Tuesday, November 29, 2011

Tip #7: Know Your Doctors: A Short Guide to Hierarchy! ~ More Insider Tips on How to Get the BEST Medical Care in the Hospital ~

Who are all these people who introduce themselves as doctors in the hospital?  Here is a short guide to what each title means:  

Attendings:  These are the most senior physicians.  In a teaching hospital they are in charge of the fellows, residents, interns, "observers" & medical students. 
  • All of the junior physicians are operating under this doctor's license as most of the fellows/residents/interns have their MD or DO but do not have their license.  Therefore the attending tends to oversea the teams work to make sure it is safe & also spends a lot of time using patients to teach the junior physicians.  
  • You will not see the attending physician very often except usually briefly on morning rounds with the whole team.  
  • They tend to not be aggressively involved in patients care because they want to train the fellows & residents to make independent clinical decisions under their oversight. 
  • The attending often only knows what the resident presents to the team--so make sure that your resident gets all the details on your condition so they can present your case as accurately as possible to get the BEST guidance (and the BEST care for you!)  That said, when the attending rounds in your room in the morning & you don't hear him or her mention your most concerning issue than absolutely bring it up--it may not have gotten included in the resident's presentation.
  •  In the operating room, the attending usually either does the most challenging part of a procedure or carefully oversees the fellow/resident's surgeries & the PAs/NPs.
Fellows:  These are M.D.'s or D.O.'s who have completed their residency & are now going for an additional level of training in a very specialized area. 
  • For example, in my field, when you finish residency you can become a "board certified Physical Medicine & Rehabilitation" doctor.  But if you want to do interventional pain, then you need to do an accredited fellowship to become "Board-Certified" in Pain!
  • Most of them are licensed in the state they practice in.
Residents:  These are the people most involved in your daily care.  They are junior physicians, M.D.'s & D.O's at approximately 2-6 years out of medical school. Their job is to learn to be an independent clinician.
  • The attending physician is usually a hands off supervisor unless safety is involved.  This is to try to teach them as much independent clinical decision making as possible.
  • They are often the closest line to the attending physician but more importantly, these people are responsible for managing all your daily orders, your admission, your discharge & your medications. If they have interns under them, than they supervise the intern's executions of these activities.
  • They usually lead a team of interns and other junior residents (if they are past 2nd year). 
  • At night they will often be totally on their own at the hospital--no senior physician is in-house.  They can call the attending if a major crisis occurs but this is relatively rare.
  • They generally RUN the codes (when a person has a cardiac arrest or is found unresponsive, etc
  • They are on call frequently (this means that they spent the night in a small bed in the hospital & may or may not have gotten any sleep depending on the specialty)  and may seem quite tired.  Be patient with them when this appears to be the case.
Interns:  First year doctors.  The worker bees.  Their job is to do all the paperwork associated with your admission & discharge:  orders, prescriptions, etc. AND simultaneously be learning as much as possible.
  • They will usually be the ones to write your admission note, your daily progress notes and your discharge summary.  
  • They will usually be the first person to your bed in a crisis or code.  
  • They are generally awake all night long when they are on call & take turns covering nearly all the patients in the hospital. 
  • They will be the first person you see in the morning & the last person you see at night.  
Medical Students:  These are "doctors-in-training" and should introduce themselves as such even if the staff addresses them as doctor (as I was addressed during my training).  
  • They will usually manage the daily notes for 1-5 patients under the supervision of the resident & intern.  
  • They should NEVER be the only person who examines you daily and if this happens, make SURE that the resident & intern & even the attending know that the student is being allowed or told to operate independently as if they are a doctor.  
  • Third year medical students are in their first year of clinical exposure.  
  • Fourth year medical students are in their last year of training & should be preparing for intern-level responsibilities.
Ok! That should be everyone!  Hope this helps!


Coming Up on Next Week's Medical System Tuesday
  • Tip #8 For The Best Hospital Care:  Be Nice ~ Insider Tips on How to Get the BEST Medical Care in the Hospital ~ 

Coming Up THIS Week!
  • SuperImmunity Foods for KIDS (Calling All PARENTS!)
  • RECIPES & Ideas: Snacks!  YUMMY & Portable Plant-Based Snack Food--all sugar-free, gluten-free & without adding oil or fat!!

