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Monday, November 29, 2010

70% don't know: Carl Flatley's story on sepsis

Watch this short video video, prepared by Carl Flatley, the founder and Chairman of the Sepsis Alliance.

Read another sepsis story, or see the Sepsis Alliance website.

Thursday, November 25, 2010

Which they can take to market: The Hunger Site

Today, on Thanksgiving, I'm thinking only about food, not about patient safety. You can get food to hungry people, for free, every day. The Hunger Site, at http://www.TheHungerSite.com, enrolls advertisers who will pay for food for a starving person, in exchange for the honor of showing their ad to you briefly on the website. You can click there as often as once a day. When you click, the money generated goes directly to Mercy Corps, Feeding America, and Millennium Promise.

Here's the story of how the aid reached Zainbon in the Aceh province of Indonesia:

Zainbon is a 37-year-old rice farmer with a black baseball cap perched atop her pink headscarf. Her husband mans a desk as a temporary, low-level bureaucrat in the district transportation office nearby, but still they struggle to find the rupiahs each month to get by. She pulls at her scarf, explaining how they stretch six or seven dollars a day across the needs of cooking staples, school fees, fuel and now, in the fall planting season, fertilizer and rice seed. A Mercy Corps survey in the area recently found staple food prices climbing between ten and twenty-five percent, on top of fuel prices that jumped forty percent earlier this year.

"This is hugely important for us — the staples are rising and the salary isn't keeping pace," Zainbon says. "What about others whose husbands are just farming? They're struggling even worse."

This worldwide crisis is striking an area just starting to find its feet again after a vicious cycle of calamity. For decades, a rural separatist conflict kept many farmers out of their rice fields and fruit plantations for fear that they would be caught in the crossfire. Then in 2004, the Asian tsunami sent a wall of water up to thirty feet deep and flattened everything in the area, including the entire village of Naga Umbang.

With the houses now rebuilt, the rice paddies cleared of debris and new water buffalo roaming the yards, villagers are now teaming with Mercy Corps to strengthen their rice farming techniques and improve crop yields. And with food prices bearing down on locals, it could't come at a better time.

"We need to modernize," Zainbon said through a translator. "We're already thinking about when Mercy Corps leaves here, and this transfer of knowledge is one way we can build independence. Money from an NGO would go quickly, but knowledge and technology sticks in your mind."

The improved techniques are aimed at boosting incomes. Typically most of the rice harvest in villages like this goes to feed families. But if farmers in Naga Umbang can grow more efficiently, they will begin to see surplus rice from the same backbreaking labor they currently put into the season. And they will hopefully have the resolve to plant a second crop each year, which they can take to market in nearby cities.

Advice: Please click on The Hunger Site's "Click Here to Give – It's Free" button today, and every day. The site is run by someone I know and trust.

Thanks to the Mercy Corps for providing this story, which is reprinted here.

Wednesday, November 24, 2010

I thought this was an odd response: A father’s intuition on misdiagnosis

John James' story:
Early in my son's failed diagnosis I told his lead cardiologist that I could get a previous electrocardiogram [which produces graphs of the heart's electrical activity over time] done a few months before my son's non-fatal collapse. That cardiologist wasn't interested in this previous EKG. Since I carried a small card in my wallet with my EKG, I thought this was an odd response from the cardiologist if he knew what he was doing. My intuition said I need to find another hospital for my son. Unfortunately, I did not follow my intuition and my son lost his life to incompetent medical care. The changes in my son's EKG would have pointed the way to the proper diagnosis, which was acquired long QT syndrome [a rare heart condition].

John James' Advice: If I could tell patients only one thing it would be to follow your intuition. If you think there is something wrong where you or a loved one is being diagnosed or treated then take charge, get a second opinion, or just get out.

Read a happier story about the role of a patient’s intuition in choosing medical treatment. Thanks to John James for this story.

Click here to get John’s book and e-newsletter subscription.

Tuesday, November 23, 2010

How cool is that?: the Personal Health Record

The administrative director of Patient Always First has an 88-year-old father who lives in another state. After a lengthy hospital stay about a year and a half ago, he returned to his home but was no longer able to live alone. Different aides come in to help him as well as a physical therapist who comes to see and work with him twice a week.

Before Betsy used the PatientAlways First Health Record (PFHR), she would ask her dad, “are you taking your medicines?” and he would always say “yes.” His aide would also say “yes, I give him what he needs.”

She decided to start a PFHR for him. She called his pharmacist and got a list of his medicines, and then she called her father’s doctor, and asked if these medicines were the ones he should be taking. (She faxed the list to the doctor’s office.)

(Doctors would be glad to check a list of medicines like this because, obviously, they want you on the medicines that they want you on.)

So imagine her surprise when she learned that her father was still taking several medicines that the doctor had discontinued and replaced with different prescriptions. The doctor had no way of knowing that his patient was still taking the old medications as well as the new ones. (A real-life scenario of “medications: just plain mix-ups.”) The pharmacy continued to fill all the re-ordered prescriptions, old and new, and because so many different people were coming to the house to help, the aides weren’t exactly sure what he was supposed to be taking. The doctor was able to recognize the errors and cross out the medications that were no longer to be given.

Betsy then put her dad’s correct medications into the PFHR, and added his diagnoses, allergies, important contacts, etc. as she remembered them and as she asked him to recall. She printed out a copy of the PFHR and it sits on top of the medicine box so that anyone coming in to help can just look at the list and know what medicines to give.

(Remember, just do it. From your memory, it’s going to be better than what your doctor has had time to organize.)

Then, since the PFHR has this really neat feature where you can let other people access the record, or add to it (only with your permission), she allowed the physical therapist who visits her dad to have access to add to the record. So now, when the physical therapist comes, he types the date, vital signs, and other information about her dad’s treatment and condition that day into the record. And Betsy can see all that information when she logs on.

So Betsy can have some peace about helping her father long-distance like this- she really is checking in and helping with his health.

And if her dad should need to go to the emergency room again, then his aide could bring the printed-out PFHR, or Betsy could fax it to the ER, or the ER could even access it online themselves (if Betsy or her father gives them the username and password.)

Now, how cool is that?

Advice to Sandwich Generation women who are caring for a distant parent:
Get a personal health record for them.

Read another personal health record story, or read Dr. Oliver’s blog.

Thanks to Dr. Cari Oliver for her permission to reprint this story from her book, “Cautious Care: A Guide for Patients.”