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Sometimes It’s Better to Just Say No

Story One: When I was a child (and we’re talking a lo-o-o-ng time ago – when doctors made house calls)… if I got an earache, I would suffer.  REALLY suffer. Mom would drip some warm oil into my ear, and then stuff some cotton in behind it. She’d give me an orange flavored baby aspirin or two.  And I would just lie in bed, or on the couch, miserable.  MISERABLE.  Seems like I would sleep a lot. Two days later, my earache would be gone, and because I was a kid, and resilient, I would be back on my feet.

Story Two: When I was a kid, I fell off my bike as I flew around a corner near my house.  My bike flew off in one direction and I flew in the other, and landed smack on my elbow.  OH THE PAIN!  I pulled the cinders out of my arm, and cried all the way home as I dragged my bike with me.  That evening my dad walked me across the street to see a doctor who lived in our neighborhood.  He felt along my arm, moved it around a little, declared that I had sprained it, then put my arm in a sling where I was expected to keep it for the next few weeks.

Perhaps it’s miraculous that I survived childhood!  But I don’t think so.  I think any of us over a “certain age” had very similar experiences as a child.  We all had sore throats and earaches, we all sprained and broke bones – and we didn’t have the miracles of modern medical care to help.

Fast forward to today.  Today when we go to the doctor, no matter what the complaint, we are met with a barrage of tests, procedures and treatments.  If I had a sore throat and an earache in 2012, I would likely be given a strep test (chi-ching!) and prescribed an antibiotic (chi-ching!)  If I fell off my bike in 2012, I would be given at least an X-ray (chi-ching!), but more likely a CT scan.  I’d be prescribed an antibiotic (chi-ching!) and maybe even a pain killer (chi-ching!)  I’d need follow up testing to see how well everything was healing (chi-ching!)…

Bottom line – healthcare is so much more expensive today because we do things that we don’t necessarily need to do.  We are herded into services that we don’t necessarily need.  And (shame on us) we ASK for things we don’t necessarily need and probably shouldn’t get.

Don’t need?  Shouldn’t get?

Antibiotics, the miracle drug of the 80s and 90s, were so overprescribed that today the bugs they were intended to kill have evolved into superbugs. People die from acquiring infections that didn’t become problematic until the overuse of antibiotics.  Yet – mom takes her child to the doctor with an earache and insists an antibiotic be prescribed for her child.  Two days later, the child is no longer in pain.  (But is that any improvement over the two days it took me to get past my earache 50+ years ago?)

The existence of CT scanners, MRI scanners and PET scanners, and the need to pay for them, compel doctors to order those tests, even in cases when they may not be necessary.  Of course there are times when they are very necessary – but not always, and not as often as they are used now.  When it comes to so much extra scanning, it can create big problems for our health (too much radiation exposure from x-rays or CTs) AND our wallets – imaging is expensive, even when we have insurance.

So how can we know the difference?  How can we be a bit more savvy when it comes to test and treatments, whether or not they are suggested by our doctors?

Last month, a consortium of nine different medical specialties – the very doctors who make money when we have tests and treatments – came out with their lists of tests, treatments and procedures we patients don’t need.  They listed them all on a website, called Choosing Wisely.

If these doctors don’t think we should take these tests, then why would we have them?

What we know is that this elite group has made these recommendations.  What we don’t know is that those recommendations will filter down to the doctors who order these tests, treatments and procedures – because that’s how they make their money, and (they think) that’s how they can defend against lawsuits.  (We can only imagine how unhappy that orthopedist who makes his living running CT scans is with his own peers that tell patients not to get so many CT scans.)

So, knowing that our doctors may not be aware of the lists, or may have chosen to ignore the lists, it’s up to us patients to ask questions.  “Doctor, If I take this antibiotic, how soon will I feel better?  How soon will I feel better if I don’t take it?”  — or — “Doctor, I know an X-ray is much less expensive than a CT scan.  What will a CT scan tell you that an x-ray won’t?  Can I have just the x-ray?”

So yes, fellow empowered patients, it’s time for us to begin making smarter choices, both for our wallets and for our health.  Make yourself generally aware of the new recommendations of tests, procedures and treatments you just don’t need.  Understand that leaders in healthcare who understand about reining in costs, even if they are the ones who lose income, are calling out to their peers to make changes in their recommendations….

Unfortunately, anything in medical care takes a LOT time to implement.  But this is something we patients can do – and do with no detriment to our health OR our wallets.
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10 Patient Empowerment Tips to Post on Your Refrigerator Door

The information center in many homes is the refrigerator door.  From family photos, to postcards to magnets from pizza shops, to phone numbers and kids’ artwork – the important ephemera of our lives can be found on refrigerator doors.

So today I thought I would share some advice that is worth cutting out and sticking to your refrigerator door – 10 empowerment tips that will keep you healthier and help you get the great medical care you deserve.