The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. The Happy Rehab Doc expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.  By visiting this site you agree to the foregoing terms and conditions.

Monday, November 28, 2011

MONDAY MEDITATIONS FOR HEALING: A Commitment to Self for Caregivers & A Work In Progress

Good Morning!  Here is today's meditation to inspire your spirit to self-healing this week!  Have a WONDERFUL week!

Today's Quote 

Today, I ask my Higher Power for the ability to accept and love myself for where I am today.

Help me remind myself that I am a work in progress

Like a tree that grows from self-care and nurturing, 
I will only grow if I'm gentle with myself.

A Commitment to Self for Caregivers 
(whether you are a healthcare provider or a family member caring for a loved one):

This week I will remind myself that there is no "perfect" way to care for someone.

 Perfection is impossible, just doing our best for today is enough.


Sunday, November 27, 2011

RECIPES: What the Happy Nurse & I Are Eating THIS Week!:-)

The Healthy Librarian's version of Robin Robertson's
Sweet Potato-Spinach-Roasted Tomato-Peanut Soup
This week is going to be particularly awesome because we will have food in the house!! Between work on the Spinal Cord Injury unit and visiting my dear family member every night at the hospital, the last two weeks have been a lot of eating take-out.  If I see the name Pei Wei again I think I actually might be ill!  


Anyways, thanks to a four day weekend I've had some time to plan to do a little cooking!  This is pretty much the FIRST Thankgiving in YEARS that I haven't been working!!!  Hooray!!  Of course my hubby, the Happy Nurse, did work Thanksgiving but he has this weekend off too so yay!!  And, best news ever, my family member is out of the hospital and tucked in at home in good health & spirits :-)


So this week we'll be eating (and I'm planning for us to cook enough for the next 2-3 weeks so thats why there is a multitude!):  
 Barley Soup, TJ's 17 Bean & Barley Soup & Aztec Corn Soup
in our NEW 3-in-1 Slow Cooker!!


Soups [all freeze well, and with our NEW 3-in-1 slow cooker (only $35 at Walmart!), SO easy to make multiple soups at the same time!!]


1)  The Healthy Librarian's version of Robin Robertson's Sweet Potato, Spinach, Fire-Roasted Tomatoes, and a Bit of Peanut Butter Soup
2)  The Happy Herbivore's Aztec Corn Soup from The Happy Herbivore Cookbook
3)  17 Bean & Barley Soup with dried beans mix from Trader Joe's (Recipe on the package & on a website I found via Google!)
4) Barley Soup (my own basic recipe--vegetable broth, barley, garlic, oregano, basil, salt & pepper)


Sandwich fillers & Sandwiches:
1) Curried Bean Dip from Susan O'Brien's Cookbook: The Gluten-Free Vegan
2) Artichoke-Bean Dip from Ann Esselstyn (Prevent & Reverse Heart Disease)
3) Kale & Lemon Sandwiches by Ann Esselstyn on The Healthy Librarian


Main Courses:
1) Enlighted Big Vegn's Creamy Triple Mushroom Fettucine (without the gluten Seitan)
2) Steak & Pepper Fajitas (The Happy Herbivore Cookbook)
3)  Tempeh Joes (The Happy Herbivore Cookbook)
4)  Hawaiian Chickpea Teriyaki (The Happy Herbivore Cookbook)
5)  Portobello Steaks (The Happy Herbivore Cookbook)


Sides:
1) Mashed Potatoes (potatoes, oak milk, salt & pepper)
2)  Frozen veggies (Thank You Trader Joes)!
YUMYUMYUM!!

Coming Up THIS WEEK:
  • SuperImmunity Foods for KIDS (Calling All PARENTS!)
  • RECIPES & Ideas: Snacks!  YUMMY & Portable Plant-Based Snack Food--all sugar-free, gluten-free & without adding oil or fat!!
Next Time on Medical System Tuesdays (new feature on the blog):
  • Tip #7:  Know Your Doctors: A Short Guide to Hierarchy! ~ More Insider Tips on How to Get the BEST Medical Care in the Hospital ~
The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. The Happy Rehab Doc expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.  By visiting this site you agree to the foregoing terms and conditions.

