October 7th, 2009 by DrRob in Better Health Network, Health Policy, Opinion
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Dear Mr. Obama and all of you congress folks:
I know you have been arguing about how to fix our system (and it really does need fixing). I know there is not much you can all agree on. I know it wasn’t all that much fun to face those yelling people at the town hall meetings. The press hasn’t been nice, and the polls aren’t good either. You guys are having a rough go of it.
So I am going to do you a big favor.
What you need right now are some quick wins – some things you can do that will make people happy quickly, and things that can be done without much cost. This is low-hanging fruit that can be picked without a high ladder; it is fruit that will sweeten things and make swallowing the more bitter pills a little easier. Here is what you need to do first:
1. Allow Medicare Patients to Use Drug Discounts
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*This blog post was originally published at Musings of a Distractible Mind*
September 8th, 2009 by Dr. Val Jones in Health Tips, True Stories
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Ed Walker is 102 years old. I met him by chance on a steep hill in Lunenburg, Nova Scotia – not long after my husband blurted, “I hope you’ve got good brakes on that scooter!” Ed pulled up next to us (to demonstrate his brakes) and jubilantly announced his age, along with his suspected reason for it: “I have prostate cancer but chose to leave it alone.”
I chuckled to myself, thinking that he was probably right about his longevity-hospital avoidance connection.
Of course, the diagnosis and treatment of prostate cancer is being hotly debated these days. While no one likes the idea of leaving cancer untreated, slow-growing prostate cancer may be less of a threat to men at a certain age than the treatment required to cure it. And that’s a difficult truth to accept – especially for Americans.
My fellow blog contributors have noted the disconnect between scientific evidence and clinical practice in regards to prostate cancer. According to a recent study in the New England Journal of Medicine, PSA (a screening test for prostate cancer) testing has not made a difference in overall longevity. Urologists still favor testing (the American Urological Association guidelines recommend initiating PSA testing for all men starting at age 40) while family medicine physicians don’t usually recommend it. Is there a conflict of interest driving this difference in recommendation? Perhaps – though I suspect it has more to do with a surgical mentality (to cut is to cure!) than a conscious decision to protect one’s income. If you think there’s a shortage of urologic procedures to go around, then I’d recommend you simply consider the increasing age of the US population. It’s not as if the prostate gland is the only thing that needs work “down there.”
Perhaps Americans can take some cues from their elderly neighbors to the north – and try to accept that doing something is not always better than “doing nothing.” In the case of some prostate cancers, it’s cheaper, safer, and a lot less painful.
Just ask Ed Walker.
August 20th, 2009 by BarbaraFicarraRN in Better Health Network, Health Tips
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A Guest Blog by Kevin Soden, MD
I ran into an old friend this past week and, as all of us over 60 do, we began talking about our health and the various ailments afflicting us as we age.
He shared with me that he was currently dealing with a bad case of the “shingles” (known as Herpes Zoster in medical circles) at age 65 and how terribly painful they were. He said that he wouldn’t wish them on his worst enemy.
As many of you may know because you’ve suffered a similar problem, shingles is caused by the Varicella Zoster virus, the same virus that causes chickenpox.
Only someone who has had a case of chickenpox – or gotten chickenpox vaccine – can get shingles. The virus stays in your body and it can reappear many years later to cause a case of shingles.
Always being the doctor, I asked my friend whether or not he’d gotten the vaccine to help reduce his risk of getting shingles.
He acted shocked and was quite angry as he explained that he’d never been told by his doctor about that there was a vaccine available that might prevent shingles.
The vaccine available for adults 60 and over to prevent shingles is called Zostavax. In clinical trials, the vaccine prevented shingles in about half of people 60 years of age and older. Even if you do get shingles after being vaccinated, it may help reduce the pain associated with shingles but it cannot be used to treat shingles once you have it.
I’m really not pushing the Zostavax vaccine because it’s not recommended for everyone but rather am reminding everyone that prevention is much better than treating after someone has a disease.
Talk to your doctor at your yearly visit to see what preventive steps you should be taking.
Check the CDC website for more information about vaccines that might be right for you especially if you are traveling to other countries.
Frankly, if your doctor is not talking to you about preventing disease, then it just might be time to find another doctor.
About Kevin Soden, MD
Dr. Kevin Soden has been a medical journalist for over 20 years appearing on CBS, NBC and most recently on NBC’s Today Show. He now serves as the host for Healthline, the national award-winning daily medical television show seen on the Retirement Living Network. He also serves as the worldwide Medical Director for Texas Instruments and Cardinal Health and teaches as a courtesy Professor at the Univ. of Florida College of Medicine.
