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ONE MISCREANT

I'm curious why we allow our elected officials to dictate what is best for us.
Articles Posted: 8  Links Seeded: 24
Member Since: 7/2009  Last Seen: 5/19/2012

"Medical Records Sharing…stop it. You're killing me."

Thu Jul 15, 2010 2:13 AM EDT
By One Miscreant

"Take two of these and call me in the morning."

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Subtitled: "The Human Chemistry experiment"

In an ideal world, Doctors would be concerned with the care and well being of their patients. These same doctors would be insistent to know all of the medications and treatments the patient is receiving, in this perfect world. Let's leave specialists out of the argument for a moment. Primary Care Physicians are the pillars of our health care, are they not? But then again, all doctors should be concerned for the whole patient, even the specialist. Even if they can't get past the fear of malpractice.

"To improve the quality of our health care while lowering its cost, we will make the immediate investments necessary to ensure that, within five years, all of America's medical records are computerized," Obama said in a speech from George Mason University in Fairfax, Va. "This will cut waste, eliminate red tape and reduce the need to repeat expensive medical tests."

"But it just won't save billions of dollars and thousands of jobs; it will save lives by reducing the deadly but preventable medical errors that pervade our health-care system," he said. ~Obama at George Mason University Jan 2009

Obama wants this within 5 years. Brilliant Mr. President! Virtually impossible, but absolutely brilliant. I suppose the obstacles, both legally and systematically, to this brilliance should be left to another discussion. HIPAA and the internet, now there is a combination to be trusted, eh? By the way, was that five years from Jan 2009? Tick, tock, tick, tock, it's now 2010. But I digress.

How many people do you know, you, spouse, mom, dad, family or friends, which take 1 to 4 medications a day? How many take 5-9? More than 10? Have a heart attack and survive, you'll be above five, and heading for ten, right quick. I'll tell you one business that should never do poorly, the Rx pad printers.

Thank god someone invented those little pill carriers, eh? You know the ones I mean. They are labeled with the days of the week. Each day is supposed to contain the pills we patients are supposed to take. Otherwise, even the patients couldn't keep track of what the hell they were supposed to be taking.

Does your doctor's office, usually the nurse, but maybe the doctor, even ask you about your current medication intake? Have they ever said, "Hey wait, I can't give you that because…"? "Why are you taking those meds together?" If you're lucky, they'll look it up in a book or a web site, etc. Or are they more concerned with making sure they have the correct insurance billing information? And who the hell prints these books and publishes the information? Three guesses and one and two aren't medical researchers.

Now, for the $64,000 question. What does drug "A" do when combined with drug "B"? "C" with "A" and "B"? And so on and so forth. I really don't have to get into all the combinations and permutations of drugs ,for the average American, do I? Did you know that drug research is done, one drug at a time? Drug companies never look to see if their drug interacts with anything else. The standard is to look and see if the drug, by itself, harms anyone. The medical community should be ashamed to cling to such a myopic standard. It goes against the Hippocratic Oath. They usually wait to see who reports problems. Count the bodies, take the statistical average to make a justification for continued use. If more people benefit from the drug than it kills, sweet Jesus, there goes the bristling again.

What I want to know is "Who's ass to kick"? Who is the person responsible to tell us what the hell is going on inside our bodies, after we take 10 prescribed medications a day? Anyone? Bueller? Bueller?

*Crickets chirping*

  • Seniors represent 13 % of the total population, yet they account for about 42%
    of all prescription drug spending. Families USA, a Washington based consumer
    health organization
  • Nearly half of all seniors take five or more medications. Kaiser Foundation
  • 19% of seniors take nine or more medications. Journal of the American
    Geriatrics Society
  • 37% of all seniors (15 million) need help remembering to take their
    medications. US National Institute on Aging

(source: Fast Facts about Medication and Seniors)

Malpractice is a joke. How the hell could we sue someone, when it would take a never before attempted research project, just to figure out, which one of the heartless bastards killed us. Besides you're dead anyway.

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One Miscreant

One stylish rant... Comment and criticisms welcome. Be nice to each other, CoH.

  • 8 votes
Reply#1 - Thu Jul 15, 2010 2:33 AM EDT
Remote Viewer

So true, One Miscreant. Our so-called health care system is all about (1) maximizing profit, and (2) avoiding any liability that might be incurred in the reckless pursuit of (1).

  • 5 votes
#2 - Thu Jul 15, 2010 7:15 AM EDT
One Miscreant

Thanks for adding to the rant RV. Hope things are well with you and the Bitemeister.

I'd really love to push the reset button on how patientcare is managed. But, I think it's going to get worse before it gets better. To many boomers and not enough of them are doctors and nurses.

  • 4 votes
#2.1 - Thu Jul 15, 2010 4:54 PM EDT
V. Bevis

"To(o) many boomers and not enough of them are doctors and nurses."

Well, I'm one, although retired. Those reference books you mentioned earlier are updated regularly with the most recent info. available on drug interactions. In fact,my latest reference has a diagonal chart on the inside & backside of the book listing drug interactions; it's that important.

Most doctors keep a PDR (Physicians Desk Reference) on their desk or book shelf to look up info. esp. recently added. We ALL use a Tabor's ( or similar) for a medical dictionary, a Mosby's for the latest drug info. & frankly, most professionals in practice only prescribe or administer a relatively small diversity of drugs to patients. In other words, although there may be a large amt. of drugs on the mrkt. & growing all the time, a relatively few account for the vast majority of scripts. Thus it makes it easier to KNOW if a drug interaction is likely. In fact, sometimes adding a drug to a primary drug for a condition actually makes the initial drug work BETTER. It's called, POTENTIATION.

The problem comes when ONLY a few patients tell each Dr. they see what another Dr. prescribed. Some of this omission is to obtain controlled substances. But most, in my experience, is lack of knowledge about how important it is to carry a card with all one's meds. on it & USE it. And keep it updated. OTC's also need to be reported along with "supplements" available OTC. IT'S ALL PART OF AN EFFORT TO TREAT THE PATIENT THE MOST EFFECTIVELY THE CARE GIVER CAN.

I'm sick ( no puns) at the state of health care today in America. I'm facing double knee replacement & fortunately have found one of the best surgeons in the country. I'm fortunate; I know how to do the research. But along with that comes a downside-knowing what all can go wrong through medical errors, etc. So, the blessing is also the curse. What about all the people who can't/won't?