Saturday, November 26, 2011

Tip #6: Know the Role That Each Person Plays In The Hospital Team (quick cheat sheet) ~ Insider Tips on How to Get the BEST Medical Care in the Hospital ~

Who are all those people working in the hospital & what do they do?? 
Continuing our journey into the foreign land of the hospital, lets meet the team...
  • Nurse:  Your tour guide.  Responsible for your day to day care. Manages meds, personal care, intake & output & executes doctors orders.  Eases patient's anxiety and deals with overwhelmed (and often emotional, highly stressed) families. Have the most comprehensive view of the patient's condition & can usually make or break a patient's progress.  Their insights are extremely valuable.  Most are very intelligent, highly educated or experienced and have the patient's best interests at heart. Some are not and do not (but I've found these folks to be few & far between).  There are a lot of different kinds of nurses:  RN, LPN (LVN), APN(NP)) and I'll devote a guest post to my husband (THE HAPPY NURSE) to explain all of these sub-types and specialties but on the floor you will usually see either RN's or LPNs/LVNs. A good medical team always takes nurses' assessments into account with great weight when making any patient care decisions.  I do not recommend being rude to your nurse.  Please treat them with the respect they deserve.  Frequently understaffed.
  • Tech:  Your helping hand.  Responsible for a long laundry list of tasks including: recording vitals, running EKG's, assisting nurses in complex tasks (i.e. wound care, etc), helping you to the restroom, helping with your grooming/bathing/dressing & managing your transfers (moving from the chair to the bed, etc) so you won't fall.  Also many times get stuck running patient's errands.  Be very nice to them.  They are not your servants. Also frequently understaffed.
  • Social Worker:  Your tour management company.  Responsible for coordinating your admission and discharge.  Arranges home services, equipment, transportation and plugs you into community, government resources.  Tracks down absent family members to assist with your care upon discharge & obtain data on your advanced directives, insurance, etc if you are unable to do so.  Manages the majority of communications with your family as a whole.  Directs "family meetings" about end-of-life issues & your care plan.  Overworked, underpaid and usually extremely nice people.
  • Physical Therapist (PT):  Your Coach.  The key to your physical independence.  Their job is to help you walk again, get you strong, and push you to become as independent as possible. They are experts in the appropriate exercises for each specific surgery, illness or injury.  They generally tailor your program to return to or exceed your pre-hospital activity level upon discharge or after home/outpatient care.  They focus primarily on training the lower body and OT usually focusses on the upper body, but there is overlap. These people are extremely nice and motivated.  I have yet to meet a PT (or OT for that matter) that I don't like.
  • Occupational Therapist (OT): Your ADL guru.  In rehab, the term "ADLs" refers to "Activities of Daily Living" and OT's are the experts in these.  Eating, bathing, dressing and toileting are the basics, but their skills range to helping physically replicate your daily routine (i.e. cooking, laundry, etc) to allow you to function as independently as possible at home.  They are extremely innovative in providing you with adaptive devices that can allow you to function independently--from splints to "reachers."  Once again, nicest people ever!
  • Speech-Language Pathologists: Your Translator. Most of you will not meet these therapists but if you have trouble swallowing, speaking or processing language (like after a stroke), these people will be your best friend.  They are exceptionally well-trained and patient.  They do things ranging from the extremely technical (modified barium swallows and FEES to determine the quality of your ability to swallow) to the physical (speech & swallow exercises).  They also do cognitive assessments in patients with suspected dementia or brain injury.  Once again, like all the other therapists--I have found them to be VERY kind.
  • Nurse Pracitioners & Physician's Assistants:  Your Doctor's Point Person.  Depending on what state you are in, responsibilities & level of independence of NP's and PA's varies.  Detailing the differences between each & their training is going to have to be a future independent post as it is very complicated to describe each one's scope of practice.  For your purpose's know that they are the DIRECT line to your doctor.  They often have more experience than the doctor they work with and can offer you very important information.  They will manage your day to day care in the hospital if the doc doesn't have any residents (and sometimes even when the doc does!). If they are a surgeon's PA or NP they are often in the OR with the Doc assisting in the surgery as well.
  • Doctors: Your Team Leader:  I'm going to devote a whole post this week to doctors.  For now know that the different categories of doctors include:
    • Attendings
    • Fellows
    • Residents
    • Interns
    • Medical Students
    • Dietician:  Your secret weapon. Obviously I'm a huge fan of anyone whose job revolves around helping my patients become nutritionally healthy.  The dietician does nutritional assessments, makes recommendations to the team on how to nutritionally optimize your ability to heal and can intercede on your behalf to improve your meal choices & content.  Once again, very nice, very smart people.
    Other people you will see who are not involved in DIRECT clinical patient care include:
    • Administrative Assistant for the Unit (also known as the Unit Secretary depending on the hospital):  This person has a crazy intense job.  They answer phones & patient call lights & communicate needs to nursing staff.  They organize all the massive paperwork in everyone's charts.  In hospitals without electronic medical records, they enter all the orders.  They administratively admit & discharge patients--serving as a hub for coordinating all the services on the floor--from housekeeping to transport to maintenance.  I'm sure I've missed a bunch of stuff but you get the gist.    
    • Housekeepers:  Big job, small time frame.  These folks have to clean and sanitize rooms between patients (very time-pressured turn around) AND make sure patient rooms are kept hygienic.  They deal with contaminated trash & are responsible for managing all that laundry you see everywhere! A key role in minimizing hospital infectious diseases. Without them, all those MRSA and VRE patient rooms would spread disease from one patient to another. A lot of work, very underappreciated.
    • Dietary Staff:  manage your food--from ordering to delivering.  You see these folks three times a day and often their sunny moods (or lack thereof) really sets the tone for the day.  They have to keep food hot through long distances and make sure that each patient gets the right food (key--we don't want the kosher patient eating pork, etc!).  A busy job!
    {NOTE:  I know the above descriptions do not NEARLY capture the full extent of the responsibilities in each position!  I just tried to hit the highlights!!}

