Archive for the 'Surgery' Category

Uh-oh Video! (Can’t escape it…)

When it comes to TV and video, Al Roker provides one of my favorite quotations:

“They say the camera adds 10 pounds. OK. So I figure I must be standing in front of 10 cameras.”

Oh, yes, Al. I know how you feel….

However — I’ve decided to come out of my video-avoidance closet to share the following with you all.

First — my excitement at the invitation a week ago to appear on MSNBC to speak to a problem that I actually cited a few years ago – that July is the worst month of the year to be hospitalized. Why? Watch and see!

Visit msnbc.com for breaking news, world news, and news about the economy

(Even got my two cents in about hiring patient advocates!)

So that’s the first one.  But if I’m going to jump in to the world of video, I might as well do it with both feet.  Many of you know that I am brought in to speak at various conferences and meetings across the US and Canada.  I enjoy speaking!  So in my attempts to do even more of it, I’m told I need to have a professional video made.  So, yes, I finally bit that bullet, too, and have uploaded the online version of the opening here.

It’s not like I’ve never done TV before – I have done local TV on a number of occasions.  And broadcast isn’t the problem – ferheavensake, I have hosted a radio show for 4+ years!  But video, in general, has just always been a step I’ve avoided.

Until today.  So, OK, I feel better now.  [[gulp]]

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Hospital Gets a Plus, Communication a Minus

It’s been awhile since I posted — but you’ll understand why.

My father suffered a mild heart attack a few days ago, and (thanks for asking) is doing as well as can be expected. In his 80+ years, he has never had any indication he had a problem with his heart!  A variety of other health issues have arisen over time, but Dad’s heart was always thought to be as strong as could be….

In fact, despite protestations (“I don’t really think these chest pains are a big deal… let me just make an appointment to see my primary….”) emergency personnel arrived and whisked him off to Sarasota Memorial Hospital (Florida) where he spent the better part of the next three days.

smhospital1Some rigorous testing, a heart catheterization and an angioplasty of a small artery later, Dad is home and getting his sea legs back.

I happened to be visiting him when it struck – amazing timing, don’t you think?  I’ll be here for a few more days to make sure he’s on his feet and feeling more confident, as we review what led him to a heart attack and what adjustments he’ll need to make from here.

Of course, little did those who helped Dad know that a critique would be forthcoming once we were past the initial shock and care. I’ve been making observations throughout that might help all of us get the care we need.

I can’t say enough GOOD about Sarasota Memorial Hospital.  I’ve been admitted to, and visited, many hospitals, but by far, SMH is the best I’ve experienced.  Here’s why I say that:

The personnel were very helpful. No one was ever too busy to answer a question or explain what we needed to know.  When we had questions about the meaning of the various numbers appearing on the monitor he was attached to, each section was patiently explained to us.  When they moved Dad to a room, I was able to get easy directions to find him. When Dad was admitted, he mentioned he hadn’t eaten any breakfast or lunch, and a turkey sandwich appeared.

The hospital is immaculately clean, from the facilities to the people.  A great deal of emphasis is placed on washing and sanitizing hands and surfaces.  I watched the cleaning people use great care in cleaning up behind the patient in the next bed, wiping off every surface including the phone, the bed controls, the TV remote.  The personnel that actually touch patients (nurses, others) were diligent about washing their hands and sanitizing.  The only time either Dad or I asked them to wash their hands was in the emergency room, and then the nurse told us she had sanitized before she came in the room (although I didn’t see any dispensers outside the room.)  But she was happy to comply when Dad asked. Of course, the entire point is to avoid infections.

Dad’s nurses, in particular a young man named Eyves who was available the entire day of his procedure, and the night nurse, Bren, were particularly helpful.  Dad had a rough time of it — a lot of pain and nausea.  Both were right there for him and did everything they could to keep him comfortable.

The check-out process was excellent.  All instructions were explained to us carefully. Dad, foggy from so much painkiller, had some trouble processing instructions, but the discharge nurse was very patient, taking it very slowly so it could sink in.

