Don’t Stress Getting a Second Opinion

Our interactions with the medical field can be stressful, especially when a diagnosis or treatment plan is considered serious. Critical conditions or life-threatening illnesses evoke a level of fear not found in most other life situations, and oftentimes, there is a sense of urgency that surrounds a medical professional’s recommendation for how to get back to a healthy status. Despite the sense of urgency, making quick decisions when it comes to medical care is not always the best course of action. Taking the time to fully understand your diagnosis and course of treatment options is one of the best steps we can take to ensure a positive end result.

Part of that process is obtaining a second opinion.

Doctors are trained to diagnose and treat a wide range of conditions and diseases, and so it is natural to simply go with the initial advice from your primary care physician. However, they don’t always get it right the first time, resulting in misdiagnoses, unnecessary treatment plans or prolonged symptoms. According to a recent study, over one third of patients within the United States never get a second opinion, despite the fact that just under 10% of all patients do not fully comprehend their diagnosis or plan for care. Seeking out the advice or counsel of a medical professional above and beyond your current provider is a smart way to combat these issues, but the process of getting a second opinion is often wrought with discomfort – most of us wish to not rock the proverbial boat.

To ensure you are receiving the most suitable treatment for your medical condition, getting a second opinion is incredibly important. Here’s how to tackle the process.

What Prompts a Second Opinion?

Seeking out a second opinion is highly recommended when your diagnosis or condition is severe; however, that does not mean a second opinion cannot be obtained for less serious cases. Getting advice from another medical professional should be the norm when you experience the following:

•    Little understanding of your diagnosis or prognosis
•    A diagnosis of a severe or life-threatening disease or condition
•    When the FDA has not yet provided clear guidance on approved treatments for your condition
•    When a trial drug or treatment is recommended
•    If your provider is not able to provide clear answers on why or how a treatment will be completed
•    When complications take place during treatment

Receiving a second opinion soon after any of these circumstances take place is important in maintaining control over your medical care. Additionally, second opinions are helpful in protecting you against malpractice or questionable treatment plans implemented by your doctor. Patient Claim Line, a medical negligence solicitors firm, reports that 14% of medical claims within the UK are directly related to information provided during a second opinion. Safeguarding yourself from adverse outcomes related to your health is necessary, no matter how big or small your condition or illness.

Our Rights as Patients

Obtaining a second opinion feels a bit awkward in practice, especially when the relationship between you and your primary doctor is strong. However, it is important to remember that we all have the right to seek out a second opinion when we deem it necessary, as it is our responsibility to take as much control as possible over our own medical care. The majority of health care coverage plans afford patients the ability to get a second opinion for serious conditions without too much of a hassle. Others, however, make it more challenging to receive the advice from a specialist or another physician for a condition already diagnosed or after treatment has begun. Regardless of the circumstances under which you fall, it is necessary for you to be heard if you feel a second opinion is needed or otherwise desired.

Doctors are often willing to lend a hand for patients who want a second opinion, and most understand this to be a basic right of all patients. Take the stress out of asking for a second opinion by being open and honest with your primary medical professional about your concerns or questions surrounding a diagnosis or treatment plan. If they seem put off by your request, or disinterested in assisting you, work directly with your health care coverage provider to find another medical professional to assist you in achieving the best possible care.

Keeping your Doctor Informed

Second opinions need not be an awkward or uncomfortable request, but it is natural to feel some level of uneasiness when your desire to get a second opinion comes up. To help fight off that unrest, use the following phrases to start the conversation with your doctor or medical professional:

I want to get a second opinion before starting any treatment plan. Can you help me with this?

Would you get a second opinion if you were in my shoes?

My family has urged me to get a second opinion about my diagnosis/treatment plan.

This diagnosis and treatment plan concern me. To feel comfortable making this decision, I want to consult with another doctor for a second opinion. 