I also vigorously support info. transfer between hospitals/doctors, but I also know too much about the Internet & it scares me silly. Most medical people like myself are only barely functioning when it come to electronic technology & the ease of hacking into a database blows our minds. We truly can't be on the look-out for it or even recognize it when we see it. The doctors, nurses & other professionals who PUT the info. into those bases know the importance of confidentiality; it's drilled into us in school. But there are no "computer hacking classes" in med. school.

We're between a "rock & a hard place."

R.N., B.S.N., M.S.N.

  • 3 votes
#2.2 - Sat Oct 15, 2011 11:42 AM EDT
One Miscreant

Wonderful comments. I have one of those Rx cards.

I'd be careful about believing in those books, too heavily though. A lot of the drug info was bought and paid for by, you know who. One of the larger DC lobby's.

Is it enough for patients to report a drug reaction or intolerance. Statins, for example, is one that I began to take after atherosclerosis was found in my coronary arteries. All went well for about a year. Then every muscle in my body began to fasciculate, cramp and otherwise malfunction. I call it "twitching". It becomes maddening at times.

Listen to the ads for medicines. The "your milage may vary' statements at the end. It talks about the muscles. "Tell your Dr. it may be the signs of a serious side effect". This muscular side effect was published in those book at 3%. Yeah right, the Mayo clinic developed a statin intolerance clinic. Where they posted the the clinical figure is much higher, like 10-15% ( which is probably understated as I don't have those figures in front of me). Think about the millions who take statins, a drug pushed heavily by the manufacturers, multiply that number 10-12%. We're still talking about millions of people like me suffering side effects, with no course of treatment, except stop taking it. Pathetic. We allow ourselves to be lab rats, simply because the legislation allows it. It's too easy to get drugs released IMO.

  • 2 votes
#2.3 - Sat Oct 15, 2011 12:09 PM EDT
V. Bevis

Good points you make. I assume you tried small dose aspirin ( if you are a man) long before you went to statins? Often it works well. BTW, about a yr. ago, the research began to suggest that women take 325 mg.-a reg. adult ASA-daily instead of the 81mg. baby ASA everyone, both male & female, were told to take to reduce borderline cholesterol before more potent drugs were used, i.e. statins. I upped my dose from 81mg. PER MY DOCTOR'S INSTRUCTIONS & within a wk., got a nose bleed ( my fault from picking at my nose as it sometimes itches due to other meds. & a deviated septum) THAT WOULDN'T QUIT. When that happened twice in a day, I KNEW what was causing it. So now take it every-other-day & no worries!

My point is that even with all the caveats listed on T.V., all the warnings on drug monographs-what you get in your script bag- & even someone who doesn't have a bleeding disorder, can make something as simple as ASA a chronic problem. So, yes, everything I read I take at face value with a niggling part of my brain telling me every person is different as is even the time one takes a drug. Example: I have never been known to have any allergies-'NKA." A number of yrs. ago, I started coming back from the dentist after cleaning getting a headache & nausea which I almost never get. Finally, I figured out that it was the fluoride used in the cleaning polish that was doing it. Go figure, but I've not had the slightest problem ever since. And fluoridated water is still no problem. Why? Allergies can crop up anytime in one's life.

I assume you haven't been on all the statins available? If you have, ask if any other treatment modalities are available. It's a damn shame, but patients either need to be pro-active for themselves, or need an advocate. That & patient teaching was part of my job & I'm still "rabid" about it. Hubby infuriates me because, like most men, is pretty much only is asking a few questions & never lists what he wants to know when he sees his PCP. GGGGGRRRRR! lol

My suggestion to help you would be for you to buy a Taber's Medical Dictionary. You'd probably get it on line easier since so many mall bookstores have closed. One little idea though: learn the prefixes & suffices & then all you need learn is is the "root" word. Otherwise, all the terms would boggle the mind. But if you even learn a few ones, stay within the circulatory system as it will give you more terms relating to atherosclerosis & could help you talk with your doctors more intelligently with, hopefully, better results.

Best of Luck

Cheers!

  • 4 votes
#2.4 - Sat Oct 15, 2011 1:29 PM EDT
ohiogal-479871

I'd be careful about believing in those books, too heavily though.

The books should be a reference guide to the biochemistry and pharmacology that should have already been learned. No matter what a drug company or industry tells a health care professional, just remembering those basics will let them see right through what they say. It's the reason why drug companies advertise drugs on t.v. It's easier to get the patients to ask for a drug they don't that much about.

Is it enough for patients to report a drug reaction or intolerance. Statins, for example, is one that I began to take after atherosclerosis was found in my coronary arteriesAll went well for about a year. Then every muscle in my body began to fasciculate, cramp and otherwise malfunction. I call it "twitching". It becomes maddening at times.

It comes down to risk vs benefit. The risk of them leaving you off of a statin with coronary artery disease was greater than the risk of you getting the myalgia side effect from taking the drug. The former will definitely kill you. For example, you mentioned a ~15% risk factor for a myalgia.

If you take a non-smoking male who is 55 years old with a HDL of ~30 a total cholesterol of ~ 250, who has mild hypertension (140/80)and is currently not taking in medications to control it. His risk for having a heart attack in the next ten years is also 15%.

Many people with atherosclerosis are older, have higher cholesterol levels and have higher average blood pressure than my example. Any physician that didn't try the statin would deserve any malpractice suit against them. As V. bevis suggested, another statin formulary at a lower dose may work for you esp. if combined with vit-b3.

Thanks for the article btw. I enjoyed it. ;)

  • 4 votes
#2.5 - Sat Oct 22, 2011 4:50 PM EDT
One Miscreant

Thanks for the article btw. I enjoyed it. ;)

My pleasure.

Surely, even a text book can be influenced by those who stand to benefit by the change. Texts are not gospel. It depend on the author, publisher and just plain politics of the sales of the material.

Although, I understand mathematics, the cost benefit equation does not account for the human suffering. IMO, that argument is made by those who do not have to deal with the consequences of this "collateral damage" logic. 

The same argument is used to justify drone bombings in Pakistan. The bad guys are killed, but so are innocents, who happen to be in the wrong place at the wrong time. People die and families suffer.

