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I have been a registered nurse, nurse practitioner and most importantly a patient advocate for over 20 years. I have worked in hospitals, homes and as a private consultant, always teaching patients how to speak up for themselves and to make well informed healthcare decisions that are right for them and help them to avoid all types of Medical Errors. The many things I have seen in healthcare led me write "What Did the Doctor Just Say." In it are all the steps every patient needs to take to remain safe in the healthcare system and avoid medical errors. My personal goal is help to save 100,000 people from the horrors of a medical error and I wrote What Did the Doctor Just Say? to help make that happen.

Thursday, September 2, 2010

Is My Stress Making Me Sick?

Some of the conditions scientist have researched and found to be linked to stress are;  backachesinsomniacancer and chronic fatigue syndrome and fibromyalgia.
Stress is often a key factor when women experience either absence of menstruation orabnormal bleeding. Hormonal imbalances caused by stress may proliferate the symptoms of fibroid tumors and endometriosis, as well as make pregnancy difficult to achieve for couples with fertility problems.
Heart disease is the number one killer of American women. High blood pressure, heart attacks, heart palpitations, and stroke can be and most often are stress related conditions. 
Women can experience changes in their sexuality and develop sexual dysfunctions like vaginal dryness just because they are all stress out.    
Stress affects some by causing gastrointestinal disorders like ulcers, lower abdominal cramps, colitis, and irritable bowel syndrome.
People who are all stressed out, like care givers and single Moms have more colds and infections due to lowered immune system responses (which is caused by, you guessed it, stress). Stress can initiate dermatological conditions such as itchy skin and rashes and acne.
Stress and fatigue also cause emotional disorders and responsible for many troubled and abusive relationships.  Depression, anxiety and physical abuse are all associated with high levels of stress.  
Eliminating stress all together is impossible and without it we wouldn't push on and go further and become more that we once were.  However we all know that too much stress it not good for us.
In the next few posting I will discuss ways to decrease stress.  In this posting let's talk about exercise.  You might ask how does exercise decrease stress?  Well ...,
Exercise decreases fatigue and gives you more energy.  When you are tired you are more easily and more severely stressed.  
Physical activity increases the production of your endorphins.  Endorphins are the chemicals produced in our brain that help to decrease physical pain and reduce the signs and symptoms of physical and emotional pain like anxiety and depression.
Exercise is a moving meditation.  If you swim, run, do yoga or play a heated game of one on one you know the rush that comes from pushing your body to the next level and fully focusing on one thing at at time you have felt the benefits of endorphins, that calm, confident, zen moment when the endorphins are pumping and you feel great!
Exercise improves mood and relationships.  Exercise increase the production of serotonin, the main chemical in the brain that combats depression, stress and anxiety.  When you decrease these taxing emotions you decrease feelings of anger, resentment and isolation,  which helps you to get along better with your loved ones and to feel better about yourself and your life in general.
Getting started with exercise is actually done in steps
Step 1.  Make up your mind that you want to feel better in your body and your mind and that you can do this!! Make a commitment to love and care for family and your friends by taking care of yourself
Step 2.  Choose a couple of types of exercise to try, find a few you like and rotate them.  Let's face it many of us have at one time thought exercise was boring and we started and we stopped exercising because it was not fun or just to lonely. 
Vary your exercise routine and if you can find someone to workout with to ward of the lonileness and to make it more fun. Rotate they type of exercise you do, one day walk, the next lift weights, the next go salsa dancing, now there's a good mix.
Step 3.  Keep it simple.  You don't need a gym membership or a lot of equipment to work out with. I find one of the best ways to vary my routine is to work out with my favorite personalities on FIT TV.  The channel offers yoga, weight lifting, aerobics even belly dancing. It offers a wide variety of exercises by top experts using little of no equipment and you don't need special cloths to be in your den working out, and of course walking is natures best exercise.  Some people say it's swimming but I swim 40 laps several times a week and I talk 1-3 mile walks regularly and disagree, while I LOVE swimming and feel it is a fabulous exercise by far I believe walking is a better exercise than swimming and all it requires is a good pair of walking shoes, a safe area to walk in, some streching before hand and the get up and go to do it.
Step 4. Put your exercise on your calendar and give it the same type of commitment you give a hair or nail appointment or a date with your closest friend, because that's what it is, you are your closest friend and the only friend that you have that will be with you for every minute for the rest of your life and your health is essential to the happiness of your very best friend YOU.

