Leaderboard ad

Saturday, October 27, 2012

Medical Equipment and Supplies for Your Home

Medical emergencies can occur at any time and often happen at home. Investing in home medical supplies brings added peace of mind to you and your family. Whether your family has young children or consists of just you and your spouse, your household may benefit from having the following supplies on hand.

Defibrillators

Each year, over 200,000 Americans die of sudden cardiac arrest. In many cases, the cause of cardiac arrest is ventricular fibrillation, a type of heart rhythm disruption.

While cardio pulmonary resuscitation helps in some cases, a defibrillator may be required to correct the heart rhythm and bring it back to normal. Defibrillators that are portable, also called AEDs, provide on-site defibrillation in these emergencies. Having an AED at home means that in some heart-related emergencies, you may be able to stabilize a loved one before paramedics arrive. These devices guide you through the process and senses if it's appropriate to give an electrical shock.

Glucose Monitoring Equipment

Diabetes has become a common medical condition in western society. Diabetics must keep a careful eye on blood sugar levels to ensure it stays within normal levels. When levels rise too high or fall too low, immediate action should be taken.

All who suffer from diabetes or hypoglycemia should have a glucose meter and test strips at home. Sometimes it is not easy to tell how high or low blood sugar levels are without testing.

Even if you have not been diagnosed with diabetes, it is a good idea to test your glucose levels on occasion. If you notice that your blood sugar seems abnormal, you can make lifestyle changes to prevent the onset of diabetes. Catching diabetes early may help prevent some common complications of this disease.

Blood Pressure Monitor

Blood pressure monitors have come a long way. Today, there are digital monitors available, and they are easier to use than ever. If you or a family member has high blood pressure, or borderline high blood pressure, you should consider investing in a blood pressure monitor.

It's important to monitor your blood pressure daily. A high reading is a sign that it's time to speak with your doctor about managing your high blood pressure. If you are already on medications for high blood pressure, high or overly low blood pressure readings indicate you may need a dosage change or a different medication.

Advanced First Aid Kits

Most simple first aid kits contain only basic supplies, such as ointment, bandages, sterile gloves and gauze pads. These only treat minor injuries. Be prepared for serious injuries, such as burns, sprains, allergic reactions and deep cuts.

Buy or create a first aid kit that contains sterile eyewash, burn cream, ammonia inhalants for fainting, splints, elastic bandages, antihistamine tablets and cream, wound wash and cold pack. For any serious illness or injury, you should always seek medical assistance. However, immediate home treatment of bleeding wounds, chemical splashes to the eyes, sprains, strains, breaks, and minor burns is also important for preventing further injury.

This entry is a guest blog entry.

Monday, October 22, 2012

Poop Transplants to the Rescue!

One of the worst types of infections someone can experience is C. diff, which is short for the bacteria, Clostridium difficile. It is known for causing signs and symptoms such as significant diarrhea with a distinctly foul odor, fever, and abdominal pain. It kills about 14,000 people a year.

Most cases are caused with the use of antibiotics in older people because the antibiotics kill off normal bacteria in the intestine, allowing C. diff to grow.   

C. diff bacteria can live outside of the body for long periods, which means that patients can ingest them accidentally and easily become infected, particularly if they are in a medically vulnerable state in a medical facility. There are various medications (e.g., antibiotics) that are used to treat C. diff, but they are not always effective (recurrence rate of 25 to 30%) and in severe cases, a person may need surgery to remove part of the colon (the major part of the large intestine).

However, there is a less drastic option available for treatment, which actually has a 90 to near 100% cure rate depending on the sample studied. Although most people are unaware of it, the name of this treatment is a fecal bacteriotherapy, which is also known as a stool transplant -- or to use a less scientific term, a poop transplant.

The technique involves taking bacteria from a health person’s feces (poop) and transplanting into the intestine of the patient with C. difficile. The technique works by restoring the normal balance of bacteria in the intestine so C. difficile can no longer thrive. If you are wondering, the poop to be transplanted is preferably collected from a close relative but can be taken from a stranger. It is then mixed with warm water, saline, or milk to reach the needed consistency.

Suggested reading: Clostridium difficile: A Patient's Guide

Friday, October 19, 2012

Five Ways to Get in to See a Medical Specialist Faster

So you have an appointment with that medical specialist you were told you should see. You heard great things about this doctor and have been told he/she is the best. There’s only one problem. The appointment is 3 to 6 months from now, you have pressing needs and concerns about your situation and want to be seen earlier.