Starting the second opinion discussion off with one of these phrases will help eliminate some of the stress that comes with seeking out additional/different advice. If you choose to seek out a second opinion without asking your doctor for help, know that it is necessary to still keep them informed. Medical records including lab results, notes and current or past prescriptions need to be shared with secondary doctors in a timely manner to ensure there are no delays in receiving additional advice or care.

As much as second opinions are an important aspect of maintaining control over your health care and treatment, the process seems arduous to most patients. Obtaining a second opinion does not have to be a challenging or uncomfortable process, however. Start by knowing when a second opinion is warranted, and how obtaining this supplemental information is beneficial to your well-being on a multitude of levels. Work with your primary doctor first, and take advantage of your health insurance provider should you run into any issues. Know that obtaining a second opinion is one of your basic patient rights, and don’t be afraid to follow your gut when the need arises.

This is a guest blog entry.

How Do Diabetes Test Strips Work?

Diabetes test strips or blood glucose test strips are an essential component when it comes to testing levels of blood glucose. These small, disposable plastic strips may look insignificant, however they actually play a hugely important role in helping people with diabetes to better monitor and manage their condition. In the majority of cases, each meter will take one type of test strip only. However, there are certain blood glucose meters which also test for ketone levels and take blood ketone strips. So, how do diabetes test strips work?

Royalty free photo

How Do Test Strips Work?

The specifics of how diabetes test strips work is something that crops up a lot in diabetic FAQ. When it comes into contact with the test strip, the blood will react with the glucose oxidase chemical, which produces gluconic acid from the glucose in the blood. The meter then transfers a current to the test strip via electronic terminals which allows the meter to measure the current. Depending on the amount of gluconic acid which has been produced, the current between the terminals will vary. The blood glucose meter will then use an algorithm to determine the level of glucose in the blood based upon the difference in current.

Where Can I Get Test Strips?

Diabetes test strips and meters can be obtained on prescription from your doctor. They can also be purchased in certain pharmacies and online pharmacies. Whether or not you are able to get diabetes test strips on prescription will depend on the type of diabetes that you have and the severity of the condition. You can also get test strips from ‘diabetic strips for cash’ schemes, which buy unused and unwanted test strips from people and sell or give them to diabetics who need them. If you have been diagnosed with diabetes, your doctor will be able to tell you whether or not you need to use test strips in order to manage your condition.

How Long Do the Strips Last?

Blood glucose test strips will normally have a use by date, either on the strip itself or displayed on the box in which they arrived. Once opened, the majority of diabetic test trips will be good to use for around three to six months, however it’s crucial that you refer to the box or the information slip provided with your test strips to ensure that you do not end up using out of date blood glucose test strips, which may produce inaccurate results.

How Should Diabetes Test Strips Be Stored?

Blood glucose test strips should be stored at room temperature, and within the sealed vial. You should never refrigerate your diabetes test strips or expose them to heat, as extreme temperatures can cause serious damage. Exposure to humidity and direct sunlight can also render your test strips unusable. You should not use any test strips which have come into contact with other substances or if they have been damaged in any way.

Diabetes test strips are absolutely crucial to managing diabetes day to day.

This is a guest blog post.

EMGs: What You Need To Know

An EMG, otherwise known as electromyogram, is a test used to measure the electrical activity in muscles. It's typically done alongside a nerve conduction velocity test (NCV), which measures nerves ability to send signals.

The tests are usually performed by an electromyographer, who is typically a Psychiatrist or Neurologist. In some cases, the NCV test is performed by a trained technician. This is a procedure that can be done in-office and doesn't require hospitalization. The average EMG takes between 30 minutes and 2 hours, depending on how extensive the testing is. In most cases, it doesn't require any preparation and can be done at any time of the day.

What Happens During These Tests

At the time of the test, you'll be in a room with one or more EMG machines. They look like a regular laptop or desktop computer and aren't as intimidating as they sound. The test usually consists of two parts, and you'll be laying comfortably on an examination table while they are performed.

