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Six Simple Steps To A Long And Healthy Life -Or- A New Way To Protest Bad Healthcare Legislation

healthcarebillRegular readers know that I’ve been promoting healthy lifestyle choices since this blog’s inception. In fact, I even used to lead a weight loss group called “Lose 20 pounds with Dr. Val.” I’ve often joked that because of the law of the conservation of mass, when someone loses weight, someone else must “find” it. And well, I guess I realized – looking towards 2010 – that I had found some of that weight myself!

If healthcare reform debates teach us one thing, it’s this: the future of healthcare coverage is uncertain for all of us, so the most important thing we can do is avoid needing it (if at all possible)! Time to turn that into a New Year’s resolution… so here’s what we can do:

1. Achieve a healthy weight and maintain it (I suggest a BMI less than 25 as a rough target).

2. Exercise 60 minutes/day most days of the week, or walk at least 10,000 steps a day.

3. Do not smoke.

4. Drink no more alcohol than the equivalent of 1 glass of wine/day.

5. Eat a diet rich in fruits, veggies, whole grains, and lean protein.

6. Get all your preventive health screening tests and vaccines.

Easier said than done – I know. But here’s the deal: we have to do it because it’s our best chance for a healthy, long, hospital-free life. True, there may be unforeseen circumstances outside of our control (accidents, cancer, infectious disease, auto-immune disorders), but for many Americans these six simple steps would bring about significant personal “healthcare reform.”

So if you’re feeling angry about all the legislative shenanigans surrounding healthcare reform, I offer this suggestion – channel that anger into getting yourself as healthy as possible, so that you won’t be dependent on this broken system for your health needs. We each have the power within ourselves to make healthy lifestyle choices – and those choices need to begin now.

Let’s protest bad healthcare reform legislation by getting trim and fit. Send Washington a message: we don’t need your $3 trillion overhaul… we’re doing our own overhaul this New Year’s! Yeah!

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3 Responses to “Six Simple Steps To A Long And Healthy Life -Or- A New Way To Protest Bad Healthcare Legislation”

  1. Dr Val. Have you been reading my blog? LOL

  2. mike hensgen says:

    I guess that means no more Popeye’s Fried Chicken…oh well, seriously, I find a website like http://www.myfooddiary.com helps keep me on track diet AND exercise-wise.

    Happy New Year to all!

  3. Having watched many of our elected ‘reformers, I think they need to read this blog post as much as the rest of us.

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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.

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