December 14th, 2007 by Dr. Val Jones in Humor, True Stories
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My sister Vicki lives in Grand Rapids, Michigan with her husband, three children and
an alarmingly large and slobbery Saint Bernard named Gilbert. Several Christmases ago she decided to teach her then 5 year old son, Harrison, about Christmas tree decorating. She took him to a Christmas tree farm and helped him select a tree. They hauled it back to the house and my sister managed, with no help whatsoever from Gilbert, to set it up in a nice corner of the living room. The tip of the tree reached the ceiling and its full figured branches spread from icy window to window.
Vicki and Harrison spent hours and hours winding lights, tinsel, ornaments, paper angels and popcorn strings around the tree. Little Harrison couldn’t wait to see the final product, with glittering lights and a magical star to top off their fine work. They decorated into the early evening, and the living room grew dark as the sun set over the snow covered neighborhood. At last it was time to plug in the tree lights.
As Vicki plugged in the lights for the first time, Gilbert roused himself from his resting place in front of the fireplace and shook off his drowsiness. Harrison held his breath in eager anticipation of the twinkling display that he had helped to create. My sister turned off all the overhead lights.
As the plug entered the outlet, the tree lit up with thousands of tiny glittering lights. Harrison
marveled at his glorious creation. “Mom, it’s the most beautiful tree in the world!”
My sister sat down on the couch and hugged her son tightly in her lap as they relaxed and enjoyed the view. Suddenly, Harrison’s eyes fixated on one of the branches.
“Mom… look! There’s an icicle on the tree!!”
My sister squinted and followed the direction of Harrison’s pointing finger.
Sure enough, there was a glassy, 5 inch long, icicle-appearing object perched in a tree branch in the middle of the tree.
Harrison’s raised his voice with glee: “Mom! It’s a Christmas MIRACLE!!”
The little boy broke free of his mom’s grasp and ran up to the tree to inspect the icicle at close range. As he reached out his hand to clasp it, his look of amazement turned to horror. The icicle was in fact a long
string of dog drool that had flicked off of Gilbert when he shook himself out of his sleep.
“Ewww!!!” Harrison screamed. My sister slowly realized what had happened and started laughing
uncontrollably. Gilbert wanted to get in on the fun and began barking and running in circles. He became tangled up in the extension cord and pulled the tree right out of the tree stand. At that moment, Vicki’s husband returned from shopping with the other 2 children. As he turned on the lights he found my sister
trapped under an unraveling Christmas tree, a hysterical child frantically wiping his hands on paper towel, and a barking, drooling Gilbert in the midst.
“What happened here?!” he shouted, attempting to rescue Vicki from underneath the tree.
“It’s a Christmas miracle” was her muffled cry.
And this story will be in our family for a long time to come.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
December 4th, 2007 by Dr. Val Jones in Medblogger Shout Outs, Opinion
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I have witnessed various disappointing doctor-patient interactions over the years. Sometimes the doctor is insensitive, other times he or she doesn’t listen to the patient – and errors can result. Young physicians are more prone to inappropriate patient and family interactions when they are feeling inadequate and insecure. A fellow blogger describes just this kind of problem with a young pediatrics resident:
A meek lady with a white lab coat
walks in and just starts asking medical questions. So
my answer to her first question was “Who are you?” She apologized and
said she was the pediatrics resident and asked a bunch of questions
that didn’t seem to us to have much bearing on the situation at hand.
We asked about why my son was making unusual gasping breaths ever since
he woke up and she said it was because he was crying. We said that he
was making these breaths before he started crying. She then said it was
probably hiccups. My wife, who is a registered nurse, said there was no
way it was hiccups because she felt him pressed against her body and
could tell. The resident then said that it was probably due to the
anesthesia. I could tell she was just giving that answer to say
something but really had no clue what was going on. So I challenged her
on it and said “Have you ever seen this after anesthesia before?” She
paused and said, “Maybe once.”
Although this is not the wost example of an unsatisfying doctor-patient interaction (read the rest of the post to get the full story), it is pretty typical for inexperienced physicians to “make up” explanations for symptoms or problems that they don’t understand. This can be dangerous or even life threatening if certain symptoms are ignored.So how do we protect ourselves against this kind of potential error? Sadly, the current quality assurance programs are rather ineffective. In his recent blog post about ensuring physician quality, Dr. Scalpel published a letter he recently received from his hospital. The letter was prepared as part of the Joint Commission quality assurance program. They actually require doctors to get a letter of recommendation from someone (who doesn’t work with them) to ensure that they’re practicing good medicine… It’s like asking a stranger to grade your work competence.
Dear Dr. Scalpel:
In
accordance with Joint Commission regulations, we are required to
request an evaluation of your clinical performance. The Credentialing
Committee now requires the completion of an evaluation form by a peer in your specialty who is not a member of your group practice.
