It’ll be several more weeks before she can text as usual again — but so far, she said she’s been using the “hunt and peck” method to text. (Perhaps it would be better to start using the iPhone to call clients?)

It’s worth reminding patients: If any repetitive motion like texting starts to cause pain — or numbness, tingling or inflammation — it’s time to take a rest from it.

In the five years since the disaster, 80% of the city’s population has come back — but the health care system is only at roughly 50% of its former capacity.

Large sections of the city have been without a hospital since the floods, meaning residents dealing with a medical emergency may face a 20+ minute drive to the nearest hospital. In particular, New Orleans East may not see its main health care facility, Methodist Hospital, reopen for another three years.

Those neighborhoods with existing hospitals frequently have to make do with smaller hospitals that offer fewer services.

Plans are in the works to build or renovate several medical facilities. Among them: a $775 million project to replace Training Hospital and the large LSU-VA Hospital in Mid-City.

The two products being recalled are the ASR XL Acetabular System and the ASR Hip Resurfacing System. About 93,000 of the products have already been implanted — most successfully.

Patients with the implants are advised to contact their doctors for monitoring annually.

The company has agreed to pay “reasonable and customary” medical costs related to the recall, including new hip replacement operations.

New research reveals that orthopedic surgeons who have an interest in specialty hospitals or ambulatory surgical centers are more likely to schedule patients for surgery. Significantly more. Patients treated by an owner-doc were 54% to 129% more likely to have carpal tunnel repair, 33% to 100% more likely to have rotator cuff repair, and 27% to 78% more likely to have arthroscopic surgery.

Federal law doesn’t allow physicians to refer Medicare and Medicaid patients to centers that the doctor has an ownership stake in. And most states have similar laws to protect private insurance patients.

But those laws don’t include specialty facilities or ambulatory surgical centers.

The study, which appears in the Archives of Surgery, looked at patients treated in Idaho between 2003 and 2007.

When provided with in-person, professional interpreters, patients who have limited-to-no English reported higher satisfaction in communicating with their health care provider. The treating physicians and nurses reported similar satisfaction.

While many hospitals have tried to accommodate patients by training employees in languages commonly seen in their ER — using patient family members to translate or providing phone/headphone-based interpreting services — the study found these all fell short when compared to on-site professional interpreters.

In fact, when patients had access to professional interpreters, patients, doctors and nurses were four times more likely to say they were satisfied with the interaction.

Researchers also found that patients with professional interpreters had shorter stays in the ED and had generally better outcomes.

The study was published in Annals of Emergency Medicine.

Unlike other safety-critical industries like aviation and nuclear power insist on having multiple precautions and fail-safes in place to ensure that workers can’t commit a fatal error over a momentary lapse such as hitting the wrong button.

But nurses and other health care providers have no such safety net when it comes to the tangle of tubes that may be hooked up to a typical patient. Rather than use color-coded tubing or incompatible hook-ups, most of the tubes used for blood, medication, food, etc. are identical.

That makes it all too easy for a nurse or other health care provider to accidentally grab the wrong line and push liquid nutrition into a vein or IV fluids into tubes meant to deliver oxygen.

Several hundred such errors are known to have lead to patients’ death (and many more caused severe injuries in patients who survived). Experts believe that due to under-reporting the actual numbers of patients affected are much higher. A 2006 survey found that 16% of all hospitals had experienced at least one feeding-tube-related error.

Why does this problem persist? Most experts blame lax oversight by the FDA and successful efforts by manufacturer organizations to slow efforts to create more stringent standards.

One basic move would be to make feeding tubes incompatible with tubes meant for the skin or veins. The FDA is currently reviewing that plan as well as related suggestions to make the tubing safer for both patients and their caregivers.

DRNJ claims the practice violates patients’ rights and leaves them vulnerable to harmful side effects and emotional distress from the forced medication. Among the cases cited in its filing is one patient who paces non-stop due to discomfort from medication side effects. The exertion is wearing down the skin on his legs.

DRNJ lawyers say that too often, doctors see a reluctance to take medication as yet another symptom of mental illness — making it more likely that a patient with reasonable objections to a medication will be forced to take it.

The New Jersey Department of Human Services and Department of Health and Senior Services were both named in the suit. So far, neither has commented on the case.

Researchers examined the brain scans of young women who regularly experienced moderate to severe menstrual cramps and compared them to scans of young women who reported minimal cramping.

They found that the women who suffered more severe cramps had several brain abnormalities, including:

• a decrease in volume in regions of the brain that control pain processing, higher-level sensory processing and emotional regulation, and
• an increase in volume in areas of the brain that handle pain modulation and endocrine function.

More research is needed to determine how the changes effect (or are affected by) the women’s menstrual symptoms. But researchers say the data shows that menstrual cramps and related symptoms need to be taken more seriously by the medical community, because they do have long-term consequences for women’s health.

The report is in the September issue of PAIN –
The Journal of the International Association for the Study of Pain.
.

Over a five-year period, Harlem Hospital Center in New York had some 7,000 echocardiograms that were only read by technicians — the ordering physicians never saw them, for reasons that aren’t clear.

Pretty scary sounding. But follow-up examination of the records found that of the 7,000 ECHOs, only 14 of them had been misdiagnosed. Twelve of those 14 patients were contacted — and none of them had suffered any adverse effects.

That silver lining is disguising a nasty gray cloud. Delving further into that data indicates something doesn’t add up.

To be so accurate in diagnosing via the tests (99.8% accurate, to be exact), the hospital would have to have the world’s best team of technicians — and one wonders why the physician oversight would be needed.

It would also seem safe to assume the doctors ordered those tests for a reason — yet they clearly didn’t use the results when deciding on a course of treatment for their patients. Why not? And why didn’t anyone notice that vital test results were missing?

For that matter, with so many patients seemingly unaffected by their ECHOs never being read, it’s fair to ask how many of those patients actually needed the test performed in the first place.

Without more information, it’s hard to come up with acceptable answers: Perhaps most of the patients were retested later. Possibly more patients were negatively affected than has been disclosed. It’s also possible that this group of ECHOs was not representative of the majority of tests. (Physicians and techs may have given lowest priority to results which showed no indication of disease — and these are the tests that fell through the cracks in the system.)

Regardless, this case has served to shine a light on some of the less visible signs that something has gone wrong with the health care system. Do you blame it on overworked/distracted employees, defensive medicine run amok or something else? Let’s hear your thoughts in the comments.

Connecting with patients and the wider community through social networking is increasingly common for hospitals, small practices and other health care providers. But some of the most popular social networking tools leave their owners and users exposed to a potential legal risk.

Developers of medical apps for the iPhone and similar devices could become targets for lawsuits if patients decide the information provided to them wasn’t correct. Health care providers who appear to be endorsing the use of these apps could conceivably be put at risk, as well.

Of course, standard disclaimers that these apps are meant for reference only could go a long way toward reducing the risk. But it’s an important reminder that as providers explore new tools and resources available online, they need to be aware of the quality of the tool, its credibility and how well patients may perceive the tool’s accuracy.