Whether you follow health news or business news, you couldn't help but notice the hub-bub about Steve Jobs, the founder and CEO of Apple Computer, and his liver transplant. While most of us will never need such a drastic and difficult treatment, Jobs' approach to getting the healthcare he needed raises both process and ethical questions.

Some Background:

Steve Jobs, age 54, is an icon of business, the "god" of Apple computer, with a creative and inventive mind. Over the years he has earned billions of dollars for himself, his company and his stockholders.

Steve Jobs is/was also a very sick man. He has battled pancreatic tumors for a number of years, and ultimately knew he could no longer survive without a liver transplant. So, he got one.

What's unique, and is causing controversy, is that Jobs lives in California where the waiting list for a liver would have made it impossible for him to get one. In California he would have died. So instead he kept an eye on areas of the United States where the waiting lists are far shorter. When a liver became available in Tennessee, Jobs hopped his private jet and claimed it.

Some argue that wasn't fair. That someone in Tennessee didn't get a liver (and possibly died) because Jobs jumped the line. In the United States, you can't buy an organ. There is a complicated system that moves people closer to, or farther from, the front of the line depending on the depth of their illness and their geography. Because Jobs had the money and the private plane, he could affect his geography.

There is further controversy because investors in Apple Computers feel as if they should have been told about Jobs' degree of illness. Since it affects their income, they contend they had a right to know, and they are upset because they weren't told about his need and pursuit of a transplant.

The Questions:

Health: Was it fair for Jobs to jump the line by traveling to Tennessee to get his new liver?

Business: Did Jobs owe his stockholders information about his health so they could make business decisions?

My Opinions:

Health: Jobs' ability to jump the line points out the inequities in a system that has mostly been considered to be highly ethical and fair. On any given day in the United States there are 100,000 people awaiting a transplant, and 19 of them die. In a general sense, I understand why some think it's not fair, especially the family of someone who may have died because Jobs got the liver they might have gotten. However -- if you had the need and the means, wouldn't you do whatever you could to get the treatment you needed?

Business: No matter whether Jobs was president of a large corporation or a greeter at Wal-mart, I believe he owes information about his health to no one else. It's HIS health. It's HIS private business. No matter how his investors feel about it, including Warren Buffett who believes Jobs' condition should have been disclosed, I say - no, Jobs owed information to no one. Besides, he's been sick for a long time -- that was nothing new. Granted, we would all like a crystal ball when we buy stock, but he could have been hit by a truck or died in a plane crash and it would not have been predicted.

What do you think?

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation!
_{NEWSLETTER | FORUM | BIO | TWITTER}
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Photo © Sean Gallup / Getty Images

Hospitals are dangerous places to be. And there's no more dangerous time of the year in a hospital than during the month of July.

I actually sounded a similar warning to you when I blogged last December about the danger of being in a hospital during the holidays. It's just common sense. During holidays, including Christmas, Thanksgiving, the 4th of July and others, the full time staff takes days off -- as they should! -- but it leaves the part-timers and sometimes temporary staff in charge of your care. And it often means that staffing is not 100%. Fewer good people around to take care of your needs.

But July is even worse in many hospitals across the United States:

1. The 4th of July holiday fits the holiday profile described above.


2. This is the time of year when many of the most experienced medical practitioners take vacations, too... So they aren't absent for just the few holiday-days. They're absent for weeks at a time.


3. NEW doctors. Inexperienced doctors. Interns, first year residents -- those who are now called "doctor" by virtue of the fact that a few weeks ago they completed medical school. They may be finished with their book-learning, and may have spent time with some patients as they accompanied more experienced doctors through hospitals and in offices. But they aren't licensed, and they've spent very little time actually practicing any medicine. If you're in the hospital where they are practicing, they'll be caring for you.

So.... add together a holiday, an absence of experienced doctors, and wet-behind-the-ears doctors and what do you have?

Yes. Danger.

If you must be scheduled to be hospitalized, whether it's for an elective surgical procedure or a specialized form of test, or whatever it might be -- then postpone your hospital stay as long as you can, maybe even into the Fall.

