Tuesday, February 09, 2016

Know your anesthesiologist

I read an article the other day that said many visits to the gastroenterologist before a colonoscopy are not necessary--and I commented that I would rather visit with the anesthesiologist.

If you have had surgery, you know that often the one and only time you will see this person--who may even be breathing for you--is right before surgery and only for a couple of minutes.

The American Society of Anesthesiologists recommends that especially with an older patient or child, the patient needs to work closely with this doctor (or nurse-anesthesiologist).

Patients need to know what will happen and what will be done to make the experience as comfortable as possible for them.

People fear anesthetic--I know I do.

You need to make sure the anesthesiologist knows the following--not lie there passively listening as he or she jokes about the "cocktail" you will get.

--Past medical conditions--allergies, asthma, sleep apnea foremost.

--Medications you are taking or maybe just stopped because of the surgery. Ibuprofen, aspirin, St Johns Wort--many things can complicate a surgery.

--Smoking. Stopping even a few days before surgery can make a big difference.

--Problems with anesthesia in the past? Tell all.

Being older can make you a candidate for post-operative delirium. This can make you confused or unable to listen to the details of the surgery you just had. If you have experienced delirium in the past--tell the anesthesiologist. Ask for a recovery room with a window--so you can tell if it's day or night. Have your glasses and hearing aids handy so you can tune in.

Children are another case. You need to be calm and comforting as the parent. Don't overpromise--saying it will be like home or even fun. Discuss the anesthesia at length--how long will the child be "out," will he or she be sick afterward? Anesthesiologists are working with the FDA on a program called Smart Tots--you can look it up.

Surgery is a big deal...and being rendered deliberately unconscious is also a big deal. Engage!

Monday, February 08, 2016

Even older drivers support checks on those over 70

This is in England. The Institute of Advanced Motorists worked with a researcher at the Warwick Medical School at the Univ of Warwick to survey more than 2,600 drivers and former drivers on their opinions and driving history.

More than half of the over-70s said they self-regulate, staying off the road in busy traffic, after dark, or in bad weather.

These drivers drove significantly fewer miles than other age groups--and 84% rated their skills as excellent. Only 6% had ever considered giving up driving.

Nonetheless, almost 60% of those surveyed said drivers should be tested every five years after age 70. Eight-five percent said they should get an eye test every five yrs also. (They also wanted an eye test every 10 years for everyone.)

Around age 70, more than half said, drivers should get a medical exam.

Ninety-four percent said doctors should be required to tell patients when their medical condition affected their ability to drive.

Eighty-two percent said driving is very important to them (more women than men).

So...should we adopt these rules here in the US? I know several personal stories of people who drive and who should not be.

In one instance, when my daughter was a toddler, an elderly driver almost smashed her stroller with her in it. The driver momentarily thought the green light at a cross street was for her.


Friday, February 05, 2016

Student invents app for university gyms

Rachel Koretsky (pictured) is not only a gym rat, and American Univ student, but also a tech startup mogul. She invented the phone app upace.

The app allows students to click and find out how crowded the gym is, plan their times, and sign up for classes.

She told the website DC Inno she is adding new features all the time.

She developed upace through the AU Entrepreneurship Incubator. AU also served as the pilot for the project.

More schools will be added in 2016. A couple more offer it now.

Has her age and gender been a factor? Age cuts both ways--university decision-makers know she understands the problem, but on the other hand, it may make her seem like a student and not deadly serious.

Still, she is marching on. I mean, "working it out."

Thursday, February 04, 2016

Weed can damage short-term memory--but not by much

I came up in the 1960s, marijuana was around, I never cared for it, but I still know adults who smoke everyday.

There is no question in my mind that it makes people kinda boring to be around if one is not sharing the bowl.

New research in the JAMA J of Internal Medicine confirms it--if you smoke a LOT of weed, it can damage your short-term memory. But only, dude, like a little.

They have a fun new term--marijuana year--that is a year of smoking daily. A marijuana year is also if you smoke every other day for two years or once a week for seven years.

(If you got that, you must not be smoking too much.)

The more you smoke--the worse you perform on memory tests. Kind of.  To wit:

Two groups of 10 people...You give them a list of 15 words and 25 mins later, see how many they remember.

--The first group, non-smokers or those who smoke only occasionally--Maybe nine out of 15 words.

--The second group, smoked every day for a period of five years. 8.5 words out of 15.

Doesn't seem like a dig difference? Researchers admit it's not. But they say if you smoke every day from 20 to 45, you may remember 2.5 fewer words.

So to me the bottom line is you can toke up every day for five years or more and it has little effect on your cognitive abilities and focus. At 45, you can search for a word as it is.

Maybe I am the boring one. Or I need to start using it. Or this is a nothingburger study. I report--you mellow out.


Wednesday, February 03, 2016

You may not be getting evidence-based treatment in hospitals

I was hospitalized once for a drug interaction, but they claimed it was asthma (which I did not have). The nurse who took care of me--I could hardly breathe--said she was doing what she did for her son, which was moisture and sitting with me as I gasped. Apparently, there was no protocol for how to handle people who could not breathe.

According to Berndadette Melnyk, dean of the College of Nursing at Ohio State, use of tested practices is relatively low.

Many hospitals get poor scores in handling pressure sores or falls.

A substantial percentage (30%-40%) of hospitals do not meet national benchmarks for quality and safety.

 The study appeared in Worldviews on Evidence-Based Bursing. The team interviewed 276 chief nurse execs.

Most nurses interviewed believed in evidence-based practices, but said their organization employed these only sometimes or not at all.

Case in point: Children with asthma continue to be treated with nebulizers in the ER, although studies have shown better outcomes with a bronchodilator with a metered dose inhaler and spacer.

Evidence-based techniques yield at 28% improvement.

The nurse team also concluded that more nurses need to learn more about evidence-based practices and how to meausre outcomes.

Melnyk recommended you ask your nurse or doctor about the treatment--is it backed by science? Look it up--demand answers.

I got the nebulizer--and "breathing treatments" from a couple of techs who came around every so often during my stay. I went home with an inhaler. Stopping the offending medicine, though, ended the so-called asthma.