Even the food in the restaurant is good!  Add that to the free parking, great signage (very easy to find my way around) and the fact that we could use cell phones, had free internet access and no restricted visiting hours…

The ONLY fly in the hospital ointment was communication from the doctors — a problem that was a much larger minus than it needed to be.  The problem was this:  we were told that both the proceduralist who performed the heart cath/angioplasty and another doctor would visit us a few hours afterwards to explain the findings and next steps.  It never happened. In fact, the proceduralist NEVER visited, and Dad’s new “assigned” cardiologist (the recommendation from his primary) didn’t visit until the next day.  Both he and the primary get a few points for phoning me (it was 7:30 AM, and I hadn’t gone in to the hospital yet).

This problem was not about the actual communications; rather, it was about managing our expectations.  If we had been told we wouldn’t be contacted by either doctor until the next morning, we would not have expected it, nor would I have been upset when we didn’t.

And this is where Dad’s nurse, Eyves, gets more brownie points. When I made it clear how peeved I was many hours after we expected the proceduralist to arrive, he tracked down another doctor in that same practice who then called me and explained in a very detailed manner exactly what the findings were during Dad’s procedure.

This won’t be our last experience with Sarasota Memorial Hospital. My parents are both older and both have health issues. I expect I’ll get to know much more about this facility. I’m very thankful to know there is so much emphasis on the important aspects of care.

One more point to make:  as mentioned, Dad was “assigned” his new cardiologist.  I helped him understand that he is under no obligation to accept that assignment.

The same is always true for you.  Referrals can work out well, or they may not.  Just because you are referred to a specific doctor does not mean you are obligated to stay with that doctor.  You may always choose your own doctor, as may Dad.

No one ever wants to be hospitalized, but if you’re in Sarasota and you need hospital care, give Sarasota Memorial Hospital a try.

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Informed Consent Called Into Question

A new post by my blog guest Anonymous, poses a question, “Informed consent is just a cruel joke, isn’t it?”

This gentleman, who underwent surgery, was given Versed as anesthesia, despite stating that he did not want to be given any drug that would render him unconscious.  So, not only did he deny consent, he stated that he did not want to be put to sleep at all.

We don’t know too many of the details, and we have not been given the other side of this story.

But it does call patients rights into question.  And our understanding of Informed Consent.

Take a read — see what you think — and if you have ideas for what could have been done differently?  Please post your comments, too.

Versed, PTSD and Questions About Informed Consent

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Some January Healthcare Thought-Provokers

thinking

Not sure what it looks like where you live, but it’s cold outside where I live in Upstate NY, and we’ve got plenty of the white stuff on the ground.

Whereas some friends might curl up with a good book, I tend to gravitate to puzzles and thought provokers when I’m indoors and have some time on my hands.   So I thought I’d provide you with a few links and summaries.  I’m curious about your opinions:

1.  Scenario:  Your Uncle Henry lives in Rural-alia and needs prostate surgery.  His primary care doctor refers him to a general surgeon who provides Henry with a list of all the side effects and describes the surgery and potential, probably outcomes, including incontinence and impotence.  Uncle Henry settles on a date for the surgery, but confides in you that he’s really frightened and does not want to live with those side effects.

Questions:  Do you suggest to Uncle Henry that he go into the city to find a second opinion?  Do you tell him there are newer forms of surgery that may minimize the chances for those outcomes?  Is it up to the surgeon to explain to Henry that there are other hospitals and surgeons that can do a better job?

BackgroundShould patients be told of better care elsewhere?

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2.  Scenario:  Aunt Genevieve has been hobbling around for years on that bum knee of hers.  She finally lets you talk her into visiting an orthopod, and he tells her she really needs to have her knee replaced.  She follows through, the surgery and recovery are a bear, and she begins to have real problems almost immediately with the knee not really working right.  Then, as you dig into more information for her, you find out her surgeon is actually one of the inventors of the knee which was used in the surgery.

Questions:  Do you confront the surgeon about the problems?  What do you ask him to do about them?  And does it matter that he owns the patent (and therefore makes money) for the artificial knee?  Should he have disclosed that fact to Aunt Genevieve?

BackgroundDon’t be a victim of  medical marketing

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Thoughts on either one?  Just hit the “add a comment” button below…

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