Attached,
you will find a letter and accompanying evaluation form which you
should forward to a peer of your choice for completion. In order to
proceed with the processing of your reappointment application, it is
necessary that you ensure that the required evaluation form is
forwarded to a peer and returned to us in a timely manner. A return
envelope is provided for this purpose. Please note that the evaluation
form must be returned to us by the person completing the form. If we do
not receive the evaluation form before ________, your clinical
privileges may be interrupted.
Sincerely,
An Unnamed Bureaucrat
So, how do you ensure that you’re getting good medical care? It’s not easy, and you can’t necessarily depend on oversight committees to come up with sensible safeguards. Being an informed patient is part of being an empowered patient – you should do what you can to research your doctor’s and hospital’s credentials and reputation (you can do that right here with Revolution Health’s ratings tool), you should read about your diagnosis or condition on reputable websites like Revolution Health, and you should advocate for yourself or loved one at the hospital when necessary. You have the right to reasonable explanations for care decisions – and if you’re concerned about a symptom, you should ask about it.
Unfortunately, there’s no way to guarantee quality medical care. However, perhaps the most important thing you can do (besides advocate for yourself and become educated about your condition) is to develop a close relationship with a primary care physician. Establishing a medical home with a good primary care physician can go a long way towards helping you to navigate the system. They can be your best advocate in this broken system.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
November 16th, 2007 by Dr. Val Jones in Humor
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I had a special lunch event scheduled today, so I went to a stylist to give my hair a little more volume. (My hair is pin straight and rather fine, so it takes a fair amount of work to make it look substantially different than this.)
A coworker arrives in my office. He looks at me, tilts his head to one side and says,
“Have you been outside today? Your hair is usually very sleek, but today it’s really messy and ‘all over the place.'”
“Um, no, I actually paid someone to style my hair today. That’s what’s different.”
Blank stare.
New topic.
Dudes.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
November 14th, 2007 by Dr. Val Jones in News, Opinion
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“Grow old along with me! The best is yet to be, the last of life, for which the first was made.”
— Robert Browning
As a rehabilitation medicine specialist I do a lot of work with cognitively impaired men and women. The brain is a fragile and fascinating organ, and perhaps the most perplexing one to treat. Alzheimer’s disease, of course, has no known cure – and those who contract it meander through a frustrating cognitive web towards a final common pathway of dementia, dependence and eventually death.
Former Chief Justice Sandra Day O’Connor has been in the news lately because her husband, an Alzheimer’s patient who requires nursing home assistance for activities of daily living, has forgotten who she is. But even more emotionally difficult is the fact that he has fallen in love with a fellow nursing home resident, and has been behaving like a love-sick teen – holding hands, staring into her eyes and kissing her tenderly.
The New York Times reports that Ms. O’Connor is “happy for her husband” that he has found joy in the midst of his cognitive decline. I wonder if there truly isn’t part of her that mourns the loss of those kisses that were once for her.
My fondest hope is that I can grow old with my husband, and that we will enjoy our final years together, in possession of all our faculties. I hope that Robert Browning’s poem will ring true at the end, and that I never have to watch my husband forget who I am. Sadly, since my grandmother passed away from Alzheimer’s – I wonder if it will be my husband, and not me, who watches the other decline?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
October 15th, 2007 by Dr. Val Jones in News
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I was always taught that chlamydia (a bacterial sexually transmitted infection) could cause infertility in women but didn’t affect men at all. Now it seems that male fertility may also be affected by chlamydial infections.
New research from Spain suggests that chlamydia can damage sperm DNA as well as their swimming ability. In fact, DNA damage in sperm from men infected with chlamydia is 3 times higher than in uninfected sperm. Also, fertility rates my be reduced by as much as 73% in couples infected with chlamydia.
Fortunately for men, their new sperm (produced after antibiotic treatment for chlamydia) appears to be normal/unaffected. For women, the damage is permanent. The crafty chlamydia bacteria crawl up into the fallopian tubes and create such an inflammatory reaction that the tubes are often scarred for life. Eggs released by the ovaries may be blocked from entering the uterus from narrowed and scarred fallopian tubes. This is why one chlamydial infection can put a woman at increased risk for ectopic pregnancy, miscarriage, infertility, and chronic pelvic pain.
It is estimated that as many as 1 in 10 people ages 18-25 are actively infected with chlamydia (in the US and Britain). The treatment can be as simple as one dose of oral antibiotics (1g of Azithromycin). Since chlamydia can be asymptomatic in men and women, and hard to diagnose in men in particular – I personally would recommend having both partners take a dose of Azithromycin before having unprotected sex in a monogamous relationship. Obviously, it’s always far better to have protected sex – but since 1 in 10 people have this infection, it seems pretty clear that people are not using condoms all the time. If you want to preserve your fertility – be vigilant about this infection. The good news here is that it’s easy to treat and can be prevented.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
