This week's WOW (Website of the Week) is a great resource for information about complementary and alternative medicine. If you have ever considered these non-traditional forms of medicine, then a good review of this site will help you make more informed choices.

It's the website of the National Center for Complementary and Alternative Medicine. From probiotics to acupuncture, from herbal supplements to research results, if there is evidence for or against the use of any of these CAM forms of treatment, then the information can be found at the NCCAM website.

NCCAM's website is easy to navigate, and offers phone and email access if you have questions.

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I've shared the story of Fred Holliday with you before.  Fred, age 39, died last summer after his too late diagnosis of Stage IV kidney cancer.  Too late, because he and his wife Regina had to work five jobs to be able to afford health insurance.  And little help, because when he was transferred from one hospital to another, Regina was told it would take 21 days, and 73 cents a page for her to get her husband's medical records transferred, too.  Without the records, the new hospital would not care for -- in fact, they would not even provide food -- to Fred.

Wrong wrong wrong.

Fred died soon after, age 39, leaving behind Regina and their two young boys.

I'm telling you Fred and Regina's story again for two reasons.  My first post told you about the mural Regina was in the process of painting to tell Fred's heinous story.  Titled 73 Cents, it illustrates the uncaring, cold, disorganized -- dysfunctional -- "care" Fred received (or perhaps more to the point, the lack of care .)  Regina has now finished her painting, which uses the side of a building as its canvas, just miles from Capitol Hill.  You can see the entire span of the mural in this report from NPR.

The second reason is because it raises a theme that seems to fester just under the skin of so many healthcare interfaces these days -- and I wonder how the people involved feel about it.  I hear stories just like Regina's so frequently and I just have to ask what these healthcare employees are thinking?

An example, in Regina's words, from the NPR story:

"I had gone down to medical records," Holliday says, "and they said, 'That'll be 73 cents a page and a 21-day wait.' I said, 'My husband is upstairs with Stage IV kidney cancer in your hospital and you're telling me I have to wait 21 days? Everything's on the computer. All you got to do is print it out and you're going to make me wait 21 days?' And they're like, 'Yeah, that's just the way it is.' I was floored."

Have you had this experience?  A totally unhelpful reply from a medical professional that takes you to your wit's end?

Are you a healthcare worker that must provide these kinds of useless answers to patients and caregivers?  And if so, how can you sleep at night?  Do you go home realizing the negative impact you've had on someone's life and survival?

Or - have you or a loved one suffered from this sort of ineptitude and its effect on your care?  From what institution? Perhaps seeing its name in such a derogatory light would make a bad institution sit up and take notice -- and do something to correct it.

Likewise, if you know if a hospital or healthcare institution that has figured out a good customer service model, will you share its name with us?  Perhaps others would begin to see that they can at least pretend to care about their patients.

Not much of value in this post today -- it's mostly a rant.  This isn't a problem that can be solved by being an empowered patient at the time of diagnosis and treatment.  But we can certainly begin calling out the bad guys -- and the good guys, too -- and make our feelings known.

If you want to share a rant, or even a good story, join us in the patient empowerment forum.

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The symptoms began yesterday.   A runny nose, sneezing, my ears plugging up and popping throughout the day....

I woke up this morning all stuffy. My ears are plugged, my sinuses -- oh!  My eyes are tearing and my head... aches....

So I've parked myself here at the computer, box of tissues to my left, cup of tea on my right -- but I'm wondering.  Do I have a cold?  Am I in the early stages of the flu?  And good grief... what if I have swine flu?

Kristina to the rescue!  That's Kristina Duda, who is our About.com Guide to Colds and Flu -- who has put together a very simple comparison table so we can figure out which upper-respiratory problem we've got.

It's pretty clear I have a simple cold.  No fever, no body aches, gradual onset... it's just a lousy cold.

Which one do you have?

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Women, in particular, and the men who love them, find themselves scratching their heads over two big changes in female cancer screening guidelines this week.

Two groups of medical professionals, independent, and looking at studies that have taken place over many years, have changed up the recommendations on when women should be screened for breast cancer and cervical cancer. In both cases, the guidelines suggested women begin their screenings later in life, and less frequently than previous recommendations had suggested.

In the uproar that has resulted, everyone -- from the media to individual women -- have ignored the most important words in these new statements. Those words are RECOMMENDED and SUGGESTED and GUIDELINES.

To get all bent out of shape over recommendations, suggestions and guidelines takes away from our power as patients! Nobody is saying that these are new rules that are set in stone. No one is telling us we CAN'T be screened!

Granted, there is some fear that Medicare or health insurers will take away reimbursement for these screenings.  But we are quite a ways from that.  Paying for a screening exam and treating cancer in its earliest stages is less expensive than later treatment for a later stage cancer.  And with healthcare reform coming down the pike, it seems like few payers would venture to remove these simple tests from their offerings....

