have been hospitalized since 6/22 with severe pain and a prolonged cough. They recently found staph pneumonia in my sputum and started antibiotics. The doctors also believe opioid-induced hyperalgesia is contributing to my pain. My IV opioid taper is over, and I am now only receiving oral medication, which has not consistently controlled the pain.
I currently have severe lower-to-mid left back pain, recurrent right outer-thigh nerve pain that may now be changing location, and major functional limitations. I still need assistance getting out of bed and using a bedside commode. I have also reported intermittent double vision, blurry vision, and a peripheral light in my left eye.
The hospital may discharge me tomorrow, but I have several unresolved safety issues:
I cannot reach my grandparents and do not know whether they are home or still out of state.
I still require assistance getting out of bed and toileting.
Someone would need to empty and clean the bedside commode.
A couch and heavy dresser must be moved before the hospital bed can be delivered.
Friends may be able to move the furniture, but this is not confirmed yet.
My mother and stepfather, who might otherwise help, are currently sick with respiratory symptoms.
I am being transported home by ambulance, but transport alone does not solve the lack of help once I arrive.
I see three possible options:
Go home tomorrow and hope the equipment and caregiving situation can be arranged.
Request a formal hospital-to-hospital
transfer for an independent reassessment. This would bypass a new ER evaluation, but my current doctor and records would be involved, and I worry the receiving hospital may simply accept Vanderbilt’s conclusions.
Accept discharge and seek care at another hospital, either going directly by ambulance or trying home first and calling another ambulance if I cannot function. I understand another ER might not admit me or offer a different pain plan.
Questions:
Would discharge be unsafe when I still require assistance transferring and do not have a confirmed caregiver at home?
Should I insist that PT/OT and case management document my current assistance needs before discharge?
Is a formal transfer the safest way to obtain an independent assessment, even though my current team will communicate with the receiving hospital?
What should I ask case management to document or arrange before I agree to leave?
Is there another option I am overlooking, such as short-term rehabilitation, skilled nursing, or delaying discharge until my home equipment and assistance are actually ready?
I am not asking for guaranteed IV medication or zero pain. I want a medically safe transition and a realistic plan that does not leave me unable to get out of bed, toilet, or care for myself once the ambulance leaves.
I’m just exhausted and in pain. There’s probably other words but I can’t find them.