Rep. Bill Huizenga of Michigan said he skipped an emergency room visit after his son broke his arm to avoid the costly treatment
From: http://www.cbsnews.com/news/republican-says-sons-broken-arm-was-poor-political-point-on-health-care/
Thursday, December 22, 2016
Live. Work. Play: Molly’s Diabetes Story
Working for the American Diabetes Association® means making a difference for millions of people and working toward a future free of diabetes and all its burdens.
We all have a story to share. Some of us live with type 1 or type 2 diabetes, gestational diabetes or prediabetes. Others have loved ones with the disease or have lost someone to the fight.
The following are personal stories from the Association’s staff about why we are so committed to the mission to prevent and cure diabetes and to improve the lives of all people affected by diabetes.
Molly with her sons at a Step Out Walk.
Molly Duerr
Corporate Development Officer
Edina, Minnesota
“The sky is the wrong color blue!”
This is one phrase I use a lot to describe life with type 1 diabetes. It is a phrase I learned after I was diagnosed in 1995 and had the opportunity to attend Camp Needlepoint in Hudson, Wisconsin. The experience I had at this diabetes camp was incredible, and I believe it really shaped the person I am today.
When I arrived at camp at age 16, I had been diagnosed with diabetes only three months earlier. This was my first time getting to meet other kids with diabetes. It was the most amazing experience to be surrounded by others who made me feel, for the first time in months, “normal.” While I was at camp I learned so much, from carbohydrate counting to how to use an insulin pump, as well as how other people my age lived with diabetes every day.
After camp, I decided that I wanted to go on an insulin pump. At that time (1995), it was very uncommon for someone under the age of 18 to use one. After I proved my diabetes knowledge base over several months, my doctor allowed me to go on the pump.
Since Camp Needlepoint had been such an incredible experience for me, I started to volunteer my time, first as a camp counselor and then on the medical staff as a Certified Insulin Pump Trainer. Knowing what the American Diabetes Association had given to me through my experience at Camp Needlepoint, I decided that I wanted to work for the organization and make an impact for others living with diabetes.
After finishing graduate school, I took a job in New Jersey working on the Tour de Cure®, the Association’s premier cycling event. After a year in the New Jersey office, I transferred to Minnesota to work on the American Diabetes Association Minnesota Gala and the Diabetes EXPO. I quickly found that my passion for serving those with diabetes came through my ability to work with companies who funded our mission, whether by supporting an event, program or awareness campaign. Now I’m proud to serve as the Corporate Development Officer for the Midwest region, working with companies to find the best way they can support our mission and those affected by diabetes.
What keeps me motivated to live well with diabetes are my greatest accomplishments, my children—Alex, age 8, and Zach, age 4. Having diabetes while pregnant was challenging, not only because I needed to keep my blood sugar between 70 and 140, but also because I had what felt like a million doctor appointments. This taught me that diabetes is like a marathon: You can’t focus too much on one number or the next; it’s about the entire race.
After living with diabetes for 21 years, one thing I’ve learned is that it is unpredictable. You can do the same things, eat the same things and still end up with a different result. My answer to this blood sugar uncertainty is what I learned at camp many years ago: Sometimes, the only answer is “the sky is the wrong color blue” that day.
I work hard every day to raise funds not only to help everyone live well with diabetes, but also to help find a cure—and not just for myself, but for everyone. Alex often asks me about what is happening in diabetes research and when we will have a cure, because he can see the daily struggles and the family team effort it takes to make sure I am as healthy as possible.
Some days, living with diabetes and working in the diabetes field can be difficult. But I can truly say that I believe everything happens for a reason, and my reason for having diabetes is to help others. I am fortunate that many of the friends I made at Camp Needlepoint, right after I was diagnosed, are still very close to me. They are an important support system for me today—and I am proud to give back.
To learn more about nationwide employment opportunities and life at the Association, please visit diabetes.org/careers.
