Health Care and Poison Ivy

Summertime is almost in full swing. That means school is out, families are going on vacation, picnics and playtime for kids, and hiking in the woods and on trails. When everyone heads outdoors to experience nature at its best, it’s always best to take precautions especially if you are headed into areas that have a lot of green foliage. Or, if you are the type that loves working in your garden or flower beds, you can bet that you’ll be dealing not only with your plants, flowers, and vegetables, but also with lots of weeds, and some of them can be down right nasty. One of those mean green weeds is poison ivy, and it thrives during the heat of the summer season.

According to pediatrician Dr. Vincent Ianelli, most parents love when their kids go outside to play. Unfortunately, in addition to the sun and bugs, poison ivy can be a big problem for kids playing outside. Poison ivy can also be a hazard to gardeners, people landscaping their yards, hikers, campers, and anyone else who likes to spend time outdoors.

Although some people truly are immune to poison ivy, most people develop a rash after coming into contact with poison ivy or the similar plants, poison sumac and poison oak. If you think you are immune because you have never developed a rash before, keep in mind that it can sometimes take multiple exposures or several years before you finally begin to develop an allergic response to urushiol, the chemical in poison ivy that triggers the rash that most people get, according to Dr. Ianelli. Whether or not you think that you or your kids are immune to poison ivy, it is a good idea to not take any chances and to learn how to recognize and avoid poison ivy. Unfortunately, the old 'leaves of three, let it be' phrase isn't usually enough to help everyone avoid poison ivy.

According to the Poison Ivy, Oak, and Sumac Information Center, about 15 percent of the 120 million Americans who are allergic to poison oak, poison ivy, and poison sumac are so highly sensitive that they break out in a rash and begin to swell in 4 to 12 hours instead of the normal 24 to 48. Their eyes may swell shut and blisters may erupt on their skin. “This is one of the few true emergencies in dermatology,” says William L. Epstein, MD. Get to a hospital as soon as possible. A shot of corticosteroids will bring the swelling down. Much more information about various treatments can be found at this site: http://poisonivy.aesir.com/view/medical.html .

How do you get poison ivy? According to Poison-Ivy.org, from touching it, or touching something that has touched it, like your clothes or your dog. You normally get it from touching the leaves, but yanking the vine out by the roots - even in winter - will give you a wicked rash. Using a weed eater to remove poison ivy will result in spraying your legs with poison ivy. If you are bare-legged and get scratches while splattered with sap from poison ivy, you may be headed to the emergency room. And there are more unusual ways to get it, like breathing smoke from firewood burning with poison ivy on it, which can also put people into the hospital.

At first you get a slight itchy spot, which gets worse and worse. It can be a a small itchy area that will annoy you, or it can cover your whole body with giant red sores that will drive you nuts, according to Poison-Ivy.org. The poison ivy rash, even when not huge and ugly, can be one of the itchiest experiences a person will ever have. Within a hour or so you should rinse with lots of cold water - like a garden hose. Hot water will open your pores and let the oil in. Taking shower could be a disaster. (Later, after the oil is all absorbed or washed off, and you HAVE a big rash, hot showers can ease the itch for a few hours.) For up to about 6 hours washing with alcohol may still help remove the oil, but many say that after 1/2 hour the oil has soaked in and you can't remove it. The next day is really too late. Check with your doctor to see if early treatment can prevent the rash before it really starts. For a serious case you MUST SEE A DOCTOR. For less serious cases check with your local drugstore or pharmacist, or see the list below for remedies. Here is a list of popular home remedies:

• Take a shower in the hottest water you can stand, for as long as you can stand - this may ease the itch for a few hours. Be careful not to get burned by the hot water.
• If heat eases your rash, you can also try a hair dryer, but BE CAREFUL. Don't burn yourself.
• Jewelweed is widely thought to help the rash. Mash the weed and apply to the rash.
• Spray with a deodorant containing aluminum, which most do.

Much more details about dealing with poison ivy can be found at this website: http://www.poison-ivy.org/html/faq.htm .

Additionally, according to the American Academy of Dermatology (AAD), if you have any of the following, go to the emergency room right away:

• Trouble breathing or swallowing.
• Rash covers most of your body.
• You have a huge number of rashes or blisters.
• Swelling, especially if your eyes swell shut.
• Rash develops anywhere on your face or genitals.
• Your skin itches all over with no relief.

