Tag: Healthcare

America Collection/General interest
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Warning: May Cause Cardiac Arrest

by Fran Johns
Medical worker looking through microscope

DO YOU REALLY WANT TO READ THAT ECHOCARDIOGRAM REPORT?

Photo by Lucas Vasques on Unsplash

Not for the faint-hearted: Echocardiogram Test Results Reports

Perhaps they are also not for the laity — you and me, the dummies whose hearts get echocardiogrammed and reported on, but what do we know? 

I should’ve quit with the ‘sigmoid septum’ thing. The report said it was ‘normal variant with aging . . . and no evidence of outflow obstruction.’ Wouldn’t that be enough?

But no. Something in these official Reports hypnotizes you. You plunge ahead.

‘Mild diastolic dysfunction!’ Can one live with dysfunction in the diastol? I don’t know. I mean, I know dysfunction just about everywhere else . . .

It is, in all probability, dysfunctional by definition to read the report of one’s recent echocardiogram. So why in the heck do they send you the thing? To raise your blood pressure, perhaps. I read on.

Oh, lord, ‘Mild tricuspid regurgitation.’ That’s got to make you sick.

Plus, a lot of the report has to do with Teichholz formulas. Did I miss something in Human Biology 101? Dr. Teichholz had to have been there somewhere, unless he wasn’t born until after I passed Human Biology with a D minus/minus/minus. Still . . .

For now I just need to get finished with the particulars. It’s my heart they’re reporting about, after all. And if my excellent medical team didn’t want me to know these details, surely they would not have sent the Test Results Report for my edification and enlightenment?

We embark upon a ‘Tricuspid annular plane excursion, systole,’ followed by a ‘Lv ejection fraction.’ Does this sound like any fun to you? Personally, I read it as someone being on an excursion barely long enough (fractionally, that is) to eject. It’s enough to make your heart race.

Which mine did, until I got to the very bottom. At the very bottom of the Test Results Report is a message from my primary care doc, who just finished reading the same report. Could he have put this message in bold, and kept the rest to himself? He wrote:

“Fran, the echocardiogram is quite reassuring. Really nice to see. No concerns that need intervention at all.”

Oh. Okay.

America Collection/General interest
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Just Don’t Get Sick on Friday, After 12 Noon

by Fran Johns
Photo by Aarón Blanco Tejedor on Unsplash

Early Friday morning — OK. But after, say, 11 AM, either convince yourself you’ll be fine until Monday or just go ahead and drink the hemlock. It will save untold humanoid hours.

Medical providers provide only sketchily after Friday noon. By Saturday morning, forget it. They’ve all gone to the beach for the weekend, or they’re taking their kids to soccer games, or one way or another doing things regular people do after Friday noon. These just do not include responding to the needs of the puny, so deal with it.

I, unfortunately, was feeling puny on a Saturday morning; and of course I exempt myself from all advice given to the rest of the populace. Therefore, I commenced a program to reach a Prescribing Physician for some drugs of which I felt a great need. This was about 9 AM.

If you are unwise enough to ignore my advice and follow, instead, my pathway, here’s what you may expect:

An hour or so of leaving your name, phone number, insurance information and intimate details of your lifelong personal history on assorted phone-trees. The chirpy voice requesting all this will assure you the doctor/clinician/pharmacist/whoever will respond within the hour. This is a lie. But in the grand scheme of lies one encounters when feeling puny on a Saturday it is negligent. I mean, really. Looking back, did you honestly feel as terrible as you told the chirpy voice at the outset?

Then, a few more hours of texting with your children, friends and the occasional perfect stranger who seemed medically knowledgeable on Instagram. They will all have excellent suggestions for stuff you never heard of, like probiotics that you can pick up at the nearby health foods store; so plan for another few hours of discussing your healthcare needs with the friendly health foods store people while you wait for the healthcare person who was going to call back by 10.

Photo by engin akyurt on Unsplash

It is now supper time, but you’re too sick to eat anything so what does that matter. If you’re really lucky, someone will by now have broken through to the healthcare person who just got back from his kids’ soccer game, so he will actually text you a response. Something like “Oh, the XYZ isn’t working? Well I’ll write a prescription for PQR!” Relief.

But of course, all reputable pharmacies are now closed.

