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Five safe surgery tips for patients

Many patients fail to realize that there are practical steps they can take to help ensure a successful surgery. Here are five recommendations to consider before going under the knife

My late daughter, Katherine Eileen Hallisy, was 5-months-old when she was diagnosed with malignant tumors in both eyes. We knew cancer would be a formidable enemy. But we did not expect to fall victim to medical error, misdiagnosis and fragmented and chaotic care.

I learned the hard way how to protect my daughter. Once, when Kate developed worrisome signs after a biopsy, our discharge papers directed us to contact the emergency room. Staffers there did not expect to be contacted for follow-up, and advised use to stay home. We missed an opportunity to identify the early signs of life-threatening sepsis, which caused my daughter tremendous suffering.

We learned that we had to ask the right questions at the right time, to communicate effectively with providers, and to take steps to avoid errors and infection. It was Kate who suggested that we share our hard-won knowledge with others so they could avoid many of the problems she faced.

My promise to Kate eventually led to our non-profit, The Empowered Patient Coalition.


Now I speak to hundreds of patients, and on their behalf at conferences around the country. There are about 80 millionsurgical procedures a year in this country, and unfortunately, many patients do not realize that there are practical steps they can take to help ensure a successful surgery. That’s why I developed five recommendations for patients to consider when considering surgery:


  1. Deciding on Surgery. No surgery is risk free. So do you know why surgery is needed? You should be clear about how successful the surgery is in correcting your specific condition. Ask if there is medical evidence that supports surgery over other treatment options. What should you expect if you decide not to have surgery?
  2. Choosing a Surgeon. Ask if your surgeon is board-certifiedin the specialty you require. Check to see if she is a member of the American College of Surgeons and the American Board of Medical Specialties. Check to see if your surgeon has anymedical board disciplinary actions. Ask your surgeon how many times he has performed your specific surgery. What have been the outcomes? What is the complication and infection rate? Demand specific answers and not vague generalizations like “not many.”
  3. Surgical safety. Will your surgeon be performing your entire surgery? Will she be assisted by other surgeons, residents, or students? How much direct supervision will doctors-in-training receive? I learned the hard way to ask these questions after surgical residents operated on my daughter instead of the senior pediatric orthopedic surgeon. There were no complications, but I was alarmed. Patients   need to be completely clear about the identity and the experience level of their surgeons. Be sure the surgeon signs your surgical site and confirm the location by adding your initials as well. Ask your surgeon if she will take a “time-out” in the operating room to confirm the right patient, the surgical site, and the correct procedure. Ask if the team uses a surgical checklist to ensure that important safety protocols are followed.
  4. Preventing infection. Patients play an important role in preventing infection. Ask if you need antibiotics before surgery and remind the staff to administer them. Inquire about using a pre-surgical body wash in the days before surgery to lower the bacterial count on your skin. Do not shave your surgical site in the 24 hours before surgery to avoid making cuts in the skin where bacteria can enter. Try not to touch or scratch your surgical site and keep your hands clean by washing with soap and water or by using a hand sanitizing gel.
  5. Recovery and home care. Be sure that pain and nausea are controlled, because they can delay healing. If you are receiving narcotic pain medications, be sure your vital signs are closely monitored since a bad reaction may lead to hallucinations, nausea, or labored breathing. Pay close attention to your discharge instructions and be clear about your medication schedule, when to see the doctor for follow-up, and when to remove bandages or bathe. Ask if you need any medication to prevent blood clots.


For more information, see our free Hospital Guide for Patients and Families.





Nem Chandra Singhal

4 years ago

How many points are applicable in India ?

Round 2 goes to Obama; slams Romney's outsourcing plans

Obama, who drew flak from his own party for a lacklustre performance in round one two weeks ago, this time often dictated the terms of the debate questioning Romney's approaches towards China, immigration, taxes, unemployment, gun laws and other domestic and foreign

Hempstead (New York): A combative Barack Obama has hit back at Mitt Romney, retrieving lost ground in the second of the three high-stake presidential debates, saying his Republican rival's plans on outsourcing will only result in more jobs in China and India, reports PTI.


Obama, who drew flak from his own party for a lacklustre performance in round one two weeks ago, this time often dictated the terms of the debate questioning Romney's approaches towards China, immigration, taxes, unemployment, gun laws and other domestic and foreign issues.


During the 90-minute face-off at the Hofstra University in Hempstead for a town hall style debate, Romney retorted claiming US has been losing manufacturing jobs to China as enterprises feel it is "more attractive" to go offshore than to stay here.


A snap CNN/ORC International poll showed 46% of respondents thought 51-year-old Obama won, compared to 39% for 65-year-old Romney. The result was within the survey's margin of error.


Both Obama and Romney fielded questions also on topics like gas prices and Libya from members of the audience, a group of 82 undecided voters from New York's Nassau County.


The question on outsourcing of American jobs overseas came at the fag end of the debate, which saw an aggressive and assertive Obama take on Romney as he tried to improve on his performance at the first debate in Denver where the Republican leader came out as the surprise winner.


"One of his (Romney's) big ideas when it comes to corporate tax reform would be to say, if you invest overseas, you make profits overseas, you don't have to pay US taxes.


"But, of course, if you're a small business or a mom-and- pop business or a big business starting up here, you've got to pay even the reduced rate that Governor Romney's talking about. And it's estimated that that will create 800,000 new jobs. The problem is they'll be in China. Or India. Or Germany," Obama said.


"That's not the way we're going to create jobs here. The way we're going to create jobs here is not just to change our tax code, but also to double our exports," the president said.


Responding to the question on what plans they each had to keep jobs in the US, Obama said while Romney and he agreed that the corporate tax rate should be lowered, there is a difference on the way they both would approach the issue.


"I want to close loopholes that allow companies to deduct expenses when they move to China; that allow them to profit offshore and not have to get taxed, so they have tax advantages offshore. All those changes in our tax code would make a difference," Obama said, slamming Romney for wanting to expand the tax breaks.


Romney shot back that "if you elect President Obama, you know what you're going to get -- you're going to get a repeat of the last four years."


Responding to the question, Romney blamed Obama for not labelling China as a currency manipulator, promising to put the label on Beijing on day one of his presidency.


"We are going to have to make sure that as we trade with other nations that they play by the rules. And China hasn't. One of the reasons -- or one of the ways they don't play by the rules is artificially holding down the value of their currency. Because if they put their currency down low, that means their prices on their goods are low. And that makes them advantageous in the marketplace."


"We lose sales. And manufacturers here in the US making the same products can't compete. China has been a currency manipulator for years and years and years. And the president has a regular opportunity to label them as a currency manipulator, but refuses to do so," Romney said.


Romney repeatedly took on Obama, blaming his rival's policies for rising federal deficits and debts, leaving more than 20 million people jobless.


"We don't have to settle for what we're going through," Romney said at one point. "We don't have to settle for unemployment at a chronically high level. We don't have to settle for 47 million people on food stamps. We don't have to settle for 50% of kids coming out of college not able to get work. We don't have to settle for 23 million people struggling to find a good job."


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