Tuesday, August 31, 2010

Sure, put that crown on the card, no problem

Michelle Andrews, Washington Post, Aug 31, 2010, says often patients are lured into sketchy credit situations in the face of a medical emergency.

Some states are looking at these purveyors. Often such cards are used for dental, chiro, dental, Lasik, and hearing procedures. Things not covered by insurance.

One common event with these is to do an application for “extended payments” without knowing it’s a card. Then the bills come.

It may be interest free if paid within a time limit, but if that is not met, the whole balance will be slapped with a huge interest rate—even the part paid off.

Or the whole bill will be put on the card—including what insurance might pay. Try to get THAT straightened out.

GE Care Credit, for one, gives dentists a kickb…rebate…for getting patients into this, although they say this doesn’t always happen.

New York State is also on the trail of Chase Health Advance and City Health Card.

If you are stuck in some urgent deal, ask for an extended payment plan—the practitioner will in effect be extending interest-free credit, but some will.

Monday, August 30, 2010

Seroquel may be danger to healthy young soldiers

The AP’s Matthew Perrone writes about how Seroquel, an anti-psychotic, is one of the VA’s biggest sellers and is given for sleeplessness and PTSD.

This means to soldiers or returned vets.

Several have died.

One young soldier kept getting his dose upped to 1600 mg, twice what a mentally ill person would get. He was also taking other medications. He died in his sleep. The VA noted the other meds and said it was “standard of care.”

The drug can cause weight gain (this young man put on 40 lbs) and tremors (he had them).

There have been many lawsuits (40,000 mostly saying it caused diabetes).

The other young men who died were also taking many other things.

Yes, often they asked for more Seroquel—it cut the nightmares and have them seven hours in a row. But it’s powerful stuff.

I am not a doctor, do not play one on TV, but can we be careful of stacking these drugs on people?

Seroquel is also given to restless old people—there has been trouble there, too.

Friday, August 27, 2010

Hip, hip...oh, no

What’s up with Johnson & Johnson—is one or more Johnsons out to lunch?

Jonathan D. Rockoff and Jon Kamp (WSJ, Aug 27, 2010) write about the latest recalls from the J’s—A whole hip and a hip “resurfacing” kit. Apparently too many people had to have repeat surgeries with these.

Yeah, repeat surgeries. That would suck—go through some horrible, scary, painful thing, get after-care lined up, people take time off, a walker, PT, then…something’s not right here.

What do you do if you have one of these? Take yourself back to the shop? Basically, yes— call the doctor. My sister and brother did that—whew, different manufacturer.

Involved are the ASR Acetabular System and the ASR Hip Resurfacing System (the latter sold only abroad).

No more than 5% are supposed to have a “revision” within five yrs—this one was 13%.

Oh—and those revisions? They don’t work quite as well, are more prone to infection, and take more recovery time. They also cost more, although the J&J subsidiary, DePuy, says they will pick that up.

I am sure it will be pure joy to put all that together then check back in to the hospital. Docs should only recommend this, they say, if ions (from shredded metal) are up in the blood or there is soft tissue damage.

Yeah, no problem.

Thursday, August 26, 2010

School nurse, endangered species

The school nurse is no longer the woman in the office with the cot who puts a cool towel on your head if you barf in class. (Remember that sweeping sawdust the janitor used—that was scary stuff.)

Nurses hand out daily meds to kids, screen them, save their lives if they have a bad asthma attack, monitor epidemics, test hearing, and a range of other services.

Oh, who needs all that? Half the schools lack a full-time registered nurse. Often, they circulate by a few times a week or less. Some schools have a box of Band-aids in the principal’s office.

The states are broke (news flash). The Robert Wood Johnson Foundation did a report on this called Charting Nursing’s Future. In it they detail how states are going after grants, weird taxes, and partnerships with insurance companies and nursing schools to get those nurses out into the schools.

At the Federal level, legislation is gaining traction to require a nurse for every 1,000 students or fewer. Studies should be done (of course). And another office needs to be created (of course) to identify best practices.

For more info… http://www.rwif.org/files/research/cnf14/pdf.

I remember going to the nurse’s office. It was always a woman in those days. Now, I don’t know. She called your mother. Your mother was not always overly thrilled, though could still sound somewhat worried.

Wednesday, August 25, 2010

Gulf seafood--bring on the jumbo gumbo?