If you must be hospitalized and you can't put it off till later, then know that you or your caregiver will need to be particularly vigilant about keeping track of all aspects of your hospital stay. VERY vigilant.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation!
_{NEWSLETTER | FORUM | BIO | TWITTER}
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Photo © Microsoft Image Gallery

Last summer I shared my adventures of cleaning out my medicine cabinet. Most of us don't realize that it's not as simple a task as just throwing things away, rearranging items or wiping off the shelves.

Not even close!

I was reminded twice about that in the past couple of days. First, my morning glance into the medicine cabinet is like a nagging voice in my head. "What a mess! You should be ashamed! How can you find anything in here? You'd better hope Martha Stewart doesn't show up!" It's not unlike opening the refrigerator door. (Don't you always wonder if the mold that forms on leftovers couldn't somehow cure a dread disease?)

My second reminder came from Mark Cichocki, a fellow About.com guide, who provides some very specific ideas about how to dispose of old meds and medical waste. He reminds us that it can be dangerous to pets and children, or even to the entire community, if we don't dispose of old drugs or waste properly. That includes a major problem if we simply flush or dump them.

So here are some of Mark's ideas:

• Be sure to block out your name and other personal information on any pill bottles or other containers. It's a way to protect yourself from medical identity theft.
• Add kitty litter, sawdust or coffee grounds to any liquids to make it less likely someone will (intentionally or unintentionally) try to ingest them.
• There are other options like pharmacies that will take back old drugs or groups that collect them for distribution in third world countries.

Take a moment to review all of Mark's ideas -- he's done a good job. You'll find additional ideas in last summer's review of how to dispose of old drugs, too.

Cleaning out your medicine cabinet is a great summer task. A sense of accomplishment, plus one less thing to worry about if Martha Stewart shows up at your backyard picnic.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation!
_{NEWSLETTER | FORUM | BIO | TWITTER}
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Photo © Gary Alvis / istockphoto.com

I've seen it coming for several years now.

Apart from my work here at About.com, I call myself Every Patient's Advocate. My writing and speaking is aimed at the general you; outside of helping myself and loved ones navigate healthcare, I've never attempted to hold someone's hand individually to navigate the healthcare system.

But some of you do. And many more of you want to. I hear from you often, and while I can steer you to the articles I've written about becoming a patient advocate, I can't give you first-hand accounts of the actual work itself.

But patient advocacy, or the work of patient navigators, is beginning to hit a tipping point of conversation. I am thrilled!

The proof is in two excellent resources that were published this week:

From NPR: Patient Advocates, Tips from You and Advocates Help Patients Navigate Health Care Maze (which features my colleague and friend, Dr. Jonathan Fine's Bedside Advocates program)

From Encore Careers: Encore Navigators Improve Health, Reduce Costs I expect we'll see many more of these fine articles. If you see one you'd like me to read, will you let me know?

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation!
_{NEWSLETTER | FORUM | BIO | TWITTER}
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Photo © Ocskay Bence - Fotolia.com

Have you had a run-in with the healthcare system in America?

Was it affected by, or did it later affect, your ability to pay for your care, get insurance coverage, or afford healthcare coverage?

If so, President Obama wants to hear about it. And he has provided a way for us to share those stories easily.

While reviewing this possibility for you, I spent some time reading some of the stories that are already there. They are heartbreaking and make me so angry. In every case, they show us the real affects of money vs. health, and what happens when money is deemed more important than health.

As I've written MANY times before: American healthcare is not about health or care. It's about sickness and money, using sickness to make money.

Take a moment to share your story with the President. Then, if you have the time, come back here to share your story, too! Just copy and paste in the comments below, or in the Patient Empowerment forum.

Moving stories will be one way we move healthcare reform forward in positive directions.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation!
_{NEWSLETTER | FORUM | BIO | TWITTER}
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Photo © President Obama's Healthcare Action Center

A couple of weeks ago, I asked you to help me prove an assumption (yes, I know what they say!) that our opinions about whether healthcare should be a right might be colored by whether or not we have good healthcare coverage.

You can see the poll results here.

Turns out -- I was wrong! Well, at least I was partially wrong. And seriously -- that's a big relief.

My assumption was that the people who have good healthcare coverage would believe that we should have to earn the right to good coverage; that it should not be a given right that we should have healthcare access whether or not we have the means to purchase it.

However -- as you can see by the poll results -- that's not exactly how you, as a voting body of readers, feel.