Sunday, July 11, 2010

A Prayer for the Gulf Is A Prayer for Your Health and Safety

The health of our world and our Dear Mother Earth is directly related to our health. Because that is true as a healthcare professional I am deeply concerned about the oil leak in the Gulf of Mexico. What is happening in the Gulf has implications for us all. This is a very important issue for everyone on the planet Earth.
Just in terms of In terms of global warming alone, the implication and the consequences of the spill are enormous. The ocean cools the earth. Much of the ocean in the Gulf is now a black tar driveway and we all know how hot black tar is. Water meant to cool the earth is now heating it instead.
When the ocean is hotter it moves faster making for faster, bigger, stronger storms, hurricanes and tornados will increase in size and magnitude and the oil in the ocean will gush upon the land. When the air is hotter water evaporates faster, creating water shortages. Many of you don't know this but we (all over the world) are facing tremendous crippling water shortages right now without increasing the heat. The process of water evaporation will cause the rain to become oil. The rain clouds will travel and spew oil in other places around our land, in other water supplies, on our food supply and on us. The oil is also killing the algae in the water. Algae are a major source of our oxygen supply. Without them the fresh air at the beach disappears and is replaced by hot, black oil, that by the way, is combustible! The oil contains methane gas which could easily ignite in extreme temperatures creating fires on the ocean and creating smoke and fumes that would easily kill the young, the old and live stock. No this isn't a pretty picture, it is darn scary and it's horrid that we do not have a plan to correct this sort of incident when we have many other oil ridges off our shores!! As a human and occupant of the planet earth and a healthcare professional I am so sad about what is happening to our Dear Mother Earth and I am asking you to join with me and I hope millions of others in praying for the success of any and all efforts to stop the destruction of our earth and the gulf coast. And specifically I am asking you to join in prayer with us for the success of the capping efforts scheduled for tomorrow. If you choose to join with us, Thank You. And I look forward to celebrating the success of the capping efforts with you and remember the Doctor Just Said A Pray for the Earth is A Prayer for Your Health and Safety

Monday, April 19, 2010

10 Things You Can Do to Relieve Sinus Suffering

It's allergy season and millions are suffering with nasal congestion, headaches, tooth pain, face pain, stuffy nose an inability to sleep, gastric reflux and sinus infections are soon to follow if allergies aren't kept under control.  In many parts of the country people are suffering horribly.  In the following post I offer 10 things you can do to relieve sinus and allergy suffering. So, let's get started.   
     Seasonal allergies are triggered in the spring and the fall by pollen producing trees, weeds and grasses.  When pollen is present in the air, it can land in a person’s eyes, nose, lungs and on the skin causing the body to become irritated and to attempt to right off the irritation and that fighting is commonly known as an  allergic reaction. Symptoms may include allergic rhinitis (hay fever)allergic conjunctivitis (eye allergies) and allergic asthma.
     The more pollen you are exposed to the worse the symptoms of nasal congestion, stuffiness and pain will be. Therefore the first step in reducing the symptoms of seasonal allergies is to reduce the amount of pollen and other irritants you are exposed to and all over hygiene that reduces the amount of pollen you are exposed to and how your body responds to that irritation. 
10 Things You Can Do To Relieve Sinus Pain and Suffering


1.  Clean your eyes and your nasal passages: Use nasal saline rinses to decrease the amount of pollen that your eyes and nasal passages retain. Retained pollen accumulates and increases the amount of irritation your sinuses are exposed to over time.  When you decrease the pollen load your body carries you will decrease your symptoms.  


2. Shower after being outside to remove pollen from your body again this will decrease the amount of pollen your immune system is exposed to and irritated by over time.


3. Keep your windows closed during the early morning hours when pollen is highest to prevent the wind from blowing pollen on to surfaces in your home where they linger and continue to irritate you. 


4. Vacuum your furniture to remove landed pollens and pet hairs from household surfaces


5.  Strengthen your immune system. A strong immune system will have a less violent reaction to irritants  and that equals a less severe allergic reaction. Taking vitamins A,C,E and Zinc found in fresh fruits and vegetables will help to regulate your immune responses


6.  Decrease the amount of meat, salt and sugar you eat as these all cause mucus and increase congestion


7.  Eat chili peppers and breathe in menthol and minted oils like the ones found in Vicks Vapor rub as these two things will cause your sinuses to drain and relieve the congestion that makes you so miserable.


