How To Prevent Unusual Hazards in 2007
14 Dec 2006
Of course you all know how to keep healthy this year. Keep active, eat healthy foods, don’t smoke, drink alcohol moderately, have regular medical, dental and eye checkups, buy a bathroom scale so there’s no burying your head in the sand about obesity, etc, etc, etc. But here are some precautions you may not have considered.
Are you scheduled for surgery in 2007? If so, there’s a sure way to circumvent a horrendous surgical error. We’ve all heard stories about surgeons amputating the wrong leg. Or fixing a hernia on the side that didn’t need it and neglecting the one that did. If you think this is past history, you had better think again.
The Canadian Medical Protective Association (CMPA) says that in spite of a decade of preaching preventive measures to avoid wrong-site surgery, about 10 cases occur every year in Canada.
During the period from 1995 to 2005 wrong-site surgery happened 106 times. Each year 6.3 cases involved a lower extremity and 4.3 the upper limb. The most common error was carrying out arthroscopy (looking into the joint with an optical instrument) on the wrong joint. This misfortune happened to 24 patients.
CMPA reports at least one case of a total knee replacement of the wrong knee! Hand and foot cases usually involved the wrong hand or an incorrect toe.
One would wonder how these errors could ever happen. It was primarily a failure of common sense. In some instances the patient was anesthetized, the extremity prepared and draped before the patient was even seen by the surgeon.
In other situations the extremity that supposedly required surgery was marked by someone other than the operating surgeon. Or medical records and X-rays were not available in the operating room. In effect, hospital policy was rarely followed, or not at all.
To help prevent this problem some hospitals have initiated a "timeout" before the incision is made. This gives everyone a moment to reflect on whether all the I’s have been dotted and all the T’s crossed before proceeding.
But what can patients do to prevent wrong-site surgery? Dr. Claude Martin, a Physician Risk Manager with the CMPA says that the Canadian Orthopedic Association optimistically pioneered a fool-proof method. Surgeons were required to initial the extremity that requires the surgery. Obviously this was not always done. So if there’s no initial on your operative site before you are wheeled to the operating room, demand that the surgeon place his initial on the right extremity while you’re still awake.
Dr. Richard Beasley, a professor at the Medical Research Institute of New Zealand, has a wakeup call for computer users. The "economy class syndrome" that triggers fatal blood clots on long distance flights is starting to strike computer users.
He reports that a 32 year old man was spending up to 12 hours at the computer and rarely stood up. He was healthy with no cardiovascular risk factors. But at one point he complained of a swollen calf which subsided after 10 days. During the next four weeks he had trouble breathing and finally collapsed when a blood clot broke off and traveled to his lungs. He luckily recovered from "computer embolism" with the use of blood-thinning drugs.
Another researcher, Dr.Stephen Moll at the University of North Carolina, says he has seen similar cases and they all resulted from immobility for long periods of time.
Ships collect barnacles from immobility and humans collect rust in arteries. For instance, it was well known during World War II that Londoners spent hours in cramped quarters in the underground subways. And some died from "subway embolism".
Dr. Benjamin Brennen, a researcher at Rambam Medical Center in Haifa, Israel, says the popular view is that Jesus died from blood loss and asphyxiation. He speculates that his death it was ultimately the result of a blood clot.
So what’s the message? It’s prudent to figit often while working at the computer. Move your legs, wiggle the toes and above all else get up and walk around frequently. You may even get a great idea while doing so.
But also remember during 2007 to eat well, drink moderately etc, etc, etc.