• 69% of you feel as if healthcare should be a right (of which 7% are not residents of the US)
• 27% of you feel as if healthcare should not be a right
• Of those of you with good healthcare coverage, only 42% felt as if healthcare should be a right... so... my assumption was partially true.

There was nothing scientific about this. But it definitely shows we have opinions on the subject. As healthcare reform continues to be a large topic of debate, I expect you'll think back to this poll on occasion. It will be interesting to see if your congressional representatives feel the same way you do.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation!
_{NEWSLETTER | FORUM | BIO | TWITTER}
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Photo © About.com image

And if not, did you assume that meant everything was OK?

It may not have been. And you may be sicker because of it.

A group of researchers at Weill Cornell Medical College issued the results of a study in the Archives of Internal Medicine that said that, of the people studied, 7 percent of patients who were given one of 14 standard medical tests as ordered by their primary care doctors, and whose results were abnormal (meaning -- a problem!) never got notification of that problem. No one ever called them with their problematic test results.

Don't think for one minute that scenario was unusual. As our primary care doctors are pressed harder and harder for time, more and more test results are not being shared with patients. And more and more of those "missed sharings" are bad news.

What does this mean for patients? It means we need to step up to make sure we get the feedback we need on medical tests we take. No excuses from our providers and no excuses from us. It's our body, it's our medical problem, it's our responsibility. End of lecture.

Learn:

• How to Get your Medical Test Results
• How Primary Care Doctors are Dropping the Ball on Medical Tests
• How to Get your Medical Records and
• How to Correct Your Medical Records If There Are Mistakes

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation!
_{NEWSLETTER | FORUM | BIO | TWITTER}
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Photo © Eric Hood / iStockPhoto.com

Once in awhile a headline comes along that truly raises many more questions than it answers for empowered patients. This is one of them.

It's a perfect example of why patients need to be second guessing much of what they hear and read, and why even when we do that, it may only confuse us more. No easy answers. PLENTY of big questions.

The FDA has issued a warning against an over-the-counter cold symptom remedy called Zicam which is a homeopathic, zinc-based solution. In this case, the FDA claims that the nasal spray versions of Zicam have caused 130 people in 10 years to lose their sense of smell. The FDA has insisted Zicam nasal spray products may no longer be sold until they receive FDA approval.

Here's what I know about Zicam -- not much! But, I have used Zicam tablets (not nasal spray) when I first felt symptoms from a cold. I tried them after my sister insisted that Zicam had been a great boon to relieving her cold symptoms. Clearly many feel as if these products are helpful or the manufacturer could not stay in business.

Also, because the drug does not contain ingredients that would require FDA approval, Zicam products have always been sold over-the-counter, meaning we did not need a doctor's prescription to buy them. They don't contain any ingredients that require FDA approval.

Let's take a look behind this headline, because the details coming out now seem to suggest that there may be even bigger questions that aren't being asked or answered:

• Millions of dollars worth of this nasal spray have been sold for more than 10 years. The FDA cites 130 reports of problems through its MedWatch program since 1999. It also says that Zicam's manufacturer has received 800 problem reports. So why did it take so long to withdraw this spray from the market -- or -- why is it withdrawing a drug with so few reports (compared to the numbers of people who have used it?)
  
• 130 or even 800 problems in all these years is very few (unless, of course, you are one of the people affected) -- but I have to wonder if perhaps those patients had something else in common, too.... for example -- did they take the Zicam along with another drug that triggered that loss of smell? Or did they eat something that interfered? Or were they exposed to some other agent they breathed that, combined with the Zicam, made them lose that sense of smell? Did they forget to shake the bottle? Were they past the expiration date?

Sorry -- no answers -- just more questions:

• Why is the FDA clamping down on one over-the-counter herbal / homeopathic remedy? There must be many others with far more problematic outcomes to pick on. Or -- maybe there aren't? And if there aren't, then maybe these homeopathic remedies aren't as bad as the skeptics would like us to believe?
  
• Or maybe the FDA is picking a battle that will bring it some positive press because it has failed to protect us in so many other ways? If so, I find it interesting that they are picking on a product that never went through the approval process to begin with (it didn't need to). Why aren't they protecting us from truly dangerous drugs that they have approved?
  