You will still find a pharmacy. Can I help it if it’s in the sketchiest or nuttiest part of town? You should’ve gotten sick 12 hours sooner. Well, anyway. Most cities will have an all-night (or Open Until 9:30 PM) pharmacy in one quaint area or another. If you’re in San Francisco, for example, that will be in the heart of the Castro District, where liveliness does not calm down a little until about 3 AM. On arrival to pick up your meds you may encounter an apparently dead person in the middle of the sidewalk, but another person standing near will say, “Nahh, he’ll be fine. . .” when you make polite inquiries. So you get in line — the lines will be very long, considering all the people who need drugs at 9 PM of a Saturday night — and you are eventually rewarded with a prescription.

Author photo of formerly dead person with rescuers

Outside again you will find the paramedics have arrived to collect the formerly dead person on the sidewalk and deliver him to wherever users of weird drugs go to sleep it off.

So. Everybody’s OK now. Go home, take your own weird drug and feel better in the morning. But next time, try to get sick on a Monday.

America Collection/General interest
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Miracle Drugs, Miracle Products . . . Really?

by Fran Johns
Photo by Mihai Surdu on Unsplash

“Surefire cure for erectile dysfunction!”

“Lose 10 pounds this week!”

“Lower your A1C!”

“XYZ Brand cured my (fill in the blank)!”

The ads bombarding you 24-hours a day via the internet, TV, social media and every known pathway all have one goal: to get you to buy their product. Some of them are true. Some are truly misleading. Some of them are downright dangerous.

Chances are there’s a product out there that could be useful. Chances are even better that there are things that would be a total waste of your time and money, or downright damaging.

How can one rational person sort it all out?

Three experts recently appeared at the Commonwealth Club in San Francisco to offer help: Dr. George Lundberg, founder and president of the Lundberg Institute (designed to build better-informed patients, physicians and relationships between the two;) Dr. Kirsten Bibbins-Domingo, Editor of the Journal of the American Medical Association (JAMA😉 and Dr. Kamran Abbasi, Editor of the British Medical Journal (BMJ.)

Commonwealth Club Humanites Forum Chair George Hammond with Dr. GeorgeLundberg (seated.) – Author photo

“There’s information overload,” said Dr. Domingo; “there’s disinformation, there’s spin. We need clear, consumable information.” Dr. Abbasi added that thanks to social media and the proliferation of non-medical sources, it’s hard for ordinary consumers to find evidence-based medical information.

All this is thanks to Direct to Consumer marketing. Every country in the world bans DTC marketing — except the U.S. In 1997, during the second Clinton administration, the Federal Trade Commission relaxed its rules, allowing such ads to take hold. They’re unlikely ever to go away. Some estimates put the amount spent annually on DTC ads at nearly $10 billion.

Those ads are required to carry disclaimers in small print. Or they’re read at warp speed so nobody hears. “Common side effects include nausea and diarrhea, muscle ache, headache and joint pain. Rare cases of paralysis, brain disease or death have been reported.”

Dr. Abbasi offered two bits of wisdom:

1 — Consider the source. Where’s that information really coming from? You can always check with JAMA or the BMJ; but if that’s too much trouble you might just check with your own physician or healthcare provider before you listen to Dr. Oz.

2 — Follow the money. Who paid for that miracle drug, that claim, that ad?

In other words, read (or listen to) the small print before you buy. JAMA or BMJ are two good places to start; either can direct you to answers of your medical questions.

The ads promise nirvana, but failure to question can be harmful to your health.

caregiving/General interest/Health/Healthcare/Medicine/Optimism Collection/physicians/Politics & Causes/San Francisco/USA
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On Being a Blessing

by Fran Johns

There was an invisible pall hanging over the banquet hall.

An annual feel-good celebration of a cherished cause, the room was filled with friends and supporters of the San Francisco Free Clinic. The Clinic offers medical care for the uninsured; the pall had to do with the new President-Elect’s pledge to increase the ranks of those uninsured by unknown millions by immediately repealing the Affordable Healthcare Act.

health-care

For 23 years, SFFC supporters have filled the same banquet hall. The annual event, initiated by the late San Francisco investor/philanthropist Warren Hellman and his wife Chris, generates the entire budget for SFFC’s operation. Not coincidentally, the San Francisco Free Clinic was founded 23 years ago by the Hellmans’ daughter and son-in-law, Tricia and Richard Gibbs, two young physicians who decided to throw over the prospects of their lucrative medical practices in favor of starting a free clinic for the growing ranks of uninsured in need of quality medical care.

(Full proud disclosure, this writer and her husband have been supporters of the Free Clinic since its opening day.)

