Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

22 Av 5766 - August 16, 2006 | Mordecai Plaut, director Published Weekly










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Home and Family

Your Medical Questions Answered!
by Joseph B. Leibman, MD

Director, Emergency Services, Bikur Cholim Hospital

I believe your prayers helped, and my father has been released from the hospital and is in rehab. This gives us an opportunity to discuss more aspects of his care.

1) My father recovered well, but was forced to spend extra days in the ICU because a floor bed was not available. This may sound great -- one-to-one nursing, better doctors, excellent attention -- but I counselled my mother to get him out of there as quickly as possible.

What was my rush? Many times, people in the ICU are very sick and get high-powered antibiotics. This could lead to bacteria that are resistant to most antibiotics and that can really endanger a patient. I personally do not like to use antibiotics (or any medicine for that matter) without a clear need. But in the ICU often they must.

2) My father was eventually transferred to a telemetry bed. Telemetry means that the patient walks around with a little radio-like device in his pocket which allows his heart to be monitored anywhere near an antenna. This allows a patient to get up and around. The problem is, however, that someone has to be watching the monitor and that is boring and sleep- inducing. So the monitor has bells when problems appear on the screen. The problem is that these give many false alarms and therefore are often ignored. But that is the best we can do.

3) ICU patients are often bedridden and this can cause pooling of blood in the extremities, as well as a collapse of the lungs, and also pressure sores. To deal with this, patients sometimes need to be given blood thinners or have a machine that presses the blood out of the legs to prevent clots. These clots, if allowed to form, could dislodge and reach the lungs. To prevent lung collapse, one often has to blow into a spirometer, a little chute with balls in it that keeps the lungs exercised. Pressure sores can be prevented by keeping the body clean, by frequent turning of the patient and by air or egg crate mattresses.

4) Many antibiotics cause loose stool. Often patients are alert enough to tell the nurse they need assistance to use to the bathroom, even if they are too weak to go there by themselves. Nurses save time by putting diapers on patients or putting in catheters. This is time saving, but is hard on the patient who feels a loss of dignity. There is often not enough nursing help, so finding a person to help out (it does not have to be a nurse) could go a long way.

5) After discharge from the hospital patients are often very weak. Kupot pay for physiotherapy, and some pay for rehab facilities. Here is where four therapists come in. Respiratory therapists build breathing. This is especially important for patients who were on respirators and need to build up their lung muscles. Physical therapists do exercises to build up muscles that have been weakened through the illness. This can help in patients with back pain, or in stroke patients. Occupational therapists not only help get people back to an occupation, but help with the activities of daily living such as buttoning shirts, tying shoes, using the rest room. Speech therapists can help stroke and Parkinson patients become understandable. Therapists are often quite successful, and I am seeing this firsthand with my father.

My father's name is Shmuel ben Faiga, and not as I wrote last time.

Write me in care of the Yated.


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