I suggest, instead, that we patients realize that we are still the ones in control of these kinds of decisions, in partnership with our physicians.  If you want a mammogram, or a PAP test -- or guys, if you want your PSA -- ask your doctor to perform them or order them -- and then get those tests.

Your peace of mind does not need to be forfeited just because a set of guidelines have changed.  We aren't (or at least should not be) lemmings, afterall.

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Photo of lemming - public domain from Wikipedia Commons (Yes, that's a real lemming!)

Today is the Great American Smokeout, and if you are a smoker, that's probably nothing new to you.

Among my friends and acquaintances, few of them smoke anymore, but those who do, wish they didn't.  Some have tried to quit a dozen times or more.  Their hearts are willing, but their addiction owns too much of their lives.

One interview I did this week for my radio show was about smoking as a public health challenge.  Part of the discussion centered on third-hand smoke, a new concept to many smokers.

First hand smoke is the smoke one inhales directly from a cigarette (or pipe or cigar or....)

Second hand smoke is the smoke one inhales when someone else is smoking.  For example, when you walk past a group of smokers outside a building.  It's still smoke, full of all the toxins and substances that create lung cancer, exacerbate asthma or create other lung and breathing problems. Experts tell us that 10 - 15% of lung cancer is caused by second-hand smoke.

The perils of exposure to third hand smoke are just now being understood.  Early in 2009, the term "third hand smoke" was coined to point out that spending time near a smoker, or in a room where someone has been smoking, creates health problems, too.  For example, a mother or father smokes, then picks up the baby.  The baby's health is negatively affected by the toxins left behind on the parents' clothing or in their hair.  Even if the smoker goes outdoors to smoke, away from the child, those chemicals remain to affect the baby.

If someone has smoked in a room you spend time in, you will be affected by the toxins that remain in the drapes, the carpet, the furniture -- even things like books or newspapers or pocketbooks or toys -- anything that is exposed to the smoke but doesn't get washed before we come near it.  Even worse, because there is less room, is the third-hand exposure in a car -- the upholstery, the carpet on the floor, the fabric ceiling.  For those of us who do not smoke, the minute we smell smoke on someone else -- a family member or a co-worker -- we have been exposed to third hand smoke.

I'm not going to suggest to smokers that they quit for their own well-being.  That's up to them and they've heard it from every nag in their lives.  But a smart patient understands that sometimes we must make choices not just for ourselves, but for the people around us, too.  We must protect our herd.

Second AND third hand smoke seem like a great reasons to quit.

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Photo © Udo Kroener - Fotolia.com

This weeks WOW (Website of the Week) is all about clinical trials.

Have you ever considered a clinical trial?  Participation in a clinical trial can be a very generous exercise, in which you participate strictly to improve medical science for future generations -- or it may be a lifesaving -- where you participate because it's your last, best chance for helping yourself.

So this week's WOW is the master list of clinical trials which are taking place around the world:  www.ClinicalTrials.gov.

Here's how to use this website:

Once you have satisfied yourself that you understand what clinical trials are, the risks and benefits of participation, and the questions to ask before you commit to participation, then link to clinicaltrials.gov.  Then search for a trial of interest by your medical condition, a drug you think might help you, the location of the trial or the group sponsoring the trial.

Clinical trials.gov is is provided by the US government (National Institutes of Health) and is HON Code compliant, providing two very important credentials for reliable Internet health information.

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Photo © Clinical Trials website

If you are a regular reader, you've perhaps read previous posts about my family's experience with my mother as she transitioned through Alzheimer's disease. For more than a decade, it has been a heartbreaking and frustrating experience to watch Mom descend into her own hell -- a wonderful human being who lost her ability to relate to the world around her.

Mom died last week, bringing a very peaceful end to that hell-on-earth.  We know she is no longer incarcerated in a body that won't let her participate in the events and conversations around her.  I've written my public good-bye to her elsewhere....

My post for you today regards what was perhaps the only positive part of this experience from our family's point of view.  That is, the fact that Mom and Dad had taken the time many years ago to put together some of their advance directives, to prepare for a time when one of them would have to care for the other.

They have/had wills -- but that's really a separate subject.  More important to Mom's end-of-life was the fact that they had signed DNRs - do-not-resuscitate orders.  And when Mom had a heart attack about 13 days before she died, that told the professionals that they were not to take extraordinary steps to revive her.

And that was a blessing.

For the next 13 days, Mom was cared for very lovingly by the staff in the memory center where she lived (assisted living / skilled nursing), but received no hydration or nutrition.  She was comfortable, received pain drugs, and was in a coma.  In the end, her transition was as peaceful and gentle as it could have been.

I share with you two pieces of advice today.  First, to remind you of a post from last week about memory screening.  Thousands of locations -- tomorrow -- in clinical settings, will be available for you to get your memory tested.