    Next Time on Medical System Tuesdays (new feature on the blog):

    • Tip #7:  Know Your Doctors: A Short Guide to Hierarchy! ~ More Insider Tips on How to Get the BEST Medical Care in the Hospital ~

    Coming Up THIS Week!

    • SuperImmunity Foods for KIDS (Calling All PARENTS!)
    • RECIPES & Ideas: Snacks!  YUMMY & Portable Plant-Based Snack Food--all sugar-free, gluten-free & without adding oil or fat!!
    The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. The Happy Rehab Doc expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.  By visiting this site you agree to the foregoing terms and conditions.


    Friday, November 25, 2011

    NEW Design!!

    Okay!  Here is a NEW design for the blog!!   After getting a few comments about folks having difficulty reading the white text on black (and then a comment from my sister about how the black background "was not happy"), I decided to change things around!  

    Please let me know what you think!  I hope that it is easier to read and "happier!":-)

    Thursday, November 24, 2011

    Gratitude...:-) Happy American Thanksgiving!!

    "If the only prayer you said in your whole life was, "Thank you," that would suffice." ~Meister Eckhart


    Today and everyday I'm reminded of the unbelievable multitude of blessings in my life.


    I've learned through OA that there is nothing like a gratitude list to take me away from my own self-obsession (whether it is self-critique, self pity or self righteousness) and turn my thoughts to others.....Funny thing. Finding the things to be grateful for makes it pretty hard for negative thoughts to creep into my head!!  Sharing my gratitude list with the people I'm grateful for is even more powerful!


    Today I think I'll make a commitment for the next year: Thanksgiving to Thanksgiving to list five things that I am grateful for EVERY day:-). Then I'm going to pick one or two of the people on that list and tell them the next day why they were on the list and what they've brought to my life.


    Why don't you join me this year and commit to finding five things to be grateful for everyday? Then have the courage to share your feelings with someone on that list?


    An attitude of gratitude might just change everything....if you don't believe me check out this NY Times ArticleOr check out one of my favorite bloggers, The Healthy Librarian's take on the subject!


    This might be our best year yet!!:-)  Thank you one and all!!


