The Savvy Patient: guarding against C. Diff.

You're already wary of the potential for airborne respiratory infections in close-quarter and long-exposure situations such as hospital stays. We continue to be warned that we're on borrowed time with regard to a pandemic outbreak of some deadly form of one of the influenza viruses.

And the significant increase in contact infections, particularly from hospital environments, has been very troublesome in recent years with staph infections such as MRSA getting lots of attention. The deadly potential here has made it critical for the savvy medical care patient to be aware and proactive, to avoid an infection episode that could be worse than the condition that prompted the hospital stay in the first place.

Now warnings are also on the rise for another medicine-resistant bacteria strain that can be contracted from contaminated surfaces and objects in medical facilities. Clostridium difficile, often referred to as "C. diff.", is a potentially deadly organism described in this Mayo clinic online article:

"C. difficile bacteria are everywhere — in soil, air, water, human and animal feces, and on most surfaces. The bacteria don't create problems until they grow in abnormally large numbers in the intestinal tract of people taking antibiotics or other antimicrobial drugs. Then, C. difficile can cause symptoms ranging from diarrhea to life-threatening inflammations of the colon. According to the Centers for Disease Control and Prevention, each year in the United States C. difficile is responsible for tens of thousands of cases of diarrhea and at least 5,000 deaths. And the problem is getting worse. The number of C. difficile infections doubled between 1993 and 2003, with most of the increase coming after 2000."

What can you do to reduce the likelihood of dealing with a C. diff infection?

1. Stay out of the hospital. Take responsibility for your health before you are experiencing a clinical event that requires a doctor visit or hospital stay. You have choices about what you eat, drink, breath, and what kind of sleep you get. "Not enough money, not enough time" you say? Once you have a clinical event, you will spend time and money dealing with the event. You would spend far less upfront, preventing illness, and have a far better quality of life in the process.
2. Concentrate on building up your immune system. The state of your nutrition, stress levels, and even activity levels can degrade or enhance your immune function. In a world with increased numbers of medicine-resistant virus and bacteria, your built-in immune function is a critical line of defense in keeping you healthy. Know what you need, get what you need, for optimal immune performance.
3. Learn and take action to ensure a healthy gut, or digestive system. According to a BBC report, C. diff-related disease "occurs mostly in patients infected with C.diff when their normal gut flora is disturbed, for example during antibiotic treatment." Did you know that more than 70% of your immune function is in your gut?
   
4. Get ruthless about cleaning when you are in a higher-risk environment such as a hospital. A recent column in the AARP Bulletin suggested that patients (or loved ones watching out for patients):

• Insist that everyone treating you clean their hands before touching you
• Clean your own hands thoroughly before eating
• Do not touch your hands to your lips
• Do not place your food or utensils on any surface except your plate
• Ask loved ones to bring wipes containing bleach for items around your bed
• Assume any belongings that come with you are contaminated
• Do not mix clothes from the hospital with the family wash, wash them with bleach
• Be careful about eating in food service areas where staff where their scrubs or uniforms
  

You get the picture.

C. diff is very resistant to all but the deepest cleaning approaches. Few antibiotics are effective, and relapses after treatment are common. Mortality rate is as high as 30%.

The savvy health care consumer will stay out of that fight if at all possible. "The best offense is a good defense" as they say.

In the press: Suddenly Sick

A recent special report by the Seattle Times, "Suddenly Sick", includes a disturbing look at the forces at work that affect your health outcomes - and your costs - when you seek treatment from the US health system.

"You walk into your doctor's office for a physical exam and step on the scale. Last year, the doctor said you were overweight. Now he says you are obese — at the same weight.

A nurse takes your blood pressure. You have hypertension — with the same previously healthy reading you've had for years.

The doctor scans your wrist bone. You have a condition called "osteopenia" — with the same bone density that was fine last time you were measured.

You mention you are not enjoying sex as much as you used to. Diagnosis: a new kind of sexual dysfunction.

You leave the office with a head full of worry and a fistful of new prescriptions, joining more than 40 percent of Americans who take one or more prescribed drugs daily in the effort to stave off more serious trouble.

You are suddenly sick, simply because the definitions of disease have changed."

While not the first time this observation has been made, this report should deepen our misgivings about how much we've allowed our health 'paradigm' to shift into something that is costing us more than it's helping us. The degree to which this is organized and in-trenched is incredible.

You've suspected this was happening. Get this perspective on how far it's gone, and let's push back. There is a better, safer, more cost-effective way. 

See the Seattle Times web site for the full report.