8.  Hold gentle pressure on the sore spots in your face until you feel the spots release under the gentle pressure. This is a reflexology technique and it can be very effective when done properly.


9. Take your medications with care. Make sure you ask all the questions I suggest in What Did the Doctor Just Say before taking medications


10. If you have any medical conditions especially heart disease, urinary problems or visual problems be sure to research your medications and discuss them with your health care professionals before taking them as some drugs used to treat allergies should not be taken by people with these conditions





  

Thursday, April 8, 2010

Should There Be an Obesity Tax?


The conversation around obesity is becoming very heated and lively debate. One radio interview host I spoke with recently suggested there be a fat tax. His point was that heavy people have many more health problems than do thin people and that they should pay their "fair share" of healthcare cost by having taxes and fines imposed upon them. 

Clearly tempers are flaring (an not just about obesity) in our land as the healthcare debate rages on and we look at ways to cut cost. 

I do not think any group should be taxed or penalized. Our health issues are much to complicated to be solved by taxes.  Taxes do not address the reasons why we are over weight. They do not address emotional eating, food addiction, cultural foods that lead to obesity, or the cheapness of fatty foods that make them more attractive to the young and the poor. 

Fortunately or unfortunately my opinions do not set policy in our nation and the obesity tax is an active discussion especially in NY state where they are considering taxing sodas and other sugary drinks to reduce their consumption and the pounds associated with high calorie drinks. This is effectively and obesity tax and there may be others to follow.

As healthcare costs continue to rise and we are forced to buy health with the young and old, fat and thin all dividing the cost equally the argument is sure to become even more dynamic because it is well documented that heavy people are more likely to health serious and costly health problems that increase the costs of providing care to everyone in the nation, with some saying those that have more risk of becoming ill (the obese and the elderly) should pay more for insurance they are more likely to use.  Some of the problems overweight people are more likely to have are:  

 Heart Disease and Stroke

Heart disease and stroke are the leading causes of death and disability for people in the U.S. Overweight people are twice as likely to have high blood pressure, a major risk factor for heart disease and stroke, than people who are not overweight. Overweight people are more likely to have very high blood levels of cholesterol which can also lead to heart disease. Being overweight also contributes to chest pain and sudden death from heart disease or stroke without any signs or symptoms.
Obesity Is Linked to Diabetes
Type 2 diabetes is a major cause of early death, heart disease, stroke, and blindness. More than 80% of cases of type 2 diabetes can be attributed to being overweight or obese.  
Obesity and Cancer Are Linked
Being obese also increases the risk of dying from cancer. In women, these include cancer of the uterus, gallbladder, cervix, ovary, breast, and colon. Overweight men are at higher risk for developing colorectal cancer and prostate cancer.  
Obesity Is Related to Gallbladder Disease

Your risk of gallbladder disease and gallstones is increased if you are overweight.  
Obesity Can Cause Osteoarthritis?
Osteoarthritis is a common joint condition that most often affects the knee, hip, and lower back joints. Carrying extra pounds places extra pressure on these joints and wears away the cartilage (tissue that cushions the joints) that normally protects them. Weight loss can decrease stress on the knees, hips, and lower back and may improve the symptoms of osteoarthritis.

Obesity Is Linked to Gout

Gout is a disease that affects the joints that is caused by high levels of a substance called uric acid in the blood. The large amount of uric acid can form into solid or crystal-like masses that deposit in the joints. Gout is more common in overweight people and the risk of developing the disorder increases with higher body weights.
Obesity Is Linked to Sleep Apnea?
Sleep apnea can cause a person to snore heavily and to stop breathing for short periods during sleep. Sleep apnea may cause daytime sleepiness and even heart failure. The risk for sleep apnea increases as body weight increases.  
The good news is that by decreasing your weight be 10-20% you can decrease your chances of having serious consequences of obesity, of course the question then becomes how do I do that. In a future post I will discuss weight loss strategies. In the meantime, we all know exercise, calorie reduction, decreasing stress and increasing water intake will help to take off the pounds, good luck America

By Lynn R. Parker and WebMD

Monday, March 29, 2010

Older Middle-Class Americans Locked Out of Reform


Older middle-class Americans locked out of reform

The most damaging concession in the Senate legislation has received relatively little discussion in the last few days: as the bill now stands, many Americans in their late 50s and early 60s who don't have employer-based coverage will find comprehensive insurance unaffordable.
Under the Senate bill, insurers cannot discriminate against customers who suffer from pre-existing conditions. They cannot charge women more than they charge men.
But they can demand that older Americans who are shopping in the Insurance Exchanges pay premiums that are triple what a younger customer would be expected to shell out. (The House bill only let insurers double premiums.)