• On the other hand, maybe FDA personnel are fearful (and rightfully so) that if they don't make a statement about Zicam nasal spray, with the information they have, then they would be accused of ignoring problems submitted to them?

Again -- no answers. Plenty of questions.

I also find it interesting that today, three days after the FDA edict about Zicam nasal sprays, I was able to walk into my local drug store and find plenty of Zicam boxes on the shelf for me to purchase. No warnings. So could it be that even this FDA edict has no teeth?

What can we patients learn? You know, I usually suggest we follow the money. If there is a money trail here, I don't believe we have any way of following it. It must be under the table.

In this case, then, it looks like the only lesson to be learned is that we must realize as patients that any substance we ingest, whether it's a prescribed drug, an over the counter drug, or an herbal "natural" remedy -- we must realize that there is a risk to taking it, no matter how easy it is to purchase.

And then we need to hope that in cases like this, where a remedy has been chastised / disapproved of / pseudo-hand slapped... we have to hope it's for all the right reasons.

Learn more about:

• Reading behind the headlines to understand medical news
• The definition of homeopathy or homeopathic
• Why we need to follow the money to understand medical headlines

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation!
_{NEWSLETTER | FORUM | BIO | TWITTER}
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Photo by Trisha Torrey / from the shelf at my local Rite Aid

No one wants to catch the H1N1 Swine Flu. And just like any disaster, the swine flu is a scare that has brought the crooks out, ready to take our money, like leeches in the swamp.

It shouldn't surprise any of us. Yet, thousands of people will spend their hard earned money on some bogus product that 'guarantees" to either protect them from getting the swine flu, or will help cure it. Most of these fraudulent products are being sold on the Internet. They range from shampoos to vaccines to acai berries to "kits" that are promoted to help you prevent you from getting the swine flu.

The FDA has risen to the occasion and has developed a website that will help you check out any of the products you may find, to help you confirm the product can, or won't, be helpful to you. I was surprised to learn that some of the products are actually used medically for other applications, but are not approved for swine flu applications.

Please protect your wallet from these crooks. Financial times are tough enough without wasting your money.

• Learn more about the FDA's list of fraudulent H1N1 Influenza products
• Read some Frequently Asked Questions about swine flu

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation!
_{NEWSLETTER | FORUM | BIO | TWITTER}
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Photo © dragon_fang - Fotolia.com

Next week, while the grown-ups in Washington duke it out over healthcare reform, 8-year-old Charlotte Rose will make her mark on Capital Hill as a part of the Juvenile Diabetes Research Foundation's Children's Congress.

I'm as proud of her as I could be if she were my child.

Charlotte Rose is the granddaughter of my friend, SaraKay Smullens. Two years ago, after a disturbing medical event, Charlotte Rose was hospitalized, then diagnosed with type-1 diabetes. At the time, I would hear from SaraKay about their fears, with requests for prayers, of course. It was a frightening time for the entire family.

Today Charlotte Rose is not only a good patient, but she has become an activist, too. Not content to take care of only herself, she will join 149 other children with diabetes, ages 4 to 17, as they descend on Washington to talk to their congressional representatives about the disease they live with every day, asking those representatives to help them find a cure.

Here is what Charlotte Rose has to say about her diabetes:

“Living with diabetes is really hard. It is hard to feel different from my friends. It is hard to keep track of every single carb that I eat. It is hard to watch my friends enjoy many treats that I cannot have. When I first got diabetes I told my parents that I was too young to have diabetes and that it was too scary. I told them to make it go away. I know they would if they could, but I believe that Congress can do what they can't. I am almost never scared anymore. I am strong and I work very hard to stay healthy.”

As empowered patients, we put so many of our efforts into taking care of our own navigation through the healthcare system. However, some take it a step further. They advocate for the bigger picture, too. Charlotte Rose, as young as she is, is one of those who is working to improve care for children of the future.

When you hear about the JDRF Children's Congress next week, think of Charlotte Rose. At her young age, she's accomplishing something that many adults will never accomplish in their lifetimes. I expect you'll be proud of her, too.

• Learn more about the Juvenile Diabetes Research Foundation
• Learn more about the JDRF Children's Congress 2009

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Learn more or join the conversation!
_{NEWSLETTER | FORUM | BIO | TWITTER}
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Photo: Charlotte Rose (left) and her sister, Amelia (Photo provided by the family.)