What to Bring BEFORE You Go To The Emergency Room to Keep You Sane

What to Bring BEFORE You Go To The Emergency Room to Keep You Sane

By Natan Schleider,  M.D.

July 29th, 2018

One Horse Power Ambulance (Circa 19th Century)

Having gotten a call that my 5 year old daughter had just fallen at the playground in camp and was complaining of right wrist pain, I hustled down to pick her up. While crying inconsolably, the ice pack on her wrist already warm, she said ‘I can’t move my fingers and I want to go to the doctor–but I don’t want a shot.’

The wrist was swollen and very tender to the touch so with nothing but my wallet, smart phone on 40%, and keys, I picked Ellie up and went to the Pediatric Emergency Room directly, panicked, not thinking, unprepared. As doctor who has worked in the emergency room (ER), I should have known better: bring the stuff you need when going to the emergency room as if you were going on a camping trip or off to boot camp.

The ER was packed and we were ushered into a bed outside multiple rooms where the screaming of tormented children rang louder than the ambulances outside.

Long story short, we got there at 1:30 pm and were discharged at 2am and my daughter ultimately left with a cast in a sling having fractured her distal forearm. Hospital staff did not want me leaving my daughter unless I had to use the bathroom because the orthopedist and x ray transport would be here ‘any minute but no promises.’

My personal experience is that the average ER visit lasts 6-12 hours and here is the irony, the less sick you are, the longer you wait for care as heart attacks get prioritized over sore throats in a setting which is almost always understaffed.

While I credit the hospital staff for being polite and professional–they don’t make the rules in the ER nor control how busy it is–I know of no modern emergency room where you are greeted at the door with a handshake or smile, offered a glass of water, or a ‘welcome packet.’

As emergency rooms are losing business to urgent care centers, valet service (at hospitals, not the ER), a coffee machine and crackers, and a single chair for the parent are the latest in luxury amenities.

I was given a computer/tablet about a dozen times to sign consent forms–not to watch Netflix during the prolonged wait (seems like a reasonable idea doesn’t it).

Moving forward when going to the ER, may I suggest/note:

  1. You not go as only 10-30% of the time is it a true medical emergency…get a good doctor who can triage you same day and picks up his/her phone.
  2. Bring snacks, ear plugs, ear buds to listen to music or watch movies or whatever on your mobile device, a good book, a portable phone charger, beverages, a change of clothes, your toiletry kit, a portable chair or cushion, and your medicines.
  3. Learning to meditate because you’re gonna be there at least twice as long as your are initially quoted.

I would love to hear about any emergency room experience or wisdom via Twitter, Instagram, of Facebook!

Over and Out,

Natan Schleider, M.D.

PS–Being a health care provider does NOT afford you any special or speedier care unless you’re on staff in that ER or are a super famous doctor or specialist.

Cosmetic Medicine Part 1: What A Doctor Does for Prevention and Treatment of Sundamaged Skin

Cosmetic Medicine Part 1: What A Doctor Does for Prevention and Treatment of Sundamaged Skin

by Natan Schleider M.D.

July 23rd, 2018

Now that I am 42, those blissful days at the beach when I casually remembered to add SPF sunblock occasionally are catching up. Suddenly my skin in looking like it has some age spots, wrinkles, and my forehead has pigment changes.

I realize I’m no male model but when ‘liver spots’ appear I start worrying that shuffleboard all day and dentures are on the way so let’s nip this in the bud in the most cost effective way possible.

Natan Schleider MD sun-damaged skin on foreheard
Natan Schleider MD sun-damaged skin. Note two dots on back of my hand.

I’ve been using Retin A Micro Gel 0.06% for about a few months and see no results so I’m considering other options.

According to John Hopkins these are my treatment options:

  • Botulinum toxin type A. An injection of botulinum toxin (a complex type of protein) into specific muscles will immobilize those muscles, preventing them from forming wrinkles and furrows. The use of botulinum will also soften existing wrinkles.
  • Chemical peels. Chemical peels are often used to minimize sun-damaged skin, irregular pigment, and superficial scars. The top layer of skin is removed with a chemical application to the skin. By removing the top layer, the skin regenerates, often improving its appearance.
  • Soft tissue augmentation or filler injections. A soft tissue filler is injected beneath the skin to replace the body’s natural collagen that has been lost. There are multiple different kinds of fillers available. Filler is generally used to treat wrinkles, scars, and facial lines.
  • Dermabrasion. Dermabrasion may be used to minimize small scars, minor skin surface irregularities, surgical scars, and acne scars. As the name implies, dermabrasion involves removing the top layers of skin with an electrical machine that abrades the skin. As the skin heals from the procedure, the surface appears smoother and fresher.

    A gentler version of dermabrasion, called microdermabrasion, uses small particles passed through a vacuum tube to remove aging skin and stimulate new skin growth. This procedure works best on mild to moderate skin damage and may require several treatments.

  • Intense pulsed light (IPL) therapy. IPL therapy is different from laser therapy in that it delivers multiple wavelengths of light with each pulse (lasers deliver only one wavelength). IPL is a type of nonablative* therapy.
  • Laser skin resurfacing. Laser skin resurfacing uses high-energy light to burn away damaged skin. Laser resurfacing may be used to minimize wrinkles and fine scars. A newer treatment option is called nonablative* resurfacing, which also uses a laser as well as electrical energy without damaging the top layers of skin.

*Nonablative dermatological procedures do not remove the epidermal (top) layer of the skin. Ablative procedures remove the top layers of skin.

I’m leaning toward the laser because I am inpatient and want fast results but the price in New York City may be $1,000-$2,000 so I may need to go with something else?

I recommend my dermatologist who isa brilliant and has a great bedside manner: Dr.Roy Seidenberg [https://www.laserskinsurgery.com/Dermatologists/Roy-Seidenberg-MD

To be continued after consult…how exciting!

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Thx for reading!