Re: Patient, protect thyself

[Guest guest]

Yes, it is THAT bad. Medical/physician errors are the 3rd leading cause of

death, topped only by cancer and heart disease. However, I suspect there are a

sizable portion of cases in the first two slots whose lives were cut off due to

medical errors, and not the cancer/heart issues. Sure, the cancer/heart issue

may have been not far away from conclusion, but ...

And these are just the physician mistakes we know about. This does not account

for all the ones where they were hushed up, redirected, etc. It's always nice to

have surgical nurses in the family. lol

The bottom line is, doctors, and nurses, need to stop worrying about how to

remodel their third vacation home, and start to do better jobs. Period. We, as

patients, shouldn't have to be worrying, asking so many damn questions when

we're sick, etc., and then having to pay

so much damn money for questionable work.

>

> Patient, protect thyself

>

> http://www.latimes.com/features/health/la-he-

> patients28jan28,1,5485739.story?track=rss

>

> Actor Dennis Quaid and his wife, , have newborn twins who

> were given overdoses of a blood thinner at Cedars-Sinai Medical

> Center last November. Mistakes happen even at top-tier hospitals.

> Consumers need to help caregivers avoid mistakes.

>

> By Jan Greene, Special to The Times

> January 28, 2008

>

> The numbers can be worrisome -- 1 out of 10 hospitalized patients

> picks up an infection or suffers some kind of mistake while in the

> hospital, statistics show. And the stories are frightening -- Dennis

> Quaid's newborn babies were given a huge overdose of a drug two

> months ago at a hospital with a top-notch reputation.

>

> So what is a medical consumer to do? Should we all be afraid to go to

> the hospital?

>

> 'It's never just one thing' that leads to serious error.

>

> It's not quite that bad, say experts in medical quality and error

> prevention; hospitals these days are being held to higher standards.

> But, they add, there's a long way to go on patient safety efforts.

> And consumers also have a role to play in keeping themselves safe --

> asking questions, gaining a better understanding of how the

> healthcare system works, and more.

>

> " There's an assumption that the providers should have all the

> information and you should just take at face value what the provider

> tells you, " says Dr. Angood, a trauma surgeon and vice

> president and chief patient safety officer for the Joint Commission,

> a national organization that accredits hospitals and other healthcare

> facilities. " One of the biggest things we can do in healthcare is to

> help patients understand that they need to be better consumers --

> it's good to question, to ask for clarification and solicit second

> opinions as needed. "

>

> Here are some tips from organizations such as the Joint Commission

> and the federal Agency for Healthcare Research and Quality, which is

> charged with improving quality and safety of healthcare, on how to

> reduce the risk that you or a loved one will experience a medical

> error.

>

> In the hospital

>

> * Ask questions.

>

> The best way to help your caregivers avoid mistakes is to talk to

> them. Many medical errors are related to medications -- getting the

> wrong drug or the wrong dose. A 2006 report by the Institute of

> Medicine on medical errors calculated, based on national data, that a

> hospital patient is subject to one medication error per day, on

> average. Medications most likely to be associated with errors, the

> report found, were insulin, morphine, potassium chloride, heparin and

> warfarin.

>

> If you are in the hospital and being given a new drug or dose, ask

> the nurse what it is or why the dosage has been changed. If you don't

> know why you are getting a medication, ask why.

>

> The hospital may have a bar-coding system for medications that is

> meant to double-check by computer the patient's name and drug dose

> against what the doctor ordered. (Currently, only 11% of California

> hospitals are fully using bar-coding technology for administering

> drugs, according to a January study by the nonprofit California

> HealthCare Foundation.)

>

> If you have a bar code on your patient wristband, be sure it's

> checked every time. Even if there's no bar code, the caregiver should

> check your name.

>

> * Vigilance is easier if you have someone else with you, particularly

> if you're having surgery or are too sick to keep track of your own

> care. Try to have a support person there when you get checked in,

> when the doctor visits (most likely in the morning), before any major

> procedures and upon checkout.

>

> " People need to watch out for their family members, " says Maribeth

> , director of the Market and Policy Monitor Program for the

> California HealthCare Foundation. " Often errors are caught because a

> family member says, 'That doesn't make sense to me.' "

>

> If you are particularly concerned, have no one else to watch out for

> you or a relative and can afford it, consider hiring a patient

> advocate or private duty nurse to provide backup during key periods

> of a hospitalization. Some hospitals employ patient advocates to help

> sort out miscommunications. A registry of private-duty nurses

> available by the day may be available at your hospital. Private

> patient advocacy groups exist too. (Be warned: They can be pricey,

> and not all medical staff welcome involvement of a third party.)

>

> Hospitals are becoming more open to support people in patient rooms

> and are even designing new hospitals with bigger rooms to accommodate

> more people, some even providing something to sleep on overnight.