The first test, the NCV, the doctor will attach some small electrodes to the surface of your skin and then touch you in another area with electrodes to produce a small electric shock. This is to determine how well your nerves conduct the current - an indication of how healthy they are. You may feel a slight tingling sensation during this test, but the electrical current is always at a safe level. This procedure is normally repeated a few times to ensure all nerves in the area are tested.

The second part of the test is known as a needle examination. In this test, the doctor will insert very thin needles into relaxed muscles and gently moved around to record the muscle activity. The needle insertion itself may cause a little pain, but once inserted you should only feel a little pressure or discomfort.

Why an EMG is Performed

EMG tests are most often performed when a patient has symptoms that might indicate a muscle or nerve disorder. These symptoms can include, numbness, tingling, muscle pain, weakness or cramping and some types of limb pain. Also, a patient experiencing difficulty walking, handling objects or buttoning clothes may need an EMG.

Disorders EMG Tests can Diagnose

The results of EMG tests can be used to rule out or diagnose many conditions including muscle disorders like polymyositis and muscular dystrophy.

Results may also help in the diagnosis of nerve disorders such as a pinched nerve, peripheral neuropathies and carpel tunnel syndrome and disorders that affect the root of the nerve like a herniated disk or sciatica.

EMG test results are also used to diagnose disorders that affect motor neurons in the spinal cord or brain like polio and amyotrophic lateral sclerosis, otherwise known as Lou Gehrig's Disease.

The EMG test is a relatively new procedure, with electrodes and the cables necessary to produce signals being mass produced in the mid-1980s, and is one of the fairly recent medical testing advances that can detect and diagnose conditions and save lives. 

This is a blog post by Nancy Evans.

Egg Freezing: The Fertility Process That Gives You Options

Did you know your age significantly impacts your fertility? As you get older, the quantity and quality of your eggs begins to decline, reducing your chances of having a healthy pregnancy. You’re most fertile in your twenties, followed by your early thirties, but what if you’re not ready to start a family within this time frame?

Thanks to advanced egg freezing technology, you can now preserve your fertility at its peak. This opportunity extends your childbearing years, giving you more options for the future. If you’re considering egg freezing, take some time and learn what you can do to be successful.

HOW DOES EGG FREEZING WORK?

Freezing your own eggs for future pregnancy involves four key phases:

Evaluate

Your first step is consulting with a reproductive endocrinologist to review your medical history and discuss your pregnancy goals. Bloodwork is drawn to test your hormone levels, and then an ultrasound is performed to assess your ovarian reserve. Finally, if you are not on the birth control pill, your doctor may ask you to start taking it for a month or two to regulate your menstrual cycle.

Stimulate

To prepare your body for egg retrieval, you will receive hormone injections that stimulate the ovaries to produce as many mature eggs as possible. During this time, which usually lasts five to 10 days, you will have regular bloodwork and ultrasounds to monitor egg follicle growth in your ovaries. Medication dosages may be adjusted based on follicle development. After about two weeks, once your follicles have reached maturation, you are given a “trigger” shot 36 hours before your retrieval. Timing is very important! The trigger shot, or hCG (human chorionic gonadotropin), causes your follicles to release the mature eggs just when you are ready for retrieval.

Retrieve

Eggs are retrieved during a 10-15 minute procedure in which you are under mild anesthesia.
Your doctor will use an ultrasound-guided needle attached to a catheter to remove the eggs from your ovaries. You may experience some cramping following the procedure; it takes about two weeks for your ovaries to fully recover from stimulation and retrieval.

Freeze

Once retrieved, the eggs are taken to a lab where an embryologist separates the mature from the immature eggs. All mature eggs undergo vitrification, a new technology that is the most effective way to preserve eggs. To prevent damaging ice crystals from forming, eggs are exposed to liquids known as cryoprotectants, then placed into liquid nitrogen and stored. Until recently, egg freezing happened through a slow-freeze process that often led to ice crystals forming in the eggs, destroying them. Now, the vitrification process freezes eggs so rapidly that ice crystals are unable to form, keeping the cell structure together. As a result, eggs that have been vitrified are virtually indistinguishable from freshly retrieved eggs. Within 24 hours of your retrieval, the fertility clinic will let you know the number of eggs retrieved, and the number of mature eggs frozen.