Save
Save
Save
Save
Save
Save
Save
From: American Diabetes Association http://diabetesstopshere.org/2016/12/22/live-work-play-molly/
Ablation: Treatment for Ventricular Tachycardia - Part 2
From: Mayo Clinic http://www.youtube.com/watch?v=jK54aWqNrXY
Ablation: Treatment for Ventricular Tachycardia - Part 1
From: Mayo Clinic http://www.youtube.com/watch?v=8Pe_OoB7vok
New Approach to Concussion Diagnosis
Ability to process sound provides clues about brain injury, researchers say
From: http://www.webmd.com/brain/news/20161222/new-approach-to-concussion-diagnosis?src=RSS_PUBLIC
Serious Yoga Injuries Are Rare, But on the Rise
Problems requiring ER care up about 70 percent, even more in older people, study finds
From: http://www.webmd.com/balance/news/20161222/serious-yoga-injuries-though-rare-are-on-the-rise?src=RSS_PUBLIC
Advocacy highlights of a busy 2016
2016 was a busy year for the Association’s Washington office.
From: http://www.ada.org/en/publications/ada-news/2016-archive/december/advocacy-highlights-of-a-busy-2016
From: http://www.ada.org/en/publications/ada-news/2016-archive/december/advocacy-highlights-of-a-busy-2016
Natural movement: Going back to basics
From: http://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/natural-movement-going-back-to-basics/art-20267226
Delay in Clamping Umbilical Cord Benefits Babies
New guideline follows research showing that waiting 30 to 60 seconds boosts iron levels throughout 1st year
From: http://www.webmd.com/baby/news/20161221/delay-in-clamping-umbilical-cord-benefits-babies-doctors-say?src=RSS_PUBLIC
Innovative Programs Help Addicts Get Off Opioids
Long waitlists for drug rehab led to two promising efforts in New England
From: http://www.webmd.com/mental-health/addiction/news/20161221/innovative-programs-help-addicts-get-off-opioids?src=RSS_PUBLIC
Antibiotics Duration and Kids' Ear Infections
10 days of the medication was twice as effective, study finds
From: http://www.webmd.com/cold-and-flu/ear-infection/news/20161221/short-course-of-antibiotics-not-best-for-kids-ear-infections?src=RSS_PUBLIC
Ex-pharma execs accused of scheme to prescribe opioid drugs
A new criminal case raises questions about how some in the medical community are pushing the use of addictive painkillers. Six former executives and managers from Arizona-based drugmaker Insys Therapeutics face conspiracy charges over what a federal prosecutor calls a racketeering scheme. Jim Axelrod reports.
From: http://www.cbsnews.com/videos/ex-pharma-execs-accused-of-scheme-to-prescribe-opioid-drugs/
From: http://www.cbsnews.com/videos/ex-pharma-execs-accused-of-scheme-to-prescribe-opioid-drugs/
Former drugmaker execs accused of bribing doctors to push pain meds
Six former employees of Insys Therapeutics face conspiracy charges over allegedly rewarding doctors for prescribing their spray version of fentanyl -- even when it wasn't necessary
From: http://www.cbsnews.com/news/insys-therapeutics-conspiracy-charges-bribing-doctors-fentanyl-subsys-opioid-addiction-painkillers/
From: http://www.cbsnews.com/news/insys-therapeutics-conspiracy-charges-bribing-doctors-fentanyl-subsys-opioid-addiction-painkillers/
Making health decisions in the face of uncertainty: Let your values be your guide
Follow me on Twitter @DavidAScales
My sister texted me recently about my nine-year-old niece. She’d been experiencing joint pain so saw her pediatrician for a check-up. They did some blood tests, which were all normal except one.
“Should we be worried?” my sister asked.
“I’m no pediatrician, but I’d let it go,” I said. “It’s like seeing a cloud in the sky and asking me if I’m concerned about a hurricane.” Should we worry about and investigate every cloud when most don’t end up being a passing storm, let alone a hurricane?