And second, especially as the holidays begin next week, meaning, time with our families and loved ones... it's time to discuss how you want to die.  It's time to have that conversation so that you, too, will find peace in your final days.

There is one other lesson we learned that surprised me at first.  That is -- Mom had wanted to be an organ donor.  Dad talked to the people from hospice about it, and learned that organ donation can only take place when someone dies in a hospital.  Of course, that makes perfect sense!  We just had not given it any thought before.

Finally -- a thank you -- BIG thank yous -- to Bev, Jeannie and Lena and the rest of the staff at the Glenridge, where Mom has lived for almost five years;  to TideWell Hospice of Sarasota, FL -- Sharon, Donavan and Tina, were by Mom's side for these past few months.  And special loving thanks to Dad, who was there for Mom for 60+ years, even more devotedly for the past decade - a caregiver supreme.

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Photo © Trisha Torrey

Screening tests, believe it or not, are somewhat controversial, depending on who's talking about them and who's giving them.  If you ask your doctor about screening tests your doctor might order (and perhaps even make money from) then they are a great idea!  If you ask a doctor about screening tests he or she doesn't order him or herself, like the ones given in churches and community centers, then you'll be told they are considered "overtesting."

And yes -- I understand that concept of overtesting and buy in.  I do think we get tested too much, and it takes its toll on both our bodies AND our wallets.

That said, I also understand our more patient point-of-view and that is -- we want peace of mind.  The reason we patients are willing to undergo tests we may not really need is because we want to KNOW.  If we KNOW, then we sleep better at night, even if we learn bad news.  Because at least we KNOW.

So when this piece of information crossed my desk, I wanted to share it -- because a memory screening test holds special meaning to me.  I'll tell you more about that special meaning in a few days.  Right now it is too difficult to write about it....

November 17th is National Memory Screening Day.  It's a day when you can get your memory tested by people who can let you know whether your "lost" keys are really lost, or just forgotten.  They can help you better understand steps you can take to keep your memory sharp.  They can take a look at where your brain is -- and steer you in the right direction to keep it working in a healthy way.  No more question marks.

If you have worried at all about whether you are developing any form of dementia, Alzheimer's disease, or just trouble keeping track -- then link to the National Memory Screening Day website, look up the locations for the screenings, and visit them on November 17th. They have some good information about how the screening works, and what the results mean listed at the website, too.

Try not to forget.

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Photo © National Memory Screening Day

Last year on Veteran's Day, I suggested that this day of recognition and honor, remembering those who have served and protected our freedom and our country could also serve as a trigger - a reminder that it's important for each of us to get our flu shots. It's a way we can honor and protect those around us who we love.

This year, getting flu shots takes on new meaning. In November 2008, H1N1 swine flu wasn't even on our radar! And this year, we find ourselves contending with two possible killers -- both the seasonal flu and swine flu, too.

Yes, I am well-aware that some of you do not believe flu shots are helpful to you. For some reason, you are not able to be convinced that flu shots are safe and useful. True, some people are allergic, and obviously, someone with an allergy should not be vaccinated.

But for the rest of you? Well.... We simply have a difference of opinion. We will just have to agree to disagree.

For those of you on the fence? Here are some questions to ask yourself to help you decide whether or not to get flu shots -- seasonal flu or swine flu -- should you get those flu shots?

On this Veteran's Day, and in honor of those who have served to protect our country, I ask you to honor and protect yourself and your loved ones by getting your flu shots.

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Photo © Getty Images

Yes -- I do mean WOW -- but in this case, it stands for Website of the Week.

Beginning today, and early each week, I plan to feature a website that you, an empowered patient, can use to improve your chances for getting the good healthcare you deserve.

Today's offering is Lab Tests Online, that's http://www.labtestsonline.org/ -- a great resource for finding out what those tests are the doctor has ordered from you, then interpreting them when the results come in.

Further, you can look at the names and descriptions of medical tests that are used for different diseases or conditions, and you can what kinds of screening tests can be used to diagnose various diseases or conditions.

Here is an example of how to use the site:

Say your doctor says she wants to run a CA-125.  You know there is a suspicion of ovarian cancer, but you have no idea what kind of test it is. What should you wear to the test?  Is it something that requires to you fast the night before?  What's a normal outcome?

Go to Lab Tests Online.  Look up the CA-125.  You'll learn that it's a simple blood test (yes, wear your jeans!) and it says nothing about restricting food prior to the test.  It then explains what outcomes you and your doctor should be looking for.  By reading the information and digesting it ahead of time, you'll be better prepared to discuss the possibilities and outcomes with your doctor.

Lab Tests Online is provided by the American Association for Clinical Chemistry and is HON Code compliant, providing two very important credentials for reliable Internet health information.

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Logo © Lab Tests Online