Lawn-sense

So yesterday I mowed a lawn for the first time. My dad always used a landscaper when I was younger, so I never had the chance to use a lawnmower. For those of you out there who are like me in this regard, I share some important lessons with you in today’s blog entry. Others may simply find my inexperience with lawn mowing to be amusing.

“Wait!,” you say. “This is a medical site, not a home improvement site.” True, but were you aware that a lawn mower is one of the most dangerous pieces of equipment in the home and causes thousands of serious injuries each year. For example, in 1990, there were 87,000 visits to the Emergency Room due to lawn mower-related injuries. What kind of injuries are we talking about? How about chopped off fingers and toes, loss of vision, broken bones, and severe burns? That’s pretty serious stuff.

Here were some of my mistakes yesterday that I immediately plan to correct. First, I did not use gloves. As a result, since I couldn’t figure out how to pour the gas in the mower without spilling a bunch of it all over the place, my hands were saturated with gasoline. Not only does it smell bad, but it was quite uncomfortable.

The second mistake was not wearing protective glasses. Luckily, nothing bad happened to me, but debris could easily have flown out of the mower and hit me in the eyes. To that end, I also should have worn pants and shoes (not shorts and sneakers) to protect my feet and legs from flying debris.

The grass was pretty long and the machine kept jamming on me because of this. As a result, I had to clear numerous blade jams. I made sure the machine was off when I cleared the jams, but next time plan to use a paint stick instead of my fingers to do this because you never know what can happen.

The one thing I did right was clear the yard of whatever debris I could find such as large sticks or rocks. If this stuff hits the blades, watch out! This is why children should not be nearby when you mow. Well, that’s about all for now. Feel free to write in to the blog with your mower safety tips or stories.

Free TV for everyone!

Why on Earth is it that hospitals cannot provide patients with basic TV channels for free. I’m not saying people should have free cable in the hospital, but they should at least be able to have the basics (channels 1 through 13). The only cost to the hospital would be electricity.

What many people do not realize when it comes to hospitals is that a hospital is a business. The bottom line is to make money. So there is a charge to watch even basic television channels. Now, there may be some hospitals that don’t charge for basic TV, but many do, and in my opinion, NONE should. Why?

Because for many patients (particularly those who are elderly, have no family, and/or few financial resources) television can be their only source of mental stimulation. But without it, I have seen people lie in bed for weeks on end staring at nothing but four walls. This lack of stimulation can lead to profound depression, particularly for those patients who can’t get out of bed due to injury or disease. Someone may respond that there is always reading, but many elderly people have difficulty reading fine print and many poor people do not have reading glasses.

If anyone reading this has ideas on how to advocate effectively for all patients to have access to basic television coverage, post a message to the blog or email me at suggestions@medfriendly.com. I’d love to hear from you. Maybe we can make some progress on this front.

Candy for the call bell

Most people are familiar with a call bell, a push button device that one presses in their hospital bed to get the attention of the nurse. Now days, most hospitals have integrated call bells into the same devices that operate the television set. The result is a single, hand-held device with a small array of buttons. Most people have no problem discriminating between the buttons, but I have seen elderly people have difficulty with this. This is more likely to be the case at night, when the room is dark and the patient wakes up somewhat confused and needing help. In that situation, trying to sort between the call button, TV power button, channel buttons, and volume buttons can be a challenge.

Yesterday, I saw a family come up with a great solution. They taped a pre-wrapped piece of sucking candy to the call bell. This way when the person wakes up at night, he/she no longer has to search amongst a bunch of buttons that all feel the same. The patient now just needs to feel for the big piece of candy and press down on it to ring the call bell. What a great idea!

Take an extra minute

So today I assessed an elderly woman who could not walk and could barely speak due to the placement of a tracheostomy tube. For those of you who are unfamiliar with this, a tracheostomy tube is a tube inserted in the windpipe to assist with breathing. When I was done with the evaluation, I could have easily turned around, said goodbye, and walked out of the room. But what would I have left behind? Answer: An elderly woman sitting in a chair with no television on, who can’t walk to reach her call bell and who can’t cry out for help.