    And to my wonderful husband, the Happy Nurse, in case I haven't told you enough: EVERY single day I am SO grateful for the blessing of having you in my life and being your wife:-)

    Wednesday, November 23, 2011

    RECIPES: Thanksgiving Ideas for Plant-Based Folks Like Me!

    Ok so if you are like me and are JUST starting to figure out what you are going to bring to Thanksgiving Dinner than this post is for YOU!!  I"m going to come back to my medical series after the holiday but for now its time for a favorite topic for a Compulsive Overeater like me....FOOODDDD!!!!:-)  Its nice to be able to laugh about that now :-)


    This is going to be my first Vegan Thanksgiving--and now that I think of it, it will be my first Thanksgiving being Gluten & Sugar Free too!! Ack!!  So in this post, I've turned to other bloggers to get some much-needed advice and ideas on what I can eat/bring to the family table!


    Totally Vegan:





    The Fat-Free Vegan's Thanksgiving Meatless Loaf  (a bunch of other bloggers are raving about this too!)


    New York Times: A Thanksgiving Feast, No Turkeys Allowed!


    New York Times: Well's Vegetarian Thanksgiving


    Vegan & GLUTEN & SUGAR FREE!!


    Vegan Pumpkin Bread (this recipe is from one of my favorite bloggers (Amy Green) that I've been following ever since I became sugar-free and gluten-free last spring!!  Her baking recipes are just amazing.  Check it out:  Simply Sugar and Gluten Free!)


    Vegan Peanut-Butter Cups!  (Ok we really don't keep peanut butter in the house anymore but maybe for a holiday....:-))


    Ok and now what I'm certain I'm bringing:

    1) Ann Esselstyn's Artichoke & Spring Onion Dip (from Prevent & Reverse Heart Disease by Dr. Caldwell Esselstyn (Amazon link) with my favorite non-oil, gluten-free, vegan crackers:  "Mary's Gone Crackers" Mary's Gone Crackers!!!
    2)  Herbivore's Brownies!! (made out of black beans!!  I'll let you know how they turn out!)

    ....The rest....we'll just see!!! 

    Next time:  Tip #6:  Know the Role That Each Person Plays In The Hospital Team ((Who ARE These Different People Taking Care of You & What DO They Do??!!))


    Coming Up AFTER Thanksgiving:
    • SuperImmunity Foods for KIDS (Calling All PARENTS!)
    • RECIPES & Ideas: Snacks!  YUMMY & Portable Plant-Based Snack Food--all sugar-free, gluten-free & without adding oil or fat!!
    The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. The Happy Rehab Doc expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.  By visiting this site you agree to the foregoing terms and conditions.

    Tuesday, November 22, 2011

    Tip #5: What is the Hospital Routine? (Insider Tips on How to Get the BEST Medical Care in the Hospital)

    Being in the hospital is literally like moving to a foreign country.  People eat & sleep at different times. There are all these people wandering around but you don't who they are or what they do.  A lot of the time it feels like everyone is speaking a foreign language.


    Tips #5 & #6 are your travel guide:  


    Tip #5:  Know the hospital routine:
    • Nurses & Techs usually change shift at 7 am & 7 pm.  If you want ANYTHING (especially pain medication) ask for it BEFORE 6pm or 6am.  Do not expect to have any response to requests between 6:45pm-8pm or 6:45am-8am unless it is an emergency & you are seriously ill.  Family members & patients:  do not ask to talk to a nurse during this time frame.  Why? They are giving report to the next nurse or tech.  If you want the next nurse to have ALL the important details about your family member or yourself than you should allow them to transfer care uninterrupted.  Your care on the next shift will be better!
    • Social Workers:  they usually work 8am to 4/5pm & are INCREDIBLY busy & overworked.  Most ones I know end up staying after the time they are supposed to leave.  If you want to meet with them, don't ask to do so after 3pm.  Ask early & it will happen.  Ask late & you may have to wait until the next day.
    • Physical & Occupational Therapists:  they usually work 7am-4pm.  They usually see their last patient at 3pm.  You will not be able to talk to them after this time & You probably won't ever have therapy after 3pm.  
    • Dietary Staff & the Kitchen:  They bring trays to patients at Breakfast (usually 6am-8am); Lunch (usually 11am-1pm) & Dinner (usually 5pm-6:30pm).  If you want snacks in between meals you will need to talk to the Dietician or the Nurse.  On the floor they usually have a few sodas, crackers, applesauce/pudding & juices.  Don't expect a big spread in between meals.
    • Doctors:  We usually sign-out our patients around 5pm to the person covering for the night.  This does not mean we leave then--I regularly work past 6pm--but what it does mean is that if you ask for your doctor after 5pm you usually won't get them (you will get the night person).  Ask before 4pm if it is urgent that you see them that afternoon.  But as noted above, if you have further questions that aren't answered in the a.m. rounds & are very important to be answered that day, ask the doctor in the morning if they have time to come back in the afternoon before they leave
    Next time:  Tip #6:  Know the Role That Each Person Plays In The Hospital Team ((Who ARE These Different People Taking Care of You & What DO They Do??!!))