In some cases, depending on what the ultimate diagnosis is (e.g., cancer), delaying treatment for months can negatively impact prognosis and can even be a matter of life and death. So, you have a choice:  a) find another doctor who can see you sooner but is not as highly regarded as the doctor you want to see, or b) find a way to get in to the doctor you want to see quicker. Here are five quick tips you can use to increase the chances you can accomplish the latter.

1. Ask to be placed on a waiting list. Cancellations happen regularly due to life circumstances (e.g., a sick child, death in the family, unexpected schedule conflict) and doctor’s offices maintain a waiting list to quickly fill in the appointment slot if a cancellation occurs. Some doctor offices will provide you the option to be placed on a waiting list but sometimes you will need to ask. Be sure to provide a cell phone number as a well as a land line to increase the chances you can be reached.

2. Check in once a week with the secretary. Getting on good terms with the appointment secretary is always a plus. If you call every day, you will not accomplish that goal, but calling once a week is a good idea for several reasons. First, it adequately conveys your desire to be evaluated, which can cause you to be moved up the waiting list when a free slot becomes available. Second, you may find that the secretary just got off the phone with someone who cancelled and since you just so happen to be on the phone, you may get chosen as the person to fill the appointment slot. I recommend using this technique mid to late morning to take advantage of an afternoon cancellation. You can still be on a waiting list and check in once a week.

3. Use your contacts. If you have a friend or family member who knows the doctor you want to see or someone who works at that office, use this to your advantage and see if that person can arrange for you to get moved up on the schedule.  You would be amazed how often this works and it can trim months off of appointment waiting time.

4. Ask the doctor who referred you to exert some pressure on the specialist. Doctors like to keep each other happy because they usually refer to each other. If option #3 is not applicable, the referring doctor is who you can reach out to try and expedite the appointment for you. This can be done with a quick email or phone call. 

5. Lastly, you can try to personally reach out to the specialist and convey why you feel that you or a family member should move up on the schedule. This can be done with a phone call although it will be difficult to reach the person directly. Best bet is usually to do an internet search for an enail contact by which to compose your message. If you know of other techniques, feel free to post that here.

Monday, October 15, 2012

Five Ways to Relax if You Think You May Have Cancer

At some point, it happens to most of us. One way or the other, you discover that there is something not quite right with your body and the doctor you first see about it tells you that more testing is needed to figure out exactly what is wrong.

Perhaps you found a small lump under your arm, maybe you were told that there was an abnormality on a blood test, or perhaps something came back looking unusual on a magnetic resonance imaging (MRI) scan or an ultrasound. Often, the major concern in these situations is that the abnormality may be cancer.  In many cases, a biopsy will be needed to make this determination.

The problem in this situation is that it often takes a considerable amount of time (e.g., weeks to months) before you can get evaluated by a specialist and then undergo the more specific diagnostic tests needed to make final diagnosis. During the interval, it is very common to let your imagination run away with you, especially when researching the issue over the internet, and become convinced that you have a serious medical condition with a poor prognosis. Here are a few tips to help you get through this time:

1. Tell yourself that you will worry when you actually have something to worry about. You may read this and think “but I do have something to worry about. I have a lump and I might have cancer!” The key word there is might, not definitely. Of course, this approach is not designed to reduce all anxiety about the situation because some anxiety is certainly natural. It is a technique, however, to decrease anxiety and remind oneself to focus on what is actually known in the present as opposed to what might happen in the future.

2. Be careful with internet research. While it is natural to type your signs and symptoms into a search engine to research what may be causing a particular problem, be aware that by doing this you are likely to focus on the worst case scenario possibilities as opposed to more benign explanations. Having some information at your fingertips is good, so you can ask knowledgeable questions to your doctor, but try to remember that the doctor will have the education and training to figure out which diagnosis is applicable to your situation and which is not. Of course, not every doctor is perfect or correct, which is why a second opinion can be sought.

3. Do not diagnose yourself. Many people spend weeks to months between appointments in a depressed, anxious, and/or irritable mood because they have been saying such things as “I know I have cancer” or “I know it is multiple sclerosis” without any solid evidence to support it. In many cases, this is a psychological defense mechanism to brace oneself for the worst possible news. However, wouldn’t a better approach be to focus on point #1?

4. Do something to keep you busy. Spending your time between diagnostic evaluations withdrawn, sleeping in bed all day, and isolating yourself from your friends and family only serves to increase depression and despondency. It will also make the time go by much slower. Better to keep yourself engaged in some kind of activity you enjoy that will make the time go by faster.