Commentators such as Ruth Marcus have suggested that this makes sense: "Older people cost more money to insure than younger Americans--and more than three times as much. Is it fair to require younger people to shoulder all the extra cost?"
In theory, this might sound reasonable. But, in practice, red-lining older citizens so that younger Americans don't share in their risk just won't work. Marcus and others who support "age rating" should take a hard look at the numbers. The fact is that if this provision stands, a large share of people in this older cohort won't be able to afford good coverage.
Households in the 55-64 age group report median joint income of just $55,400. Half earn less. Only 25 percent enjoy joint income over $100,000. In other words, fully one-quarter earn somewhere between $55,400 and $100,000 --too much for a couple to qualify for more than a tiny subsidy, too little to able to afford pricey insurance. (When it comes to subsidies, the cut-off point for a family of two is $58,280.)
Middle-aged Americans need full, comprehensive coverage. Yet under the Senate plan, which offers four levels of insurance, many older middle-class households will be forced to pick the short blanket. The legislation offers four tiers, ranging from platinum plans that cover 90 percent of the cost of "essential care" to bronze plans that pick up 60 percent of medical bills, leaving 40 percent for the patient to pay out of pocket. Premiums for bronze plans will be significantly lower.
A 30-year old might feel comfortable with a bronze plan. After all, he doesn't plan to use the insurance very often. But most 60-somethings need to go to doctors regularly to control chronic diseases and address the many problems that come with age. And if they are middle-class, they probably cannot afford to shell out 40 percent of the charge every time they visit a specialist.
Granted, their out-of-pocket payments would be capped at $11,900, but for a household earning just $59,000 before taxes, $11,900 represents more than 20 percent of their after-tax income. Even for a couple earning $75,000, $11,900 is a hefty sum. No doubt, many would simply put off going to the doctor.
Just how much would a couple have to scrape together to buy a platinum plan? The Office of Personnel Management, which now oversees the Federal Employees Plan, will be contracting with private insurers. They have not done a good job of holding down premiums for government employees-- from 2001 to 2008, average premiums climb by 62.3 percent.
Judging by what federal employees pay now, it appears that under the Senate bill a top-of-the line platinum policy would cost a younger couple at least $10,000--probably closer to $12,000 in today's group market. (I'm taking these numbers from states where insurance is more expensive because insurers are required to cover people suffering from pre-existing conditions, just as they will be under reform.)
That means that even if an insurer charged the older couple only twice as much, the premiums could run as high as $20,000-$24,000 annually.
If it seems impossible that a 60-year-old couple earning $59,000 a year would be expected to pay that much,consider this: In Massachusetts, where insurers are only allowed to double (not triple) premiums based on age, an older couple in Boston faces premiums that run as high as $24,000 a year.

The Senate bill does offer some hope. If a state's insurance regulations do not let insurers gouge older customers, insurers must "comply with the State's more protective age rating requirements." And in fact, some states do shield older citizens. As Howard Dean pointed out over the weekend on Meet the Press, in Vermont, insurers can charge 60-somethings only 20 percent more--not 300 percent more.
But where you happen to live should not determine whether or not you have access to good care. That is not what I thought we meant by "universal coverage."
BY MAGGIE MAHAR, The Healthbeat  

Monday, March 22, 2010

What Healthcare Reform Means To You and to Us


President Obama will sign into law a healthcare reform bill that will provide  insurance to the 32 million Americans who are currently without it and the more than 2,000-page health insurance bill has left more than a few people wondering what the healthcare reform bill will mean to them.
      
