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HRT: No Wonder Women Are Confused

Confused about hormone replacement therapy (HRT)? I can’t imagine why…

*This blog post was originally published at tbtam*

A Patient’s Contagious Confidence And Endless Possibilities

In a recent post I wrote why patients are the most important part of the medical team, and my colleagues, Elizabeth Cohen, Kevin Pho, MD, Donna Cryer, JD, and Carl R. Sullivan, MD, shared their insights as well. Today, Ginger Vieira, a patient living with type 1 diabetes and celiac disease, says:

“You, as the patient, are the most important part of the medical team because you are the one who makes the daily decisions, who balances your disease around dinners, soccer games, long hours at work without enough time to check your blood sugar and eat lunch. You are the one who takes the knowledge you learn from your doctor and fits it into your everyday life. That’s a huge role, and it’s never easy.”

Ginger Vieira shares her story about the challenges and how her positive attitude is allowing her to lead a life she thought was off limits.

Contagious Confidence, Endless Possibilities

By Ginger Vieira

“Don’t let anyone tell you that you can’t do something.” My twin brother, Pete, said this to me several months ago. I wrote it down on an index card and taped it to my bathroom mirror. Funny thing is, it’s never been other people telling me I can or cannot do something. The loudest voice I hear is my own.

When I was diagnosed with type 1 diabetes in the seventh grade over eleven years ago, the first list that ran through my head was the list of things I probably couldn’t do anymore. I couldn’t eat ice cream without first counting the grams of carbohydrates in the bowl and determining how much insulin I needed. I couldn’t play basketball anymore (at least, that’s what I thought). I couldn’t buy candy and popcorn with my friends when we go to the movies without feeling overwhelmingly guilty about eating such diabetic-off-limits food. The list of foods, activities, dreams and goals I thought were off-limits seemed endless. Read more »

*This blog post was originally published at Health in 30*

How Often Should Bone Density Testing Be Done?

Not as often as you think, even though Medicare may be willing to pay for it every two years. Via Science Daily:

Now a new study led by Margaret L. Gourlay, MD, MPH of the University of North Carolina at Chapel Hill School of Medicine finds that women aged 67 years and older with normal bone mineral density scores may not need screening again for 10 years.

“If a woman’s bone density at age 67 is very good, then she doesn’t need to be re-screened in two years or three years, because we’re not likely to see much change,” Gourlay said. “Our study found it would take about 16 years for 10 percent of women in the highest bone density ranges to develop osteoporosis. That was longer than we expected, and it’s great news for this group of women,” Gourlay said.

The researchers suggest that for T scores > -1.5, repeat testing needn’t be done for 10 years. Women with T scores between -1.5 and -2.0 can be re-screened in 5 years, and those with T scores below -2.0 can have every other year testing as is done now.

To be honest, I’ve been spacing out bone density testing in woman with good baseline scores for some time, but not knowing how long I can go. This is great information for me and for my patients.

*This blog post was originally published at tbtam*

Pregnancy As A “Pre-Existing Condition”

Women who own individual healthcare policies, please take note. Should you become pregnant in the future, your individual healthcare policy might not cover your pregnancy.

A recent article in the Los Angeles Times by Michelle Andrews was revealing. Andrews described the plight of a North Carolina biology teacher who subsequently left teaching after the birth of her twins. She became a small business owner and was covered under individual health insurance policies. However, when she became pregnant again, she had a rude awakening. Despite paying an insurance premium of $400 per month, her pregnancy wasn’t covered unless she had paid for a special rider, prior to becoming pregnant. Since half of all pregnancies are “unplanned” how can you pay for coverage six months in advance of an unplanned event?

On October 12, 2010, the Committee on Energy and Commerce produced a dismal report that revealed a total disregard and absence of concern for pregnant women and their unborn babies by the insurance industry. The Committee’s chairmen, Congressmen Henry Waxman and Bart Stupak revealed the following: Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Oocyte Preservation (Egg Freezing): Readily Available, Yet Still Experimental

Oocyte preservation, or egg freezing as it’s popularly called, is now being offered by over half of U.S. fertility clinics, and half of those not offering it now plan to do so in the future. This according to a national survey conducted in mid 2009 and reported this week in Fertility and Sterility.

Over two-thirds of the 143 centers offering oocyte cryopreservation will do it electively, as opposed to those that offer it only to women undergoing cancer treatments that threaten their natural fertility.

Go West, But Be Prepared To Pay

Centers located in the Western part of the U.S. are more likely to offer elective egg freezing than those in the East. Not surprisingly, centers that only accept out of pocket (as opposed to insurance) payments were more likely to offer the procedure, reflecting the history of infertility advancement, which, unlike almost any other area of medicine, has largely been financed by private individual dollars. Read more »

*This blog post was originally published at tbtam*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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