Saturday, November 25, 2017

Morning Rounds: Cancers with modifiable risk factors

In this week's Morning Rounds, CBS News contributor Dr. David Agus joins "CBS This Morning: Saturday" to discuss a new study that looks at cancer cases where modifiable risk factors played a role and another study that looks at the physical activity of desk workers.

From: http://www.cbsnews.com/videos/morning-rounds-cancers-with-modifiable-risk-factors/

#DearDiabetes: Michael Eisenstein

Dear Diabetes,

Is that what they call you? My intimate stranger who invades every bit of me. They should call you out, put you on the FBI’s Most Wanted list and turn you into D Dust …

No one really knows you. Is that why you’ve attacked so many? Invaded enough of us so we’ll give you a name? You’re famous now. There have been thousands of studies, trials, journal article after journal article and investigators everywhere. You’re even on TV! But where is Detective Columbo asking the subtle questions to take you down? Where is Holmes, as your White-Walker Baskerville Hounds bay in the pancreatic moors?

The hundreds of millions you’ve taken hostage, as you took my family and I. The hundreds millions more you’re lurking within, that you haven’t taken yet, waiting for you to scrutinize their lives. How dare you?

I’ve called you “The Riddler,” because you are. At 17, my smarty pants internist told me I was hypo – as in glycemic. “Glucose too low,” he said after a gross glucose tolerance test – “It’s telling me you’ll have diabetes when you grow older.”

You were already inside my dad, hurting him. He took these little white pills to keep you at bay, along with other pills for the angina you caused. But that was my dad, not me, and I didn’t connect you to his heart – not yet. Didn’t connect it to me, the way I thought about most things at that live-forever age. I was too smart to get diabetes.

However, Mr. Smarty Pants was right. I got the call about you at work, decades later. My doctor calls and says, “Your fasting sugar this morning was 400. Eat something.” My blood test wasn’t supposed to show that; I thought maybe 85 or 90, or in the 70s like when I was 17. Thunderbolt. It felt like I’d been shot, unprotected by my fancy desk, in my cushy office with my big stupid job and my expensive Brooks Brothers tie. Frozen. I called my wife, who said, “Don’t worry. We’ll figure this out.”

Quickly, I turned to Google. What can I eat? “Low carbs,” the Internet said, and “just meat” and “go vegan.” Some chirped, “Cinnamon!” I began to Google more. Heart disease. What? Amputations! Phantasmagoric. I still played tennis, I was athletic, but suddenly you, a stranger, lurked inside me. Someone please pull your puppet strings and waft away like a frayed kite to the dark galaxy you came from.

I felt fine, but knew I wasn’t. At the follow-up, the doctor said I had high cholesterol and HBP. Three new things to worry about. Stay tuned, more to come. And more did come.

My wife’s obstetrician told her she had you, gestational diabetes, a new name for you. He warned her that the real you, type 2 diabetes, could follow. And you did a few years later, moving quietly into her body, as you did in mine. Both of us now on Metformin, both of us wondering more about the future. Both of us thinking about you every day.

Then you took a liking to our firstborn. You struck early with type 2 when she was 19. Now all of us were popping Metformin, fighting you, hating you, dragging you around all day—an invisible ball and chain. I never imagined my firstborn being hauled into an ambulance with KTA, languishing in the ICU with sacks of IV fluids drip, drip, dripping into her veins.

But I‘m where I belong now, my intimate stranger. Fighting you with my colleagues at the American Diabetes Association, where I was meant to be. There’s science everywhere—journals piling up on my desk, each one brilliantly attacking a piece of you, no matter where you hide. We are determined to strike at you, to find out who you really are, to discover why you’re here, and to put arrows into your heart to finish you off. One scientist told me you were evolutionary, and that nothing can eliminate or remove you from our bodies. Another says with a smile, “That’s so wrong; you’re not really part of us.” We’ll find you, turn off your switches, pull the plug on you, eject you from our bodies, forever.

DONE.

Michael Eisenstein
SVP, Products, American Diabetes Association

 



From: American Diabetes Association http://diabetesstopshere.org/2017/11/24/deardiabetes-michael-eisenstein/