I also understand doctors covering their asses with the same stats. I the didn't give it to me they would be liable. So, if there is a clinically higher probability, than what is published by the manufacturer, that if the do I or others will react negatively, they're probability of benefit is reduced on both ends. However the probability of being sued goes the other way, they get sued by those who don't receive treatment and sued by those who suffer the side effects. While statins are not yet proved to be harmful in use, in time they will, you can still see that suffering is suffering. This is one case the benefit by the many, does not warrant use by all.

Like I said before a roughly, 10-15% negative reaction clinically, where statins are concerned, is still in the millions. To much suffering IMO.

From what I've read, statins actually impede the same process, that the body uses to process lipids and sugars at the cellular level. Sound kind of counter intuitive to me. But hey who am i to argue profit and loss. AKA Mitochondrial disease. [Insert sarcasm here]

Thanks for your contribution. I do appreciate it.

  • 4 votes
#2.6 - Sat Oct 22, 2011 6:31 PM EDT
FlNutmegger

Interesting stuff here folks and while some of of it went right over my head I still learned some good stuff. Just coming off radical colon resection surgery I do know about collateral damage (pain) pretty intimately. Thanks for sharing!!

  • 4 votes
#2.7 - Sat Oct 22, 2011 6:39 PM EDT
One Miscreant

It seems I missed comment on V. Bevis. I apologize.

Yes I still take the 81 mg aspirin and I will look into the higher dosage. Thank you for that alternative. But I understand asprin is good for the colon.

As far as the statins question, yes, I tried three of them. My cardiologist wouldn't take me off them, until I tried three. Three strikes and I was out. I had muscle pain, cramping and fascinations on all three, reduced when Iwas off. You may know him, The Marquis de Sade (just kidding doc). But even when we had run into the brick wall, he puit it on me to find something, anything, even voo doo, to lower my cholesterol. I told him I hope he's on duty when I show up in the ER. He was there when I showed up the first time. *wink* Once my muscles were compromised they won't even tolerate climbing a staircase. So even simple exercise was out of the question.

  • 2 votes
#2.8 - Sat Oct 22, 2011 6:47 PM EDT
One Miscreant

FlNutmegger sorry to hear about your surgery. Hope thing are "moving' in the right direction. Sorry couldn't pass it up. Thanks for the kinds words from all.

  • 4 votes
#2.9 - Sat Oct 22, 2011 6:50 PM EDT
FlNutmegger

One Miscreant, FUNNY!! :>)) And yes all seems to be working according to plan!!

  • 3 votes
#2.10 - Sat Oct 22, 2011 7:26 PM EDT
ohiogal-479871

Surely, even a text book can be influenced by those who stand to benefit by the change.

Agreed. That's why text books are reference guides and for teaching the basics.

Although, I understand mathematics, the cost benefit equation does not account for the human suffering.

I don't think I mentioned cost benefit. I agree that cost should not account for human suffering.

My comment was about risk vs benefit; as in the risk of you not being on a statin vs you taking it.

The chances of someone with coronary artery disease suffering from irreversible effects such as angina, cardiomyopathy, a mycardial infarction, congestive heart failure, or embolizing a piece of that plaque to their intestines, kidneys, or brain is viewed by society as being worse than suffering from a reversible side effect from the muscle (or liver) of a statin.

Also, the goal is not to keep anyone on a statin forever (although pharma would love that), but hopefully use it as a tool to buy someone enough time to get them out of the danger zone of an adverse cerbro/cardiovascular event(s) and get them to a point where diet and exercise can do the trick instead.

Lastly, while asprin helps, the only thing it can do is decrease the ability for platelets to stick together and form a plug. It doesn't do anything to stop excess lipid production or help with plaque removal.

  • 3 votes
#2.11 - Sat Oct 22, 2011 7:37 PM EDT
ohiogal-479871

Just coming off radical colon resection surgery I do know about collateral damage (pain) pretty intimately. Thanks for sharing!!

Sorry to hear that :( Please get well soon.

But I understand asprin is good for the colon.

It is! :)

But . . .

it is bad for the stomach and the duodenum. :(

  • 4 votes
#2.12 - Sat Oct 22, 2011 7:41 PM EDT
FlNutmegger

Aspirin is off my diet because of a Coumadin regimin created by a Pulmonary Embolism. It does not pay to get to be older than dirt don'tcha know? My doctor keeps looking at me and shaking his head and never lets a chance pass at reminding me that I have worn the old body out!! :>))

Thanks for the suggestion all the same!

  • 3 votes
#2.13 - Sat Oct 22, 2011 7:55 PM EDT
One Miscreant

..is viewed by society as being worse than suffering from a reversible side effect from the muscle (or liver) of a statin.

I mean no disrespect but..Call it cost or risk, tomato tomaato. Until you are the one suffering the side effect, it's a numbers shell game. Had I not followed "societies" recommendation, I could walk around the block or up a flight of steps. As a matter of fact, during cardiac rehab, I had lost 10-15 lbs. Then the statins started to kicked in. Now, I sit and wait for the inevitable plaque rupture event or platelets closing off the remainder of an artery or any other such real possibilities. I will see my cardiologist in the ER in spite of all our attempts to fix the situation. It is what it is.

  • 4 votes
#2.14 - Sat Oct 22, 2011 9:31 PM EDT
ohiogal-479871

Call it cost or risk, tomato tomaato.

Let's not confuse the definitions.

A cost vs benefit assessment has to deal with putting dollars amount on health care. It is a module used by institutions to determine if a treatment or screening is worth the cost.

A risk vs benefit assessment has to do with the individual and their own personal risk factors. In other words individual already has a disease, the person is already suffering or going to suffer, and the treatment is used to hopefully change the course of someone who is already sick.

No one forces any one to visit the physician or take a medication to try and alter the course of a disease they already have. It is up to the person to decide which risk they feel comfortable with as it is the individual who is going to be dealing with the outcome regardless.

If having muscle aches and pains is the absolute worst outcome for an individual l then they probably shouldn't try any type of drug that will effect their muscles even if it means risking having a heart attack or stroke. If having a heart attack or stroke is the absolutely worse out come for an individual they may opt to risk taking the statin even if it risks being debilitated by the drug.

Both are horrible outcomes and there is no wrong or right answer each person must decide for him/herself. :(

Fighting any type of disease is like fighting in a war. You want get lucky anddo the most damage to the illness as quickly as you can, with the least amount of damage to yourself.

Anyway, I just saw an article on JAMA and I hope it helps. In a Canadian study (just published last month) they showed that a 9.8g (about 1000 calories) of viscous fiber (oats, barley, or psyllium) showed a 13% decline in LDL after only 6 months. Other suggested foods were plant sterols and soy protein.