According to an AP story, an Oakland seafood store owner says everyone freaked seafood-wise when the well blew, but are now back scarfing Gulf shrimp same as always. People do ask if anyone is regulating it, though, whatever that means. Giving it to FDA scientists for lunch and seeing if they eat it?

In August, one poll showed 54% of Americans were leery of the Gulf stuff.

Another store says people don’t even ask about where it came from anymore.

The Natural Resources Defense Council, however, would not mind seeing some studies with published results.

The big worry is some oil hydrocarbons that can cause cancer. The FDA uses “sniffers” (I am assuming a machine, not a person with a really bad job) and minces up fish and shrimp and tests it. (I was kidding about the FDA doctors.)

People want to go back to this—they want to help the fisherfolk down there.

I read that one restaurateur here in Arizona said Gulf shrimp is iodine-y. Does anyone agree?

I do think it’s weird, a little anyway, that the minute this spill or spew got boring and overstayed its welcome, it was declared “better.” Today’s take was that some obliging microbes ate the whole thing.

Tuesday, August 24, 2010

Check for these first, why don't ya?

I see article after article about women with weird symptoms, abdominal pain, infertility, weight gain, and so on. The doctors are always baffled. Then, almost every time, it is endometriosis or polycystic ovarian syndrome (PCOS).

It’s not like these are rare diseases that attack only left-handed women of East European origin or something.

Don’t doctors ever watch Mystery Diagnosis? Nah, probably not.

PCOS is an endocrine disorder involving excess male hormones. Irregular periods show up in the teen years. Weight gain is another symptom. Doctors are used to that one—diet sheet. Or you can be skinny with PCOS—got ya on that one!

PCOS can lead to diabetes or heart disease. Conceiving may be a nightmare or impossible. But PCOS is treatable.

With endometriosis, the uterine lining cells grow in the abdomen outside the uterus—sort of like ivy on a wall. Ultrasound does not show it, as it does ovarian cysts. The cramps can be awful as this stuff acts up and gets all fused to other organs in there.

Often doctors try to say this is irritable bowel syndrome because that region can be involved.

If you have low-grade complaints like this—or even screaming cramps—tell the doctor how bad it is.

And don’t be afraid—both of these can be corrected in a lot of cases and you can still have a baby.

Monday, August 23, 2010

Breakfast like a king

My Mom used to follow nutritionist Adelle Davis and Adelle said, “Breakfast like a king, lunch like a prince, and dine like a pauper.”

Apart from the feudal implications, is this good advice? Sure, probably. Studies do show that people who eat breakfast lose weight more easily (if you are into that). Breakfasters get Type 2 diabetes less often. They think better.

Breakfasts should contain a protein item…so that latte is not enough.

Actually, 12 grams of protein are recommended—half a cup of skim is only 4 grams.

Recently Consumer Reports on Health got into this breakfast riff. Some suggestions? Well, eggs (pasteurized and not poison) are good. Whole grain breads or cereal. Nuts, seeds, unsaturated fat.

Peanut butter! We are all about the peanut butter!

Watch the sugar. Women should eat only 6.5 tsps a day, men, 9.5 tsps. Some nannies would scream at that much even.

Oatmeal is good—it contains biotin—I am getting back into oatmeal, personally, because my hair is falling out.

Yogurt is good. Ricotta. Or cottage cheese—makes a good toast spread.

Bananas? Biotin—can you tell I am biotin obsessed these days?

If you don’t like breakfast stuff—eat turkey on toast, leftover pizza (now you’re talkin’), or even a baked potato with no-fat sour cream. We make them in a batch and reheat…they get a little wrinkly, but taste OK.

We’re a little wrinkly ourselves. We don’t judge.

Thursday, August 19, 2010

Women should eat differently at different ages

All day, what to eat, what not to eat, yipes, you could go bughouse. Don’t eat food that has an ingredient list. Don’t eat white food—cheese, milk. Don’t drink. Do drink wine. Don’t eat meat. Eat all meat. Eat food only from the outside aisles of the supermarket, not the middle. Eat raw, Cook always.

Your body needs certain nutrients to keep on truckin’. As one big cheese in the nutrition community once told me, “We don’t eat nutrients—we eat food.” Once transformed into food, these nutrients combine in ways you can’t get in a pill bottle.