Adult Congenital Heart Disease: Arrhythmia Management



From: Mayo Clinic https://www.youtube.com/watch?v=FN0PeUNa9I8

USDA Ethics, Post Employment for Further Restricted Employees



From: USDA https://www.youtube.com/watch?v=Pl1gwtevhKw

USDA Ethics, Widely Attended Gatherings



From: USDA https://www.youtube.com/watch?v=e1lWmUEEhqw

USDA, The Ethics Pledge – Post Employment Restrictions



From: USDA https://www.youtube.com/watch?v=LwO6lsJBQPg

USDA Ethics, Hatch Act for Further Restricted Employees



From: USDA https://www.youtube.com/watch?v=Ri_X-ULU_zs

USDA Ethics, Gifts Between Employees



From: USDA https://www.youtube.com/watch?v=XKhJqTJqVa0

USDA Ethics, Gift Exclusions



From: USDA https://www.youtube.com/watch?v=gYu36j7d0fk

USDA, Introducción a Ética



From: USDA https://www.youtube.com/watch?v=WB0Oj-oT69M

USDA Ética, Regalos Derivados de Fuentes Externas



From: USDA https://www.youtube.com/watch?v=8SH0zQft34Q

Mayo Clinic Minute: Hope for Alzheimer's disease



From: Mayo Clinic https://www.youtube.com/watch?v=pSNPc4-_xf4

Minimally Disruptive Medicine 2017 Workshop: Setting the Stage



From: Mayo Clinic https://www.youtube.com/watch?v=dsG_ZkIe0C8

Minimally Disruptive Medicine 2017 Workshop: The Patient Revolution



From: Mayo Clinic https://www.youtube.com/watch?v=psMqxkzjYX4

Minimally Disruptive Medicine 2017 Workshop: Burden of Treatment Experience in France



From: Mayo Clinic https://www.youtube.com/watch?v=xiiyrlvdZwk

Smoggy Air May Spawn Weaker Sperm

Microscopic particles in the air called particulate matter (PM2.5) may affect the quality of sperm, which in turn can make it difficult to fertilize a woman's egg, the researchers said.



From: https://www.webmd.com/men/news/20171122/smoggy-air-may-spawn-weaker-sperm?src=RSS_PUBLIC

It's the Latest Diet Craze, But Is It Safe?

It's a simplified approach to eating that essentially views fruits and vegetables through the same prism as candies and soda. All that matters is the total caloric tally.



From: https://www.webmd.com/diet/news/20171122/its-the-latest-diet-craze-but-is-it-safe?src=RSS_PUBLIC

This Thanksgiving, Promise Yourself: Don't Choke

Turkey on a Platter

Researchers say people are more apt to get food stuck in their throats at the holidays.



From: https://www.webmd.com/food-recipes/news/20171121/this-thanksgiving-promise-yourself-dont-choke?src=RSS_PUBLIC

A Vioxx comeback? A startup eyes the drug for hemophilia

The blockbuster drug was pulled in 2004 amid health concerns, but it may find a second life as a hemophilia treatment

From: http://www.cbsnews.com/news/a-vioxx-comeback-a-startup-eyes-the-drug-for-hemophilia/

FDA addresses IV fluids, saline bag shortage

Silver Spring, Md. — The Food and Drug Administration announced Nov. 17 that hospitals are reporting shortages of IV fluids, particularly small saline solution bags, stemming from destruction caused by Hurricane Maria in Puerto Rico in September.

From: http://www.ada.org/en/publications/ada-news/2017-archive/november/fda-addresses-iv-fluids-saline-bag-shortage

12-year-old taking medical marijuana sues Jeff Sessions and DEA

A 12-year-old girl with severe epilepsy is spearheading a campaign to legalize medical marijuana​ across the country

From: http://www.cbsnews.com/news/medical-marijuana-epilepsy-seizures-alexis-bortell-lawsuit/

Could this brain-training program ward off dementia?

In what researchers call a first, healthy seniors who tried a specific brain-training program were less likely to develop dementia​ down the road

From: http://www.cbsnews.com/news/brainhq-brain-training-program-ward-off-dementia-alzheimers/

Boy with cancer dies after wish for early Christmas

Jacob Thompson battled neuroblastoma for four years, and people around the world pitched in to bring him joy in his final days

From: http://www.cbsnews.com/news/jacob-thompson-dies-after-public-fulfills-wish-early-christmas/

Overweight women may need more frequent mammograms

New research suggests heavier women are at greater risk of having breast cancer​ detected after the tumor has grown large

From: http://www.cbsnews.com/news/overweight-women-may-need-more-frequent-mammograms/

Insurance plan networks: 5 things you need to know

Follow me on Twitter @dianewshannon

My 18-year-old daughter recently moved to a university about 1,500 miles away to study theater. Tears, texts, and several care packages later, she settled in, only to develop a hamstring injury that prevented her from participating in required dance classes. In short, she needed several months of physical therapy.

After searching for options near the university, she told me that visits would cost as much as $200 each. Our health insurance plan only covers urgent or emergency care outside of our local area, and physical therapy was not considered urgent. When she enrolled, we had assumed she would get preventive care when she was at home and use a local walk-in clinic for urgent needs. We hadn’t considered services like physical therapy. Suddenly, opting out of the university’s student health plan didn’t seem like such a smart idea.

