Category: Personal Health

How to Become a “Hospital Warrior”

Check this out. What you will see is the story of a layperson who has learned the hard way, i.e., by fighting for appropriate medical care for her husband, how to work the hospital system.  Terminology is, as always, important. At the Hilton Head Volunteers In Medicine Clinic, we use “Patient Navigators.” Frankly, many of our patients have never had a doctor before, don’t speak English, and need help getting to the right person at the right time. That’s different.

“Patient Advocate” is closer to what is being talked about here, but still falls short of some of the visceral feeling that is being discussed in this book. What we see in this tome is the advice that someone needs to actually get belligerent to get the right care for a patient in some circumstances in some hospitals.

An unfortunate case in point. At a friend’s birthday party a couple of weeks ago, on a Saturday night, I met a great couple. Happy. Healthy. Beaming. She in her 50’s, he in his early 60’s. That day, he had won a 5-mile kayak race. They had gone to a wine tasting, and now he was dancing at the party. My wife and I left at about half time, but the party continued until 1 AM. He had a difficult time walking the short distance to his home. Couldn’t breathe. Not COVID. In an ambulance to a local hospital at 2:30 AM. Three days later, I was told he was going to be intubated. The next day, I learned that in the process of being medevacked to MUSC, our tertiary care hospital in Charleston, he had died in the helicopter. A full five days after initial admission to the local hospital!!!

Bottom Line. As I looked at this book’s URL, I wondered. I wondered whether if a “hospital warrior” had been fighting for his care, would the chopper have lifted off days earlier and he might still be alive?

We’ll never know!  

The Covid Vaccination Struggle and “Market Forces”

In my most recent round of 10 On Doctors’ MindsSMmonthly conversations with physicians about the impact of the pandemic on their private practices in primary care, cardiology, oncology, etc., I have been asked by several clients to talk about the impact of “market forces” on vaccination acceptance among their patients.

As I predicted in a previous post, the Pfizer vaccine receiving “FULL FDA APPROVAL” didn’t matter in a single practice with which I conversed. Patients simply have no idea of the difference between “Emergency Clearance” and “FDA Approval.”

For practices with large numbers of working patients, the possibility of a “VACCINE MANDATE” was predicted by my discussants to have a significant impact, although not without a lot of rancor as the picture above, on the left, would suggest.

By far, the best conversation I had on the topic of convincing patients to get vaccinated was with a cardiologist in the Bronx, who actually was the first US physician to contract COVID himself at the beginning of the pandemic. He tells skeptical patients that they are right.  The vaccine is a hoax, as is the pandemic. The 600,000 people who have reportedly died of COVID were actually taken to Area 51 in Nevada, where they are being kept against their will. Etc., etc.  At the end of this riff, he asks patients if they believe all of that. Most, not surprisingly, say “No!” His retort? “Then your only choice is to get the vaccine.” One patient shot back that he was going to have to “Evaluate the science further.” To which the cardiologist, obviously no shrinking violet, responded, “You’re a truck driver. How are you going to do that?” Sort of the current situation in a nutshell! 

But check this out. An ICU nurse’s graphic reminder that when you show up at the ER gasping for air, there are no more choices. Everything available for treatment, including intubation, will basically be forced upon you. No volition. No more “bodily autonomy.” 

Bottom Line. One thing that my discussants are telling me this month is that the only “market force” they have seen motivate a recalcitrant patient to get the vaccine is actually seeing someone close to them die of the disease. 

Question. How can we synthesize the impact of that horrendous but impactful experience and get it into widespread public distribution???

Keeping Weight Loss Supplements Out of the Hands of America’s Youth

In my previous post, I talked about the bad habits that were brought to us courtesy of COVID-19. But check this out. Yet another healthcare issue being brought to light by the pandemic. 

Here’s the story in a nutshell.  During the pandemic, kids were among the people that we talked about in the previous post who are overeating and, surprise, gaining weight. Big time. Doctors report that hospitalizations for eating disorders skyrocketed during the height of the pandemic. 