And if you like them, I invite you to download them (in the form of a small poster) to stick on your refrigerator door! (although – maybe you prefer to stick them on your bathroom mirror or medicine cabinet?  That’s OK too.)

  1. Become the expert in your own medical challenges. Read everything you can about your symptoms or diagnosis, ask questions, study anatomy, acquire and review copies of all your medical records. Be the authority on YOU.
  2. Using your YOU expertise, partner with your doctors and other providers. While they may have a medical education and experience, YOU are the one who has lived in your body your entire life.  Be an active participant on your own healthcare team. If your provider won’t listen to you, or share in your decision-making, then find one who will.
  3. Pursue a second opinionwhenever you are diagnosed with a difficult disease or condition, or surgery, chemo, or long term treatment are prescribed. And if they disagree?  Then seek a third.
  4. Don’t be afraid to say NO.  Sometimes less is more. As the authority on YOU, you’ll know when NO is the right answer.
  5. Thank your doctors and their staff members when they have been collaborative and helpful.  They work in a tough environment.  Appreciation, when appropriate, can go a long way toward strengthening your partnership.
  6. Read and listen past the headlines.  Get the whole story, then pursue additional, objective resources to confirm their veracity and to determine how well they apply to YOU. In particular, be sure Internet health  information is credible.
  7. Review your medical bills. Experts tell us that up to 80 percent of medical bills contain errors.  Incorrect bills will eventually cost us all in higher premiums and taxes.
  8. Provide support to others. Shared experiences can help others who suffer the same medical challenges you do.  Refer them to good doctors, and support groups, and offer an ear when they want to share their joys, or need to vent.
  9. Accept support from others. Whether it’s a loved one, or a professional, sometimes it’s imperative to have an advocate by your side to keep YOU safe, or keep you from being railroaded.
  10. Finally, wash your hands regularly and cough or sneeze into your elbow.  Infections are dangerous and deadly whether acquired during a hospital stay, or brought home from school by the kids.  Hygiene can go a long way toward keeping infection at bay and keeping YOU healthy.

Don’t forget – if you like these tips, you can print them out as a small refrigerator poster – here they are.

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Check Out Those Health Charities Before You Donate

This column first appeared
in the Syracuse Post Standard
December 6, 2011

It’s that time of year again.  The holidays, of course. But also the end of the tax year, when charities, including groups like cancer societies or hospital foundations, are pleading for donations.

Each year in December my husband and I make contributions to the charities we think are important, many of which are health-related.  Last year money was tight, and we knew we would either have to cut back on how much we donated, or leave some organizations off our list.

To help us make those difficult decisions, I did some background research on each of the charities we ordinarily support. I was surprised at what I found!  And learned some tips to share with you, too.

First, I learned that when children need specialized cancer treatment, they will get the same treatment  whether they live in Paris, Tokyo, Sydney – or Syracuse. Pediatric oncologists worldwide share their research and successes to the benefit of children everywhere.

I had to ask myself – why would we send a contribution to a children’s hospital out of state?  Since children receive the same specialized treatments, doesn’t it make more sense to donate in our own backyards?  I’m sure those famous children’s hospitals provide excellent care.  But if my child was sick, and I had to stay with her in a city far away, how would I get to work?  Where would I stay?  Bottom line – we decided to donate to our local children’s hospital, knowing local kids would get the great care they need.

Next up – family interests. Within my husband’s family or mine, we have loved ones who have dealt with Alzheimer’s, diabetes, lymphoma and breast cancer.  We have always donated to those very large, national charitable foundations, thinking our money was going toward education, research, and of course, a cure.

Not so fast! It turns out that not all charitable foundations are equal – including those we’ve sent money to each year.  I discovered that some charities are actually quite questionable. For example, too much of their money goes toward “undetermined” administrative costs. Or worse, only a small percentage of their budget goes toward their stated goals of education, patient support or research.  One very well known charity is spending the bulk of its donations on legal fees, suing smaller charities!

Based on that information, we decided against supporting two of the organizations we’ve sent money to for years.

As a result of this process, I realized that if more of us were choosier about our donations, health-related or not, the most effective and efficient organizations would have more funds to really make progress with their missions – a benefit for everyone.

You may want to review your charity choices, too, to be sure your donations have the best chance of accomplishing the goals you think are important.

Here are some additional resources for
choosing the best charities for your donor dollars:

How to Donate Money to Health and Disease Charities

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Conspiracy Theorists and Flu Vaccines – Pick Another Battle Please

A couple of weeks ago I posted a flu vaccine commentary and poll after listening to Dr. Dean Edell on the radio. He was talking about people who refuse to get vaccinated. He made the comment that vaccines have been proven effective for decades, and he’s tired of trying to defend them. That if people refuse to get vaccinated, and die — well — that’s just a way to clean out the gene pool.