In their teen years, women need more calcium. The bones for your whole life are being built—the rest of your life will be maintenance as bone breaks down and is replaced (or not). Teens need four servings a day of dairy or dark green veggies such as spinach and broccoli.

In their 20s and 30s, the childbearing years, women should keep up the greens for the folic acid needed to give a baby a good start. Eat colorful food—not pasty iceberg and potatoes. Peppers of all colors, spinach, golden roasted chicken.

As you dance less and play softball on the weekends less in your 30s, drop to 2,000 cals or less. Be sure you get enough Vitamin D, 200 iu a day up to age 50, 400 iu a day to 70, then 600 iu above 70. Some docs say even more!

If you have heavy periods, cook with an iron skillet.

Women in their 40as and 50s suddenly find their body has become very efficient—it stores fat for "later," whatever your body thinks later will be. Fiber intake should go up. Keep up the folates and green veggies big time.

Older people need to return to a teen diet. Calcium, green leafies.

Make the food look pretty, mix the colors, take your time eating. Have a friend over. Laugh.

But for heaven’s sake don’t begrudge yourself every bite, I really shouldn’t, I don’t eat that, maybe just a bite. This is life—this is living.

Wednesday, August 18, 2010

Looking smart today

Ray A. Smith, WSJ, Aug 12, 2010, writes about clothes that are smarter than I am!

I am letting my t-shirt just take over. Ahhh. Naptime.

There are new fabrics that respond to heart rate or even track it. Another brainstorm is cloth that prevents odors.

Clothes will even be able to tell someone you fell down. Now THAT’s embarrassing. Who? Surely not my doctor, if I have one by then—like they care.

A waterproof suit is coming from Brooks

Some new undies from Uniqglo also make you burn more calories or stand up straighter. They used to call those pantyhose.

Another shirt has a message that only comes out when you sweat on it. The message is “All you need is you.” Man do these people need namers and tag writers!

Of course, there are glitches. One fabric that changes colors when it gets warm got really changed in the armpit area—yick. Other people think some of the fabrics are stiff or the properties wash out.

Good grief—leave us alone. Mood rings were bad enough.

This post was typed by my pants, but I approved this message.

Tuesday, August 17, 2010

Hellooo, it's your robo-nurse

Jessie Scheiwe, Los Angeles Times, says some doctors are experimenting with telecare—telephone-based care.

Some psychotherapists even use it.

Offices use it to keep track of patients on a regimen—such as a diet or diabetes care.

Cancer patients, according to one study, showed improvement in pain and depression if checked on by phone.

Women who just had a baby were also assisted and it eased post-partum depression.

Even an automated call can help—it makes people feel part of something, like someone cares.

When I was on a blood thinner, sometimes the doctor’s office would call if my monthly blood test was weird—it did feel like someone cared. Usually, I had to call them.

We are going to be seeing a lot more ways of getting care. USA TODAY has a story on group appointments. Up to a dozen people with an ailment meet—nondisrobing exams were in the front of the room, more intimate ones behind a curtain. Participants promised in writing not to blab the medical secrets of others.

I don’t know, people—what do you think?

We are going to pay more, get less, and have to be flexible.

Maybe we are being overtreated, who knows… Check out www.treatmenttrap.com.

Wait and see is sometimes OK. I would wait and see, I think, before I would go to a group appointment. Yet, I did go to a joint replacement "class" with a relative once---and it did answer a lot of questions at once.

Monday, August 16, 2010

Hide the kids, she's sick of supplements

Good grief, we just have one body, even if it’s fat—how many weird pills and nostrums do we need? Eat some green veggies, orange veggies, beans, lettuce, meat, fish maybe (though some has the big bad mercury) and maybe even some cake.

Live! I spend so much time on this stuff it’s ridiculous.

I noticed my hair was kissing the head good-bye. Long strands. What had I been doing? Let’s see. Well, fish oil, so good for the heart, you know. Glucosamine-chondroitin, whatever they are, for rickety knees.

You know—the stuff we try, then keep popping in.

I read up on gluco/chond—sure enough, female hair loss is a side effect. Tossed it. Within 24 hrs, my knees no longer felt like hot grapefruits full of razor blades. They are almost pain free now!

The fish oil even has come under question by those self-proclaimed know-it-alls, Dr Oz and Dr Roizen. There could be cancer-causing PCBs in some of those oils. OK, the docs say, switch to algae-based Omega 3. Yick. Algae—no thanks (I have a pond, not a fan, and had heart palps once on blue-green algae).