USING YOUR FROZEN EGGS TO GET PREGNANT

The beauty of egg freezing is you have control over the timeline in which you would like to conceive. You can access your frozen eggs whenever you are ready to proceed with in-vitro fertilization (IVF).
Prepare For IVF Transfer

You begin by taking medications, including estrogen and progesterone, for about four weeks to prepare the endometrial lining of your uterus to accept the embryos during the IVF transfer.

Receive and Fertilize Eggs

When it’s time for the transfer, the egg bank sends your frozen eggs to the fertility clinic, where they are removed from storage and quickly rehydrated and warmed. Next, the embryologist examines your eggs to determine their quality. Then, eggs are combined with your partner's sperm using a process called intracytoplasmic sperm injection (ICSI), in which a single sperm is injected directly into each egg with a needle, instead of allowing sperm to penetrate the egg in a Petri dish.

IVF Transfer

After fertilization, the embryos begin to develop. The embryologist selects the most viable embryo(s) to place in your uterus three to five days after the egg retrieval. The doctor will transfer these embryos into your uterus by inserting a thin tube called a catheter through your cervix. You and your doctor will discuss the optimal number of embryos to transfer based on several parameters.

Pregnancy Test

Two weeks after the transfer, you will return to the fertility clinic to take a pregnancy test; specifically, a blood test that measures the level of hCG, also known as the pregnancy hormone. At that time, you will learn whether the cycle was a success.

Make Future Fertility Yours

Egg freezing is a reliable option to explore when considering your future family; don’t let your biological clock - or anything else - determine when the time is right for you to have children. 

This is a guest blog post.

More Than Just Heartburn: Know the Risks of Untreated GERD

Sixty million Americans suffer from heartburn at least once a month and most of the time it’s nothing serious. But an estimated 19 million have burning and discomfort at least twice a week on a long-term basis and could be at risk for complications of a condition known as gastroesophageal reflux disease (GERD).

While GERD can’t be diagnosed by heartburn alone, heartburn could be an indicator of GERD and should be evaluated by a doctor. Thankfully, most cases of GERD can be managed with lifestyle changes, but ignoring it could trigger a variety of other health problems. Here are a few:

-  Irritation or swelling of the esophagus (esophagitis). Triggered by constant exposure to stomach acids as they wash over the lining of your esophagus, it can cause pain and make your esophagus vulnerable to scarring and additional damage.

-  Esophageal stricture.  If your esophagus stays irritated long enough, this tube that carries food from your mouth to your stomach may develop a narrow area filled with scar tissue known as a stricture. Strictures can make it hard for food to pass and may cause choking. Strictures can be corrected with procedures to stretch or dilate the esophagus.

-  Hoarseness when you speak.  Not every case of GERD comes with classic heartburn. You may notice your voice changes and you become hoarse, have a sore throat, or chronic cough—all of which may be part of untreated GERD.

-  Asthma and pneumonia. As stomach contents wash up your esophagus, there’s a chance they could take the wrong path, entering your lungs. Anytime an outside fluid gets into the lungs you have a risk for the development of infection (pneumonia), shortness of breath, and the development or worsening of conditions like asthma.

-  Tooth decay. Sometimes considered a symptom of advanced GERD, tooth decay occurs when stomach acids wash all the way back up to the mouth. You may notice this as a sour taste in your mouth and nothing more—but contact of acid with your teeth over time can cause erosion and permanent damage to your teeth.

-  Barrett’s esophagus.  Also an advanced complication, these precancerous changes in the lining of the esophagus can only be diagnosed by endoscopy—when your doctor runs a light and tube down through your esophagus and takes a sample of the tissue for testing. There are no symptoms of Barrett’s esophagus outside of what your GERD may cause, and if left untreated could lead to esophageal cancer.

