Patient Empowerment in Infection Prevention

Steps that I took prior to Surgery Number 8:

  1. Attended a Colorado Patient Safety Coalition meeting in hopes of finding comparative infection rates for Hospitals.  Result: No information was available.
  2. Read all the current guidelines from SHEA, APIC, and CDC.  Result: Good knowledge and considerable increase in fear.
  3. Met with my surgeon and demanded a prescription for decolonization therapy.  Result: Surgeon recommended an infectious disease doctor who put me on a decolonization program two weeks prior to surgery. I used chlorhexidine shampoo, mupirocine in my nose, and oral antibiotics.
  4. Took vitamin E for three months prior to surgery.  Result: ??
  5. Requested an 8:00 AM surgery time.  Result: Ignored.
  6. Got a really short haircut and shaved my upper body with clippers two weeks prior to surgery.
  7. Increased sleep from 7 hours/night to 9 hours/night.  Result: Got very hard to sleep the night before.
  8. Prayed constantly.  Result: Worked.
  9. Negotiated with surgeon to include vancomycin as the prophylactic antibiotic, full air-supplied suits for the surgical team, no shaving, double gloves.  Result: Doctor did all but the suits.
  10. Wrote, “Please, please, don’t infect me,” across the doctor’s informed consent form.  Result: Surgery team chanted, “Let’s get it right this time,” on the way to the OR.
  11. Post-op doctor put me in a private room (probably to keep me from talking to other patients).  Result: Big bill ($900) to fight about.
  12. Continued taking vitamins and avoided taking showers until stitches were removed.

But the ultimate question remains. If a patient insists on treatment that his doctor disagrees with, is he guilty of practicing medicine on himself? If something still goes wrong, who is the responsible: the doctor or the patient?

There is a very interesting medical term called “conservative treatment,” generally defined as the plan that uses the very least amount of medicine to create the highest probability of a good outcome. Doctors don’t always choose the conservative approach. Sometimes they choose the most expedient plan, the most profitable plan, or the really new high-tech plan that they are dying to try out. One question a patient should always ask multiple doctors is, “What is the most conservative treatment plan for this condition?” They may not agree with each other but you will gain a great deal of knowledge on the range of options available.

Kerry O’Connell

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About Kerry O'Connell

Kerry O'Connell is a civil construction project manager and a member of the Colorado Health Facility Acquired Infections Advisory Committee. A committed patient safety advocate, he calls for restoring empathy and compassion in health care. He became a Numerator in 2005.
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