Try eating half your daily calories with cholesterol lowering foods and see if it helps!

Any way, I enjoyed the convo and congrats on the wt. loss,

Good luck to you and Take care!

  • 1 vote
#2.15 - Mon Oct 24, 2011 8:49 AM EDT
Reply
Knowlton's Rangers

"But it just won't save billions of dollars and thousands of jobs; it will save lives by reducing the deadly but preventable medical errors that pervade our health-care system," he said. ~Obama at George Mason University Jan 2009

Will this be creating thousands of jobs or doing away with them. If you are doing away with them it sure ain't getting Americans back to work.

  • 2 votes
Reply#3 - Thu Jul 15, 2010 7:26 AM EDT
One Miscreant

Well in the old days we feared computers would eliminate jobs. But the information has to get into the database or it's worthless. Doc's and Nurses shouldn't be doing data entry. And we all know how often systems crash or don't work as intended, so system support people are needed. So, in the long run, I'd say it's job creator.

Of course a lot of people will need to be retrained. So the educational systems will get a shot in the arm too.

Thanks Knowlton.

  • 5 votes
#3.1 - Thu Jul 15, 2010 5:04 PM EDT
rescue dogs62

When I was in nursing, the first thing I did was update medications lists on every patient and any changes in medical history. On the initial visits both when I was doing private practice and then when I was in research I would have the patients bring "EVERY bottle of prescription and supplements they were taking" because you couldn't always depend on a correct list from the patients, and many times, over the counter medications interacted with drugs they were taking, and they wouldn't think they were important enough to mention them. My doctors, and even my dentist's office updates medication lists, and any new procedures, etc at every visit.

I'm fortunate, I guess, but I have most of my physicians associated with one hospital, and they are all connected by internet. When my internist orders lab work, the results are in my cardiologists office the same day as the internist. The same when I have an echo at the cardiologist's office, the internist have the report. I not only get a copy of any test that's done for my own records, but I my cardiologist's office will not only give me the report, but will also back up the echo on a CD so I have it.

When I have a visit to my internist on leaving the office I'm handed a computer print out of all of the medications I'm on, any changes that have been made, any orders or procedures ordered, instructions given and next appointment., and I have it for my records. I keep a copy of all my meds, insurances, etc in a packet on my refrigerator for the paramedics if they're ever called. I also have a med alert record on line, and although I haven't filled it out, I now have a med alert with a USB data record to wear on a chain so if I'm ever taken to a hospital in a condition where I can't provide information, they can just plug the USB into their computer and everything's meds, medical history, emergency contacts, allergies, is on it including my advanced directive.

This may sound like overkill, but I live alone and have several serious medical problems. Prior to this, whenever I was hospitalized at a different hospital, and would get my records on discharge, although I give a very complete and accurate medical history, every single physician and specialist's report had some inaccuracy on their medical summary and they didn't even agree with each other.

As I side note for those who don't know it, particularly for the elderly, if you have a secure lock on your door, and have to call the paramedics but can't get up to unlock the door, or your home catches on fire while you're not home, you can get a certain type of NOX box that attached beside the front door. It's secure, you put a key in it, and the only people who have access to the box are the fire department/paramedics. Otherwise, they have to break a window to access your home. I notified my local fire department, and my "med alert" security system, of the presence of the key so if they call the fire department/paramedics they can provide that information. When I notified the fire department, I had a hook and ladder and four fire and paramedics come out to the house to see the location of the box,. I also have the access code to the security system in with the key so they don't have to listen to the incessant alarm.

  • 6 votes
#3.2 - Sat Oct 15, 2011 3:02 PM EDT
One Miscreant

Excellent post. This is how I imagine health care professionals doing it. Thanks for the reassurance that some do it, without being prompted by the feds.

I have taken it upon myself to collect as many of my records as possible. When I went to a rheumatologist with this huge file, he thanked me and told me there was nothing he could do for me. Anything he would have done was already in my file. TIt was the first time I took comfort in a doctor say,"I can't help you".

Good note on the elderly BTW.

  • 5 votes
#3.3 - Sat Oct 15, 2011 4:40 PM EDT
Kate In Greensboro

My physicians (primary care internist, cardiologist, and pulmonary specialist) share electronic medical records (EMR) and it's a real help - for me and for them. If I were to be hospitalized in my town, the hospital is part of the same network, so my EMR is also available there. Since I don't have insurance, this helps me tremendously in avoiding duplication of and coordinating blood work and other diagnostics which can be very expensive. A few years ago, before the EMR system was in use, I had blood drawn and was charged 3 times for the same test - each doctor wanted the test done and not even I knew the others had already done it. (It took me 3 months to pay off that mistake.)

- - - -

On the issue of emergency access to the home, my mother's "med alert" company recommended a lock box with a key and if they dispatch fire/abulance, they include the access code in the dispatch. (It's also handy if I lock my keys in the car!)

  • 3 votes
#3.4 - Sun Oct 16, 2011 12:29 AM EDT
Reply
mightyj

One- That rant had style. I gave it a serious high five......wait judges ruling......9.2........8.7........9.8..Wow the French judge hasn't scored anybody from our neck of the woods that high since freedom fries. You can forget about Bueller I think he's sick or something, I saw a kid collecting for an operation of some kind.

On a serious note they are going to kill us all eventually, I don't have insurance so they won't kill me, unless I pay upfront. JJ

  • 6 votes
Reply#4 - Thu Jul 15, 2010 7:31 AM EDT
One Miscreant

Screw the french judge...*wink*

Bueller must have healthcare, to be sick so much, eh? I'm sorry to hear you don't. I guess you may end up being on Obama care, eh?

  • 6 votes
#4.1 - Thu Jul 15, 2010 5:06 PM EDT
mightyj

one- am re-locating to a state where insurance can be had but not afforded. The state we are leaving is an economic house of cards and somebody is about to haul a few major ones off of the bottom. I don't care about health insurance for me. I just want to get it for my kid, insured by Visa and Matercard is a bad deal when it comes to her.

There is no Obama care! That was all a hoax to steal money, I am still for the individual being able to purchase the same health care I provide to illegal aliens with my tax money. JJ

  • 4 votes
#4.2 - Thu Jul 15, 2010 6:48 PM EDT
rescue dogs62

same health care I provide to illegal aliens with my tax money.