A highlight of the annual event has always been brief closing remarks from the host, and after Hellman’s death, this task fell to the Drs. Gibbs. This year, Richard Gibbs said a few words and then turned the podium over to his wife.piggy-bank-w-stethoscope

“One thing I have now learned,” she said, “is never to write a speech the day before an election.” She went on to explain how the Free Clinic has made incremental progress in its mission every year since its founding, and she had prepared remarks about that narrative with the expectation that this would continue. With the election of Donald Trump, though, comes the realization that the story of ongoing progress – Clinic staff not only provide care, they regularly guide clients into finding affordable insurance – will encounter a speedbump. Acknowledging that many in the room probably voted for Mr. Trump, and that politics would be inappropriate to the event, Gibbs said she still had wanted to find a way her remarks could be relative and upbeat.

So she turned to the story of Abraham. Gibbs is a serious student of the Torah, and would not have had to spend extra time on recalling that story. She noted that Abraham’s narrative was not incrementally always upward, but had its own speedbumps.be-a-blessing

“God told Abraham to be a blessing,” she said. “And I realize that’s what we can do. You are all a blessing to (the Free Clinic.) We can all go out and be a blessing.”

For election week in California, it was a reassuring thought.

 

General interest/Health/Healthcare/Medicine/physicians
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Illness, Wellness and Procrastination

by Fran Johns

gumby & stethoscopeYou may have had an experience like this: some nagging health issue not quite bad enough to take the time to tackle. Or with a solution that seems too painful, too bothersome… so you let the issue keep on nagging, usually getting worse.

For me, it was a minor foot issue – okay, an inelegant ingrown toenail. My good pedicurist, alternating with a private podiatrist (my healthcare provider does not provider for regular foot care,) kept the darned thing at bay for the past four or five years. It was a pain in the foot, but on the scale of one to ten it peaked to eight only rarely. Almost a year ago, my podiatrist reached the limit of his patience.

“Look,” he said (while I tried not to look,) “I’ve nursed this thing along for months, maybe years longer than need be. Go for the surgery.” He drew a few lines to show where a slice of toenail would be cut off. “Kaiser has some excellent podiatrists. It’s done with local anesthesia and only takes a few minutes. Three or four weeks of soaking etc, keeping it clean, you’ll be fine.”

Those were the words he spoke. What I heard was: Local anesthesia! Sticking needles in between my toes! Three or four weeks with one foot in a pan? A month without walking along the admittedly dirty park trails? It took me another six months to screw up my courage. Months of anticipated agonies one could hardly wrap the mind around, months of despair over a lengthy recuperation…

Toe 8.7.15Finally I took a deep breath and scheduled the surgery. Instead of (or before; I still wasn’t looking) the shot in the toe there was a freezing action the doctor said would “feel like ice pouring over the area” which was, in fact, breathtakingly painful for about 15 seconds. And that was it. A few minutes later I was handed a sheet of instructions for “after a nail procedure,” fitted out with a Velcro’d boot, and sent off to drive home. It was all I could do to remain pitiful enough for a few hours’ sympathy. The next day, the fancy bandage came off. Recovery boiled down to Band-Aids and a little pother of three-times-a-day soaking for 5 minutes. Probably the most difficult part of this long-feared episode was being confined to home for two days, soaking, elevating (not critical, but perhaps helpful) and feeling pitiful. By the end of the second day I was going stir crazy. So I suited up in socks and Birkenstocks and went to a jazz service.

There I met an old friend who left San Francisco several years ago. “I guess you hadn’t heard about Bob’s surgery,” she said, when I asked how long they’d been in town. “They found a tumor on his kidney. He was at the VA, and they took out one kidney, his urethra, a lot of other stuff. They say he’s fine now. We got an apartment here so he could recuperate.” About that time her recovering husband walked up for a hug.

“Well,” I said, “I was going to complain about my toenail.”

 

 

Abortion/Family and Friends/Feminist Collection/Healthcare/Politics & Causes/Reproductive rights/Women
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Hobby Lobby, 1 – Women, 0

by Fran Johns

(This first appeared on Huffington Post)

It is hard not to despair.

A woman entering a clinic for personal healthcare now must wade through potential hordes of obnoxious strangers getting in her face with stuff – often angry stuff, often misinformed and always unrequested. Where is the right to privacy, to lead one’s own life without the interference of obnoxious strangers?