Maybe some walnuts for Omega-3. Not walnut pills, or powder. Walnuts themselves—six whole ones day.

But I mean it about the cake—a little is good for the soul, which can always use some supplementing.

No, Star did not say not to take your prescriptions. Ask your doctor. Check your list often. Don't mention the cake, though. That never ends well.

Friday, August 13, 2010

Some teens putting off driving

Tracey Correa of the McClatchy Newspapers says more teens are not running over to Motor Vehicles on their 16th birthday.

Some wait years.

The percentage of Californians getting a license at 16 has dropped from 31% in 1991 to 19%.

Many households can't afford the second car and insurance these days, but the big factor is parents—they just keep chauffeuring to keep the kids safe and out of habit.

They often have to push the kids to get a license now.

Free drivers’ ed in school is almost a memory. The courses cost (my kid’s did).

Many states restrict driving for a couple of years. No more than one teen passenger, no driving after midnight, that sort of thing.

Kids are also afraid of drunk drivers.

Sometimes they take the test and fail and get timid.

I never drove at all—took three lessons out here in AZ, of which the less said the better. But if I ever do standup comedy, that is my opening act.

But—kids—not driving held me back from a lot. You need to get with it eventually. Listen to Auntie Star now.

Thursday, August 12, 2010


I don’t even own a laptop and some people are already being maimed by theirs. I am so not worthy!

Aching, neck, throbbing head, tingling fingers. Too long on the old laptop.

This is “almost inevitable,” sez Kevin Cameiro, DO, a doctor in the Dept of Physical Med and Rehab at the Univ of NC.

Your body should be at a 90-degree angle to your arms and the screen should be straight ahead.

But, but…the screen on a laptop is fixed to the bottom—you can’t achieve this.

One solution is to hook the thing to a docking station—we are out of my pay grade instantly here, so you figure it out.

If you must use it, as is, put it on the desk so the screen is at least straight ahead. Try not to be bending your neck. That girl in the picture--don't do that.

Make sure your wrists are supported if you use a mouse.

Take frequent breaks. Roll you wrists and neck.

Stay hydrated.

You are young and strong—don’t crap out before your time, I always say. (I do, ask anyone.)

Wednesday, August 11, 2010

No on that tongue stud

Besides being cringe-y, gross, spitty, and ugly, what is wrong with a tongue stud?

The Univ of Buffalo School of Dental Medicine has now found that kids push the stud against their upper teeth, displacing them and causing a gap.

Then the person just keeps pushing the stud into the gap. The teeth can even break.

Hemorrhage, infection, stud madness, who knows. Worst case, orthodonture, if that will even help!

The coolness quotient is not worth it. At least not to a dopey old adult.

I saw something worse, though—tongue splitting. Some unlicensed idiot cuts your tongue up the middle and leaves two independently writhing halves. Mop with a paper towel and enjoy.

Tuesday, August 10, 2010

Blear of flying?

It's fast, but flying can be icky.

Consumer Reports on Health (July 2010) says book a seat on the wing, where you will feel less motion.

Sleep a lot before you go. Consider sleeping pills for a few nights.

When going through security, ask for a pat down if you have a pacemaker, insulin pump, or other implanted device.

Take Dramamine if you get airsick. Take it 30 mins before leaving. (Ginger for after-surgery nausea doesn’t work as well on airsickness.)

While flying, stop reading if you feel queasy. Walk the aisles once an hour, don’t cross our legs, bend them as often as you can to prevent clots.

Drink lots of water and less caffeine, which eliminates water from your system. Never drink the water in the bathroom.

Once you’ve landed, if flying east, try 2-3 mg of melatonin at your local bedtime while you adapt. If flying west, take a small dose, say .5 mg, if you wake up early and want to go back to sleep.

I take Vitamin C, too—so many critters in cabin air. And I don’t mean snakes.

Monday, August 09, 2010

Sunburn is still a burn

I used to get those blister sunburns as a kid. Where the blisters are like translucent grapes all over your shoulders. Supposed to be precursor to skin cancer, like I don’t have enough to worry about.

Linda Penney of Newsday writes about treating sunburns at home These are first-degree burns, you know.

A cool bath and cool compresses are recommended—to draw out the heat.

