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Top Ten Frequently Missed Aspects of a Hospitalization

1.  Deep Venous Thrombosis (clot) avoidance.  Each person in a hospital setting should inquire what their regimen is for preventing clots while being in the hospital.  It may simply be frequent walking, compression stockings, or may require medication or procedures.  Each patient is different, but it should be part of a daily discussion while in the hospital.

2.  Deep breathing assistance.  Especially after surgery, rib fractures, or pneumonia there should be a plastic device at the patient’s bedside for them to MEASURE and maintain how deeply they are inhaling.  This prevents flattening of the lung and secondary lung infections.

3.  How long do I need these IVs?  Ask EVERYDAY if the IV medication can be switched to oral medication.  The sooner the IVs can be removed, the better.  IVs are an access point to infections of the skin, veins, and blood stream.

4.  Nutrition.  Always inquire about your nutritional status.  Most patients loose precious protein stores while lying in bed.  Many processes like surgery and infections require much higher nutritional requirements than we need at home in our day to day lives.

5.  Medications on discharge.  Be cautious to accept a discharge date on the SAME DAY that your doctors trial a new medication.  Ask for 24 hours of observation on the medication prior to discharge.  If your doctor feels that this is not necessary, ask them to explain why.

6.  Question all medications daily.  Ask your nurse or doctor what medications that they are giving you and why – EACH DAY.  You would be surprised how often medical teams forget to stop a medication when it is no longer needed.

7.  Labs.  Inquire if they REALLY need to take blood from you every day.  It may be necessary, but daily labs are often written for and forgotten about.  That can lead to unnecessary blood loss and eventual anemia.

8.  Physical exercise/therapy.  Regardless of the reason for your admission to the hospital, inquire if there are in-bed exercises or in-hospital facilities for you to maintain your lung, heart, and muscle health while in the hospital.  This can greatly increase recovery rates and get you home faster/healthier.

9.  Hand washing.  Make sure that YOU see health care workers wash their hands in YOUR room prior to working on you.  Passing bugs around a hospital is a tremendous burden on health care and these types of infections lead to thousands of deaths annually. 

10.  Ear plugs and eye shields.  Sleep is VERY important while in a hospital trying to heal.  Make sure to get some ear plugs and an eye shield to avoid light from instruments while you sleep.

For more specific advice on YOUR hospital admission, contact Dr. Kay at Informed Health Advocacy.com  or call 949-214-9925.

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Believe it or not, it appears that having a diagnosis of prostate cancer does not clearly mean that surgery, radiation, or other treatment is necessary.

In the New England Journal of Medicine (July 19,2012), there is a very powerful study concerning prostate cancer.  A "powerful" study, by the way means that the sample size and methods employed in the study make the results statistically more accurate.

Prostate cancer effects approximately 17% of men.  The diagnosis often begins with a screening laboratory test showing an elevated PSA level in the blood.  This is followed up by a biopsy of the gland.

Traditionally, if one was known to have prostate CANCER, then either surgery, radiation, hormone therapy, or a combination of the above were recommended.

In this recent study, it was shown that for lower grade prostate cancers that treatment does not improve survival (and treatment may actually increase death rates and complications).

Despite this information, it is unlikely that you will have your doctor offer you the option of "no treatment" if you or a family member end up with prostate cancer.  The reason for this is medical liability. 

If you would like more information or assistance in dealing with a diagnosis of prostate cancer, contact me.

Good Health,

William N. Kay, MD

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There is more and more evidence that even a single typical abdominal CT scan confers a real risk of future cancer in young adults and children whom get the scan. 

Abdominal CT scanning is used routinely these days in working up appendicitis in emergency rooms when young patients present with abdominal pain. 

There is a new study that "low dose" CT scans are JUST as effective at diagnosing appendicitis and ruling it out.  These low dose scans use up to 80% less radiation. 

What is the downside with "low dose" CT scans?  Well, the images are not quite as "crisp."   However, when it comes to appendicitis diagnostics, the not-so-crisp images get the job done with MUCH less radiation to the patient.

Next time you or someone you know needs an abdominal CT scan, consider requesting this.   Or, call me, and I will!

Good health.

Willaim Kay, MD

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Research on magnesium continues to support its broad health benefits through anti-inflammatory and anti-oxidant mechanisms.  The new research that I would like to make people aware of is that magnesium seems to have a protective effect on the kidneys – especially in patients with diabetes.  It is well known that one of the long term complications of diabetes is kidney failure (chronic renal failure).  One study has shown that kidney failure in diabetics that were low on magnesium (hypomagnesemia) had a quicker decline of their kidney function compared to those that had normal levels of serum magnesium.  As magnesium is relatively inexpensive and available without a prescription, diabetics should consider magnesium supplementation as part of their diabetes management. 

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An advance directive (sometimes referred to as a Living Will) is a set of instructions.  These are instructions that you decide “in advance” of a situation where you will not be able to communicate your own wishes.  It may seem farfetched, but as a trauma surgeon, I can tell you that it is very common for folks to end up in situations throughout their life where they are unconscious or too dazed to speak on their own behalf.

In situations where you cannot speak on your own behalf, having advanced directives helps you, the medical team, and your family.  Imagine having to decide if your spouse or sibling should be kept on life support or not.  I have seen a lot of guilt and family disagreement over such issues.  All which could have been avoided if the patient would have taken the time to have an advance directive created.

Advance directives are designed to make complex medical decisions.  It is highly recommended that advance directives be created with the advice of either your doctor or a knowledgeable medical advocate. 

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