>

> * Keep close track of your medicines, including herbal or homeopathic

> remedies, supplements and over-the-counter drugs such as aspirin. And

> tell your caregivers what you're taking. Some of these substances can

> interact negatively with one another -- ginseng, for example,

> interferes with the blood-thinner warfarin; chondroitin may cause

> excessive bleeding during surgery. A study assessing data from 21,000

> U.S. adults in 2002 found that more than two-thirds of people using a

> supplement and a prescription medication in the same year did not

> tell their doctor about the supplement.

>

> You can bring your current medications with you in a bag and have the

> doctor, nurse or pharmacist who visits your hospital room upon

> admission go over them and ensure that information about them is

> included in your hospital record. You'll also want to be sure that a

> medical professional gives you advice about how to start taking any

> long-term medications again after hospitalization.

>

> * Ask everyone who comes into your hospital room to wash their hands

> or use antibacterial lotion. Along with medication mistakes, the

> other complication most likely to occur from a hospital stay is

> getting an infection. Hospitals are germ factories, and there are

> some nasty, antibiotic-resistant bugs you really don't want to take

> home with you.

>

> Patients shouldn't feel uncomfortable about requesting that people

> sanitize their hands -- many hospitals, in fact, put up posters

> reminding them to do so. In a study reported in 2001, 39 patients at

> a hospital in Oxford, England, agreed to ask all healthcare workers

> who were going to touch them to wash their hands. The result: an

> average 50% increase in hand-washing rates.

>

> * If you're having surgery, ask your surgeon what measures are in

> place at the hospital to prevent wrong-site surgery -- for example,

> having the wrong limb operated on. One of the hospital mistakes that

> gets the most attention, it is rare but does still happen despite a

> lot of bad publicity. (The Joint Commission has collected 615 reports

> of them since 1995.) Hospitals now commonly use some marking

> technique, such as having the patient sign the area to be operated on

> and repeatedly asking the patient which site is to go under the knife.

>

[Guest guest]

Augold, doctors are human beings. So are the myriad of healthcare

workers who have a hand in patient care. For each hospitalized

patient there are probably hundreds of human beings who could make a

human error and affect a life. It's a fact. The Heparin story could

have happened in ANY hospital. What the medical establishment is

doing to combat this is such things as " Failure, Mode and Effect

Analysis " . I have participated in many, where we take a procedure and

plot it out on a flow chart and find where mistakes are most likely

and work to make changes to minimize the chance of error and maximize

the chance that errors will be discovered before they effect the

patient.

Should you still be vigilant? Absolutely! We are all humans doing our

best. I don't believe that personal obsessions make us so thoughtless

that patient's lives are disposable. People make mistakes.

Holli

[Guest guest]

Yes they (doctors) are human..but what happened to that bed side manner and

caring...and...what was that oath again?

Geri

[Guest guest]

The situation with healthcare is that the downside of unwanted or

unanticipated effects is so personally devastating.

Doctors and nurses who profess to have have never made any sort of

decisional or treatment errors are: (1) Lucky; (2) Perfect; or, (3)

Liars. My personal ranking of the choices would be 3, 1, and finally

2.

You are demanding perfection from as-yet-to-be-perfected individuals

who work within an imperfect system, all the while trying to master

and understand a complex and not yet - if ever to be - totally

understood mechanism, the human body.

You are alleging malfeasance if not outright negligence. If you

believe the medical and nursing establishment to be replete with

those who " worry[ing] about how to remodel their third vacation home,

and start to do better jobs. " , I suggest you opt out of the current

system and find your own way to health care. On a more snide note,

I've observed that many who have opted opt, do come back when their

condition(s) have worsened and then expect healthcare miracles. In

other words, the health care system then takes the hit for the

client's previous poor choices.

Again, the situation with healthcare is that the downside of

unwanted, unanticipated, or unforseen effects is so personally

devastating. Until total understanding of the human mechanism

occurs; and, clear and unambiguous 'decision trees' of health care

arise (cookie cutter thinking?); and, totally perfect providers

arise, we all will just have to do the best to our abilities.

Or, as you appear to have a solid understanding of how easy and

straightforward health care is, I suggest you become a healthcare

provider, work within the system, and allow your perfection to

permeate the rest of the world.

[Guest guest]

I have a funny story that recently happened when my 28 yr old daughter was in

the hospital having hip surgery for hip dysplasia. (She has CMT too)

When she was put in a room a nurse came in and started panicing and saying

" Honey relax, you have to relax!!! " She thought my daughter was so tense that

she was tightening her muscles to pull her foot into the classic CMT foot! We

ended up writing a note on the board in her room that her feet are always like

this, not to worry in case they came in when she was sleeping and she couldn't

explain.

