Getting ready to work out at the fitness center?  Football practice in an hour?  Going to your son’s wrestling meet at the high school?  Yoga class this morning?

Quick, pack the gym bag! 
Change of clothes, ✔

Flip flops for the shower, ✔

Deodorant, ✔

MRSA Superbugs?

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 ago? 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, 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, a rash erupts… anything 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.

A Patient’s Guide: How To Stay Safe In a Hospital
February 4, 2012

Propping up a patient’s hospital bed at a 30-degree angle can help prevent hospital-acquired pneumonia. Using alcohol wipes kills staph bugs, but you need bleach wipes to kill C. diff germs.  Read more…

Meaningful Patient Empowerment in the Era of Health Care Reform
January 29, 2012

Safe & Sound in the Hospital Featured on The Doctors
January 23, 2013

Safe & Sound in the Hospital is featured on The Doctors TV Show!  January 23rd, ABC. (Check your local listings.)

Karen Curtiss Interviewed About Her Role Model for Healthy Living
January 22, 2013

Karen Curtiss is interviewed about her role model for healthy living, her mother, Margaret Aydt!

Read More at Your Health Journal by Len Saunders

One in three patients is accidentally harmed in U.S. hospitals every year, according to a 2011 Health Affairs study…
Read more/listen to Podcast

Hospital Bills- Shock & Awe!
By: Karen Curtiss
Author, Safe & Sound in the Hospital: Must-Have Checklists
and Tools for Your Loved One’s Care

Founder, CampaignZERO, Families for Patient Safety,
www.CampaignZERO.org

After a hospital stay, the bills will start pouring in, and trust me, they will be shocking – and confusing. Fees for doctors you’ve never met will show up on your bill, along with lab fees and other costs for services performed “behind the scenes” during every hospital stay. If you have good insurance, most of the charges will be covered, but even your portion may be an “ouch.”

Most hospital costs are simply out of our control.  Until we have a good system for shopping around for good health care – as we do for cars and groceries and just about everything else we buy – we have to accept the hospital charges we get, and pay up!

Where you do have control, however, is in making sure the prescriptions and medical providers who take care of you are covered by your insurance policy.  This is particularly true if you rely on Medicare alone.  More and more doctors are opting out of Medicare — which is why a supplemental policy is worth considering.

It’s good to remember that, just because the hospital is in your insurer’s network, it doesn’t mean that all services and medications are too.

Question Your Prescriptions

Before you leave the hospital, the doctors will often start prescriptions to make sure they work.  This is a good practice called “stabilizing on the meds.”

But what if your insurance doesn’t cover them?

• For each drug you get, ask: Will you write a prescription for me to take this at home?

•  If yes, ask someone to help you check with your insurance company to find out if it’s covered.  (You can ask the hospital’s social worker or case manager, or a family member or friend to do this for you.)

•  If not covered, ask the insurance company if there is a similar drug, or generic, that is covered.  (Again, make sure that whomever helps you, gets this answered.)
  • If so, share this info with the doctors and nurses
  • Ask if any are suitable substitutes
  • Be frank with your doctors about cost concerns- they’ll understand
    

  Doctor Charges

  Another potential surprise is that some doctors, or other medical providers who treat you, may not be covered by your insurance carrier. Here’s a good example: you are in labor and the baby goes into distress so an emergency C-section is ordered. When the bill arrives, you are responsible for the entire fee for the anesthesiologist even though your insurance plan covers all other delivery costs. Why? The anesthesiologist bills separately as an independent contractor to the hospital, and she doesn’t take your insurance.

  This issue can crop up with physical therapists, occupational therapists, infection and wound specialists, lab fees, and other services. For every new medical provider who takes care of you, you may want to ask: “Do you take my insurance?” And if not, it’s perfectly OK to ask for someone else who does.

  These are tough conversation to have – who wants to think about the business end of things when you’re concerned about your health?  This is why it’s really wonderful to have a family member or friend with you in the hospital all the time.  Let them manage details like this so you can focus on getting better!

  Incorrect Billing

  First of all, if you have any questions about your bill, don’t hesitate to call the hospital’s business office.  Make a list beforehand so the time is well spent for both of you.