Many patients are like my sister, looking for certainty that everything is normal, and if not, a concrete diagnosis. “Part of the reason why the culture of medicine prizes [certainty] is people come to expect it in us,” Steven Hatch, the author of Snowball in a Blizzard: A Physician’s Notes on Uncertainty in Medicine, said in an interview.
Most doctors, and many patients, have a low tolerance for uncertainty
Yet while most doctors agree that medical uncertainty is ubiquitous and inevitable, it might not initially seem that way when you go to the doctor. Physicians are often happy to oblige a patient’s quest for certainty. Some negative tests might reassure them, and sometimes they might reassure us. We’ve all heard stories about the doctor who didn’t test for something and cancer was later discovered.
That’s because physicians don’t tolerate uncertainty well. “The culture of medicine evinces a deep-rooted unwillingness to acknowledge and embrace it,” according to authors of a recent opinion piece in the New England Journal of Medicine. Our tests and teaching from medical school and beyond push us to think a right answer exists for every clinical conundrum, says Hatch.
Medical uncertainty is frustrating for patients and doctors; it’s also challenging to try and understand it. For any decision we make — to do more tests, or not to test —we have to weigh two risks against each other: the risks of being harmed by the side effects of the test itself versus the risk of missing a serious diagnosis by not testing. It’s the preoccupation of monitoring every cloud to ensure not missing a hurricane.
Those risks are never certain, but abstract numbers based on statistics and probabilities help us weigh decisions. The closest we get to medical certainty is when a probability approaches 100%.
Making decisions about your health in the face of uncertainty
But that rarely happens. For most real-world scenarios, every doctor and every patient has their own threshold for uncertainty versus the risks of further tests. Some lean toward testing, minimizing the potential harms of further testing; others assume everything will be okay and that multiple doctor visits and testing pose the greater inconvenience. You have to know yourself and your values to guide which risks you’d prefer to tolerate to get closer to certainty.
I take that approach with my patients. As a patient, it’s important to understand that your doctor doesn’t have all the answers and that medical textbooks often don’t either. There. When I don’t know something, I try to be clear about what I know versus what is not known, by anyone. I explain the limits of medicine, that most of our studies shed light on things that kill you, so, in a backwards way, the fact that we don’t know very much about your illness is reassuring. It means it is very unlikely to kill you.
That’s not always the most reassuring statement. Patients suffering from pilonidal cysts, irritable bowel syndrome, or lactose intolerance, to name just a few examples, can be debilitated by painful and even dangerous conditions. In those cases, we have a discussion about values —which feels riskier to you: getting hurt by the side effects of more testing to rule out the most dangerous diagnoses, or missing a diagnosis like that because we didn’t test for it?
One patient I know has been devastated by the countless numbers of her relatives who died from cancer. When I asked what risks she might be willing to take to screen for cancer, she told me she would accept all of them. Whatever mammograms, breast biopsies, Pap smears, colonoscopies, or blood tests were necessary, she wanted them. When it came to cancer, her threshold for uncertainty was very low.
Another patient of mine was an elderly man who took no medications. Based on his age, blood pressure, and cholesterol level, we used an online calculator to estimate that he had about a 15% chance of having a heart attack in the next decade. This is a clear indication to start a medication that helps reduce the risk of heart attacks — the chance that the benefits outweigh the risk is very high. We were approaching certainty in our medical recommendation, but he didn’t want to follow it. He likes living without medications, telling me unless the risk of a heart attack in ten years was 50% he wouldn’t consider changing. We were dealing with hypothetical situations based on statistics, but it gave us a mechanism to figure out where his thresholds rested.
My sister texted me her concerns that the blood test might be a harbinger of an obscure diagnosis — the worst-case scenario, the hurricane. She was worried. I said the most important thing was communicating with her doctor just how much the uncertainty worried her. Only then could they partner on a way to balance the need to reduce the uncertainty without exposing my niece to an array of risky tests.
