Speedy Hospital Response

In light of the discussions about hospitals and CPAPs, just for the heck of it, I checked the websites of the two major hospitals in my area that I would be likely to use.

One mentioned bringing the CPAP if one has a sleep disorder and one did not (naturally, the hospital where I had my cancer surgery).

http://www.ochsner.org/patients_visitors/what_to_bring/ says

# Bring any devices you will need after surgery such as crutches or canes.
# If you have sleep apnea, please bring your CPAP machine.

I dropped a note to the webmaster at Touro Infirmary regarding this omission.

In less than an hour, I had two emails from the hospital -- one apologizing for the omission, and the second telling me it had been corrected, here http://www.touro.com/content/patientfaq.htm, where it says

Q. When I check-in and register, what kind of personal belongings should I bring?
1. You may bring a small bag of personal belongings such as toothbrush, robe, slippers and hairbrush. If possible, label all your belongings. Labeling greatly increases the chance of finding your items should they become misplaced. Whenever possible, please leave your valuables, jewelry, at home. Touro does not assume responsibility for lost articles but will make every effort to help you find them. If you lose an item, notify your nurse immediately.

For patients who suffer with sleep disorders and use a Continuous Positve Airway Pressure system (CPAP machine), please be sure to bring the device with you.

I think I'll still make sure it's in my doctor's orders if I have to go into the hospital. But I was impressed with the prompt correction.

Wow, that's great customer service. Thanks for posting it, as I have no idea what my local hospital(s) advise on that issue. You've prompted me to check it out.

BTW, how's your mom doing, Kira?

BleepingBeauty wrote:Wow, that's great customer service. Thanks for posting it, as I have no idea what my local hospital(s) advise on that issue. You've prompted me to check it out.

BTW, how's your mom doing, Kira?

Was discussing the issue of apnea with my oncologist on Thursday (she now has my machine and pressures listed in her notes), and thought I would check. And yes, it was excellent customer service -- but Touro is, generally, a very good hospital from a medical stand point.

My Mom is OK... I have to call and see if her PCP has scheduled the NOX, as it's been two weeks since we saw him, and no test has been done. He didn't seem to think it terribly important... but Mom is losing more and more of her short-term memory. I really wish doctors were more up on sleep disordered breathing!

Mom tried to do a 30 day intensive therapy to get her back on her feet and washed out at 3 days -- she panicked at being in a strange place. Either Dad or I had to be with her continuously or she came unglued. So, she's home again, and Dad is trying to arrange for more home therapy.

http://www.benzo.org.uk/ashop.htm
My emphasis added.

Benzodiazepines & Older People

Professor C Heather Ashton, DM, FRCP
March, 2002



School of Neurosciences
Division of Psychiatry
The Royal Victoria Infirmary
Queen Victoria Road
Newcastle upon Tyne NE1 4LP

The Ashton Manual · Professor Ashton's Main Page

• ]Older people are more sensitive than younger people to the central nervous system depressant effects of benzodiazepines, and indeed to all central nervous system depressant drugs in general.
• Benzodiazepines can cause confusion, night wandering, amnesia, ataxia, hangover effects and pseudodementia in the elderly, and should be avoided wherever possible.
• Increased sensitivity to benzodiazepines in older people is partly because they metabolise drugs less efficiently than younger people, so that drug effects last longer, and drug accumulation may occur with regular use.
• However, even at the same blood concentration, the depressant effects of benzodiazepines are greater in the elderly, possibly because they have fewer brain cells and less cortical reserve than younger people.
  
  <snip>
  
  There are particularly compelling reasons why older patients should withdraw from benzodiazepines since, as age advances, they become more prone to ataxia (leading to falls and fractures), confusion, memory loss and psychiatric problems (sometimes leading to a false diagnosis of dementia or Alzheimer's disease). A slow tapering regimen, in our experience, is easily tolerated, even by people in their 80s who have taken benzodiazepines for 20 or more years.
  
  Methods of benzodiazepine withdrawal in older people are similar to those recommended for youger adults. Such methods include slow tapering of the benzodiazepine in current use, sometimes with liquid preparations if available, and also judicious stepwise substitution with diazepam (Valium), especially for those using short-acting benzodiazepines such as alprazolam (Xanax) or lorazepam (Ativan). There is, of course, a great deal of variation in the age at which individuals become "older".

Heather Ashton
March 2002