And out on the street, kids were increasingly scrambling to find “appetite suppressants” that would permit them to regain the self-control that they had lost when they went into “lock down” and no longer had to face their friends.

The plot thickens. These products, like “supplements” in general, are unregulated, and many contain hazardous ingredients. Danger for kids and adults alike, but kids are more vulnerable and have more advertisements for these products directed specifically at them. 

Bottom Line. So here we see society putting a Band-Aid on a hemorrhaging artery. Rather than bring such products under Federal regulatory scrutiny and control, thus protecting adults and adolescents alike, three States are trying to keep these products out of the hands of young customers by restricting the marketing and sales of such products to them. You read that right…Three States!!! AND. Is it not likely that the local nature of these actions will simply drive the supplement market to the Internet? 

Aw c’mon. We can do better! 

Are Physical Exams Obsolete?

Sometimes! Check this out. What you will see is a post by our friend, The Country Doctor, who argues that such examinations are often conducted without a good reason.  and perfunctory. As evidence, he offers the successful journey that most physicians made into telemedicine during the COVID-19 pandemic, successfully treating patients without laying eyes or hands on them. 

BUT. The conversations I have been having with physicians for my ongoing On Doctors’ MindsSM project have clearly indicated to me that many of them feel otherwise. For them, telemedicine was a necessary, temporary adaptation to permit their practices to go on rather than being put under, in terms of both patient care and finances, by the coronavirus.  Now that offices have reopened to personal visits, telemedicine is being relegated to extremely limited use, if any. Doctors report that they need to observe their patients to get the full picture of what is going on. Specialists in fields from cardiology to neurology have specific evaluations that they want to make, and they have to be done in person.

But is the same thing true for PCPs in a “routine” office visit? A brief story. When my wife and I moved to Hilton Head Island almost a decade ago, we promptly joined the concierge practice of what we were told (and it is true!) was the best Internist in Beaufort County. On my wife’s first visit, the physician laid her hands on my wife’s throat and “felt something.” Scroll forward and her cancerous thyroid was summarily removed. A good “routine” physical exam? Damn straight!

Bottom Line. I get the Country Doctor’s point.  Sometimes physical exams look a lot like “going through the motions” for no reason whatsoever.  BUT. To catch the unanticipated, as well as to build patient relationships, they are probably about as far from obsolete as they could possibly be!!!

Worry And Stress With Covid-19

Check this out. What you will find is a Kaiser Family Foundation survey finding that 45% of adults in the U.S. report that their mental health has been negatively impacted due to worry and stress related to the pandemic. Lockdowns, job losses, service in the front lines of COVID treatment, etc. are all contributory factors here. And yes, drug and alcohol abuse are rising as a result. And yes, other articles report significant increases in calls to spousal abuse hotlines.  

Bottom Line. Dr. Fauci tells us that it will take “a year or so” to get back to normal lives following the development of a COVID vaccine and effective treatments. Given the impact that the pandemic is demonstrably having on the psyche of adult Americans, and by proxy on American children, I think he is being too optimistic.

I think it could take generations!

Do It Yourself Abortions

You may not want to read this whole article. It is a very long read. Actually, you may not want to read any of it. It is sort of horrifying. So, let me just share the gist of the article with you. It is actually contained in the article’s lead in:

“A secret network of women is working outside the law and the medical establishment to provide safe, cheap home abortions.”

Years ago, before Roe v. Wade, we often heard horror stories of “back alley” abortions, done with coat hangers and such, that turned out terribly wrong. For decades after that landmark decision, although such black market abortions doubtless still went on, we heard less about them. Now this. A group of women are working assiduously to help each other to learn to do home abortions correctly. Safely. Although they are breaking dozens of laws by doing so, they nonetheless feel empowered to help each other to provide access to inexpensive home abortions. Out of the back alley, into the home. No more coat hangers. Herbs instead. 200 women. Compared to less than 2,000 abortion clinics nation-wide. One wonders where this movement will wind up, especially in States that are using facility “safety” requirements and other Roe v. Wade work arounds to close abortion clinics. Bottom Line. More generally, I am left to ponder whether, in the “digital era,” patients will band together to take control of other areas of their health care as well. “Networks” can be very powerful forces, especially in a time when “doctor shortages” make meaningful access to physicians increasingly difficult. AND. What are the psychological benefits that accrue to patients who can help themselves, and others, to take care of healthcare issues without relying on physicians? How about the risks? Think about it!