What you can do to defend yourself against GERD

If you’ve been diagnosed with GERD there are many ways you can ease your symptoms and live a better quality of life. Medications are a typical first line treatment, but may come with side effects. Talk to your doctor about the best treatment for you and also consider:
-  Changing your diet to avoid trigger foods

-  Exercising and losing weight

-  Not smoking

-  Using a GERD pillow at night

-  Eating smaller, more frequent meals

-  Talking to your doctor about adjusting medications that may worsen GERD symptoms

Gastroesophageal reflux disease may develop from different causes and may present itself in many ways. Being informed about the complications that come with it is half the battle towards minimizing GERD’s negative effects. Talk to your doctor if you think you may have GERD and learn more today.

This is a blog post by Nancy Evans.

The Many Wonderful Benefits Of Organic Juices

It is sad how the quality of edibles is degrading day by day. Adulterated food products, though cheap, are harmful for you in the long run. You cannot afford risking your family’s well-being, and when it comes to the health of your loved ones, only the best will do. An organic nutritious diet keeps you and your family fit and fine.

A glass of fresh fruit or vegetable juice is a great way to kick-start the day! Check out the many blessings and benefits of organic juices mentioned below-

Get real vitamins and minerals

Unlike processed juice cans, organic juices have nothing artificial about them. These juices are freshly squeezed out from a real fruit or vegetable. This way you get all the proper vitamins and minerals of the fruit directly. Your body needs some important vitamins and minerals for proper functioning and organic juices replenish that need.

Instant energy 

Organic juices keep you active and energised throughout the day. As some fruits are naturally sweet, the sugar content in them is a great source of energy. This is because consuming fresh fruits and vegetables keep you refreshed, increases you stamina and boosts your immunity. You can focus better and not feel exhausted every time.

Boosts the immunity

The many vitamins and minerals present in organic juices help fight harmful bacteria and prevent other diseases. Fruits such as oranges, lemon, and apples are great to boost the immunity as they contain Vitamin C, an important factor that fights all the harmful viruses and infections.

Help in losing weight 

Yes, consuming organic juices also takes you one step closer to shedding those extra kilos and getting that perfect toned body. Although proper workout is also necessary, one cannot deny the role or juices. Pure coconut water, lemon juice and beetroot help you manage your weight issues as these fluids your appetite and are very low on calories.

Keeps your skin glowing and youthful

Drinking organic juices daily can work wonders on your skin. Getting that perfect radiant, glowing and youthful skin is no more a dream! Lot of fruits and vegetables have anti-aging properties as well that help you look naturally beautiful. Also drinking organic juices reduces inflammation and baggy eyes and gives you an even toned complexion.

Keeps you hydrated throughout the day

Fruits and vegetables such as watermelons are a great source of water and consuming them as juices also help you overcome dehydration. Also the sugar content in some fruits manages the glucose levels of the body. Especially beneficial in the hot and humid summer, organic juices keep up the water content in your body and keep you hydrated throughout the day.

Prevents ulcers and kidney stones

Most of the fruits and vegetables are rich in vitamin C, and are therefore a great way to strengthen your immune system! Also vitamin C reduces the risk of ulcers and painful kidney stones considerably. The citrus acid present in many fruits prevent kidney stones form forming and ensure proper elimination of wastes.

Cures other deadly diseases

Rich in nutrients the organic juices are low on calorie and fat free thus balancing the cholesterol levels and even preventing heart attacks!  Vegetables such as spinach and kale help in the production of blood and even prevent deadly diseases such as diabetes, blood pressure and even fight cancer!

Contains antioxidants

Consuming organic juices also gives your body the much needed antioxidants that cleanse your body and eliminate the harmful toxins. Antioxidants also prevent acnes and pimples and keep your skin clear and blemish free.

Contain healthy carbohydrates and proteins

Fruits and vegetables are also a rich source of healthy carbs and proteins. This means a glass of organic juice can help you develop those rock hard muscles! Also most fruits have healthy levels of carbs and are almost fat free and hence a healthy option for athletes.

