Recent Experience With Procedure Oriented American Health Care During My Mother's Hospitalization

My mother is a frail 95 year old who developed recurrent deep vein thrombosis and was started on first line therapy with a oral blood thinner Eliquis. For some reason the aspirin she was prescribed was not discontinued this caused her to developed a gastrointestinal bleed after about a week on the blood thinner and aspirin. She was hospitilized and the blood thinner and aspirin were discontinued and she recieved a blood transfusion. The next day she underwent upper endoscopy which was negative except for a small hiatial hernia. The bleeding stopped and her hemoglobin stabilized at 8.6. After an ultasound showed clots still present in the deep veins of the legs the hospitialist scheduled her to undergo an invasive procedure called a inferior vena cava filter to prevent a blood clot traveling to the lung. My mother has had blood clots in her legs before but never had a blood clot go to her lung so it did not appear that she had a clear indication to have this invasive procedure. I spoke with my sister and we communicated to the doctor before we agreed to the filter we wanted to talk more about doing a invasive procedure on a 95 year old with renal insufficency. We were concerned about the adverse effects of a contrast load on the kidneys. We were told the interventional radiologist who does the procedure was out of town and wouldn't be back until the morning the procedure was to be performed. The next day my brother was unable to get some help from the nursing staff to get my mother up to the the bathroom and my family was continually irritated by the lack of responce when they called for assistance from the hospital staff. When asked why she didn't get breakfast we were told she was NPO for the inferior vena cava filter procedure. My sister quickley called the hospitialist and cancelled the procedure. My mother is now home on a lower dose of the blood thinner Eliquis and contnues off the aspirin and is stable without any evidence of further bleeding. I continue to be disapointed in the emphasis on procedures in the American health care system. Inferior vena cava filter procedures bring in thousands of dollars to hospitals, but have no proven outcome benifit over medical therapy with blood thinners for deep vein thrombosis in preventing tromboembolic events. While inferior vena cava filters have an important role in preventing blood clots traveling to the lung in a small select group of patients, they are associated with multiple complications, and do nothing to address the painful leg swelling assoicated with the clots. It's a sad state of affairs when you can't get someome to empty a bed pan in the hospital today, but if you want a expensive invasive procedure it will be done urgently without careful consideration of the risks involved.