I had established a communication system with the patient and instead of leaving her like she was, I simply asked her what she would like before I left. This led to turning on her television, tilting the screen so she can see it, turning the volume up so she can hear it, and making the call bell accessible to her. This took less than a minute to do. I’m not the only one who takes the extra time to do these sorts of things, but I am certain there are many who do not. So I hope to encourage any healthcare providers or family members of loved ones in the hospital to take the extra minute and make sure the patient is comfortable before you leave. Remember, many patients can’t just get up and do things for themselves like you and I.

Working in a hospital without getting depressed

People often ask me: “How do you work in a hospital everyday and not get depressed?” That is a good question. Most people hate hospitals. And there certainly are many sad things that I see on a daily basis. Whether it is someone who is paralyzed, amputated, terminally ill, disfigured, dying of AIDS, or permanently disabled from a stroke or traumatic brain injury, I see something sad every single day.

I deal with the sadness in two ways. The first is that I feel I am doing something to impact people’s lives in a positive way. I will never forget a patient I had earlier this year who was quite young, yet terminally ill. I had done a mental status examination on her and as I was walking out of the room, she asked me, “How can you help me deal with this?”

Although supportive therapy was not the reason I was consulted, I discussed some ways for her to cope with a very dire situation. I reminded her about the positive things she had done in her life and how she had made a difference to others in her line of work and as a mother. She seemed relieved when I left. Sadly, she died the next day from her illness. However, I felt happy that I had made a small, yet positive impact in her life, and that helps me carry on.

The second way I cope with what I see each day is by reminding myself how lucky I am to be healthy. Whenever stressful things happen to me, I try to think back to what I see each day and remind myself that my problems pale in comparison to those of many people. The average person would benefit by reminding him/herself of this fact every day.

Family ties

It’s time for another one of those insider tips on how to make sure your family member is provided with the best care in the hospital. If I were only able to give one recommendation to people in this regard, it would be this: Be an advocate for your family. If the medical staff knows that family members are actively involved and watching, there is less chance that your loved one will be lost in the mix or that mistakes will be made. If the nurse is attaching the patient to the wrong type or dose of medication on an IV, tell me which patient is going to be better off: the one that has family checking these matters or the one that has a family that assumes everything will always go ok, without mistakes? Medical mistakes happen all the time, which is why I always say that two sets of eyes are better than one.

The average person is usually intimidated in “bothering” a doctor because he/she is busy. While it is true that doctors are busy, they should be available to answer concerns you may have about your loved one. But how do you get in touch with them when they make rounds at 5 am or 6am and then are gone for the rest of the day? Good question.

The technique I have seen work best is for a family member to write a note on a small piece of paper saying, “Attention Dr. Smith! Important! Patient’s son requests that you contact him as soon as possible regarding his mother’s care. Phone number is 555-5555.” Request that this note be taped onto the FRONT of the medical chart so there is no way the doctor can miss it. If you are not there to write the note yourself, call the unit and ask someone to write it for you. Trust me, it works.

If for some strange reason, the doctor does not call back in a reasonable time period, call back and ask to speak to the fellow or resident that is following the patient. Often times, what happens is that the resident or fellow (terms for doctors in earlier stages of training) follow a set number of patients and answer to the main physician, who is known as the attending. You should try and contact the attending for the most important matters, but developing a good relationship with residents and fellows can be very helpful because they have the ear of the attending.

The bottom line here is to make your presence known. Also, don’t be shy in advocating for certain lab tests or procedures to be ordered. I have seen time and time and again where a doctor orders a procedure only because the family pressured him/her to do so. Sometimes, useful information comes of this. Other times not. But read up on the condition of your family member so you can be informed. Lastly, while I am encouraging family members to be advocates, there is a fine line between advocacy and alienating yourself from the staff. One simply needs to use common sense here and use good judgment.

Say cheese!