Then another nurse came in and looked at her chart and said " I see you have

something wrong with your tooth! "

We tried to see the humor in this but basically they just don't know about CMT.

I am sill amazed at how many health providers don't when it is such a common

neuropathy. They are only human. I have a good friend that is a RN and I have

educated her on it but if they have not run across someone with CMT they usually

know little or nothing of it.

Cyndi

[Guest guest]

Cyndi, LOL, I had a similar experience in the hospital.

While in the hospital to have my foot fused, the nurses kept coming in and would

ask if I could feel them touching my toes.

" No " I would reply, and then add that I couldn't before the surgery either.

" Oh, are you diabetic? "

" No, I have charcot marie tooth "

" Oh, what's that? "

etc.

I had one of the nurses go to the web and print out info on CMT and post it in

the nurse's station.

O

[Guest guest]

ORnurse,

Thank you for chiming in, I was feeling a bit outnumbered! I wish

that everyone could see that the majority of us are doing our best,

but as you so elegantly pointed out this is a very complex system and

an even more complex organism. Even the best doctor or nurse or

physical therapist is going to make a mistake sometime, that's a well

documented fact.

They talk with contempt about the days doctors were seen as " gods " then get mad

when we aren't gods and can't manage miracles, can't manage to be perfect and

don't know every detail of medicine regardless of our specialty.

I have been very honest that I (a sufferer of CMT) knew next to nothing about it

until my diagnosis last year. And I'm a doctor. I guess many would count me as

one of the incompetents when in fact I know a great deal about diseases most

doctors don't, because it's my specialty and not theirs. Next time a Dr doesn't

know what CMT is, ask if he knows what TTP is. That's what I treat. Most will be

mystified.

Holli

[Guest guest]

When you stated: " You are alleging malfeasance if not outright negligence. If

you believe

the medical and nursing establishment to be replete with those who " worry[ing]

about how

to remodel their third vacation home, and start to do better jobs. " , I suggest

you opt out

of the current system and find your own way to health care. On a more snide

note, .. " I

believe your pithy reaction pretty well supports my point, even though you

misunderstood

my point. The medical establishment - specifically doctors and nurses - is not

'untouchable'.

Look, there is NO treatment, per se, for CMT, so there is NOTHING to opt out of.

On

another level, if you read these posts often, you will see that many here have -

in your

words - 'opted out' by taking vitamins, and other alternative treatments. That

positive 'opt

out' was not original with Western doctors. Also, many here have 'opted out'

from taking

statins. Etc. I think you react too much, probably because you're in a closed

profession. I

never agued for 'perfection', but we can certainly, legitimately disagree with

aspects of the

medical profession. The medical profession is not longer sacred, like the

ancient priests

are no longer, in part due to the huge increase in general knowledge among all

us

bumpkins. Sure, if I'm in a car wreck, I would rather have 'doctor Who' put me

back

together, rather than my neighbor, despite the number of medical errors. But,

I'd rather

drink a beer with my neighbor, because he sues doctors, and that's more

exciting. lol

And, I'm sorry you took it personally, but, yes, I think those in the medical

profession can

do a better job. Hell, we all could do a better job at what we do. But, if my

attorney screws

up on my case, I might lose money, but not my life. With the medical profession,

if they

screw up, you can lose both.

I'm finished - I don't want to fuss any longer. ;-)

[Guest guest]

Holli,

How does one get a doctor interested enough to even try to understand CMT?

Makes me sick when I saw how my dad was doctored...dogs get better care then he

did! There wasn't a damn thing I could do about it!I cry even today knowing how

he suffered. Needlessly!!!

I'm still trying I'm sixties and I'm having a very hard time with confidence

with doctors..How many times I had meds that were recalled or not good for me

with my CMT...Even when I have told them they still gave me the meds under a

different name. My last doctor nearly killed me( and others before that) because

he thought he was such a know it all. This has happened to me over and

over...Your right doctors were like Gods in my youth...I felt as though they

cared more then!

I'm not saying all doctors are uncaring...but it's damn close! They don't want

to go the extra mile anymore.

Geri

[Guest guest]

My neurologist explained it well to me. He said that we (the patients) that have

the conditions usually will know more than the doctors because we are only

needing to learn about one condition and stay on top of the research and news,

rather than he needs to know a

lot about a lot of conditions. It helped me to understand what doctors must go

through.

As far as a doctor goes, he is kind, compassionate and I never feel rushed when

I have an appointment. Are there other traits I wish he had such as better

follow up, sure, but isn't that true about all the people in our life?

Holli, your input here is very much appreciated, especially coming from someone

with CMT and a member of the medical community.

Jackie

[Guest guest]

Holli:

There is a problem with medicine and the perception of medicine, and

it is the contest between art and science.

