Imagine the electric thrill your doctor gets when as a patient you tell him, “Doctor, you’re a life-saver!” And he was! He ordered the medicine that brought you out of congestive failure.
Now, imagine the bolt of lightning that sears your brain when you realize that the treatment your doctor ordered almost cost you your life. In teaching institutions and large corporative HMOs this happens more than they care to admit. Here Are 2 Medical Disasters You Can Avoid If Follow My Tips & If You Ask the Right Questions:Medical Disaster 1: A simple knee operation ending in amputation
D.W was a 63-year-old woman was in scorching pain with an arthritic right knee. So, she saw the new surgeon in town who seemed like a very nice, educable and competent surgeon.
The surgeon suggested a total knee replacement. “You’ll be good as new!” he reassured her. Yet, the severe pain and swelling after the surgery still prohibited her from regaining normal range of motion.
After three months her knee was so stiff the surgeon performed a “manipulation under anesthesia” to break up scar tissue. It didn’t work.
At six months post operative another surgeon told her, “Your surgeon is a very nice man, but he is brand new in practice and the prosthesis was not put in correctly.” He recommended a revision. During the revision the patellar tendon ripped off the tibia, and the new surgeon reattached it with a bone screw. Later, the wound popped open and the screw head stuck out of the wound. The knee became infected. Now she is facing an amputation.By asking these 4 questions, you can avoid this easily preventable medical disaster:
1. How many operations of this nature have you performed?
2. What can go wrong and what will you do to prevent it from happening?
3. What other forms of treatment are there?
4. Who would you go to, outside of your own office, if you needed this treatment?” Get a second opinion.Medical Disaster #2: A gall bladder surgery that almost cost a patient’s life
J.M. was a 55 year old suffering every day with chronically infected gall bladder. His internist referred him to the teaching institution and medical center due to serious scar tissue around the gall bladder making a laparotomy and excision of the gall bladder necessary.
In the beginning, J.M. was really pleased with the team of residents and medical students who would be taking care of him. He liked his attending surgeon who was very prominent in his field, and he was reassured when the surgeon greeted him in the operation room the next morning.
During surgery the attending opened up the abdomen, and then let the chief resident take over the removal of the scarred gall bladder while he left to make phone calls. The attending poked his head back into the room to make sure everything was okay, and then left.
As the surgery went well, the chief resident then gave the closure to the first year resident so he can go see consults. The first year resident used this opportunity to let the medical students practice tying square knots during the closure.
That night the floor nurse called the resident to help manage severe pain. He ordered IV Toradol, which is usually very effective. But he forgot the medical student’s history and physical of the patient, which he’d signed-off on. This report indicated that J.M. was allergic to aspirin – similar to Toradol.
The next morning J.M. had hiccoughs and the lower part of the wound closure started to pop open. An X-ray of the abdomen showed free air where a perforated ulcer had occurred in the stomach due to the Toradol. But that’s not even the worst part.
JJ.M started to vomit blood and go into shock. He was then rushed back into surgery where a successful hemi-gastrectomy was performed. This time the attending stayed and closed the entire wound himself.Here are my top 4 tips to help you avoid this medical disaster:
1. Always ask, “Doctor, are you personally going to perform my surgery, and will you be there until the end of the operation?”
2. Be aware that when you are in a teaching institution, someone is going to be learning on you.
3. Actively engaged yourself in your care. Be questioning, not confrontational. Ask what medicines you are being given and know your allergies.
4. Ask, “Doctor, have you practiced in other cities before coming here?” A doctor that moves a lot is a “red flag.”
These eight principles or questions can help you avoid the above medical disasters and many others described in my new book, Death on the Learning Curve”. Knowing them will empower you receive the best care possible when treatment is necessary.
By Dr. Pierce Scranton
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