    Coming Up AFTER Thanksgiving:
    • SuperImmunity Foods for KIDS (Calling All PARENTS!)
    • RECIPES & Ideas: Snacks!  YUMMY & Portable Plant-Based Snack Food--all sugar-free, gluten-free & without adding oil or fat!!
    The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. The Happy Rehab Doc expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.  By visiting this site you agree to the foregoing terms and conditions.

    Monday, November 21, 2011

    Tip #4: Key Things You Need to Know About Yourself To Tell The Docs: How to Make A Medical Info Sheet!! More Insider Tips on How to Get the BEST Medical Care in the Hospital

    Ok so today I'm going to talk about PREPARATION!  This is something REALLY important that you can do to immediately improve the level of care you receive from the moment you walk into the hospital!  


    We health care providers LOVE organized patients because your organization allows us to quickly get a full clinical picture of you--therefore giving us the opportunity to treat you more effectively & efficiently. 


    The other reason we LOVE having an organized, prepared patients is because it is very obvious from the beginning that you are OUR TEAMMATE!  By preparing your medical info sheet you indicate to us immediately that you are NOT a passive participant in your health care!  You are actively trying to understand what is going on in your body.  This bodes well for both your recovery & your survival of serious illness!


    So here we go...


    Tip #4:  Key Things to Know About Yourself: (I say "your" but this could apply to any of your family members)

    First, make a clearly written/typed sheet with your NAME & DATE OF BIRTH on it with all the following data:

    MAKING THE MEDICAL INFO SHEET:

    1)  Know your medications & keep them with you at ALL times on that clearly written/typed list:  

    •  names 
    • doses 
    • frequency 
    • when/why each one was started 
      • (i.e. I take Metoprolol 50mg twice daily.  Started in 1996 for High Blood Pressure) 
    • Include EVERY vitamin as well & things like Birth Control Pills & Metamucil, etc.  
    • If you don't know the answers to these questions, call your primary care doctor to clarify and/or have them "proof" your list.  
    • ONCE AGAIN:  PUT THIS INFORMATION ON A CLEARLY WRITTEN/TYPED LIST (The Medical Info Sheet) & TAKE IT WITH YOU EVERYWHERE! 
      • I like the idea of putting it folded up in a tiny ziploc bag in your wallet.)
    2)  Know Your Allergies--

    • including 
      • medications, 
      • foods, 
      • materials like latex
    • for EACH one write what the allergy looks like (what happens when you take it)
      •  (i.e. Penicillin:  Rash & trouble breathing, discovered in 1989)  
    • PUT THIS INFORMATION ON THE "MEDICAL INFO SHEET" ABOVE
    3)  Know Your Past Medical History: Including:

    • current medical conditions that your doctor is treating you for 
    • surgeries & 
    • past hospitalizations WITH dates!  
    • if you are a cancer patient or have a history of cancer, write out what treatment you received or are receiving & when 
      • i.e. I have breast cancer.  I have had a mastectomy, finished 3 cycles of chemotherapy & am now on the 2nd week of radiation therapy
    • PUT THIS INFORMATION WRITTEN/TYPED ON THE MEDICAL INFO SHEET & TAKE IT WITH YOU EVERYWHERE! (keep this safe!)