His awards include 3 Telly’s, the 2008 CableFax award for best cable health show, the 2008 and 2001 National Award for Excellence in Medical Reporting from the National Association of Medical Communicators, a finalist for the International Freddie Awards in 2001, and as the Executive Producer for Rush of the Palms received the 2003 International Film Critics award for short films.
Kevin published The Art of Medicine: What Every Doctor and Patient Should Know…a critically acclaimed book focusing on improving doctor-patient communications. He is also the primary author of a consumer medical book Special Treatment: How to Get the High-Quality Care Your Doctor Gets. He is also a contributing author to the recently published A Practical Approach to Occupational and Environmental Medicine and to Physician Leaders: Who, How and Why Now? He has just finished his third book Think Like a Man: Male Behaviors that Can Help Woman Lighten the Load, Loosen Up and Find Happiness in a Stress-Filled World. He also is a regular contributor to numerous popular magazines.
Soden graduated with honors from the University of Florida College of Medicine and is one of the original inductees into the UF Medical Wall of Fame. He also has a Masters in Public Health from the Medical College of Wisconsin and a Masters in Personnel Administration from Florida State University.
*This blog post was originally published at Health in 30*
August 19th, 2009 by Gwenn Schurgin O'Keeffe, M.D. in Better Health Network, Health Tips
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If you are a family with kids and have grandparents or great grandparents alive, you likely enjoy visiting with your relatives from time to time. While your small children may not always get much out of these visits, especially while very young, they do wonders for our older relatives who so enjoy visits from family and delight in seeing us become parents and expand our families.
I remember vividly visiting my grandparents as they aged, as a child, a teen, a young adult and when I became a parent with my own infants and toddlers. I recall well their delight…and the vivid images of their aging lives: durable medical equipment like canes and walkers in the corner of the room. And, the kitchen counter with rows of medication bottles that made the counter appear like the pharmacist’s counter at the local pharmacy. Given all of my grandparents had arthritis towards the end of their lives, none of those bottles had child-resistant tops.
Whether at home, an assisted care facility or a nursing home, the issue I worry about with small kids are floors and medications. Even if someone is handing an older person their medication, a pill can fall to the floor without being noticed and later found by a toddling child who mistakes it for a piece of candy. That’s what happened last week when 15 month old boy found a shiny pink pill on the floor of his grandmother’s house and didn’t think twice about tossing it in his mouth. Thankfully, it was bitter so he spit most of it out but it was a blood pressure medication so we had to given him activated charcoal, a lot of it, and then observe him in the emergency room for 6 hours.
This story had a happy ending but could have been a disaster had it been a different type of pill or a higher dose, or a group of pills. It’s very, very important that we all take a moment to think about the pill safety of our older relatives – for their sake and the sake of the small children in their lives. In addition to products that can help dispense pills more safely, making sure floors are clean before visits and supervising kids during visits are essential.
As an aside, the moral to this story can be extended to hotels and homes we may visit that we are not as familiar with. Pills can easily fall out of pockets, purses and luggage. When traveling anywhere with small kids, get on the ground and look under beds, chairs, sofas, pillows and be sure there are not any pills or other small items that we wouldn’t want our small children, or even older children, to touch, or worse – eat!
BTW, can you find the pill in this picture? Hint: it’s blue.
See On The Edge Of Something blog for the “before” shots showing the pill in a spoon on the floor.
Not so easy, huh? Unless, of course, you are a very small child with the eye sight of a falcon and live close to the ground routinely. Now do you get the point?
*This blog post was originally published at Dr. Gwenn Is In*
August 3rd, 2009 by KevinMD in Better Health Network, Health Policy
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Reducing health spending, as Congress is finding out, is difficult.
Some health economists have pointed to medicalization of common complaints, like erectile dysfunction and attention deficit hyperactivity disorder, as one reason. Indeed, Dartmouth researchers, who are cited as favorites of the current administration, feel that an “epidemic of diagnoses” is what’s making us sick.
But, Darshak Sanghavi writes in Slate that this may be a red herring, and clouds what’s really driving up costs, namely, the amount we spend prolonging the lives of the elderly. He points to David Cutler, an adviser to President Obama, and his analysis that “it costs far more to prolong the lives of the elderly ($145,000 per year gained) than the young ($31,600), and the rate of spending on the oldest Americans has grown the fastest.”
None of the current health reform proposals target this, understandably, because it would be politically difficult to tell elderly voters that we need to spend less on their care.
And because of that, Dr. Sanghavi rightly concludes that, no matter what gets passed, “we’re just putting off the day of fiscal reckoning.”
*This blog post was originally published at KevinMD.com*