Readers of the post took offense, calling me arrogant and ignorant. Among them are people who are truly afraid, people who are allergic, people who feel as if they have done their due diligence and have dismissed vaccines (empowered patients!) — and conspiracy theorists.

I wrote a follow up post, citing highly credible sources for all to see, showing why I believe flu vaccines are so important. The bottom line is that the flu is dangerous — both the H1N1 swine flu and the seasonal flu are killers. Vaccines are the only defense we have today (who knows – maybe we’ll have something better in the future?) And the statistics tell us that we have a 591% better chance of dying from the flu than we do dying from the flu vaccine. You don’t have to be a Las Vegas gambler to understand those odds.

I am actually VERY pleased that so many people have given researched thought and consideration to the question – even the ones who disagree with me.  However — I must say — I’ve had it up to my eyeballs with the flu vaccine conspiracy theorists…. seriously. And if you are one, I say to you — get a life!

Here are the conspiracy theorists’ arguments. They remind me of a saying I heard many years ago — “Just because I’m paranoid doesn’t mean they aren’t out to get me.”  Further – they have violated the first rule of questionable healthcare practices, and that is – Follow the Money.

Here are some of their lines of reasoning, and my comments:

1. Flu vaccine is only produced to make pharmaceutical companies richer. To that I say — don’t be silly. For the cost, personnel and too tiny profits to be made by producing vaccine, pharmaceutical manufacturers would much prefer to put their efforts into producing something that actually makes a worthwhile profit for them.  Included is the manufacturing are symptoms relievers — far FAR more profitable in the long run.  Why would they want to prevent an illness at very little profit at the expense of bigger profits from medicine that could relieve or fix us?

2.  Flu vaccines were developed from African Green Monkeys - and the real intent is to eradicate the population of the earth! This one gets the “give me a break” award on so many counts… First…  if the government wanted to eradicate the entire population of the earth, they could do it FAR more efficiently by using, oh, say  anthrax or dengue fever – or some other killer.  Why would they go to all the trouble to develop something that actually took science?  Why not a shortcut, and something cheap to do it?

3.  And then I have to ask – why would the government (which government anyway?) want to eradicate the world’s population? If the government eradicated the world’s population, then who would be left to govern?  and who would be left to pay taxes to that government?  and who would be in charge anyway?  (because the government is comprised of people who would get sick, too)…. etc etc….

Sorry — but these theories are just plain laughable.  You want a conspiracy?  I think there’s a conspiracy to make me waste my time looking these things up — because I do my due diligence, unlike some of my readers.

Here’s the deal — I understand that not everyone wants to be injected with flu vaccines, and even that some must avoid vaccines because their bodies cannot tolerate them.  However — for the great majority of us (GREAT majority) — flu shots will keep us healthier — and will keep our loved ones and those around us healthier — than not getting flu shots will.

Further — as reasonable people, we need to understand that unless we have a real concern about negative effects of vaccines, we must accept responsibility for passing possibly deadly flu on to others when we don’t get the flu vaccine.  H1N1 or seasonal — they are both killers.  I’m not willing to be responsible for making someone else sick, nor chancing that they could die.  I would not be able to sleep at night.

Do you?

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Swine Flu and Chicken Little – Too Much Hype?

After a week of hearing that the sky is falling because swine flu was going to take us all down, there’s a lot of second guessing about whether government(s) and the media have over-hyped the potential for a pandemic, and whether we have all over-reacted to the fear.

chickenlittle1I say – we have not overreacted – but I worry about Chicken Little.

The initial reports from Mexico indicated real potential for problems.  Governments, WHO and the media were in a d*mned if they do and d*mned if they don’t position:  Had they NOT reacted, then I guarantee you, the flu would have spread faster, further and more people would have died.  Then they would have taken the hit for not reacting appropriately– like George Bush deservedly did for Katrina — and we would all be left behind cleaning up behind the mess.

So I believe the reaction and the hype, and the reminders about the impact seasonal flu has on all of us, are warranted. I, for one, appreciate it.  Lives have been saved.  Awareness has been heightened.

That said…

I actually have more concern about the next time around. Whatever virus mutates, whether it be bird flu, swine flu, or hippopotamus flu — no matter which one it is — will we all be (pardon the pun) immune to the hype?  Will we ignore the governments and media who try to prepare us to keep us safe?  Will we go about our daily business tuning them out?  Will we turn a deaf ear because “remember swine flu?  no big deal!”

Chicken Little (who may be carrying bird flu, by the way) reminded us that the sky CAN fall when we don’t pay attention.  So the real point is that we need to be prepared with falling-sky contingency plans.  That’s what WHO does.  That’s what governments do.  That’s what media reports.

We just need to be sure we pay attention and take action, regardless of how hype-y it seems to be.

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