Way back when, when there just were no treatments for most diseases

and conditions, the art of medicine held sway. In many cases, the

only available treatment was perhaps some self-admitted nostrum and

more importantly, the bedside manner. Our patients might have felt

better or perhaps just accepted their condition better.

Through the years, as hard science entered the profession, I think

some of the reliance on art had decreased. Science has

produced 'miracle' cures and the society as well as the medical

community have come to expect some great new advancement weekly.

Parenthetically speaking, you cannot discount what the film industry

historically has done, ie., ... perfectionizing(?) ... doctors and

nurses. The public at large as well as we healthcare professionals

have come to expect miracles from ourselves. When miracles do not

occur, well ....

From my email address, you can surmise I have some surgical

experience. At one community hospital where I worked, we had two

general surgeons. One surgeon was technically superb and had

outstanding surgical outcomes; I would have had him do my surgery.

Yet, he was constantly being sued by unhappy patients. Why? He was

an abrasive ass with no people skills. It is also true that the pre-

operative morbidity of his patients was somewhat higher.

The other surgeon .... well, he was someone I wouldn't want to

operate on my worst enemy. No, let me recant ... it would be OK for

him to operate on my worst enemy. His surgical technique and

outcomes were deplorable yet he was never sued. Why? He was a nice

guy with great people skills.

As far as healthcare professionls' " ignorance " of CMT, I agree with

you. I think I was a great operating room nurse and a pretty good

nurse overall. Prior to my own diagnosis in 1997, while I might have

recognized that CMT was some kind of neurological disorder, I really

had no clue what it was. But then, what is CMT? It can be so

variable in presentation that I sometimes think of it as trying to

grab jello.

[Guest guest]

augold1213:

Fine. May your personal self-treatment decisions not harm you.

[Guest guest]

Thanks. You can't get much worse than death, from institutionalized medicine.

;-) But, like a good soldier, never throw the baby out with the bath water ....

I pick and choose what I want from medicine. ;-)

[Guest guest]

I am responding to Geri's question (directed at Holli) about how one gets a

doctor interested enough to care.

I find being positive, proactive, maintaining a sense of humour, and showing

interest in caring for yourself causes all of the many people I work with to

be engaged positively with me. Maybe doctor's reflect back the energy and

enthusiasm we show? If we show negative and distrust, maybe just like

normal people, doctors turn off to our needs?

Here is a good recent example of mine - I had to wait about 1.5 hours for my

last appointment, and that was with a doctor in the clinic I had not met

before, and with two med students. I was irritated as my self-funded physio

appointment was about 45 minutes after he had started to see me, and it

takes 30 minutes to get across town in a taxi (you can see the expense of my

day increasing by the minute). I walked into the appointment irritated -

and giving bad energy and an attitude that I could sum up as " tell me

something I don't already know, I am here to teach you " and it just was so

wrong, I decided mid course to change my approach in the appointment. I

said " ok I am already going to be late so let me just send a text and be 30

minutes late and then I can help your students learn and maybe I can start

again as less of a B**** " and I apologised, and instead it was a good

appointment with the students learning a lot. The doctor wrote to my

general doctor a separate letter saying I seemed to be in a good place of

managing my CMT, and shared with me some info on antibiotic and pain

medicine I had not know previously. A good result in what started as a

disastrous encounter with the medical establishment.

Attitude makes the world of difference. I realise this may be frustrating

for some people to read - especially if you feel frustrated - but it is my

experience that when I am in a better mood I get better care.

Best wishes from London!

Donna

[Guest guest]

Believe it of not I'm very up-beat when I see my doctors, but they can't even be

bothered to look up CMT. I have even called before hand stating I want a doctor

that knows what CMT is. But when I see the doctor and say CMT most of the time I

get a HUH!!!

That's get a little disappointing after so many years ...trying to work with

them...and they always know what's best...even when you show them about

medications and vitamins having a negative affect on CMT. I even asked MDA about

my medications and they said they were ok...they aren't. Guess they just don't

have the time anymore.

Geri

[Guest guest]

Donna in London,

I agree. Doctors/nurses are human (well, most ... lol), so are by definition,

emotional creatures first. I actually have a good relationship with all my

doctors. Yes, all. My problem is primarily systemic, institutionalized medicine,

and (God help us all!) medico-politics.

[Guest guest]

Donna in London,

I agree. I try to take the same approach and although I don't often go to a

doctor, when I do, if I be patient with them for not understanding and

definitely show an enthusiasm, I find it helps them come up with some ideas to

help, when otherwise they probably would just get frustrated with me whether

it's due to their lack of understanding or not, it is my responsibility to

maintain an upbeat attitude so that does pass on to the physician. You are so

right about the attitude thing!

Dawn

It's not having what you want, it's wanting what you got.