Gary is a tall, lanky 50-something guy whose stooped posture now betrays pain and significant muscle deterioration. He has the walk and energy level of a 90-year old and, despite weekly therapy prescribed by an orthopedic specialist, his body seemed to be aging by the minute.
Fortunately for Gary, his wife spoke up to her neurologist at one of her own recent appointments and described his condition. Amazingly, the neurologist offered a diagnosis on the spot that turned out to be ‘spot on’! Gary switched doctors and has every reason to hope for full recovery of his old athletic self.
Gary shared this experience with my husband, calling his first doctor’s failure diagnose his back pain correctly a “medical error”. A year or so ago I would have agreed, but I think differently now that I’ve read a terrific book by Jerome Groopman, How Doctor’s Think. Groopman describes how doctors form their professional judgments – exactly how all of us form our ideas about things.
All of us have life experiences that shape how we perceive and analyze information. Whether we realize it or not, we are chock full of filters – some would call them biases. For the most part, they tend to serve us well. How else could we sort through the information overload we seem to manage on a daily basis?
Doctors tend to filter patients’ information in the same way. They hear or see a set of symptoms and their minds immediately sort through past history with the same symptoms to come up with a solution or cure.
In Gary’s case, he saw an orthopedic doctor who saw his symptoms through the prism of his own experience with the bones and muscle of the back. His wife’s neurologist analyzed the same set of symptoms through the prism of his specialty – the nervous system that runs through the back. I don’t believe the first doctor made a mistake – he just did not have exactly the right filter for Gary’s problem.
So what’s the moral of this story? Trust yourself, trust your body. If you’re not getting better under one doctor’s care, get another doctor’s brain on your case. Get a third or fourth opinion if necessary. Don’t stop until it feels like you have the right doctor for you with the right solution you need.
It’s a new year with new fitness goals! So…getting ready to work out at the gym? Pick-up basketball game today? Going to your son’s wrestling meet at the high school? Yoga class this morning?
Time to pack the gym bag!
Change of clothes, ✔
Flip flops for the shower, ✔
Yes, your good, old gym bag is the Trojan Horse that picks up Superbugs every time you drop it in your locker, and then brings those bugs home with you. No wonder, at least 16% of the population carries MRSA around inside their bodies, too.
Don’t panic yet. You can carry MRSA for your entire life without a problem, as long as you have a super healthy immune system or your body isn’t trying to fight off disease. But once your health is compromised, MRSA steps up its game.
Here’s a good example. Do you remember the fear and frenzy of the HINI epidemic a few years back? Media stories fueled international anxiety, and one, in particular seemed to hit hard: a 17 year old robust high school football player, who’d performed brilliantly under Friday night lights, was near death in a hospital ICU by the end of that weekend. The 60 Minutes reporter covering this story focused blame on HINI flu, but also made the offhand comment that this young victim was also infected with MRSA.
When all was said and done, the bally-hood HI91 flu “epidemic” claimed about 25,000 lives — about the same number who die every year from the “regular” flu. MRSA claimed at least 4 times that number. In fact, about 100,000 people die every year from MRSA without any of the public hand-wringing and precautions that went along with the HI91 outbreak. But think about it, which one is the real epidemic?
The young football player whose story claimed our hearts, and stoked our fears eventually recovered, but not without struggle and lots of physical therapy. Nearly every symptom he suffered pointed to the fact that MRSA — underplayed in news reports — was really the cause of his near death.
The fact that he spent so much time in locker rooms was the first clue that MRSA had compromised his immune system to the point where HINI became life-threatening. He was one of those healthy carriers, but fighting off the flu is just the kind of dent in the armor MRSA Superbugs use to flourish and invade.
You’re not going to stop your sports – that’s just out of the question. Your sports are one of the healthy habits that actually support your immune system. So follow another checklist when you pack your gym bag and learn to spot signs and symptoms of potential Superbug trouble.
Add these to your arsenal:
- Alcohol wipes to clean…
- The interior of your locker
- The bottom and sides of your toiletries kit
- Gym equipment – before and after use
- Yoga and wrestling mats
- Alcohol wipes or rubbing alcohol to clean every scrape or cut immediately
- Topical antibiotic to apply to every cut or scrape immediately
- Antimicrobial shower gel
- Antimicrobial hand gel or foam (at least 60% alcohol based)
- Your own bar of soap in a container
- Plastic bag for your workout clothing
Follow these safe practices, too:
- Don’t share towels, razors, hair or nail clippers
- Ask if your gym uses bleach during wash (if not bring your own towels, launder with bleach at home, and do not mix with your other laundry)
- Wash your hands frequently with warm, soapy water for at least 15 seconds each time. Dry them with an air dryer, paper towel or clean, fresh towel
- If you have cuts or scrapes, keep them clean and covered with clean bandages until healed. (Wash your hands before touching! If someone else changes your bandages, make sure they wash up well, too.)
- Shower immediately after exercise, using antimicrobial soap, especially if you’ve been involved in a contact sport
- Use shower time to look for any new bumps, scrapes or cuts. Treat breaks in the skin with alcohol wipes and topical antibiotics. For bumps that look like little pimples or bug bites, see a doctor – this is how MRSA literally first ‘pops up.” See a doctor immediately, too, if your skin reddens, oozes pus, or a rash erupts… any skin problem at all that hurts or sets off alarms in your head!
- Don’t leave the locker room or gym in your workout clothes: even if you can’t shower, put your workout gear in a plastic bag and launder at home, separately from your other laundry using hot water and a little bleach
And finally, “take a look inside.” At your annual physical, ask for a MRSA swab test. It’s just a simple q-tip swipe inside your nose and it will be good to know if you’re at risk, especially if you’re ever hospitalized. Doctors and nurses know to take special precautions if you’re a carrier.
Remember our Friday night hero? If you have kids who are in and out of locker rooms, share these checklists with them and get their pediatricians on board for annual MRSA screenings. Spread the word among other parents, too. As we know, it takes a village to protect our kids. It takes a village to protect our health, as well. Together, you have the power to keep Trojan Horses out of your homes — and hometowns.
Recently, Gallup published the results of a study showing that a whopping 26% of our healthcare costs cover “defensive medicine.”
If you’re not familiar with this term, think about the times your doctor has ordered a test for you that seems a little on the “iffy” side – you’re not quite sure what the test is for, or you’ve been through it before, and it seems like a big waste of time to you. But you dutifully follow doctor’s orders because, after all, insurance is paying for it anyway.
On the other hand, maybe you’ve insisted on a test that gave your doctor cause for pause. You didn’t want to go to the effort of getting a second opinion so you insisted – and your doctor relented, and then off you went… for a CAT scan, MRI, stress test, or blood work.
In these scenarios, the undercurrent driving tests and procedures is fear – fear in your doctor’s heart that if any possible stone is left unturned, you, dear patient, will see your doctor in court.
You must be wondering why this concerns us at campaignZERØ. What does defensive medicine have to do with patient safety?
Here’s our take on the connection —
- When doctors feel defensive, they don’t have the luxury to feel introspective too. It’s a common-sense fact — the two emotions simply don’t coexist peacefully in a single caring soul.
- If doctors can’t be introspective, they can’t get to “sorry” when they make an error (as all humans do sometimes – despite very best efforts and intentions.)
- If doctors can’t get to sorry, they can’t learn from their mistakes. They can’t become better doctors and better human beings.
So, while money and cost should be a concern for all of us, we should care just as much about the caretaker — who will then do a better job of taking care of us.
Let’s break the vicious circle of defensive medicine. Let’s start building a caring circle of better, safer medicine.