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Improve Communication With Your Doctor While In The Hospital

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If you are in hospital, don't expect your memory to do all the work for you. If you have a question, write it down, then, when the doctor does come for a visit, you won't forget to ask.

Under the best of circumstances, going into hospital as a patient is stressful, because it invokes great change in your life. You have changed your environment, your daily routine, and your eating habits. There are the intrusions of strangers poking and prodding, and wheeling you down the hall for tests.

An image of a doctors stethoscope

Coordinating the whole scene is your doctor, who usually sees you for just a few minutes each day. If this encounter is not handled well by both parties, it can lead to further anxiety and confusion. That’s why doctors need coaching in bedside manner.

Especially while you are in the hospital, the ability to communicate accurately with your doctor leads to better healing and potentially can even mean the difference between life and death. This has been confirmed in a series of studies performed and published over the past forty years. Good doctor-patient communication makes a difference not only in patient satisfaction but in patient outcomes including resolution of chronic headaches, changes in emotional states, lower blood sugar values in diabetics, improved blood pressure readings in hypertensives, and other important health indicators.

However, in a recent national survey of both doctors and hospitalized patients, effective communication remains elusive.

Only 48% of patients said they were always involved in decisions about their treatment, and 29% of patients didn't know who was in charge of their case while they were in the hospital.

Here's an action tip:

While your doctor's ability to communicate with you will vary by personality and training, you can benefit from a few tips as well. The following suggested questions were compiled by the Mayo Clinic, and serve as a good model for each patient.

  • What do my symptoms mean?
  • Do the medications have any side effects?
  • What is this test for?
  • What risks are involved in my treatment?
  • Do I have any options other than the treatment you've prescribed?
  • How do the benefits of the treatment compare with the risks?
  • What emotional reactions can I expect from my illness?
  • How long do I have to stay in the Hospital?
  • Do I have any limitations on my activity at home?
  • What should I call you about once I'm at home?

With these questions in hand, you should be well prepared to take some of the stress out of the hospital stay.

But what about the case where, despite your best attempts, you just can't establish that rapport with your doctor? Here are some resources for helping you decide what to do if you and your doctor don't communicate well.

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Colonoscopy for Cancer of the Colon: Hind-sight is 20-20

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Colon Cancer Prevention

 Aging is supposed to be a reward, not a punishment.  However, there are days when that may not seem to be much consolation.  Just like with a car, we can ignore maintenance at first, but after it becomes an old classic, it needs a lot more maintenance.

One human example is our search for preventable diseases.  Colon cancer is certainly one of the classic examples. 

Our society is at a high risk of the disease, for a number of reasons.  Our aging population, or changing diet with less fiber and more sugars and additives, and our increased levels of stress all mitigate increased risks of this (and other) diseases.  Because cancer of the colon is so easy to prevent, and yet so deadly if allowed to grow undiagosed, prevention trumps heroic surgery as our first option.  While prevention incorporates the usual good lifestyle choices of diet, exercise, and stress management, here are some critical elements of detection:

1.       Fecal Occult Blood test: this is a simple test kit, available from your doctor or lab, which will show trace amounts of blood in the stool.  This might be from bleeding from the gums or swallowed blood from a nosebleed, or it could come from the stomach or any part of the intestines down to the rectum.  While blood is visible as red or black discoloration in the stools, this test is sensitive enough to detect blood hidden from the human eye.  Because it is inexpensive and non-invasive, this can be done to any age group.  We often order it for patients with low iron levels, or with known bowel diseases like chron’s or ulcerative colitis.

 

2.       Colonoscopy:  This is the definitive test, routinely suggested for all adults after the age of 50.  Earlier screening is suggested for those who have any of the risk factors mentioned above, including those who have positive Fecal Occult Blood tests.

Treatment:

                1. Minor surgery:  Nip it in the bud: the point of a direct (as opposed to a “virtual” one) colonoscopy is that it will not only show any polyps, but allows the doctor to snip, zap, or otherwise eradicate them before they turn into cancers.  A classic “two-fer”, this means the diagnosis is made, and the treatment is given all during the same procedure.  For patches of suspicious cells, a biopsy can be taken which will detect diseases within a few days of lab processing. 

2.    Major surgery: If the above is too late, and the cancer has progressed into and through the wall of the colon, then full abdominal surgery is usually indicated.  Often this ends with a segment of bowel removed, and a colectomy or removal of bowel being done.  The patient is left with a colostomy bag, which is often permanent.  In some cases, the cancer may have already spread beyond the colon and into the lymph nodes, meaning that systemic chemotherapy or radiation may then be needed.

Please consider option 1, no matter how you might rather postpone or ignore it.  Those who are in denial are likely going to end up with Option 2, and for some of those, even surgery may be too late to save their lives.  Once cancer has been established,  a third of all patients will die from it.  If detected early, the survival rate should be 100%.

There are plenty of “bad luck” reasons for us to die; please don’t let “bad management” add to your risks!  Ask your doctor for a referral, and make sure you check out your colon when you are due. 

For more info on colonoscopy:

 http://en.wikipedia.org/wiki/Colonoscopy

For more articles on colon issues, check these articles on www.stressipedia.com:

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Stress-and-Constipation-How-to-Move-Things-Along

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Stay Warm With A Forced-Air Blanket

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If you've ever had an operation, and remember the shivers afterwards, you will be glad to hear of a new form of blanket coverage.

Operating rooms are cold places. The doctors and nurses don't notice it so much because they are covered from head to toe in surgical garb, and are working intently. For the patient, however, the cool ambiance can significantly lower the body temperature for a couple of reasons. First, by being put to sleep, albeit artificially with the help of an anesthetist, the body's metabolism slows down. That's why we can fall asleep on a Chesterfield after a late movie, and then wake up in search of a blanket a couple of hours later, even though the room temperature is unchanged.

For another reason, the operation often exposes significant areas of our insides to evaporation, making the patient colder than the doctors. About half of all people undergoing surgery become hypothermic during the procedure, sometimes by as much as three degrees Celsius or five degrees Fahrenheit, according to Dr. Daniel Sessler, a professor at the University of California at San Francisco. More than just a nuisance, such cooling disrupts drug metabolism, may impair blood clotting, inhibit wound healing, increase wound infections, and delay recovery from anesthesia.

Researchers have tested a lot of devices to solve the problem, but seem to have favored a forced air blanket to prevent heat loss. The device is much like a giant hair dryer which blows warm air through an empty quilt. The air fills the channels and there are slits on the inner side of the quilt which allow the warm air to diffuse over the patient. Because it delivers heat by all three mechanisms, namely conduction, convection, and radiation, it seems to work much better than radiant heat lamps and thermal ceiling devices.

Here's an action tip:
If you are going to undergo major surgery, ask your anesthetist for extra warmth during the procedure. If they don't have one of the latest forced air quilts, you should at least demand the best blanket coverage you can get.

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