Here's a checklist of items that I would use for myself...you may use it as a format and tailor one for your specific needs....
For My Hospital Stay
I have Asthma/Reactive Airway Disease and severe chemical allergies. Certain volatile organic substances such as perfume and formaldehyde constrict my lungs and when that happens, it's difficult for me to breathe. Additional symptoms that occur when I have an allergic reaction could include but are not limited to: face and extremities swell and become red, nausea, light-headedness, and body aches, etc. Please comply with the following:
Allergies: (List your allergies here)
Have any pre-op tests done at the Dr.’s office and faxed over to the hospital
All medications should be preservative free and the smallest (pediatric) dose possible for desired result.
Any anesthesia should be preservative and epinephrine free
Find out who the head nurse is and talk with her
Note on the door – NO FRAGRANCE (perfume/cologne, body lotion, deodorant, clothes detergent, dryer sheets)
Use preservative free saline IV from a bottle
Start on oxygen immediately - use patient provided out-gassed cannula
Must always wait in a private area
Room cleaned with baking soda and water or Seventh Generation All Purpose cleaner
Have own water and food brought in
Use own sheets, toilet paper, paper towels, soap
Bring own Ionizer – personal and room size along with the fan ionizer
Bring an ice chest for organic food and purified water.
Be the first procedure of the day
Utilize absorbable or silk sutures - possibly use Prolene sutures if tolerated
Use paper adhesive tape or a latex-free Band-Aid
Use hydrogen peroxide instead of alcohol or can use grain alcohol provided by patient
No inhaled anesthesia
Return Home ASAP
Muscle test all items that may be used during the procedure or stay in advance if possible
Thank you,
Being chemically sensitive requires special attention to details particularly when it comes to a hospital stay. I highly recommend contacting the compliance department of your preferred hospitals in advance so they can be prepared for your arrival whether it is a scheduled procedure or an emergency.
Have a travel bag prepared at home that includes all the information and supplies that you will need such as organic sheets & pillowcase, ionizer fan, your pillow, mattress and pillow protectors, etc. Make sure that family and friends know where the bag is. Be sure to include information on how to reach suppliers for your food and water. Some may deliver. Make sure that copies are kept on file with your medical doctor, MedicAlert (www.medicalert.com), and the hospital.