Factors to consider when buying organic juices

Keep these points in mind before you buy any organic juice
•    It should be 100% organic with no added flavours or preservatives
•    Use vegetables that are free of harmful pesticides
•    Don’t add any extra sweetener to the juice
•    avoid packed or canned juices

Mauricio Prinzlau  inspires people to go organic and live a healthy life at Bestjuicer.net. He writes about various organic juice recipes and reviews best juicers. Get in touch with him at Facebook and Twitter.

Fracking Spills Responsible for North Dakota Soil and Water Contamination

Accidental spills of wastewater at unconventional oil drilling sites in North Dakota have resulted in widespread soil and water contamination, according to a new study conducted by researchers from Duke University, which was recently published in the journal Environmental Science & Technology.

The scientists found high concentrations of lead, selenium, ammonium as well as other toxic pollutants, together with high salt levels in wastewater produced during fracking activities at oil drilling sites in North Dakota's Bakken region.

Streams contaminated by the fracking wastewater contained concentrations of pollutants that in many cases exceeded federal safety standards set for drinking water or for environmental health of freshwater systems.

Soil samples taken from spill sites showed that soils were contaminated with the radioactive element, radium, which chemically bonded with the soil following the release of spilled wastewater. In one case, the scientists still found high concentrations of pollutants in spilled wastewater four years later.

"Until now, research in many regions of the nation has shown that contamination from fracking has been fairly sporadic and inconsistent," said Avner Vengosh, professor of geochemistry and water quality at Duke's Nicholas School of the Environment. "In North Dakota, however, we find it is widespread and persistent, with clear evidence of direct water contamination from fracking."

"The magnitude of oil drilling in North Dakota is overwhelming," Vengosh said. "More than 9,700 wells have been drilled there in the past decade. This massive development has led to more than 3,900 brine spills, mostly coming from faulty pipes built to transport fracked wells' flowback water from on-site holding containers to nearby injection wells where it will be disposed underground."

During the course of the study, the researchers mapped the 3,900 wastewater spill sites to illustrate how oil drilling intensity played a key contributing role in wastewater spills.

Over a seven year period between 2007 - 2014, unconventional oil production has increased from around 100,000 barrels per day to over 1 million barrels per day in North Dakota. The increase in production is largely due to advances in hydro-fracturing and horizontal drilling technologies. The expansion of the oil and gas industry in North Dakota has spurred economic growth, particularly in the rural areas and tribal lands. However, this expansion has also fueled concern about the impact on drinking water quality.

According to lead author of the paper, Nancy Lauer, a doctoral student at Duke, unlike oil, which breaks down in soils, brine-laden spilled wastewater contains salts, heavy metals and inorganic chemicals that do not readily biodegrade. Consequently these contaminants persist in the environment for a very long time. As a result, we now have a legacy of radioactive contamination at these spill sites.

Lauer points out that soil samples collected further downstream from wastewater spill sites had higher levels of radiation than soils samples collected from a wastewater spill site itself, suggesting that radium accumulates in soils as spilled wastewater flows through.

Considering that wastewater spills can occur upstream from drinking water sources, it is important to conduct long-term monitoring of waters further downstream to determine the impact on drinking water quality, notes Vengosh. For example, in 2014 a leaking underground pipeline spewed roughly 1 million gallons of brine into Bear Den Bay, situated less than a mile upstream from Lake Sakakawea which supplies drinking water to residents nearby.

Aerial view of resource extraction in Texas.

"Many smaller spills have also occurred on tribal lands, and as far as we know, no one is monitoring them," Vengosh added. "People who live on the reservations are being left to wonder how it might affect their land, water, health and way of life."

Journal Reference

Nancy E. Lauer, Jennifer S. Harkness, Avner Vengosh. Brine Spills Associated with Unconventional Oil Development in North Dakota. Environmental Science & Technology, April 27, 2016.  DOI: 10.1021/acs.est.5b06349

Danielle Ward