As the skin heals, it can itch, according to the AAD. It is best not to scratch. Scratching can cause an infection. To ease the itch at home, dermatologists recommend that their patients try one or more of the following:

• Oatmeal bath: Take short lukewarm baths in a colloidal oatmeal preparation, which you can buy at your local drugstore.
• Baking soda bath: Draw a warm, not hot, bath, and add 1 cup of baking soda to the running water.
• Calamine lotion: Apply this to skin that itches.
• Cool showers: Short cool showers can help.
• Cool compresses: You can make a cool compress by running a clean washcloth under cold water and wringing it out so that it does not drip. Then apply the cool cloth to the itchy skin.
• Antihistamine pills: These pills can help, but you should not apply an antihistamine to your skin. Doing so can worsen the rash and the itch.

• Go to their website for more information: http://www.aad.org/skin-conditions/dermatology-a-to-z/poison-ivy/tips/poison-ivy-tips-for-treating-and-preventing .

Dr. Vincent Ianelli also has more options to treat Poison Ivy. Examples include:

• Atarax (hydroxyzine, a prescription oral antihistamine)
• Aveeno Anti-Itch Cream with Natural Colloidal Oatmeal
• Aveeno 1% Hydrocortizone Anti-Itch Cream (OTC topical steroid)
• Band-Aid Anti-Itch Gel
• Caladryl Clear Topical Analgesic Skin Lotion
• Calamine Lotion
• Cortizone 10 (OTC topical steroid)
• Cutivate cream 0.05% (prescription topical steroid)
• Domeboro Astringent Solution Powder Packets
• Gold Bond Maximum Strength Medicated Anti-Itch Cream
• Itch-X Anti-Itch Gel with Soothing Aloe Vera
• Locoid cream 0.1% (prescription topical steroid)
• Triamcinolone acetonide 0.1% (prescription topical steroid)

Newer medications that are supposed to target poison ivy symptoms include:

• Burt's Bees Poison Ivy Soap
• Cortaid Poison Ivy Care Treatment Kit
• Ivarest Medicated Cream
• IvyStat
• Tecnu Extreme Poison Ivy Scrub
• Zanfel Wash For Poison Ivy, Oak & Sumac

There is a lot of information at this website from Dr. Ianelli: http://pediatrics.about.com/cs/conditions/a/poison_ivy.htm?nl=1 .

Coming in contact with Poison Ivy is a common occurrence, especially during the warmer months. Be careful when you are gardening or out enjoying nature. The chances you may come in contact with this wicked little weed can be good. Use your commons sense when you think you may be exposed, and teach your kids about staying away from poison ivy. They will thank you for it. If you have a problem once you come in contact with it, see your doctor for treatment if your reaction is severe. If it’s worse, then go to the emergency room as quickly as possible. Don’t let a weed get the best of you.

Until next time.

Health Care and Medical Malpractice

Just about every day in the US, someone sues a medical practitioner for something that the patient feels went wrong during a procedure, operation, or some health care treatment. Litigation against doctors, hospitals, and other health care providers is one of the most often sought forms to receive some type of financial compensation for injury suffered due to negligence or other form of medical malpractice. Surgeons and doctors are constantly worried that one of their patients will sue them for something deemed careless or intentionally incorrect during a medical procedure. But to win the case, the burden of proof lies with the plaintiff.

According to the Newsome Melton law firm, despite the abundance of excellent medical care, doctors are human and they occasionally make mistakes. A patient can be harmed due to negligence or mistreatment by a medical provider. If injury can be proven, then a case of medical malpractice should be argued. To be considered malpractice, it must be proven that harm was caused when the medical provider acted outside acceptable terms of standard care. A case can be brought against the practicing physician, the hospital in which the treatment occurred, and any state or federal agencies responsible for supervision of the hospital. A doctor could be at fault for misdiagnosing a patient or skipping a customary step during treatment. Any errors that occurred in the training of hospital employees resulting in neglect or sanitation problems are also grounds for a lawsuit.

Medical malpractice happens when a health care or medical provider is negligent when treating a medical condition, according to ExpertLaw.com. Malpractice can occur from an action taken by the medical practitioner, or by the failure to take a medically appropriate action. Some examples of medical malpractice include:

• Failure to diagnose, or misdiagnosis of a disease or medical condition;
• Failure to provide appropriate treatment for a medical condition;
• Unreasonable delay in treating a diagnosed medical condition;

A health care provider may also be legally liable if the patient does not give "informed consent" to a medical procedure that results in harm to the patient, even if the medical treatment is properly performed. Much more detail can be found at this website: http://www.expertlaw.com/library/malpractice/malpractice.html#3 .