The only health insurance you provide illegal aliens is emergency treatment in an emergency room. They cannot refuse treatment, but the only thing that's offered is to stabilized the patient, they don't even provided medication. That's why the young man died of an abscessed tooth after being seen at the ER for the pain not so long ago. He couldn't afford to buy the antibiotic. Is that what you want for the 10 million Americans who have no insurance, because I certainly don't.

  • 4 votes
#4.3 - Sat Oct 15, 2011 3:07 PM EDT
One Miscreant

Excellent point. They get the same thing you and I get. Follow up with the primary care doctor.

  • 3 votes
#4.4 - Sat Oct 15, 2011 4:42 PM EDT
Reply
mstanley2265

Right after 50 my BF since HS had breast cancer, then two heart attacks, then hysterectomy, then degenerative spine disease, then chemo induced diabetes and allergies. She Just, this year, got a Family Practice doctor who knows her business. That's after 13 years of misery. She's outlasted 2 doctors (they retired) that didn't give her much hope of living much longer than a couple of years. She has 6 doctors, (5 specialists) and takes 11 meds every day. She has insurance.

Either because of or in spite of the doctors and meds, she's still alive. I who grew up real close geographical wise, haven't had to take any meds. It is truely beyond weird that she's had so many health problems and me so few.

  • 5 votes
Reply#5 - Thu Jul 15, 2010 7:48 AM EDT
One Miscreant

mstanleys-It hit me like that, after 50 too. I'm glad your best friend is a fighter. But, I also understand, that they are not all good days.

The newbies scare the crap out of me. If someone really wanted to do something with computers, it should b help them be smarter newbies. I've often read about artificial intelligence. Where it was found too difficult to get the computer to think, but not so difficult to organize information to create smarter users. So AI kind of morphed into bigger badder databases, rather than thinking computer/doctor machines.

My newly found medical knowledge will only take me so far. Newbies need to be strong right out of the gate and the oexperienced ones need to be more effective. Thanks for stopping by.

  • 2 votes
#5.1 - Thu Jul 15, 2010 5:18 PM EDT
mstanley2265

nah she's a farm girl from Ind

  • 2 votes
#5.2 - Thu Jul 15, 2010 10:10 PM EDT
Reply
ADad-1477522

Does your doctor's office, usually the nurse, but maybe the doctor, even ask you about your current medication intake?

Yep, every time I go in... Got all of 'em in a ziploc bag;-)

I got a newb for a PCP, but me and my neurosurgeon go back some 22 yrs;-) My PCP is kinda fun. She's the type that *thinks* she knows it all, but then she sat down w me a learned that I might know just a bit more then she does.. *for now*. After I brought her down a few pegs, she treats her patients a little differently.

I don't mind newbs. They r fun to train. And since I have so many different issues, they get to understand them in a better lite. Some of them take a while to understand my sarcasm and my super dry wit. But we both learn somethin'.

  • 1 vote
Reply#6 - Thu Jul 15, 2010 8:13 AM EDT
One Miscreant

ADad-Yes that was kind of rhetorical, because they need to CYA, so they ask. It's what they don't do with that information, that scares me.

I'm glad there are doctors caring for you who are willing to look at more than just the reason you see them. I have one or two, who actually ask to have records sent to them. Simply because they are fascinated by all the crap I deal with. When the show the slightest interest, they earn their payment, IMO.

Thanks for fueling the rant.

  • 3 votes
#6.1 - Thu Jul 15, 2010 5:24 PM EDT
ADad-1477522

One:

Thanks for fueling the rant.

Any time;-) (chucklin', cuz I know the feelin')

  • 2 votes
#6.2 - Thu Jul 15, 2010 6:12 PM EDT
Reply
mstanley2265

I don't mind newbs.

LOL that's what my BF said...one told her she had an ulcer and she was treated for 13 years for an ulcer. I told her that no one that follows the diet and the meds too --still has an ulcer . so off she went again to a specialist, it turns out that the chemo messed with the part of the stomach that puts food into the small intestine. chemo really messes with the human body. Nothing can be done but at least she knows she doesn't have an "ulcer" anymore...half dozen one 6 of another.. she just sighed and said I trained another one.. but she says since her doc has her medical on computer now ---things are looking up!

  • 1 vote
Reply#7 - Thu Jul 15, 2010 9:59 AM EDT
ADad-1477522

mstanley:

one told her she had an ulcer and she was treated for 13 years for an ulcer.

Yeah, I have a similar story. I paralyzed in a bus accident back in '90. I had one intern that was adamant that if I went to physical therapy (physical torture, in my book), that they could "fix" me. Ah huh... sure. like a physical therapist can fix a spinal cord injury. Yes, the work they do is awesome. I've been to a number of them over the yrs. But when it comes to a spinal cord injury, facts r facts. I had him speak to his supervisor, so that in the future he would not "build up a person's expectation, only to see it ultimately fail".

His heart was in the right place... His expectation was a bit off.

  • 1 vote
#7.1 - Thu Jul 15, 2010 5:00 PM EDT
One Miscreant

Yeah ADad. I hear you loud and clear. That "suck it up Nancy" shtick only goes so far in medicine, eh? I've had each one of my doctors tell me that muscle pain was something I needed to fight through. My heart health demanded it. Turns out it was the GD statin's all along.

That's the ultimate in medical irony, prescribe a statin for cholesterol reduction, but the statin kills muscles you need to exercise to reduce cholesterol.

  • 2 votes
#7.2 - Thu Jul 15, 2010 5:33 PM EDT
ADad-1477522

One:

Irony of ironies!!! They need to learn *MORE* about the various aspects of the drugs before tossin' 'em out to the docs, who in turn over-prescribe. Yet, the patient has a responsibility also, to make sure that *ALL* treatin' them r on the same page. I use to have a neurologist, neurosurgeon and an internal med doc. The three always talked w each other. Then I didn't need my neurologist and it was just my neurosurgeon and my internal med doc... But, my internal med doc changed like 4 times in 2 yrs, the communication stopped. So I took it upon myself to reconnect *both*, so that they both knew what was goin' on and now both talk to each other and I also give both high marks;-)

  • 1 vote
#7.3 - Thu Jul 15, 2010 6:18 PM EDT
One Miscreant

They need to learn *MORE*

They know plenty. This same class of drug bombards us everyday. But, every one of them has that pesky disclaimer. "..a rare but serious side effect..." rare really? Is that why it's common knowledge? Is that the reason for the CYA in every commercial. Statistical Russian Roulette, IMO. They think that if more people benefit than have problems, that is a good thing. But not, if your one of those rare stats.

