Brief News
Although having a good, trustworthy doctor should be a high priority, many women don't put enough care into finding one. The March issue of Cosmopolitan describes warning signs of an unsatisfactory doctor and how women should protect themselves.
The author suggests: Doctors should not be perpetually unavailable. A woman shouldn't have to wait for more than a couple of weeks for an appointment or forever at the office. Experts say the ideal maximum waiting time for a doctor is 15 minutes.
The article says that the majority of women's complaints arise from miscommunication. A doctor needs to be capable of putting medical jargon into layperson's terms. A new doctor always should ask about a patient's medical history.
Women also need to guard against being overmedicated and underevaluated, the article suggests. The article recommends obtaining a second opinion if women aren't feeling better or have serious doubt of a diagnosis.
Patients are advised to recognize that sexual harassment isn't necessarily overt and that women should be aware that they always have the right to a nurse's presence in the room. If their doctor is harassing, the article suggests women file a complaint with the state medical board of quality assurance. By taking this action, the complaint is documented and on the doctor's record. Also, inform the police and district attorney and find a lawyer.
Jeanette Tracy didn't worry about the hernia surgery being performed on her - not until she found herself awake and aware of what was being done to her body in the operating room (OR). The March issue of Redbook describes the suffering patients sometimes withstand when they are supposed to be unconscious.
Tracy is an example of a patient who experienced full awareness during the course of surgery. This means she was fully conscious and could hear and feel everything that happened in the OR. She felt the incision into her abdomen, smelled her flesh burning, and heard the surgeon's statements and requests. She was powerless and incapable of notifying anyone of her status.
Full awareness occurs in a small portion of patients who undergo surgery each year. Peter Sebel, MD, an anesthesiologist at Emory University, Grady Memorial Hospital in Atlanta who has studied the problem, estimates that about 40,000 out of 20 million surgery patients experience it.
Women are three times more likely to be involved in an awareness claim than men. One reason may be that anesthesia doses are based on studies of men. Awareness cases emphasize how little most people know about anesthesia.
Everyone responds differently to drugs, and often the nervous system registers pain even though individuals have no memory of it. According to Janet Osterman, MD, an assistant professor of psychiatry at Boston University School of Medicine, surgical trauma usually cannot be remembered consciously, but slowly a lot of people remember bits and pieces such as sounds and smells of the operating room.
Doctors are working to solve the awareness problem. Nassib Chamoun, a Harvard-trained medical engineer who is CEO and founder of Aspect Medical Systems in Natick, MA, has developed a device that measures electrical activity in the brain as drugs are being administered. In tests on more than 5,000 people, the awareness problem was eliminated. The problem of giving more drugs than necessary also was reduced.
The monitor has been purchased by hundreds of hospitals, the article says. The device, called a Bispectral Index Sensor (BIS), is available via the internet at http://www.aspectms.com. Another device that monitors normally invisible facial muscle movements was invented by Henry Bennett, PhD, a psychologist in Madison, NJ. It will be on the market soon. Bennett's device registers changes in facial tension, which are a good indication of awareness.
Unfortunately, despite advances, the problem won't be eliminated soon. It would take years for all ORs to be equipped with consciousness-measuring instruments. In the meantime, patients are encouraged in the article to ask questions. Find out how experienced the anesthesiologist is, what hospitals have devices for measuring consciousness, whether paralytic drugs are going to be used, and if they are absolutely necessary, the article suggests. Expressing concerns in advance will make doctors more vigilant in monitoring, according to the article. If patients experience awareness, help can be obtained through the Awareness with Anesthesia Research Education Foundation, 2500 N. Van Dorn St., Suite 1015, Alexandria, VA 22302.
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