So I was eating a sandwich a few weeks ago with some American cheese on it when someone said to me, “You know, that’s not really cheese. American cheese is just a bunch of processed stuff all mixed together.” Dubious, I went home and checked the ingredients, as I have a regular stash of Kraft American cheese in the fridge. Here is what I found: "Milk, Whey, Milkfat, Milk Protein Concentrate, Salt, Calcium Phosphate, Sodium Citrate, Whey Protein Concentrate, Sodium Phosphate, Sorbic Acid as A Preservative, Enzymes, Cheese Culture."

Then I saw that the package described it as a “Prepared Cheese Product.” That didn’t sound too appetizing. I am not a health-guru by any means, but I generally try to cut as much artificial processed chemical garbage out of my diet as possible. Now, it’s not like I am going to cut cheese out of diet totally since I love it and it’s good for you in moderation. But I now was on a quest for a better option.

So I found a great replacement: Borden’s cheddar and Monterrey Jack. Here the package says something a little different: “100% natural slices.” The ingredients are: pasteurized milk, cheese culture, salt, enzymes, annatto vegetable color. A lot better than the stuff I was eating before. And it’s 10 times tastier! So if you are someone who has been munching down American cheese on a daily basis like me, just realize that it’s not really cheese and there are better, more natural and tasty alternatives out there for your diet.

Tom Cruise is the one who is misinformed

As many of you know, Tom Cruise has been in the news lately for some very controversial comments about the field of psychiatry.
He has been apt to call people who disagree with him misinformed, but as you see from today’s blog entry, Tom Cruise is the one who is misinformed.

Cruise recently told a reporter: "I think psychiatry should be outlawed. I can't believe electric shock therapy is still used. I think it definitely does more harm than good." He recently told the magazine Entertainment Weekly (June 17, 2005 issue) that “People are being electric shocked. Kids are being drugged. People are dying.”

Psychiatry should be outlawed? People are dying? I work with psychiatrists every week since I am often called to evaluate their patients, on both an inpatient and outpatient basis. The notion that the services they provide are so harmful that the entire field needs to be outlawed is entirely without merit. I am not a psychiatrist and I do not prescribe medication, but I have seen time and time and again how psychiatric medication does help many people. Sometimes, it’s a lifesaver. Tom, you are the one who is misinformed.

Of course some people are overmedicated, but this is not a problem unique to psychiatry. I just saw a patient on a rehabilitation unit last week who was on over 20 medications. So should we ban rehabilitation medicine too, Tom? And by the way, psychiatrists are NOT the physicians who are prescribing most psychiatric medications. Most people get anti-depressants, anti-anxiety medications, and stimulants for attention deficit disorder from general practice physicians or family practitioners. So should we ban those medical fields too?

People die from medication-related side effects every day. That’s not to say it is right or acceptable, but once again, it is not a problem unique to psychiatry. But for some reason, Tom Cruise has chosen to single out one particular field and attack it relentlessly. So we must ask ourselves why that would be. Well, Tom Cruise is a scientologist and his religion has been assailing psychiatry for decades. Some scientology books even refer to psychiatry as a “Nazi science.” This article is not written to attack scientology, but someone needs to put Tom’s comments into perspective.

I am the first to admit that psychiatry has a checkered past due to how inpatients were mistreated in asylums and given lobotomies and shock treatments when much more humane treatments would have sufficed. But that was the past. It’s not the present. Shock treatment is rarely used today and is reserved for patients whom all other treatments have failed, such as severe depression or severe obsessive compulsive disorder. Not only is shock treatment rarely used today, but when it is used, it is done under very controlled circumstances and is far safer than the past.

The idea Tom Cruise is creating is that psychiatrists these days run around strapping people into electric chairs and shocking them against their will. Does anyone really believe that? Incidentally, patients that receive shock treatment are advised in detail about the procedure and need to sign informed consent forms before the procedure is used. Tom Cruise frequently refers to psychiatric medication as anti-psychotics, when in reality, they are only one type of psychiatric medication reserved specifically for patients who are psychotic (those who have impaired reality testing, such as hearing voices). Most psychiatric medications prescribed in the U.S. are anti-depressants or anti-anxiety medications and are not classified as antipsychotics. These are facts. Tom, you are the one who is misinformed.