I think it's fantastic that you were able to get them together. However, I think there needs to be an advocate, like you, for those who are to sick to take on this issue for themselves.

  • 2 votes
#7.4 - Thu Jul 15, 2010 7:32 PM EDT
ADad-1477522

One:

I think there needs to be an advocate

There usually is a "Patient Advocate" in most hospitals. Not sure about clinics, yet, there is always the Clinic manager, if u have issues w ur treatin' personnel. Sometimes, they r stubborn and need a good swift kick.

  • 1 vote
#7.5 - Thu Jul 15, 2010 9:50 PM EDT
One Miscreant

That's is more of an ex post facto advocate. Airing of grievances, if you will. I was thinking more along the lines of advocacy, that is part of the health care process itself. An independant advocate or group to discuss your care, in total, in the here and now. Sort of a preemptive health care. he problem is how to keep it moving and not get behind. The case loads will be enormous. It's radical thought in health care. Doc's have egos, the size of Montana sometimes.

  • 1 vote
#7.6 - Thu Jul 15, 2010 10:36 PM EDT
ADad-1477522

One:

Oh, I see where u r goin'... Yeah, that concept would be totally awesome!!! I know when I spent some time at the Mayo Clinic in Rochester, MN, they had a great system. Loved it.

  • 1 vote
#7.7 - Thu Jul 15, 2010 11:51 PM EDT
One Miscreant

Wow! The Mayo would be the standard. Exactly. Thanks for putting it out there. Any info you have, on their methodology or your experience would be awesome for others to read.

  • 1 vote
#7.8 - Fri Jul 16, 2010 2:37 AM EDT
ADad-1477522

Oh man... That was a long time ago, back in the mid '80's. All I remember (sorry, due to a great deal of brain damage, recall sucks), is that they were supremely organized. But, they had to be w all the various patients and clinics they had. The campus was a fantastic!!! I just remember bein' tested for a couple of days. They asked every question possible. Very thorough. If u have something wrong, that is the place that will definitely help resolve things.

  • 1 vote
#7.9 - Fri Jul 16, 2010 3:03 AM EDT
One Miscreant

They asked every question possible.

See...this is the care we all deserve. This is the best health care there is.

I'm sorry you had experienced it at such a disadvantage. But that's what I'm talking about. You are important, even if there is no explanation. The devil, of your situation, is in the detail. Not in a generic procedural insurance paradigm.

  • 1 vote
#7.10 - Fri Jul 16, 2010 3:12 AM EDT
ADad-1477522

One:

See...this is the care we all deserve. This is the best health care there is.

Well, I will say that it was my treatin' doc; at the time; that didn't understand my symptoms. He was the one that suggested Mayo. I just wanted a resolution; at the time. I was in a little dot of a community in the midwest. So I went to Mayo. They tested me, and came up w a diagnosis, all in two days of various testing. That much I do remember.

  • 1 vote
#7.11 - Fri Jul 16, 2010 8:15 AM EDT
Reply
LifeTravler

Hell, we're already computerized in more ways than one. What's one more computer to be hooked up to? /sarcasm mode off now

  • 3 votes
Reply#8 - Fri Jul 23, 2010 4:26 AM EDT
One Miscreant

I think it would be nice, to used them for more than playing solitaire, donchu? My recent medication issues have taught me, that nothing can replace human thinking. It gets real complicated when so many humans don't think, all at once. That's when the real damage to the patient, as a whole, is done.

Statins tearing down muscles. Depression prescriptions to mask the patient suffering. Additional meds for the resulting muscle pain, myoclonus, twitching and cramping. All four doctors, a Cardiologist, a Neurologist, a Phychiatrist and a Primary care doc, all just scratching their heads. If I hadn't resisted them all, decide to stop taking the ones I did, they would still be shoving Rx's my way and I'd most likely be feeling worse.

I think someone should open a facility to treat the whole patient. Just like the model ADad was talking about at the Mayo clinic. Look at everything, because patients are complex and so are their prescription cocktails.

Here's to feeling better. Thanks for stopping by LT.

  • 4 votes
#8.1 - Fri Jul 23, 2010 4:38 PM EDT
LifeTravler

I have to agree with you on this. If I had not been proactive, I'd probably be on multiple medications myself. I am a firm believer in the mind-body connection, and a lot of these medications are enough to kill you by themselves. I go with natural cures at every available opportunity.

  • 4 votes
#8.2 - Fri Jul 23, 2010 4:49 PM EDT
One Miscreant

Here's to your health, LT. *raises a glass*

  • 3 votes
#8.3 - Fri Jul 23, 2010 4:53 PM EDT
LifeTravler

Salute!! And to yours!

  • 2 votes
#8.4 - Sat Jul 24, 2010 7:46 AM EDT
Reply
HydeWhyte

Here, here! Yeah, I've got a bit of experience with this one, One.

In an ideal world, Doctors would be concerned with the care and well being of their patients. These same doctors would be insistent to know all of the medications and treatments the patient is receiving, in this perfect world. Let's leave specialists out of the argument for a moment. Primary Care Physicians are the pillars of our health care, are they not? But then again, all doctors should be concerned for the whole patient, even the specialist. Even if they can't get past the fear of malpractice.

True enough. I've had both kinds of doctors; the ones who fertilized me like a mushroom and my current idealist. Sometimes I don't think the ones in the 'world of should' know much more than what the latest drug-salesman said was on the brochure, while my current one studies my different medications like they were his only source of anything good in his life. He won't even let me have a Tylenol unless it first goes into his drug-interaction mind before it goes into my mouth.

By the way, was that five years from Jan 2009? Tick, tock, tick, tock, it's now 2010. But I digress.

It's now a year later and 2011. And the time bomb continues to tick. But what happens in Jan 2014? Didn't the Mayans say we won't have to worry about it by then ;)

Thank god someone invented those little pill carriers, eh? You know the ones I mean. They are labeled with the days of the week. Each day is supposed to contain the pills we patients are supposed to take. Otherwise, even the patients couldn't keep track of what the hell they were supposed to be taking.