Use Eucerin or Aquaphor to keep skin moist—this won’t prevent blistering. We used to use Noxzema.

Tylenol or ibuprofen can help with pain—and a sunburn does feel stuff and stinging.

Some people try apple cider vinegar, or plantain, or cold milk on a compress. I also have heard of using tea.

Don't pop the blisters--this is not bubblewrap.

Yick—I remember this. Not a good memory. We didn’t have plantain, though. I guess we had sunblock and were just idiots--I can't remember.

Friday, August 06, 2010

Kale chip, anyone?

My friend Gary Allen, a great foodie who wrote a book on cannibalism (OK, I know some unique people), told me about a site called REAL CHEAP FOOD.

This appealed to me financially and in terms of its no-nonsense naming philosophy.

Go to www.realcheapfood.com.

When I went to the site, the opening suggestion was Kale Chips. Cut up some kale, coat it with oil, and bake on a sheet at 350 degrees for 20 minutes, salt and eat.

People say they don’t even taste like kale!

You can also make mustard green chips. Collard green chips.

I asked my daughter if I should try it.

She said no.

Gary Allen’s nephews used to sneak around corners and point him out to their friends, whispering, “He’s a cannibal.”

Better not to judge.

Thursday, August 05, 2010

Ouch--these kids will be deformed

Backpacks! I remember grabbing my daughter’s off the floor and almost dislocating my shoulder. It felt like it was nailed there.

Turns out the school did not have lockers—all the books had to come home each night. This was in DC—a subway ride.

Neel Anand, MD, a board-certified spine surgeon in LA, says these little beauties can result in backache or neck or shoulder pain.

Make sure kids use both straps (nothing cool about being all crinky).

Make sure the thing does not slump down below the hips.

Make sure the child can and does stand up straight. If he or she is hunched, it’s too heavy.

Keep the weight to 10-15% of the child’s weight.

Try a backpack with wheels.

Wheels. What are they, 75? OK, so that’s Dork City…but these things get ridiculous!

Wednesday, August 04, 2010

Look for the nice label, allergy sufferers

Do you or your family members suffer from allergies?

What if you want to buy a vacuum cleaner or a new pillow? Will it make you worse? There is only so much Claritin one can take!

The Asthma and Allergy Foundation of American (aafa.org) and Allergy Standards Limited (ASL) have hooked up to vet household items for sneeze or wheeze potential.

Don’t you love it when people do work for you? I do.

So far, 80 products have earned the seal. Just reading that a product thinks it’s hypoallergenic is not enough for these people.

Check out www.allergystandards.com/asl-blog.html to see how they decide.

I have a relative with allergies—it’s sniff sniff all day, no matter what the season. Maybe some sniff-proofing would help.

I only get sniffy when I eat ramen that has a lot of cayenne in it. I am blessed.

Tuesday, August 03, 2010

iDosing--heard of this yet?

Forget cops and expensive illegal drugs, some people swear you can achieve a catatonic or hallucinogenic state listening to certain tones that activate the brain certain ways.

Digital drugs.

Parents are ritualistically alarmed and shocked. Kids are ecstatic (or appropriately catatonic).

The usual.

At first scientists said it was harmless…After all, isn’t music a mood changer?

Then naturally someone said, well, it might be a gateway drug to the real thing.

You know, reefer madness.

This is based on what they call Binaural beats or sequences. Highly technical tones people take years to develop. You get these off the internet. Check with Dr. Google.

What do I think? I think what goes around comes around. When do we get some nice CDs for cancer patients and pain management?

Monday, August 02, 2010

The Backyard Nursing Home

Seriously--they call it that.

The AARP Bulletin (Aug 2010) has a bleep on a portable "alternative" to nursing homes—a MEDCottage, 12 x 24, with a bathroom and way to signal caregivers that the old person needs them.

A minister invented this—and as you can see, triggered my snarkiness.

I have a shed in back like this—wired for electricity. I could add a bathroom.

So this is it? Don’t add a wing or mother-in-law suite, add a box?

Cities are lining up to zone for these things—if a doctor prescribes.

How would that go exactly? At the doctor. “I think your mother needs more supervision—she could fall—she should not be home alone.”

“OK, but we don’t have room—maybe the tool shed?”

I know—I am being a bitch. But heck, people.

They call this family-managed health care. You are the nurse. You live in the big house and just run back there a few dozen times a day.

And it's $75K.