Before we answer some of the most frequently asked questions about healthcare reform and this bill will affect you  I have a comment and a concern.
My comment; I think everyone should have access to healthcare and that having access is a matter of national security. Any nation can only be as healthy as it's people, if the people are sick they cannot work or contribute to the growth of the society.  And I think it is humane to give our citizens healthcare. 
Just today I met a 38 year old woman with breast cancer who was told if she could not explain how she was going to pay for her care that she should find a way to deal with the pain and plan to die within the year. She told me this as her daughter stood beside her holding her hand. In my mind there is something wrong with a doctor having to tell a patient to go home and die when there is treatment available because her employer does not have a benefit plan.  
However I am concerned that adding another 32 million people into our current healthcare system without adding additional nurses, doctors or hospitals will create more medical errors. The equation is this; 32 million more patients + nursing shortage + 30 percent doctor shortage + hospital closures = less time and space to see and treat each patient = more mistakes.  
If my equation is right and my 25 years in the system tells me I am, this new bill, while well intentioned will make protecting your health and safety when seeing a doctor or visiting a hospital an issue of personal security and could help to save your life.  
With the current volume of patients 40 percent of medical diagnosis are wrong and 1 in 3 prescriptions has some type of error contained in it's writing.  Can you imagine what the statistics will be with an additional 32 million people. 
In order to protect you and your loved ones from the horrors of a medical error I think every patient entering the healthcare system should have a copy of What Did the Doctor Just Say? so that they can learn how to protect themselves and their loved ones from the horrors of a medical error and I truly believe this is a matter of the utmost importance. Having made my comment and voiced my concern, let's move onto the questions everyone else is asking about the healthcare reform bill and that is how will it affect me?   
I don't have health insurance, what does this mean for me?
By 2014, every American will be required to have some form of health insurance or will be forced to pay a fine. The first year's fine would be $95 or 1 percent of their income, whichever is higher. By the second year, however, fines could rise to as much as $695 a year. Families and people meeting certain income requirements ($14,404 for individuals and $29,326 for a family of four) would be exempt from paying the fine. These people may also be eligible for the federally and state-funded Medicaid insurance program that covers poor and disabled Americans under the age of 65. 

One of the immediate changes that will take place is that young adults up to the age of 26 will be eligible to remain on their families' health insurance plans. Currently, the cut-off is 22 years old. 

Can I buy insurance through the government?
The bill does not include a public option, meaning the government will not offer health care beyond Medicare and Medicaid. People under the age of 65 who make too much to qualify for Medicaid may be eligible to receive government subsidies to help them buy private health care from new state-based insurance "exchanges," which are scheduled to begin in 2014.

My employer does not currently offer insurance, will that change?
All employers will be required to offer their employees insurance by 2014. Companies with 25 or fewer employees would receive tax credits to help them pay for the insurance. The tax credits would cover about 35 percent of the insurance cost this year and would gradually increase to about 50 percent by 2014. Employers with 50 or more workers will be required to offer employees insurance or pay a fine of up to $2,000 a piece for full-time employees that are receiving government subsidies to buy insurance through state-based exchanges. The first 30 employees would be exempt from this fine. 

How will this legislation affect senior citizens receiving Medicare?
Starting this year, all Medicare preventative services, such as cancer screenings, will be offered free of charge to senior citizens currently receiving Medicare. Also, people receiving Medicare Part D would receive an additional $250 this year to help them pay for medications that are not currently covered under the plan. 



I have insurance, how will this affect me?
Under the plan, people who are currently ill may begin seeing their premiums shrink, as the bill does not allow insurers to charge higher premiums to people who are sick. Also, people with pre-existing conditions who change insurance companies, due to a change in job status or in employer coverage, cannot be denied coverage under the bill, nor can they be charged higher premiums.

How much will this cost and how is it being paid for?
The plan will cost an estimated $940 million. Congress and the president have said that most of it will be paid for through various tax increases on individuals that earn more than $250,000 a year, as well through decreases in Medicare reimbursements to doctors and hospitals. Critics, however, say tax increases to the wealthy and Medicare cuts will not be enough to fund health reform and that the middle class will eventually be forced to help pay for it through tax and fee increases.



Questions Written By Marrecca Fiore Mar 22nd 2010 9:57AM
Comments and Concerns by Lynn R. Parker



Friday, March 12, 2010

We The People Must Create HealthCare Safety Reform, Reform That Matters to Us!!