5. Talk to a trusted friend or family member who is positive. The worst thing you can do is hold all of your emotions in about the situation. Like a teapot filling up with steam with no escape route, the teapot will eventually explode. Talking to someone about your feelings and concerns during this initial stage can be quite a stress reliever and help you see a different side of the situation that you may not have thought about before. 

Friday, October 05, 2012

10 Ways Doctors Can Protect Themselves When Attorneys Try to Influence Patient Care

The prior blog entry discussed ways that attorneys try to control a patient’s medical care to win a case. Below are ten steps that doctors and other health care providers can take to prevent themselves being placed in such scenarios or deal with them more effectively when they occur despite attempts at prevention.

1. Awareness is key. When a  new patient arrives to the office or an existing patient arrives seeking medical treatment for a particular condition or injury, the first step is to determine whether the injury or condition is compensable in some way and whether the patient will be seeking compensation for it. In some cases, this will be easy to determine based on the insurance type (e.g., workers compensation, no-fault insurance) or if the patient acknowledges when asked that an attorney has been hired or that disability is being pursued. In other cases, a patient may deny pursuing compensation but plans to in the near future, is considering it, or is not being honest.  In such cases, consider the history. Was somewhat else alleged to be at fault for the injury (e.g., car accident) or is there someone the patient may blame for the injury/condition (e.g., a doctor misreading a brain CT scan in the ER as not showing signs of an acute stroke when it actually did, resulting in delayed care and worse signs, symptoms, and outcome)? Ask if the person is seeking disability.

2. Document acknowledged compensation seeking, receipt of compensation, and/or retention of legal counsel in the medical note. If the patient denies seeking compensation or having retained legal counsel, document this as well. This way, you have a record of what information was provided to you on this topic when treatment began. If the information changes at some point, document that as well.

3. Ask the patient whose idea it was for the evaluation. If the idea solely came from the attorney, explain to the patient that your practice (an insurance billing) is specifically designed for patients in which referrals originate from other health care providers or from the patient for the sole purposes of improving healthcare (as opposed to pursuing compensation). In other words, you perform clinical evaluations, not legal evaluations.

4. If the idea for the evaluation came from the attorney but was referred by another health care provider, contact that provider to discuss the issue. I have had several cases where I place such a call and the physician tells me. “I have no idea why I am sending the patient for the evaluation. She said her attorney wanted it, so I just ordered it.” In such cases, explain your position to healthcare provider and provide the patient and referral source with contact information of other providers in the area who perform medico-legal work (which is paid for by the attorney).  

5. If the referral was legitimately made by a healthcare provider but the patient is also pursuing compensation, explain that the medical records may be subpoenaed by an attorney/judge and used in a deposition, trial, or settlement negotiations. Explain that the findings may help the patient, have no impact, or negatively impact the compensation case. Explain that you will base your findings on scientific principles and methods and that your findings may be in perfect agreement with what the patients thinks is the problem and expects as a recommendation (e.g., disability status), may be in partial agreement, or that you may have a completely different take.
6. Go through the above information with the patient in an informed consent that you have the patient sign.  Make sure the form has a statement in it that says signing it means that the patient understands what is on the form, had the chance to ask questions, and that any questions have been answered to his/her satisfaction. Explain this out loud to the patient and provide the patient a copy when it is signed. This document can protect you in the future in case of a complaint. If the patient is unwilling to sign the form you can refer him/her to another provider.

7. While there is nothing wrong with clinically evaluating patients who are seeking compensation, make it clear that while you are open to hearing input that you are the one who makes the ultimate diagnostic and treatment decisions, decides how to word documentation, and what to say in a court of law. Be clear that this has nothing to do with ego or arrogance, but after all, you are the one with the health care license and health care degree.

8. While it is perfectly acceptable to advocate on a patient’s behalf, health care providers must be cautious to avoid blind advocacy in which there is an absence of evidence to validate compensation claims. This is especially the case when extensive attempts have been made to find such evidence. While it is true that absence of evidence is not always evidence of absence, many times it is.

9. Do not turn a blind eye to evidence that emerges which runs counter to the patient’s claims. In such cases, it is best to sit down with the patient, express your concerns, and adjust the case conceptualization and treatment plan accordingly. An example would include referring a patient for counseling if significant psychological distress appears to be the main problem as opposed to a mild injury. Do not send patients for indefinite treatments that show no improvement within reasonable time frames. Be sure to measure treatment progress over time.

10. If you eventually have to do a deposition or testify, try your best just to stick with the facts without getting caught up with trying to help one side win or lose the case. The outcome of the case is for the attorneys to handle and the jury to decide. The role of the witness is to assist the court/jury by providing honest testimony that is as objective as possible.