Tom Cruise has backed up his Nazi-psychiatry comments by stating that the famous Swiss psychiatrist, Carl Jung (1875-1961), was a Nazi sympathizer. While it is true that Carl Jung was interested in the Nazi movement in terms of studying his theories of human behavior (i.e., the collective unconscious), he clearly rejected the gruesome aspects of the Nazi movement when they came to light. In fact, Jung’s anti-Nazi and anti-Hitler views were so clearly stated that he was placed on the Nazi blacklist and his comments were suppressed in Germany. Tom Cruise stated numerous times to Matt Lauer on the Today Show that he knows the history of psychiatry and that others are misinformed about the matter. Tom, you are the one who is misinformed.

Tom Cruise tried to make another Nazi-psychiatry link by saying that the drug methadone (which is used to treat heroin addictions) was originally named Adolophine, after Adolf Hitler. Well, according to the Dictionary of Drugs and Medicine, the drug’s original name was actually dolophine (not adolophine), which comes from the Latin word “dolor” for pain and “fin” for end or finish. Tom, you are the one who is misinformed.

Tom Cruise has also said psychiatry is a pseudoscience and that it is not based on research. There are numerous scientific journals strictly dedicated to rigorous psychiatric research. So once again Tom, you are the one who is misinformed. I can go on and on, but I think I have proven my point and helped you understand the motivation of the messenger.

Let me end by saying that Tom Cruise is not misinformed when he says shock treatments and medications do not get to the root of the problem as to why someone is depressed, anxious, etc. They treat the symptoms. Psychotherapy (i.e., talk therapy) helps get at the root of the probelms. Time and time and again, research has shown that the combination of medication and psychotherapy is more effective than either treatment alone. I am all for getting people off of medications if they do not need it and advocate trying non-medication treatments first, if possible. But there is a proper way to discuss these things, Tom, and making outlandish accusations against decent people and acting like a know-it-all is not the way to go about it.

Humanizing the patient

If a family member of yours is admitted to the hospital, it is crucial that some relatives stay in regular contact with the physician and medical staff. I have seen time and time again that the quality of patient care improves when the patient has someone present to advocate for their best interests. It is important to ask questions, make sure your family member is receiving the correct amount of medication, that he/she is getting fed on time, etc. I am not saying patients without good social support are neglected, but quality of care certainly rises when the patient has a strong advocate.

No matter where I have worked, I hear patients referred to by medical staff only as "the patient." Often their room number becomes a substitute for his/her name. For example, Mr. Smith becomes known as "256" (his room number). This sometimes dehumanizes the patient. Instead of being thought of as a person, they may be seen as a number.

I saw a family do a very interesting thing the other day to counteract this. They created a huge display on a giant piece of oaktag, which had the patient's name written in large print in the middle with a message below reading "Please take a minute to learn a bit about John Smith." The display had pictures from his childhood to graduation to marriage and to recent times. Pictures of his family included brief descriptive captions and there was another narrative section summarizing the person's life.

What a terrific idea! You can't help but read the display and once you do, you learn that "256" isn't just another body in a hospital bed. I encourage more families to make such collages. Besides filling people in on your loved one's life, it lets staff know that family is present and actively involved in the person's care.

Welcome to the MedFriendly Blog

Well, here it is. The first official MedFriendly blog posting. The formation of this blog is another stage of progress in the history of MedFriendly, which will be four years old in October. As the founder and webmaster of MedFriendly, I have been amazed at the impact this site has had on the lives of average people searching for medical information in an easy to understand format. This will always be the main focus at MedFriendly, but I also strive to provide readers with other forms of useful information, such as our useful links section, U.S. Hospital Index, the Doctors Index, MedFriendly measurements section, and MedFriendly message board.

So what the heck is the MedFriendly blog going to be about you ask? Good question. My initial plan is for this to be an informal area where I will inform people about what is like to work in a medical setting, how to get you or your family members good care in the hopsital, and miscellaneous daily musings and opinions. Some opinions you will agree with. Some you will not. Feel free to post your responses to any of my blog posts. I look forward to your contributions and expect the scope of this blog to expand in scope in the coming months. With that, it is time to call it a night. See you tomorrow.