The one they're giving me has 7 of those little 4-compartment daily boxes and is neatly arranged into a little calendar for the month. Cool, now I can forget a lot of stuff instead of just a little stuff. Good thing I've got this home-nurse I call my better-half to keep me in line with that one:)

Does your doctor's office, usually the nurse, but maybe the doctor, even ask you about your current medication intake? Have they ever said, "Hey wait, I can't give you that because…"? "Why are you taking those meds together?"

They ask about what I'm taking, even OTC stuff, but some of them act like it's just a technicality to even have to write it down. Seems like they're just doing some kind of CYA bit in case they get sued and have to go back and say "Well, we told him not to take that".

Now, for the $64,000 question. What does drug "A" do when combined with drug "B"? "C" with "A" and "B"? And so on and so forth. I really don't have to get into all the combinations and permutations of drugs ,for the average American, do I?

The average American aside, I don't think the doctors even have little more a clue about that one. Another interesting aspect is the wastewater discharge from municipal wastewater-treatment systems. The EPA is just starting to guess at what kinds of potential compounds may be getting discharged into the receiving streams and what effect these discharges may have on aquatic-life downstream. As a 20-year career water & wastewater treatment-plant operator, I know we don't know anything other than that we don't know practically anything about it

Well I tried to make a correction and wiped out nearly half of my reply by bumping the wrong button...now the timer is running out...

  • 3 votes
Reply#9 - Fri Oct 14, 2011 10:14 PM EDT
One Miscreant

I can get wound up very easily on this on HW. The idea for this one came from reading about Valdez Alaska. We all know what happened there. Well one marine biologist, Riki Ott, and she commented on how low level exposure to the oil and chemicals used there, has suppressed the wildlife populations there. Out side of the disaster are normal. So if wildlife can be affected by low level exposures over 20 years, our bodies must be going through something similar with all the chemical exposure we have. Including exposure by choice. The medical records program proposed, will have no impact on our treatments, until they tie them all together logically and medically. So that each doctor knows where you stand at any given point in time. Truthfully that might hurt big pharma and polluters alike.

Was a buzzer beater reply, eh?

  • 3 votes
#9.1 - Fri Oct 14, 2011 10:40 PM EDT
HydeWhyte

Wasn't intended to be, One. I'm looking at it like we're just a couple of friends sitting in a bar sharing a few beers while we have a friendly conversation about the big picture of life that we have so little control over. If I ever say something that irks you the wrong way, please know I did not intend to do that.

I guess that since it is almost impossible to tick me off unless someone is physically threatening my family, friends or the innocent, I often get distracted and forget that not everyone is like me and I say things that are not taken the way I meant them. It is much easier to make me sad and hurt, but I rarely get angry.

Of course, I have been known to make statements that could easily lead people to think I am angry but that is mostly my old SA attitude that can come out with some of the rudest viners, which I know as fact that you are not of course.

  • 2 votes
#9.2 - Fri Oct 14, 2011 11:07 PM EDT
One Miscreant

I think you took me the wrong way. I didn't think it was your fault, that this topic gets me riled up. I can do that all by myself. I expect comments to "come as they are". Otherwise, neither of has a chance to learning something.

  • 3 votes
#9.3 - Fri Oct 14, 2011 11:14 PM EDT
HydeWhyte

I think you took me the wrong way.

Looks like that was the case some but not much. I was looking at your last sentence like you might have thought the lost part of my reply might have gotten your blood-pressure up. But that's good too because now you know more about me and I would have felt (and still do) the way I described in 9.2 regardless. After I try to get some sleep tonight I'll try to reconstruct the lost part of my #9. At least the sleep-depravation staff have recently cut me some slack and are now coming in every 4hrs instead of 2.

  • 2 votes
#9.4 - Sat Oct 15, 2011 1:51 AM EDT
One Miscreant

Don't think too much on it. It's all good.

  • 2 votes
#9.5 - Sat Oct 15, 2011 2:36 AM EDT
HydeWhyte

Cool. Got a lot to do preparing to get released plus the wife is with me full-time now, so I won't have quite as much time to spend online as I've had in the last month. I've been cooped-up in these hospital rooms so long, I can hardly wait to get out and enjoy some fresh air and sunshine again.

  • 2 votes
#9.6 - Sat Oct 15, 2011 12:54 PM EDT
One Miscreant

Good for you. Sunshine and fresh air. Also good medicine. Be well.

  • 1 vote
#9.7 - Sat Oct 15, 2011 1:04 PM EDT
Reply
etva

Excellent article and thread, OM.

My mother, a nurse by profession, has been very ill for many years. Occasionally, we can get her to a doctor, but for the most part, she simply refuses. When she does go, she argues with them about everything, including medications. They've learned to focus on that one medication that might do the most good. For better or worse, she's only on 2 medications, one for blood pressure and one is an inhaler, and she's alive years later, when everyone had their doubts.

From this I conclude that will power plays a huge roll in health, but sometimes I wonder if maybe it's because she doesn't take a large batch of prescription drugs. We'll never know for sure, but it does make me think.

  • 2 votes
Reply#10 - Sat Oct 15, 2011 11:17 AM EDT
One Miscreant

I hope your mothers quality of life is good too.I only wish will power was the key. Tell her OM is rooting for her.

Thanks for the kind words.

  • 3 votes
#10.1 - Sat Oct 15, 2011 12:16 PM EDT
etva

Thanks OM. Quality of life is in the eye of the beholder, IMO, and she seems content, so long as she's in her own home, with no one telling her what to do and when to do it. She's just that stubborn. LOL:)

  • 2 votes
#10.2 - Sat Oct 15, 2011 2:09 PM EDT
One Miscreant

and she seems content, so long as she's in her own home, with no one telling her what to do and when to do it. She's just that stubborn. LOL:)

I truely believe you. My wifes grandfather pleaded with me to take him home,as he lay suffering from congestive heart failure at 99 years old. I regret not picking him up and respecting his wishes. Because now I know the value in those wishes. Hope she continues on this path, she sounds just like him. Via con dios.

  • 3 votes
#10.3 - Sat Oct 15, 2011 4:49 PM EDT
Reply
SavickConn

And who the hell prints these books and publishes the information?

I get my ICD9 and CPT4 code books from Ingenix. These code sets are designated by the Department of Health and Human Services and are the national standard for physicians and health care facilities under the Health Insurance Portability and Accountability Act (HIPAA). And all of this is approved and guided by the American Medical Association (AMA). I also get my Uniform Billing Editor and Stedmans Medical Dictionary from them.