And now, a woman working for Hobby Lobby, or for that matter any other corporation headed by a religious fanatic who believes his employees must submit to his beliefs, can be denied healthcare coverage for the most basic, most personal reasons: the need to control her own body, to make her own reproductive choices and family decisions.

Following the Supreme Court these days is hazardous to one’s health.

But let’s hear it for Ruth Bader Ginsburg.

Ginsburg read the riot act to the five men – surprise, surprise, all of them were men – who dealt this latest blow to the women of America.

Saying that religious freedom demands “accommodation of a for-profit corporation’s religious beliefs no matter the impact that accommodation may have on third parties who do not share the corporation owners’ religious faith,” Ginsburg wrote in her dissent, is likely to wreak havoc. The havoc is only beginning. And only a small part of it will be the suffering of Hobby Lobby employees. No contraceptive coverage, no abortion coverage, no options, and – because we are not talking about rich people here – no justice.

One wonders. Are mandatory burqas next? Stranger things have happened than corporate CEOs whose religious sensibilities are offended by women’s uncovered heads. There are serious concerns that the ruling could lead to other corporations denying coverage for things that bother other religious groups – blood transfusions (Jehovah’s Witnesses, Christians Scientists), psychiatric treatment (Scientologists) for example.

Freedom of religion? Bah, humbug, Ginsburg says in so many words. “(Y)our right to swing your arms ends just where the other man’s nose begins.” She might more properly have said, “where the woman’s uterus begins;” because indeed the religion-guarding gentlemen are swinging directly at women’s guts.

Call it what you will – religious freedom, protecting the unborn, freedom of expression, social conservatism – the denial of women’s rights will always, eventually run up against the voices of women who will not be denied.

Thanks, Justice Ginsburg

General interest
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If Obamacare goes, women lose

by Fran Johns

Lots of us were disappointed with the healthcare bill: I wanted single payer (but never held my breath about that,) the “death panel” fiasco cost us a critical piece of coverage… but here we are. At least we got a bill.

And “Obamacare” the Patient Protection and Affordable Care Act, has been a boon to women. It’ll be even more so, if the Supreme Court doesn’t send us back to square one. Jessica Arons outlines just a few of the ways the act has benefited women in a recent article for the Center for American Progress.

“Thanks to Obamacare,” Arons writes, “more than 45 million women have already taken advantage of recommended preventive services, including mammograms, pap smears, prenatal care, well-baby care, and well-child care with no cost sharing such as co-pays and deductibles. Starting this August, millions more will be able to obtain contraception,
annual well-woman care (a visit with a gynecologist), screening for gestational diabetes, breastfeeding counseling and supplies, and screening for sexually transmitted infections, including HIV and the Human papillomavirus—again at no extra cost.”

Add to these the millions of women now (or soon to be)  avoiding discrimination over things like pre-existing conditions, including the condition of having been born female.

If the Supreme Court doesn’t strike it down, Republicans swear they’ll do it. The war on women is no illusion.

Gun control/Health/Healthcare/Lifestyle/seniors/Women
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The curious world of cyberspace

by Fran Johns

Disappearing from cyberspace is a little like being a tree that falls in the forest. A very small tree. Having disappeared from cyberspace myself for a couple of weeks, I am comforted by the fact that the forest is very large.

It’s not that this space disappeared, just that Boomers and Beyond disappeared. Boomers and Beyond is a blog primarily about issues critical to over-50 generations, and it came to pass on  True/Slant.com a couple of years ago. It dealt with health care and fitness and housing choices and brain exercises and driving safety, and often diverted into rants about gay rights and abortion rights and gun control and other miscellany — because the True/Slant folks were a free-wheeling bunch and why should anybody quit worrying about rights and justice when they turn 50? All those profound words are archived in this nifty blog (this WordPress one right here) created by incredible friend-of-B&B-&-this space Mary Trigiani, so that if anyone stumbles into the forest and wants to study a small bush those twigs — OK, enough with the metaphor — are there to be read.

True/Slant didn’t actually disappear; it got bought by Forbes, and is gradually reappearing (as a New And Improved Forbes blogsite) there. Boomers & Beyond is reportedly going to reappear thereon, as soon as a contract appears. In the interim, it is just sitting there inert, and after several watchful readers noticed its inertia (posting anything new isn’t an option at True/Slant any more) I decided to venture once more into cyberspace.

It’s pleasant to meet you here. I hope we’ll meet again soon.

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