Narrow networks are one method that health plans use to control their costs. Basically, a plan with a narrow network covers services from a smaller number of doctors and hospitals. By contracting with fewer care providers, the health plan is able to negotiate lower costs. Generally, care providers located in other states or regions of the country are out-of-network.

If you choose a narrow-network plan, it may have a lower premium but you will have less choice in care providers. And, if you obtain care outside of the plan’s network, you will pay more. In some cases, you will be responsible for paying the total cost of the services you obtain from out-of-network doctors and hospitals.

To avoid dilemmas like mine, here’s what you need to know:

1.  If you have a choice of health plans, compare the costs and the care provider networks. Set aside some time to read and understand the benefits of each health plan. Make sure you clearly understand whether the plan you’re considering has a narrow network.

2.  Before you choose a plan, check if the hospitals and care providers that you use are included in the plan’s network. Contact the doctor’s office, the customer service or billing department of the hospital, or your health plan to see if the hospital and your care providers are in-network. Remember to check on the care providers used by family members on your plan.

3.  Take steps to protect yourself from surprise billing for out-of-network care. Sometimes consumers receive a “surprise bill” — one that is completely unexpected or far higher than expected. Often these bills relate to emergency care at an out-of-network facility or doctors who work at an in-network facility but are not in-network themselves.

What to do? Learn about your health plan benefits regarding emergency care at an out-of-network facility. If you’re visiting family in another state and need emergency care, what are the out-of-pocket costs? Knowing the costs ahead of time, you might decide to go to an urgent-care center rather than the emergency department of the hospital, if the problem is urgent but not a true emergency.

If you are planning for a non-emergency test or surgery, make sure the doctors and hospital are in-network. Contact the doctor’s office, the customer service or billing department of the hospital, or your health plan to check.

4.  Communicate with family members (your spouse, college-age children) about your plan’s network. Make sure they know which care providers are in-network — and the financial consequences of obtaining care from out-of-network hospitals or care providers.

5.  If you receive a surprise bill or find an error on your bill, take proactive steps immediately. If you find any errors on your bill or receive a surprise bill, contact the hospital or doctor’s office directly as soon as possible. You can correct any errors or try to negotiate a lower price and a payment plan. Contact the care provider as soon as possible to avoid having an unpaid bill turned over to a collection agency.

In the end, we decided to purchase the student health insurance — fortunately the enrollment deadline had not passed — and my daughter is working her way back to health and a career on the stage. And I learned a valuable lesson about the importance of fully understanding the network limits of our health plan.


Diane W. Shannon, MD, MPH is author of the Harvard Health Publishing special report Navigating Health Insurance. This Harvard Medical School Guide will help you compare health plans, estimate your costs, understand Medicare and Medicaid benefits, decipher your hospital bill, take steps to avoid unexpected charges, and reduce prescription drug costs.

The post Insurance plan networks: 5 things you need to know appeared first on Harvard Health Blog.



From: Diane W. Shannon, MD, MPH https://www.health.harvard.edu/blog/insurance-plan-networks-5-things-you-need-to-know-2017112012743

Ted and Grace Anne Koppel on COPD, third leading cause of death in U.S.

Chronic obstructive pulmonary disease, or COPD, is the nation's third biggest killer after heart disease and cancer. About 150,000 Americans die of COPD each year. Among women, it is more deadly than breast and ovarian cancers combined. Ted Koppel focuses on the disease for a report next weekend on CBS "Sunday Morning." His wife, Grace Anne, was given only a few years to live when she was diagnosed 16 years ago. The Koppels join "CBS This Morning" to discuss why they're advocating for more research into prevention and treatment.

From: http://www.cbsnews.com/videos/ted-and-grace-anne-koppel-on-copd-third-leading-cause-of-death-in-us/

Ted Koppel and wife Grace Anne on living with COPD

Chronic Obstructive Pulmonary Disease is the third leading cause of death in U.S., yet it is little understood by millions who have gone undiagnosed

From: http://www.cbsnews.com/news/ted-koppel-grace-anne-koppel-on-living-with-copd-chronic-obstructive-pulmonary-disease/

Association seeks treasurer candidates

Members interested in running for ADA treasurer can visit ADA.org to find the information necessary to file for candidacy.

From: http://www.ada.org/en/publications/ada-news/2017-archive/november/association-seeks-treasurer-candidates

December webinar to help dentists collect what they produce

The ADA Council on Dental Practice is sponsoring a one-hour program, GPS Managing Finances Webinar: How to Collect What You Produce, on Dec. 7 to assist dentists in making sound business decisions when helping patients finance treatment.

From: http://www.ada.org/en/publications/ada-news/2017-archive/november/december-webinar-to-help-dentists-collect-what-they-produce