• I’ve often heard, “Oh it doesn’t’ matter if there’s a mistake — insurance is taking care of everything.”  Actually, even little overcharges add up to big dollars, and in the end, we all pay higher insurance rates as a result.If you see a big error, like a misdiagnosis, make an extra effort to get the hospital to send you a correct bill.  I know someone who had to go back to the hospital for an infection in the stitches on his stomach from a recent surgery.  You’ll never guess what was on his bill!  Food poisoning!Solutions:
  
• For any charges not covered by your insurance policy, make an appeal to your carrier.  Before you call on your own, however, ask the hospital advocate to go to bat for you.  They “speak the same language”!
• Report errors to the hospital’s billing department in writing. The hospital cannot press for payment on any charges you say are incorrect.
• If errors are not corrected, send copies of your bills and your letter describing the errors to the hospital advocate and your insurance company case manager.  They will be helpful, but if not, you can always take your issues  “up the food chain” to the hospital president, if necessary.About 25% of all bankruptcies in the US stem from medical bills.  It’s well worth knowing what your hospital care costs, and your share of it. Believe it or not, there is wide variation in cost for every kind of surgery – even in the same city.  We are entering a new age of consumerism in health care, so “dare to compare” and spend wisely!

Medication Management is a Mess!

Founder, CampaignZERO, Families for Patient Safety,
www.CampaignZERO.org

A recent Yale study revealed that fully 75% of patients aged 65/older don’t understand their medication routine after leaving the hospital — or they get an incorrect prescription at discharge.

No wonder a third of all seniors end up back in the hospital!  In fact, many older patients overdose on meds the first day or two at home.  Here’s what happens: patients get a medicine at the hospital before discharge, and then take it again at home “at their usual time.”  Sounds crazy, but often, the hospital’s medication record gets buried in the sheaf of discharge papers, or the record is simply incomplete.

The risk for accidental overdoses is particularly worrisome in long-term care facilities where records may take a day or more to be updated.

Every patient needs a Care Partner to help make sure they get their medications according to the 5 “rights” of medication safety:

1. Right patient (double check the prescription and bottle!)
2. Right medication
3. Right dose
4. Right time
5. Right route (oral vs. nasal, etc.)

How can you make sure these “rights” are right every time for your loved one?

Take good notes at discharge. Sweat every detail!  It’s OK to ask for more time for questions.

• Go over meds your loved one was taking when admitted and those prescribed going forward. Discuss changes – understand why for each one.
• For each medication, ask:
  • What is this for?
  • What are the signs it’s working? What are the symptoms it’s not working?
  • What are the potential side effects?
  • How does this work with other meds taken (even vitamins, herbal supplements, drugstore-type aids)?  Are they safe together?
  • Any limitations for activity and diet?
  • Who should we call if we have more questions or concerns?

Note: www.WebMD.com is a good source of medication info, and it’s always a good idea to double-check these details.  WebMD offers a free app, too.

• If your loved one is 65 or older, look up every prescribed drug to see if it’s on the Beers list of “caution” medications for older adults.  If you find one of these prescribed for your loved one, be sure to bring this to the doctor/s’ attention.
  (See http://www.americangeriatrics.org/files/documents/beers/2012AGSBeersCriteriaCitations.pdf )

• Ask questions until all info about medications, and how and when to take them, are crystal clear.

• Help your loved one create a good, safe system for managing medications at home. Think about special pillboxes, apps, alarms, and checklists… anything that makes it easier to take meds safely.
  • If you are stumped for ideas, ask your pharmacist.
  • Make sure you bring any “old” prescriptions back to a pharmacy where they can be disposed of in an environmentally friendly way.
    -“Old” can be a current drug that’s in a different dose  – if in doubt, ask the pharmacist!
    -Never discard unneeded medications in the trash at home, and don’t flush down the toilet or sink. (We don’t want these going into our water systems!)

• Check in with your loved one frequently, at least once a day for at least a month after discharge.  Be on alert for signs of trouble.
  • If you have any concerns whatsoever, don’t hesitate to call a doctor.

All of these details can be daunting, but you are so smart to be pro-active.   It’s downright scary that the majority of older patients discharged don’t feel like they have a handle on their medication instructions: now you know how to help!

And now you also know, when it comes to managing medications for all of us, that old saying “It’s better to be safe than sorry” couldn’t be more timely.

Little known fact: 20 – 30% of all patients end up back in the hospital within a month.

Often, it’s because they can’t drive to get prescriptions filled or make it to follow-up doctor appointments. Sometimes patients ignore signs of health problems after a hospital stay, hoping they’ll just “go away” or they don’t want to be a “bother”.

