Ever been in a hospital? I have – and not just as a doctor but as a patient, husband, father and son.
I still remember sitting by my mother’s bed while she was dying of pneumonia hooked up to IVs and monitors and strapped down to keep her from pulling out the cords. By that time, mom had lived with Alzheimer’s for eight years and didn’t know who I was.
How inhumane that was! This was back in 1981, when hospice was practically considered a communist plot thought to undermine a doctor’s role to cure at all costs.
We’ve come a long way since then. That’s because you, the consumer, have demanded gentler care. We’ve found ways to use technology wisely, but tame its negative aspects.
Still, when a person goes to the hospital today, it’s for active medical care and it’s intense. It means being probed and prodded, stuck for blood and awakened at all times of the day. And then there are the alarms for the IV, the oxygen monitor, the straps, the cords.
So how can we make this better? A recently published article in the Journal of the American Medical Association looked at just that question in a study involving music therapy in the hospital intensive care unit.
Researchers zeroed in on patients who were on a ventilator in the ICU. Vents help to keep people alive, but as people begin to wake up and become conscious of them, they want to stop using them as soon as they can.
A ventilator is so uncomfortable that many patients say they would rather die than go back on one. Users are known to suffer agitation, depression, anxiety and insomnia; up to 25 percent have even been shown to suffer post-traumatic stress disorder up to six months later.
The ICU study took 400 ventilated patients and put them into three groups. Some listened to music – the kind they liked, according to them or their children. Some wore noise-reduction ear phones, and the others received the usual care, with nothing to block out or reduce ICU noise.
By day five, the difference was clear. Both intervention groups were less anxious and needed less sedation. They were less agitated.
It’s clear an ICU is a tough place to be. Anything we can do to make it “softer,” then, well, we should do. Noise is disturbing, and silence or the music a patient loves can relax them, even on a vent.
My spin: This is an easy fix. If you end up in the hospital, have someone bring you ear phones that either block out the noise or give you the music you love.
Dear Dr. Zorba: On your public radio show you mentioned an arthritis cream better than Bengay with no smell at all. What’s it called? I didn’t write it down because I was driving. P.S. We love the show.
– Achy Katie
Dear Achy: It’s an anti-inflammatory cream that contains diclofenac. Under the name brand Voltaren Gel (full disclosure: we once did a clinical study in our office) it’s costly, at $50 for a small 3-ounce tube. Some insurances cover it, so check it out. Also, there are some special drug stores called compounding pharmacies that make a generic version that may be cheaper. I’m all for saving money.
Dr. Zorba Paster is a family physician, university professor, author and broadcast journalist. He also hosts a radio program at 3 p.m. Saturdays on WBFO-FM 88.7.