11:54 PM EST, December 31, 2013
Good morning, and let's be honest — your New Year's resolutions are probably only good for a week, maybe two.
Instead of trying to give up chips and salsa or joining a gym, you would be better off aiming not to be one of the millions who will land in emergency rooms in 2014 for entirely avoidable mishaps. And I just happen to have some pointers from ER doctors who have seen it all.
In November, after writing about federal judge and WWII veteran Harry Pregerson's continued good deeds for his fellow servicemen and women, I got a book in the mail from the judge's nephew, Dr. Brady Pregerson.
It's called "Think Twice: More Lessons From the ER," and it's a sequel to his book: "Don't Try This at Home."
"I was sewing up a friend who had cut his hand trying to clean out the inside of a wine glass," Pregerson said. "And I told him, 'I've seen this so many times, I should write a book on stupid stuff not to do."
Like cutting frozen food with a sharp knife (the blade will find your fingers).
Like tailgating (the ER is filled with drivers who thought they would be able to stop in time).
Pregerson, like any ER doctor, has seen plenty of tragic, unavoidable injury, illness and death in more than a decade of working at hospitals in Los Angeles and San Diego County. But emergency rooms also serve as 24-hour convention centers for Darwin Award candidates — those who spray cooking oil onto the open flame of a barbecue grill or decide to climb up on the roof to clean the rain gutters after a couple of beers.
"Eighty-five percent of what is in this book is common sense," Pregerson says in the foreword to "Think Twice."
Reading his pamphlet-size compendium, I was reminded of conversations with my buddy Dr. Mark Morocco, who's also an emergency room doctor in Los Angeles. He can't recall how many times he's seen patients with fingers chopped in a tell-tale way.
"So, you were cutting a bagel?" he'll ask.
Yeah, how'd you know?
Here's a no-brainer, in more ways than one: If you ride a bike, in a region with 40 billion or so cars, you should wear a helmet, right?
You'd think so, but a long line of knuckleheads missed that memo, and Morocco sees a few serious head injuries monthly.
Lately, Morocco said, there's been a run on infected piercings. He had one patient drop in with a tongue the size of an air mattress. He couldn't understand what she was saying, but the patient's friend was somehow able to translate the babbling when Morocco asked who had done the nice piercing job.
"A friend of a friend up on Sunset."
She would have been better off going to a tire shop.
Now that anyone who stubs a toe can get medical marijuana, Morocco sees patients who prescribed themselves a little too much medicine.
"They think they're having a stroke," he said, and have no idea what's wrong with them.
He will ask if they have had anything unusual to eat or drink, and patients have been known to say they took a bite of a marijuana-laced cookie "and didn't feel anything. So I ate six."
And then there's the mysterious exploding stomachache syndrome, common among kids with bright orange fingers.
"Flamin' Hot Cheetos," said Morocco.
A recent study estimated that roughly 70% of emergency room patients with healthcare plans don't need to be there, tying up resources where medical care is at a premium instead of waiting to see their regular doctor. Morocco said he's had patients come in and say they would like an MRI for a headache or lower back pain.
He has a standard response:
"This isn't a Chinese restaurant. You can't order off a menu."
And all these hypochondriacs get into line with the uninsured, who use emergency rooms for primary care, and with genuine emergencies. "Lately, every day feels like a tightrope act to me," Morocco says. "You look the wrong way, or some stupid driver looks down at his cellphone just when you step into the crosswalk on your run, and all hell breaks loose. We are all hostages to fortune, but I still think by being smart you can make a little luck."
That's exactly the point Pregerson makes in his books. "Crossing a street can kill you if you're not careful."
Pregerson said he recently diagnosed a case of infant botulism in a toddler whose mother had fed him honey, which pediatricians advise against for patients younger than a year old because they are particularly sensitive to bacteria spores that are occasionally found in honey.
Taking aspirin after a head injury can be dangerous too, he said, because it can increase bleeding. And if you can't read the prescription your doctor wrote, the pharmacist may not be able to, either. ERs get lots of patients who took the wrong medication.
And here's one I didn't know:
If you garden regularly, make sure you have had a recent tetanus shot.
"Over one-third of the rare but potentially fatal causes of tetanus are acquired while working in the garden," Pregerson writes in his book. "Tetanus is caused by bacteria found in soil and therefore also on gardening tools."
You can find Pregerson's books and more advice at http://www.gotsafety.org.
"The ER never closes," he says in the foreword of "Think Twice." "Come any time; I'd love to meet you in person. You, however, would probably rather stay at home…."
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