    4)  Your Immunization History:  Every nurse you meet will ask you about this--just bring it with you WRITTEN DOWN ON THE MEDICAL INFO SHEET with the dates you got the shots.

    5)  Who your doctors are:  ON THE MEDICAL INFO SHEET list:

    • The name & number of your primary care doctor
    • The name & number of ANY specialist you are currently seeing & **why you see them**
    6)  MOST IMPORTANTLY: Your advanced directive telling us what to do if you get sick enough that you can't make your own decisions & you require things like life support, resuscitation etc.)  PUT THIS IN THE SAME LOCATION AS YOUR INFO SHEET ABOVE AND TAKE IT WITH YOU EVERYWHERE!!
    • EVERYONE needs one of these, and I mean EVERYONE
    • This will be one of the first questions you are asked--the admitting department usually asks it at first actually!
    • I don't care if you are 22 and in perfect health (there are always the risk of car accidents, etc) or if you are 95 and ill with a myriad of chronic illnesses:  YOU NEED ONE
    • I'm not sure of the legality of everything but at a minimum you should have your wishes written down with copies to all the key family members.  
    • If you want it to be legally binding you need to consult a lawyer (I am NOT one).  A power of attorney is a good idea too.
    • I'll write more about this in one of my Tuesday "Medical System" Posts
    ONE LAST POINT:   **if you are a caregiver of a family member or a spouse/daughter/son/mother/father than make sure you have every one of your family member's info sheets that you are responsible for.  If the patient is not able to speak for themselves, the medical team will turn to you.***  (The last thing you want is to be running over to their house to pick up their medications--usually by then the initial admitting orders will be in & the patient will be in their room on different meds!!)

    Hope this info helps!!



    Next Time:  Tips #5 & #6: What is the Hospital Routine & Who ARE These Different People Taking Care of You??

    Coming Up AFTER Thanksgiving:
    • SuperImmunity Foods for KIDS (Calling All PARENTS!)
    • RECIPES & Ideas: Snacks!  YUMMY & Portable Plant-Based Snack Food--all sugar-free, gluten-free & without adding oil or fat!!
    The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. The Happy Rehab Doc expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.  By visiting this site you agree to the foregoing terms and conditions.

    MONDAY MEDITATIONS FOR HEALING: A Commitment to Self for Caregivers & "My Symphony"

    Good morning!  I've decided to start a new tradition on the blog of posting "Meditations for Healing" every Monday morning.  I wanted to share these meditations because taking a few moments to myself for reflection everyday helps me maintain my sanity! Maybe by sharing these meditations with you all it will help me follow through on my commitments to healing myself!!


    These Monday Meditations for Healing will include a "commitment to self" for caregivers (whether you are a health care provider or a family member caring for a loved one!) &  an inspirational quote to reflect on for the week.


    A Commitment to Self for Caregivers:
    This week I will try to find 15 minutes of quiet time everyday.  I will sit alone, breath deeply & relax in the stillness of not having to do anything for anybody but myself for just one moment.  


    Today's Quote (a favorite of my Mom's):


    "To live content with small means; 
    to seek elegance rather than luxury, and refinement rather than fashion; 
    to be worthy, not respectable, and wealthy, not rich; 
    to study hard, think quietly, talk gently, act frankly; 
    to listen to stars and birds, to babes and sages, with open heart; 
    to bear all cheerfully, do all bravely, await occasions, hurry never. 
    In a word, to let the spiritual, unbidden and unconscious, grow up through the common. 

    This is to be my Symphony." 

    1. ~William Henry Channing

    I hope you have a WONDERFUL week!

    Sunday, November 20, 2011

    TIP #3: Key Question to Ask the Doctor in the Hospital (Part 2 of 5 on "How To Get The BEST Medical Care: Insider Tips From A Doc!")

    Today we are continuing in the series on my "insider" tips on how to get the best medical care in the hospital.  I hope that the last post on Tip #1: Be A Teammate & Tip #2: Be Concise & Organized made sense and was helpful to you!  


    Two of the biggest problems I found last week when being on the patient side of things was that non-medical people need to know:
    1.  what questions to ask to understand what is really going on (today's post)
    2. what things to tell the doctor about themselves to get the best care (BE PREPARED) (tomorrow's post!)

