Today, I hurt. I’ve been talking about this pandemic for well over a month. My friend list is dwindling, and there are several people I don’t plan on catching up with when this pandemic is over—and now entire communities. America’s privilege is showing, in a terrible way. Rural areas that have been luckily unaffected are […]
I was shocked to see that the NHS could ban surgery for the obese and smokers. That’s socialized medicine. You take a conglomerate group of people (the UK) on a limited budget for healthcare… and basically find the cheapest most cost-effective way to deliver healthcare. But in a way, it’s empowering patients to take responsibility for their own health. Smoking, for sure — I agree 100% that surgery should be banned for this population. Obesity is a bit trickier — there’s genetics and environmental factors at play in this one. I don’t think anyone chooses to be obese. But, people do have the power to change their eating and exercise habits. Despite these efforts, there are some people who are still obese…. and these people should not be faulted.
Why single out the obese and smokers?
Smokers and the obese have elevated surgical risk and mortality, which means more cost to treat and hospitalize and provide ongoing care.
I think the NHS is on to something here. They’re opening doors to moving the liability and responsibility away from physicians and towards patients. This is a plus. Outsiders may see it as separatism and elitist to only provide care for people who are healthy. But look at the facts and the data…. obesity has a lot of co-morbidities associated. Smoking has a lot of co-morbidities associated as well. Why should physicians be penalized for re-admissions, poor wound healing, longer hospitalizations when the underlying conditions themselves are already challenging enough? In fact, I would urge insurance companies to provide incentives to patients/the insured with discounted rates for good and maintained health and wellness. With all the technologies, medications, and information out there, it’s time patients take responsibility for their own health. I take responsibility for mine — watching my diet, exercising, working on getting enough rest, maintaining activities to keep my mind and body engaged, meditating for rest and relaxation. It’s not easy, but my health is 100% my responsibility. I refuse to pass the buck to my husband, my family, my physician, etc. I do what I can to optimize my health and future — and if that doesn’t work… I call for backup.
Patients need to change their mindset re: health. It is not your spouse’s responsibility to track your meds. It is your responsibility to know your medical conditions and surgical history. The single most important (and thoughtful) thing a patient can do is keep an up-to-date list of medications, past/current medical history, surgical history, and allergies to bring to every doctor’s appointment and surgery. This helps streamline and bring to the forefront your conditions and how these will interplay with your medical and surgical plan and postoperative care. Please do not forget recreational drugs, smoking habit, and drinking habit in this list. It is very important to know all of these things. Also, your emotional history is very important. Depression, anxiety, failure to cope, etc. This all helps tie in your current living situation with stressors and your medical history.
Links for educating yourself in taking responsibility for your health:
The experience is one I’ll truly cherish. I’ll have to go at least yearly. These people need so much and it’s really an honor to be able to reach out to them. Had 3 cases today. All pedi burns..6y, 14y, 6y. First case, the 6y old was so brave. We did a right axillary contracture release with skin graft lasted about 2h. 2nd case was the toughest anesthetically. She had burns to her face and had a mouth opening of barely 2 of my fingers. I barely got a 2.5 Lma thru. They released contractures on her neck and eyelids. She coughed in the middle of the case as one of surgeons was putting stitch in neck. She laryngospasmed….oy! Sat went down to 70s…had to give prop to break it. That, I could’ve lived without. Last case was a screaming, crying 6y. Had to tackle mask him down…luckily, he went down nicely. They did a left hand/thumb release. All the pts did well in the pacu. 🙂 so far so good…. now for dinner, drinks, and hanging with the group.
I´m currently in Antigua. ´It´s a cute, beautiful city that used to be the ancient capitol of Guatemala. We´ve walked around the city, which reminded me of San Juan, Puerto Rico. Cute city blocks with very colorful buildings. The people are extremely friendly. Heading out to a Spanish class at 1:30p for a refresher. My Project HANDS family is very nice, helpful and I can definitely see this trip being a great one! More to follow…
Back in December, I found a group on the internet called Project Hands. It’s a Vancouver based group who puts together a healthcare team composed of doctors, nurses, techs, administrators, and engineers to send over to Guatemala to deliver surgical care. I’m part of the May 2011 team. I’ve never done a medical mission trip, but I think they’re important to see how others live life and deal with medical problems. I love experiencing new cultures! Today, I leave for Guatemala and am quite excited to get going on the trip. Now, as an anesthesiologist, I wonder about the equipment and drugs that I’ll have access to…. will they be the same one I’m familiar with or will they be some kind of rigged contraption with an O2 flow tubing hooked up to volatile agent? I’ll try to post daily and include some pics as well. I’m supposed to arrive in Guatemala tonight….