Steps that I took prior to Surgery Number 8:
- Attended a Colorado Patient Safety Coalition meeting in hopes of finding comparative infection rates for Hospitals. Result: No information was available.
- Read all the current guidelines from SHEA, APIC, and CDC. Result: Good knowledge and considerable increase in fear.
- 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.
- Took vitamin E for three months prior to surgery. Result: ??
- Requested an 8:00 AM surgery time. Result: Ignored.
- Got a really short haircut and shaved my upper body with clippers two weeks prior to surgery.
- Increased sleep from 7 hours/night to 9 hours/night. Result: Got very hard to sleep the night before.
- Prayed constantly. Result: Worked.
- 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.
- 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.
- 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.
- 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.