    Lets face it.  Some docs are not very good explaining things to patients in layman's terms.  Remember, we M.D.'s have spent so many years studying that we have become an expert in diseases rather than people. I think that things are getting better these days since more focus in our medical education has been on how to improve the doctor-patient relationship.  


    Until the doctor-patient relationship is perfected, my advice is to give your doctor a roadmap of questions so they can translate their often brilliant medical skills into layman's data for you to understand enough to be a true teammate for healing.  


    Ask us these questions (and follow my advice from the last post on being CONCISE & ORGANIZED to get the most out of each conversation with the doc.)  


    ************************************************************************
    The MOST important point is to always repeat back to the doctor what you think you understand AND write it down!!--I'll give you an example on how to do that at the end of this post.  Here we go!
    ************************************************************************


    Key Questions To Ask The Doctor:
                         
    #1:  If it isn't what you think it is, what else could it be?

    #2:  If this was your mother/your father/your child who would you send them to see?  (this was a key question for my family last week because we were in a hospital initially that I wasn't familiar with & my family member needed surgery.  I asked this question to the ER doc QUIETLY & he helped us find the BEST surgeon in the facility).

    #3:  When you say that "we have a good chance" what does that mean?  What percentage of patients survive or are cured with this procedure/treatment/etc? (SO important particularly when dealing with a terminal disease or a serious, life-threatening procedure)


    #4:  Why do you think this medication is necessary & what side effects does it have?  (piece of advice--many docs will discontinue some non-critical meds immediately if they anticipate or get push-back from the family (to avoid conflict.)  The meds may actually be very helpful--for example, stool softeners/laxatives/pain medications.  I encourage you to follow what they recommend after asking WHY).


    #6:  If you REALLY don't want to do something that the doctor recommends ask them SPECIFICALLY what the consequences of refusing the med or procedure will be and why they think it is important? 


    #7:  Here are a few more excellent questions from the Agency for Healthcare Research & Quality (AHRQ).  They call these the "Top Ten Questions to Ask Your Doctor". Some of these are more applicable in the outpatient setting but they are helpful!  Check them (and AHRQ) out!


    Example of Conversation that uses the "team" approach and helps the doc communicate better:  
    (I put this together using diseases from a reader's comments & my own experiences with patients--obviously this isn't what actually happened!)  
    Patient: Doc I was wondering if it isn't pneumonia than what else could it be?
    Doctor:  Well it could be any number of things but I do think it is pneumonia
    Patient:  Doc I know that you have years of experience, could you please give me the name of another disease that looks like pneumonia but isn't pneumonia?
    Doc:  Well it could be congestive heart failure, but I don't think that is likely.
    Patient (repeating back):  So what I hear you saying is that you think it is pneumonia but another disease that can look like this is congestive heart failure?
    Doc:  Yes, that is correct.
    Patient:  Hmmm well doc I think I forgot to mention that a few years back I saw a heart doctor that said my heart wasn't very good (the patient in this example doesn't have the proper written history I mention in Tip #4 (tomorrow's post).  As you can see, this info sheet would have helped them get a lot better care from the beginning)
    Doc:  Really, I didn't see that on your history?!
    Patient:  Yes, I'm sorry I forgot to mention that in the chaos of the emergency room
    Doc:  Well this changes things a bit.  Let me examine the other data knowing this new information and get back to you later this afternoon.
    Patient:  Great.  I really want to feel better and it doesn't seem like the treatment is working.  I appreciate you looking into this.


    Hope this is helpful!!


    Next Time:  Tip #4:  Key Things You Need to Know About Yourself To Tell The Docs:  How to Make A Medical Info Sheet!! 



    Coming Up AFTER Thanksgiving:
    • SuperImmunity Foods for KIDS (Calling All PARENTS!)
    • RECIPES & Ideas: Snacks!  YUMMY & Portable Plant-Based Snack Food--all sugar-free, gluten-free & without adding oil or fat!!
    The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment.  Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. The Happy Rehab Doc expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site.  By visiting this site you agree to the foregoing terms and conditions.
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