Why isn't there a conversation from amongst our political leaders about patient safety and or Safety Reform in the healthcare debates? I can't understand their omission of this topic because safety reform could save our entire healthcare system and our lives? Let me explain.
If the Centers for Disease Control counted medical errors as a cause of death, they would be the fifth leading cause of death in America, taking more lives than motor vehicle accidents, breast cancer, and AIDS combined.
HealthGrades, our nation’s leading reviewer of healthcare quality, found that for the years 2002-04, 1.24 million errors were made while caring for hospitalized Medicare patients in the sixteen categories of error they investigated. Those errors resulted in deaths of 304,702 senior citizens. Of those deaths, 250,246 (82 percent) were potentially preventable. All totaled, those errors cost patients and taxpayers $9.3 billion dollars.
When you read the number “304,702” keep in mind it represents only in-hospital Medicare patients. The numbers do not include medical errors involving anyone under age 65, nor do they include medical errors that occur in doctors’ offices, pharmacies, rehabilitation, or long-term care facilities. No one knows how many medical errors or deaths from errors there really are. The authors of the HealthGrades study tell us that the numbers in their report “represent only the tip of the medical-errors iceberg.”
No matter what the actual numbers are, they do not begin to convey the real meaning embedded within them. Numbers cannot convey the depth of a patients’ distress when he realizes he has lost the ability to work and will soon be bankrupt due to medical costs. How can numbers convey the sadness one feels when a marriage ends under the strain of a prolonged illness? And numbers cannot begin to express the anger, depression, and resentment felt when a person’s life is ruined by a healthcare system they once trusted. The numbers are big and they are bad and yet they do not begin to tell the whole story of medical error.
Sadly, for many of you reading this, medical error is not just something you’ve heard about. In fact, statistically, each of us has a two in five-or a 40 percent-chance of being harmed by a medical error each time we enter the healthcare system, so there is a very high likelihood that you or someone you know has been harmed by a medical error. If you developed an infection while in the hospital, were misdiagnosed and mistreated or you experienced a medication or medical record and billing error. At any point in the healthcare delivery system anyone of us could fall victim to a medical error and these errors are destroying lives and further draining our nations economy, thus effecting each and everyone of us.
Yet we hear nothing in the healthcare reform bill about reducing medical errors and the harm done to patients. We hear nothing about the medical disability, social security and other social service costs associated with these errors that even further drain on our economy and our entire society, families, caregivers and business owners. Sadly we do hear that bankruptcies brought about by healthcare cost are the number one cause of bankruptcy in the United States.
So again I ask why is there no conversation about safety reform in the current debates. I don't know the answer to that question (although I have my ideas). What I do know is that in order to improve the care you receive and decrease your chances of being hurt or harmed by a medical error and to help our healthcare system survive it is imperative that each of learns how to partner with our healthcare providers and learn how to make well informed healthcare decisions that are right for us and our loved ones and that we partner with our providers to decrease their chances of giving us a misdiagnosis, the wrong medication, wrong treatments and even wrong surgeries.
Your Insurance Carrier May Not Cover the Damages
Not only could you or your loved ones fall victim to a medical error, your insurance company may not pay for the care you need because of your injuries. As of October 2008, in an attempt to force hospitals to improve care and to save money, the Centers for Medicare and Medicaid Services (CMS) will no longer reimburse hospitals for a group of errors called “never events.”
They are called "never events" because it is believed these events should not and would not happen if doctors and hospitals followed established protocols designed to prevent them. Because of these beliefs the CMS no longer pays for care required after a patient is injured by a eight types of “never events.”
Eight of the 28 types of errors classified as never events are responsible for the spending of approximately $22 billion Medicare dollars each year, and those eight types of errors are the first to be excluded from payment. This group of errors includes: infections from catheters (IV and Foley catheters); pressure ulcers (bedsores); air embolisms; being given the wrong type of blood; repeat surgeries needed to remove objects left inside the patient following surgery; falls; injury or death from medications, and the post operative deaths of low risk surgical patients.
Non-payment for the care required after a never event could have devastating effects on both patients and hospitals. If, for example, you develop a pressure ulcer (a bedsore), the treatment of that ulcer may require bandages, packing, antibiotics, creams, and surgery, easily costing hundreds of dollars per day. While you are in the hospital, the hospital is required to absorb the cost of caring for your injury. Once you are discharged from the hospital you may be responsible for the costs. This will depend upon the arrangement your hospital has with Medicare or your private insurance carrier ~ recently Blue Cross/Blue Shield, Aetna, and Cigna have announced plans to restructure their policies to deny payment of never events as well.
When you consider that Medicare alone spends up to $22 billion dollars annually to treat these eight never events, you can well imagine that thousands of patients will not be able to afford the care they need after being injured by a never event without help from their insurance carriers.
We May All Have Less Access to Healthcare Even With Insurance
Before the instatement of the never rules, most patients had no idea that the development of a bedsore while in the hospital could be considered negligence or that they may be entitled to compensation for their pain and suffering. As a part of the never event regulations, doctors are required to inform patients they have fallen victim to a never event.
With more patients being made aware they have been injured by the medical system, the number of lawsuits could skyrocket, leading to increasing malpractice rates, which some doctors and hospitals will not be able to pay. The consequences of this could be that that we’ll have less access to care as doctors leave their practices and hospitals close under the financial burden of decreased reimbursements and ever increasing malpractice premiums. In fact this is already happening in some states and may become worse as more people enter the system.
With more hospitals closing, remaining emergency rooms will be overcrowded. There are already long waits to get into surviving hospitals, where workers are exhausted from dealing with high volumes of patients.
While the CMS may be well intentioned, the consequences of refusing to pay for never events could be tough on all of us. Fewer doctors and massive hospital closures present a very serious problem and that problem is ~ we don’t have anywhere else to go.
Now that we are aware of some of the problems surrounding medical errors and we know that we are all at risk of falling victim to such an error, each of us who cares about our healthcare and our safety must ask ourselves a question, and that question is: “What can I do to protect myself and my loved ones from a medical error and help to protect the only medical system we have from collapsing.
It is up to each of us who enters the healthcare system to Take Charge of our Health and Safety and to help create a movement of healthcare safety reform that is patient driven and patient centered. If enough patients and caregivers use the the patient empowerment techniques I teach in What Did the Doctor Just Say? we the people could create a Patient Safety Reform Movement and together we could help save over 100,000 people from the horrors of a medical error.
In my next post I will share the essential strategies that have been proven to prevent medical errors with you. However if you are concerned right now about your safety or the safety of someone you have to make healthcare decisions for right now you can get your copy of What Did the Doctor Just Say: How to Understand What Your Doctor Is Saying and Prevent a Medical Error From Happening to You and Your Loved Ones
Right Now and learn what you can do to protect your and loved ones health and safety
As always, I hope I helped someone.

