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Posts tagged with "hip replacement surgery"

How to be Participatory in the Face of Adversity

From the lens of a patient who recently experienced major surgery, I now realize how difficult it is to be participatory when you are in pain and taking large doses of pain medication which dull the senses and put you in a place where you are not really thinking about anything but how to get through the next couple of days.

I consider myself to be an empowered patient who fully participates in my healthcare, questions my clinicians, and evaluates the risk/benefit of treatment plans presented by my clinicians.

I use the health data my clinician offers, including the reports and notes that are in my electronic health record, and confer with people who have had some experience with the same or similar conditions. I always go one step further  and search the web for relevant information that applies to my particular health concerns. I provide feedback to my doctors and never hesitate to speak up and ask questions. I tap the wisdom and advice of my peers and encourage my providers to be participatory.

By the time of my surgery I was fully prepared so that I completely understood what I was getting into. However, I could not anticipate that a cough that I had before the surgery would precipitate into a full-blown asthma attack for which I had not prepared. Nor could I have realized that the blood thinners that are automatically administered for  two  weeks following hip replacement surgery would be prescribed to me for three months because blood tests indicated that I had a much greater than normal potential for a blood clot. Additionally medication that I take to prevent a recurrence of breast cancer also elevated my risk for clots.

Ever the e-patient, I challenged the doctor to convince me that the risk of life threatening bleeding from blood thinners, if I were to fall or have an accident, was less than the risk of a potentially fatal blood clot. He did.

Following the hip replacement surgery I went to rehab where my medication regiment was so complicated by so many different pills that had to be taken at various intervals that I had to monitor every pill I was given, to be sure it was at the right time and in the right dose. I also had to work closely with the medical staff at the rehab to determine which medication, at what dose would keep the cough and the asthma under control. We worked as a team that included the rehab physician and nurse practitioner, the therapists, and my regular PCP. This was true participatory medicine at work.

There are some actions that a participatory patient should always take to insure best outcomes. They include:

1. Prior to going into the hospital for surgery, research all of your options and be sure to ask the surgeon, as well as your PCP and specialists who may be involved, all of the questions that you have. Be sure you are satisfied that you have full information.

2. Appoint a person to be your advocate during those days when you are not well enough to monitor the medications you are being given and the procedures that may be ordered. Be sure that your advocate understands your release instructions so that with the assistance of your advocate, nothing falls through the cracks.

3. As your treatment evolves be sure you understand, and are in agreement with everything that is suggested. Do not accept vague explanations.

4. When you are released from the hospital, be sure that you have full information on the medications prescribed, the treatment process, follow-up appointments and any home services to expect. Double check to see that you have prescriptions for all of your medications and a viable way to get those prescriptions filled quickly.

5. As an e-patient you quickly realize that there are always follow-up questions. It is up to you to work collaboratively with your providers to insure that there are open channels of communication for this purpose.

Being a participatory patient is complex because where health is concerned nothing is static. Things change and as the patient member of the healthcare team, you have to be on top of it all and ready to adapt.


Patient Safety, A First Hand View

It is a known fact that more people die annually from medical error, in both in-patient and out-patient healthcare settings, than die from motor vehicles accidents, breast cancer or HIV. Nearly 100,000 reported medical errors occur each year. As an e- patient, there are actions that you can take to insure the safety of your care. They include:
•Do not assume anything! Make sure that all health professionals involved in your care have all the important health information about you. Talk with them about what additional data they might need.

•Ask questions. If you have a test, insist on getting the results. If you are given medication be sure to ask what it is; what it is for; is it the right dosage. If there are pills you do not recognize, do not take them until you talk with your doctor. This is your right.

•Learn about your conditions and treatments. Discuss your healthcare with your doctor, nurse practitioner, physician assistant and/or pharmacist. Check the Internet to see what information you can find. A few of the helpful, unbiased web sites include:

1. Google or Bing search for the most general compilation of available data.

2., or institutions sites such as or for general information on a variety of health conditions.

3.,  and,  for the most comprehensive health information in one place.
4. , a website of the Joint Commission on Accreditation of Healthcare Organizations that provides extensive information on hospitals, sorted by geographic location and including accreditation criteria, special citations and programs.

I have been away from this blog for a while because I spent some real time as a patient, having hip replacement surgery. Although I had complete confidence in my surgeon, I made sure that I fully understood the parameters of my problem, the solution, and the recovery by asking the right questions and conducting my own research to find answers to all of my concerns. Much to my surprise, my hospital experience completely changed from previous in-patient encounters. Everyone diligently washed their hands at one of the antiseptic soap dispensers located in patient rooms and on every floor. That alleviated my biggest fear of staph and mersa infection so prevalent in the hospital environment.

Another concern was the potential for a fall as I knew that the hip replacement would incapacitate my movement for a while. However I was told to absolutely call for help when I wanted to get out of bed, and the nurses and aides were most pleasant about assisting me. The last time I was in the hospital after surgery the nurse told me I had better learn to get out of bed myself and not bother them. What a turnaround in patient safety!

Because I am familiar with the dangers of medication error, both in the hospital and at the rehab, I also questioned every IV and oral medication that I was given to be sure that the right medication in the right dosage for me was what I received. No one took offense. They appreciated my caution and understanding.

Patient Safety is not an easy goal to accomplish in the stressful healthcare setting. Mistakes are still made. However when an e-patient opts to become an integral part of the healthcare team many unpleasant medical errors can be averted.