Want To Know If You Are Going To Get Breast Cancer???

If you do want to get in touch with this rather important piece of information, I have good news and bad news. Check this out. What you will see is that the FDA has now authorized 23andMe to report out three mutations of the BRCA gene as part of its genetic testing kits aimed at consumers. Good news, but here’s kicker. These are only three of the thousand or more mutations of the BRCA gene that can lead to breast cancer. AND those with the mutation have only an increased risk of breast cancer, not a death sentence. AND, the FDA makes it clear that such consumer tests are not to be used as the basis for treatment decisions. Bottom Line. So here’s the question. Given all of the caveats, when and why should a worried consumer use this test? If you are an Ashkenazi Jewish woman who fears you might have this mutation specific to your heritage, wouldn’t you be better off going for professional genetic testing and counseling to begin with? I’m thinking, yes you would!

THE FOUNTAIN OF YOUTH

Palm Beach, FL has long been a high society hang out. And, since it is now “The Donald’s” home away from home, it has gained additional panache. But check this out. Palm Beach is also the home to a physician who claims to be able to slow down the aging process through infusions of “young blood.” While the science behind this approach is unclear, the profitability for the doctor seems better defined. Amazingly, he charges almost $200 to come to hear the sales pitch. AND. Those interested in participating in the “study” of this treatment need to be ready to pony up over $200,000 for their place in the recipient line. Bottom Line. The link I have provided discusses not only this “study,” but also numerous other investments that are being made, several by heavy hitters, in age slowing ventures. As baby boomers are increasingly coming face-to-face with their own mortality, there would seem to be a lot of $$$ here for anything that “might” work. Demonstrating efficacy here is obviously not a quick endeavor, and baby boomers are running out of time to wait for incontrovertible  science.  So interventions that “might” work, even if they look for all the world like snake oil, are going to make this doctor and a bunch of other people a lot of money. And cost a lot of consumers a ton of money as well!

“Smart Thermometers” Track the Flu Season

Check out this NYT story. You will see “smart thermometers,” i.e., temperature taking devices that upload their data to a company website, being used to track the flu epidemic across the U.S. You should also check out the home page of the company that makes these thermometers. Bottom Line. Here we go again. A health-related gadget. And an accompanying app. Will this offering scale up, or descend forever into oblivion? Asked slightly differently, does the smart thermometer meet a big enough need that it will get a sizable percentage of the American population past “gee whiz” to “must have?” Place your bets!

Please Don’t Eat Your Placenta!!!

Placenta Yup, you heard that right. Check out this piece. What you will find is that egged on by some testimonials and endorsements by natural birth practitioners and celebrities, as well as by social media chatter, increasing numbers of mothers are eating the placentas of their newborn children. I know. Yuck!!! BUT.  If it is any consolation, they are not eating placenta sushi.  Nope. Some midwives have made a side business of drying, dicing and turning placentas into the pills that you see above. I don’t know about you, but I am still on Yuck!!! Anyhow, all of this placenta eating is apparently based on the belief that ingesting one’s baby cord brings health benefits. As noted in this article, this is not the case. In fact, some significant health hazards can result from the practice. Bottom Line. SO. What does this have to do with anything? Simple.  Practitioners try like crazy to get patients to comply with their sound medical recommendations, often to no avail.  BUT.  Here we see women, an increasing number of women, eating their placentas based on medical recommendations from such scholars as Kim Kardashian, who reportedly ate her own placenta.  There has to be a learning here someplace. Is it simply celebrity endorsement, the power of which we have discussed before? Or is placenta eating biologically wired through evolution into mothers’ brains as this article might suggest? Or some combination of the above??? Figuring out the right answer here could be important as we ponder how we get people to take better care of their health!