A cautionary tale for anyone admitted to the hospital

When the Wind Blows

If you’re pregnant, this is an e-Alert you MUST READ. And if you know someone who’s pregnant, this is an e-Alert I hope you’ll forward. For everyone else, there’s important information here that will serve you well if you or a loved one are ever admitted to a hospital.

Just say no

A colleague of mine named Matt recently sent around an e- mail with happy news: His wife, Caroline, had given birth to their first child…Timothy.

Usually this type of e-mail concludes quickly with time of birth, weight, “everyone’s doing fine,” etc. But Matt had some further details (and a cautionary tale) he wanted to share with his friends at work.

Caroline’s labor was long and exhausting, but Timothy’s vital signs indicated he had come through it just fine, healthy and alert. After Caroline started breastfeeding, a nurse took the baby to the nursery for a bath and standard testing, giving Matt and Caroline their first opportunity to rest for a bit.

A couple of hours later the nurse returned to tell them Timothy had aspirated some milk into his lungs after being bottle-fed. (Matt and Caroline has specifically asked that the baby NOT be bottle-fed unless absolutely necessary.) Timothy’s oxygen levels fell momentarily followed by rapid breathing, so he was taken to the neonatal ICU unit and given a dextrose drip – apparently standard procedure.

Matt and Caroline rushed to NICU where they were in for another shock: A doctor informed them that Timothy needed a round of antibiotics – again, apparently SOP when a virus is suspected. Also, due to acid reflux, he immediately required Zantac and another acid-suppressant drug called Reglan.

Matt drew the line: No antacid drugs. As you can imagine, the doctor didn’t take this lightly. After some wrangling, Matt and Caroline reluctantly agreed to the antibiotics as a precaution, but they held their ground on the antacid issue.

So now they were faced with several days in NICU while Timothy received intravenous antibiotics. Timothy showed every indication of being in otherwise good health, so his parents were optimistic that after toughing it out for a few days their patience would be rewarded.

A great target market

At one point during their NICU stay, Matt spoke to a friend who’s a resident at a large university hospital. His friend estimated that about 30 percent of all newborns at his hospital are given Zantac or some other acid-suppressant.

Matt’s comment: “Newborns. On Zantac. You have to admit, it’s a great target market for these companies. 99.99% of babies spit up (reflux).”

Infuriating, isn’t it?

Coincidentally, just a couple of days after getting Matt’s e-mail I came across a Journal of the American Medical Association study from Harvard Medical School.

Here’s the opening line of the study: “The use of acid- suppressive medication has been steadily increasing, particularly in the inpatient setting, despite lack of an accepted indication in the majority of these patients.”

In other words, MOST of these patients don’t need the antacid drugs they’re given as standard operating procedure.

Again – infuriating. But it gets worse.

After monitoring the hospital records for nearly 64,000 patients (more than half of whom received acid-suppressive medication), the Harvard team found that the drugs significantly increased risk of hospital-acquired pneumonia.

So…how’s your blood pressure right now? Mine is off the charts!

I’d like to tell you that Timothy finished up the antibiotics and he and his parents were soon headed home, but they had no way to anticipate the whims of overreacting medical professionals. In tomorrow’s e-Alert I’ll fill you in on the conclusion of their ordeal.

“Acid-Suppressive Medication Use and the risk for Hospital-Acquired Pneumonia” Journal of the American Medical Association, Vol. 301, No. 20, 5/27/09, jama.ama-assn.org