Wednesday, February 24, 2010

It May Be Depression and Excerpt From What Did the Doctor Just Say?


It may be depression: Up to 80 Percent of Patients are Depressed
According to a University of Colorado study, up to 80 percent of all office visits involve some degree of depression. Many people suffer the effects of depression without ever knowing they have it. Depression can masquerade as chronic fatigue, insomnia, agitation, stomach upsets, constipation, nausea, chest pain, headaches, constant pain, and more. 
            The World Health Organization reports that depression is the leading cause of disability among adults of all ages worldwide. It affects approximately 18.8 million Americans. Patients diagnosed with depression spend, on average, $4,246 per year on medical costs versus $2,371 spent by patients without depression. By 2020, it is projected that depression will be the number two cause of death in the country second only to heart disease.
            Each of us is at risk of becoming depressed at one time or another for any number of reasons. The death of a loved one, loss of a job, prolonged separations, and financial problems can all bring about episodes of this crippling disease.
            When depression is missed, left undiagnosed, and untreated it is reasonable to expect patients and their families will suffer needlessly. Depression is an awful disease for which there is treatment. Left unchecked, however, it can ruin lives and make many medical conditions worse than they need be. 

Conditions That are Worsed by Depression
Heart diseasesRecent studies have shown one-fifth of all patients with heart disease suffer with depression. Depression can come after heart disease or it can be a contributory factor to the development of the disease. Canadian researchers found a significantly higher risk of death from cardiac disease one year after diagnosis in patients who were also depressed. This was true no matter what the level of heart disease – depression was more of a marker for death than the heart disease itself. Have you ever heard of someone dying from a broken heart? Of course you have. Untreated depression actually does kill.

High blood pressure: Depression increases your risk of developing high blood pressure. People who are depressed tend to smoke more, drink more, eat more, to be anxious, and they are ill-tempered and argumentative. When we eat poorly, smoke, drink, and have problems in our relationships we develop high blood pressure. 