According to MedicalMalpracticeHelp.com, it is impossible for a victim to know if their claim is worth presenting in court without first consulting an attorney. The most proficient advice will come from a lawyer that is experienced in handling medical malpractice cases. Many firms are willing to work on a contingency basis. This means that the law firm will only get paid if the victim is offered a pre-trial settlement or an award in court. Since it is unrealistic to assume that the ruling will favor the plaintiff, a lawyer will not argue a case that lacks substantial proof of injury.

Damage caps, liability reform, and time limitations can all affect the outcome of a medical malpractice claim. Each of these factors is dictated by the state’s government. It is best to seek council with a lawyer that has previous experience in the victim’s general location. Limits on the maximum amount awarded for malpractice claims vary from state to state. A few select states do not have any damage caps, while other states have very low boundaries in place, according to Newsome Melton.

Additionally, according to the law firm, liability reform is an aspect of law that not only changes from state to state, but is also constantly evolving. Terms of liability can be amended several times a year and are difficult to keep up with for those outside the legal profession. Many states mandate their own restrictions that define when a medical malpractice suit can be filed. Two years is the average time limit for most claims. Due to strict time limitations and complicated guidelines, a victim should schedule a legal consultation as soon as possible if malpractice is suspected.

Medical malpractice lawsuits have existed in the United States for more than 150 years, though today, most medical errors are never pursued in court, and a large majority of claims never result in any kind of payment to patients. And even though the direct and indirect costs of such suits account for only 2.4 percent of total health care costs, that’s still $55 billion yearly. To say nothing of the even more important social costs, an issue addressed by The Journal of the American College of Surgeons.

As reported in the NY Times, researchers surveyed more than 7,000 surgeons and found that nearly one in four were in the midst of litigation. Surgeons involved in a recent lawsuit were more likely to suffer from depression and burnout, including feelings of emotional exhaustion and detachment, a low sense of accomplishment and even thoughts of suicide. Other studies estimate that, depending on the specialty, anywhere from 75 percent to 99 percent of practicing doctors will over the course of a lifetime be threatened with a lawsuit.

According to the NY Times, doctors who have been sued may end up practicing defensive medicine, ordering unnecessary tests and medications or refusing to treat patients with more complex illnesses altogether as a safeguard against future litigation. Those same doctors can also become burned out, which can lead to even more errors, and more malpractice claims. And, one way to disrupt the negative cycle is to improve communication between patients and doctors, so that patients are aware of the risks that can occur despite a doctor’s best efforts. Another important step is instituting programs that continue those conversations even after an error occurs. But change will require looking at malpractice reform in a new way, one that gives weight not just to the economic costs but to the ways reform might affect how patients and doctors interact.

It is a good idea for a victim to speak with several law firms specializing in medical malpractice cases, according to Newsome Melton. The victim can then assess which group will provide the best legal assistance. A worthwhile attorney will offer a free consultation to determine the strength of a potential client’s case. Before the suit can proceed, the plaintiff will need to obtain a certificate of merit. This is acquired when another health care professional reviews the relevant medical documents and records of the victim. If proof of medical malpractice is found, the health care professional will serve as an expert witness in trial. The testimony will state that the acting physician deviated from normal medical standards, resulting in damage to the victim. The plaintiff’s attorney will file the certificate of merit, confirming that they have consulted with a licensed physician and obtained evidentiary support.

Medical malpractice issues are pretty complex from a legal standpoint. Who should be held responsible for errors in medical treatment? How can concepts like "informed consent" affect a case? What about damage caps in med mal cases? According to Medical Malpractice.com, medical malpractice suits require a substantial amount of investigation before being able to proceed with a case. For much more detail about that information and for individual state laws about medical malpractice, visit this site: http://www.medicalmalpractice.com/topics/state-state-medical-malpractice-laws .

If you feel that you have been a victim of medical malpractice, seek professional legal advice about your situation or case before proceeding with litigation. There may be a valid opportunity to seek damages, or there may be no real option that would allow a lawsuit to be filed. Opinions from your friends or relatives are not considered legal advice, unless one of them happens to be an attorney. And a law firm that specializes in these types of cases would be best for consulting and further action, but only after reviewing the merits of your file.

As a patient, it’s always best to seek a second opinion for major medical or health care decisions, but when you undergo surgery or other complicated medical procedures, always know that there can be risk, and sometimes substantial risk that the outcome may not be successful. That’s why it pays to have good counsel and great doctors.

Until next time.