Yet another fact: a recent Yale study revealed that 3 out of 4 older discharged patients leave the hospital with the wrong prescription, or they don’t fully understand their new medication regimen.  Also worrisome is the fact that many don’t understand what to do about the old prescriptions waiting for them at home.  Frankly, medication management is a complicated mess for most patients!  They need help to keep them all straight — and to take them all safely.

Caring Bridge offers a free, nifty calendar planner to organize friends and family to:

•  Make sure loved one gets to follow-up doctor visits (critical!)

• Have prescriptions filled (also critical)

• Make sure that someone (besides the patient) knows about all meds and is staying on top of how and when they are taken

• Follow up on any tests and their results

• Checks in with your loved one every day for at least a month to watch for signs of problems

To learn more about the early warning signs of problems, and how you can help make sure your loved one has safe & sound hospital care, check out our guide for patients’ families, Safe & Sound in the Hospital: Must-Have Checklists and Tools for Your Loved One’s Care.

What’s The Harm in Hospital Care?
By: Karen Curtiss
Author, Safe & Sound in the Hospital: Must-Have Checklists
and Tools for Your Loved One’s Care

Founder, CampaignZERO, Families for Patient Safety,
www.CampaignZERO.org

Did you know that one-in-three patients is accidentally harmed during their hospital stay?  That adds up to about 13 million patients a year who suffer needlessly, and among those, about 300,000 people die as a result.

When we talk about these big numbers, it’s really hard to wrap our heads around what they mean in real-life terms.  So imagine this: you wake up tomorrow to the news that three, fully loaded, passenger jets crashed overnight in an Iowa cornfield.  There were no survivors.

The media floods Iowa to cover the triple tragedy. The entire world demands answers. What went wrong? Who’s to blame? Grief permeates the atmosphere.  Hearts go out to the victims and their loved ones. That night, sleep is elusive. Maybe your upcoming island vacation should wait.

The next morning, headlines shriek again: three more planes were downed in the dark night – all passengers and crew are dead.  Shock. Sheer horror. No one moves, except, for reporters of all kinds who furiously dig for details, answers, anything at all to make some possible sense of the senseless carnage.

Every imaginable government agency rushes to stem panic, find answers, create solutions. The President doesn’t mince words, calling the FAA, airline CEO’s and their boards to task. Wall Street starts to melt down, world markets shake.  Who can sleep that night with such fear, anguish and broken hearts?

The third day dawns with vacation plans and business trips cancelled, and the numbing news that three more planes full of innocent passengers disintegrated overnight. It feels like the world is coming to an end.  But it’s clear this string of deadly disasters has finally stopped — the airline industry has gone down in flames too. No one dares step foot on a plane.

In this scenario, nine planes went down and 2457 innocent people lost their lives on big-name carriers they trusted.  During the same three days, the same number of patients accidentally died in hospitals they trusted, too. Except the accidental deaths in US hospitals didn’t stop at day 3. It never stops.

The numbers never go down, either because there no meaningful consequences when hospital care accidentally kills people.  The press doesn’t dig; No one is called to task.

Yet, when we are sick, we don’t have any other options.  We must take the hospital care we get regardless of the risk.

A recent study showed that, statistically, airline travel is 3000 times safer than hospital care.  (Isn’t it ironic that there are so many white-knuckle flyers?) The airline industry has been pretty open about its safety records, but it wasn’t until 2012 that we had any real guides for choosing safe hospitals… and now we do!  So before, you or a loved one ever needs hospital care, be sure to check out your options here:

www.hospitalsafetyscore.org

www.consumerreports.org

Pilots never take off without a co-pilot and they always go through their safety checklists together.  You should never go to a hospital without a friend or family member as your Care Partner.  And both of you should go prepared with your safety checklists, too.  Here are some great resources — endorsed by top leaders in patient safety — to help you get started:

Safe & Sound in the Hospital: Must-Have Checklists and Tools for Your Loved One’s Care

www.CampaignZERO.org

Cracks in hospital care are mostly “invisible to the naked eye” but when you have your hospital guide, like Safe & Sound in the Hospital,  you’ll know what to look for to help fill in the most common hazards.  You’ll also know what to do and what to say to get safe and sound care for yourself and the people you love.  Even in the very safest hospitals you find, patient safety is a team effort.

Sometimes, the plain facts I’ve just shared with you make people angry with disbelief.  I understand this reaction so, in future articles, I’ll explain why hospital care can harm even though nurses and doctors work so hard to heal. But more importantly, I’ll share insider info so you’ll know how to help them safeguard hospital care.  Partnering for patients… that’s what healing is all about.