Diabetes: According to the American Diabetic Association, diabetics suffer from depression at rates three to four times higher than the general population. A 2004 Johns Hopkins study that tracked 11,615 patients without diabetes over six years found that “depressive symptoms” predicted the onset or development of Type II diabetes. The same study found that successfully treating diabetes may be tied to successfully treating depression. Depression causes overeating and cravings for sweet and fatty foods. Depression is also associated with feelings of fatigue and lethargy, which make it very difficult to exercise or even get out of bed. Overeating and little or no exercise are real barriers to successfully controlling diabetes. 
Stroke, Parkinson’s, and Alzheimer’s disease: Up to 160,000 stroke patients annually experience a major depression. Depression rates range from 17-31 percent of patients with Alzheimer’s disease and approximately 50 percent of patients with Parkinson’s disease. Depression seriously affects the patient’s ability to participate in their own recovery. Depressed patients eat too little or too much; sleep too little or too much; refuse to exercise; and have less hope and confidence in the future.
Exhaustion and fatigue: Depression is associated with feelings of exhaustion and fatigue, both of which make living life in general and healing from any medical condition more difficult. When we do not have the energy necessary to interact in relationships, we become isolated, suffer from loneliness, and depression increases.
Stomach problems: Depression can slow down your digestion and cause constipation, reflux, indigestion, and nausea.
Eating disorders: Depression is associated with developing obesity, anorexia, and bulemia.
Chronic pain: Depression plays a part in chronic pain (pain that doesn’t go away). Headaches, back pain, muscle aches, joint pain, and chest pain can all be caused by depression. Untreated depression can lead to a life of agony and pain killers. And, guess what? Pain killers can cause or worsen depression. The combination of pain and pain killers could create a vicious cycle that could lead to harmful addictions. If you are suffering from aches and pains with or without a clear cause, consider depression as a contributing factor.
Immune system: Depression weakens the immune system and can cause you to have more colds and flu and to be more susceptible to other diseases.
Sleep disorders: If you are depressed, you may not be able to fall asleep. You may wake in the middle of the night and be unable to fall back to sleep. You may sleep all the time. Or, you may just want to stay in your bed with the shades drawn and the covers over your head. All of these behaviors can be brought on by depression.
Anger and irriatibility: Depression can express itself as anger, frustration, or by being argumentative. These behaviors make relationships very difficult to maintain. People who have closer social relationship and solid marriages live longer and have happier lives than people who are not in happy relationships. Having depression can shorten your life. 
Suicide: People who suffer depression tend to have repeated episodes and often the episodes worsen. For some, the depression will progress to the point where the person feels so badly that they believe the only viable option is to take their own life. Up to 70 percent of suicide victims were thought to be depressed at the time of the event. 
Depression Assessment Tool
If you have had any of the symptoms listed in the following assessment for more than two weeks, your provider should evaluate you for a diagnosis of depression. In addition to taking the assessment, you may want to read more about depression. It is a problem that is in involved in 80 percent of all primary care visits and is the leading cause of disability in the world.
Depression Assessment
Depression Assessment
Yes
No
Do you have feelings of sadness, isolation, hopelessness, or guilt most of the time?
Are people complaining that you are irritable or in a bad mood?


Do you feel isolated and alone even when people are around?


Have you lost interest in things that used to bring you joy like hobbies, relationships, sex, or work?


Are you sleeping too much or too little?
Are you tired most of the time?


Are you having trouble managing your high blood pressure, diabetes, or stomach ailments?


Do you have unexplained muscle or joint pain, backaches, or headaches?


Are you eating too much or too little?
Do you have a sudden weight gain or loss?


Are you having thoughts of suicide? If so, call your doctor or go to the emergency room and
GET HELP IMMEDIATELY.


            The answer to “what’s causing your problems” may not be in the CAT scan results or the lab test. You may be depressed. Often patients are depressed and providers and patients alike overlook the condition when developing a diagnosis. Yet properly treating depression can make a tremendous difference in the patient’s recovery.
            Avoid the pitfalls of missing a depression diagnosis. If for any reason you are having trouble managing your disorders; you can’t find a clear physical cause for your symptoms; or you have any or all of the symptoms of depression, please be evaluated for depression. If necessary, seek treatment. Depression affects millions of lives and can be a devasting condition. It is not all in your head. It is in your life and your body and help is available. 
Your role as team leader:
·      Complete the depression assessment. If you have had any of the symptoms on the depression assessment for the past two weeks, take this assessment form with you to your provider and have him review it with you.
·      If you feel suicidal, get help immediately. Call your provider or go to the local emergency room.
·      Get treatment if necessary. Treatment could save your relationships, your health, your life, or the life of a loved one.
·      Ask for a referral to a therapist or a psychiatrist. If medication is needed to treat your depression, have an expert manage your medication and seek counseling. Many of the issues that bring about depression are not physical; they are emotional (loss, separation, finacial difficulties, problems with your relationships, and many other things), and you may need help dealing with your issues. You may need a therapist.
  • Don’t be ashamed to say you have depression. Millions of people worldwide are depressed, you are not alone. We are all affected by our emotions and stressful life situations. Don’t be ashamed; rather you should seek help.

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