  • 3 votes
Reply#11 - Sat Oct 15, 2011 1:05 PM EDT
One Miscreant

Excellent sourcing. Are they available on-line?

The government institutions are corrupt and we all know they can be made to do anything any industry is willing to pay for. I would hope the AMA is a little better in this regard.

All I'm saying is the books and literature about drugs is not the be all end all, it's untimely about the patients and their reactions should not be poo poo'd or chalked up to a statistically irrelevant side effect.

  • 3 votes
#11.1 - Sat Oct 15, 2011 1:13 PM EDT
Kearney Outlaw

At last someone who knows something about the subject.

I have worked for several companies in the field of automating healthcare--specifically within the pharmaceutical end of things.

I've seen a lot of well-placed concerns voiced here, but with all due respect, not much in the way of actual knowledge.

Each formulary item is very well researched and comes with a wide list of possible interactions. You are vastly safer within the jurisdiction of an automated system than without. And it is cheaper.

The problem becomes one of standardization between systems.

  • 1 vote
#11.2 - Sat Oct 15, 2011 3:11 PM EDT
Kearney Outlaw

This is dated, and definitely "market-speak", but it is the truth.

Cerner Millennium PharmNet gives pharmacists and pharmacy administrators the ability to increase safety and improve pharmacy management. PharmNet links pharmacists, nurses and physicians from the time caregivers order medication through its administration, ensuring efficiency, continuity and safety. With PharmNet, pharmacists have the ability to, access more patient information, monitor patients around the clock with knowledge-driven alerts, share information directly with other caregivers, provide a continuous pathway for patient care delivery, support point-of-care medication storage, inventory and administration, produce fill lists and medication administration records automatically or on demand, work more closely with patients through mobile access and automated clinical-decision support.

Read up on companies like Cerner. Some are better at it than others, but in the end, the President's goal is laudable and completely within the scope of reality.

  • 3 votes
#11.3 - Sat Oct 15, 2011 3:17 PM EDT
One Miscreant

Thanks K-Outlaw your post is the hope side of the equation, IMO.

  • 2 votes
#11.4 - Sat Oct 15, 2011 4:50 PM EDT
Reply
One Miscreant

This has been a pleasant suprise. Resurecting a dead thread and seeing people who truely believe in the patient. I've said it before, via con dios.

  • 3 votes
Reply#12 - Sat Oct 15, 2011 4:57 PM EDT
FlNutmegger

Our local hospital uses the "Hospitalist Program" where a single doctor is responsible for others with specialties seeing a patient to diagnose their problems. I am just coming off 6 months of never never land where somebody has stolen my summer and I can't figure out just who--but I digress, in late April I was diagnosed with bladder cancer and after the surgery was given an antibiotic course to follow in order to prevent infections. Problem, I found out much later, was that it poisoned me and started a totally uncontrolled problems of diarrhea. After a couple of EVAC transports where the obligatory test were done in the ER I was finally admitted and the hospitalist took over. He assigned a total of 5 different specialists to examine me and each of them said that they could fix my problem but that I would also have to submit to further testing and in some instance outright surgery for ?problems? that just happened to fall within the bounds of their specialties. After politely refusing their offers, none of them did anything positive about their promises to help alleviate my original problems and I never saw anything more of any of them except their bills. As a senior senior citizen with Medicare & PPO Private insurance nobody can convince me that these Doctors, and I use the word very loosely here, weren't trying to mine the gold they found here! Isn't there something in their oath that says that they would never deliberately do harm to their patients? Doesn't really matter for me now because by the time they finally got around to doing something positive for me the cancer had settled in my colon and attached itself to my stomach which called for really radical surgery from which I am now in recovery! If it hadn't been for a chance referal to an Oncologist I would be toes up about now. I got a good doctor who seemed genuinely interested in the welfare of his patient--ME!

  • 1 vote
Reply#13 - Sun Oct 16, 2011 4:34 PM EDT
One Miscreant

Good post, thanks for sharing it.

All to often, it's only when things become so bad, they fear losing the golden calf is something positive done for the patient. I'm sorry for your suffering and I wish you a speedy recovery. Remission be your mantra. I guess medical records didn't help much, eh?

We seem to be in a similar boat. It wasn't bad enough that Ihad a heart attack due to atherosclerosis, a blood disorder and Ventricular tachycardia, but then one or more of the medication s I was taking started to affect every muscle in my body. I've seen a half dozen or more doctors for help with the muscle issue and no one can help. So screw'em all, I'll wait till the next major event and see if someone steps up to the plate. Because I haven't found that person on my own. Maybe if they think they are going to lose this cash cow, they might be inclined to stop the "twitching" too.

Medication combinations are the root of most obscure disorders, IMO. And it is not studied beyond FDA approval. As long as the number show more benefit, than don't, the innocent will suffer.

  • 3 votes
#13.1 - Sun Oct 16, 2011 5:00 PM EDT
FlNutmegger

Oh wow what a bummer, in the words of the kids! I wish for you only improving health for sure since you have more than your share. This is my 4th bout with cancer somewhere or other in the old bod but you still never get used to the idea! Most of my problems come from simply living too long I guess. Cancer of the Thyroid and the Chemo course I took back then told me never to do that again no matter what. A lot of my lung problems are directly related to taking one full in the chest during WWII that have gotten worse as I have aged! The Glaucoma and the rest of the stuff is according to the doctors simply a matter of I have worn my old body out! Medical joke, I guess. The docs. seemed to get real uncomfortable when I tried patiently to explain that I was making EOL (End of Life) decisions at 86 and what they were advocating was for 50 year olds not me!

Be well , and meant sincerely for sure!

  • 3 votes
#13.2 - Sun Oct 16, 2011 5:21 PM EDT
One Miscreant

I've seen them ignore those "EOL" requests/documents, recently. They still wanted to save the patient, that they couldn't get off the ventilator. The documents hadn't changed since the last time she was in there either. It was the most painful thing to watch. Be forceful and take them with you. Via Con Dios and thanks for your service Vet.

  • 2 votes
#13.3 - Sun Oct 16, 2011 5:39 PM EDT
rescue dogs62

Finutmegger,

Sorry for your experience with the hospitalists, and sorry for your diagnosis. Here's hoping the best.

  • 1 vote
#13.4 - Sun Oct 16, 2011 6:02 PM EDT
Reply
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