The post Making health decisions in the face of uncertainty: Let your values be your guide appeared first on Harvard Health Blog.
From: David Scales, MPhil, MD, PhD http://www.health.harvard.edu/blog/uncertainty-in-medicine-and-making-health-decisions-let-your-values-be-your-guide-2016122110874
Wednesday, December 21, 2016
Making health decisions in the face of uncertainty: Let your values be your guide
Follow me on Twitter @DavidAScales
My sister texted me recently about my nine-year-old niece. She’d been experiencing joint pain so saw her pediatrician for a check-up. They did some blood tests, which were all normal except one.
“Should we be worried?” my sister asked.
“I’m no pediatrician, but I’d let it go,” I said. “It’s like seeing a cloud in the sky and asking me if I’m concerned about a hurricane.” Should we worry about and investigate every cloud when most don’t end up being a passing storm, let alone a hurricane?
Many patients are like my sister, looking for certainty that everything is normal, and if not, a concrete diagnosis. “Part of the reason why the culture of medicine prizes [certainty] is people come to expect it in us,” Steven Hatch, the author of Snowball in a Blizzard: A Physician’s Notes on Uncertainty in Medicine, said in an interview.
Most doctors, and many patients, have a low tolerance for uncertainty
Yet while most doctors agree that medical uncertainty is ubiquitous and inevitable, it might not initially seem that way when you go to the doctor. Physicians are often happy to oblige a patient’s quest for certainty. Some negative tests might reassure them, and sometimes they might reassure us. We’ve all heard stories about the doctor who didn’t test for something and cancer was later discovered.
That’s because physicians don’t tolerate uncertainty well. “The culture of medicine evinces a deep-rooted unwillingness to acknowledge and embrace it,” according to authors of a recent opinion piece in the New England Journal of Medicine. Our tests and teaching from medical school and beyond push us to think a right answer exists for every clinical conundrum, says Hatch.
Medical uncertainty is frustrating for patients and doctors; it’s also challenging to try and understand it. For any decision we make — to do more tests, or not to test —we have to weigh two risks against each other: the risks of being harmed by the side effects of the test itself versus the risk of missing a serious diagnosis by not testing. It’s the preoccupation of monitoring every cloud to ensure not missing a hurricane.
Those risks are never certain, but abstract numbers based on statistics and probabilities help us weigh decisions. The closest we get to medical certainty is when a probability approaches 100%.
Making decisions about your health in the face of uncertainty
But that rarely happens. For most real-world scenarios, every doctor and every patient has their own threshold for uncertainty versus the risks of further tests. Some lean toward testing, minimizing the potential harms of further testing; others assume everything will be okay and that multiple doctor visits and testing pose the greater inconvenience. You have to know yourself and your values to guide which risks you’d prefer to tolerate to get closer to certainty.
I take that approach with my patients. As a patient, it’s important to understand that your doctor doesn’t have all the answers and that medical textbooks often don’t either. There. When I don’t know something, I try to be clear about what I know versus what is not known, by anyone. I explain the limits of medicine, that most of our studies shed light on things that kill you, so, in a backwards way, the fact that we don’t know very much about your illness is reassuring. It means it is very unlikely to kill you.
That’s not always the most reassuring statement. Patients suffering from pilonidal cysts, irritable bowel syndrome, or lactose intolerance, to name just a few examples, can be debilitated by painful and even dangerous conditions. In those cases, we have a discussion about values —which feels riskier to you: getting hurt by the side effects of more testing to rule out the most dangerous diagnoses, or missing a diagnosis like that because we didn’t test for it?
One patient I know has been devastated by the countless numbers of her relatives who died from cancer. When I asked what risks she might be willing to take to screen for cancer, she told me she would accept all of them. Whatever mammograms, breast biopsies, Pap smears, colonoscopies, or blood tests were necessary, she wanted them. When it came to cancer, her threshold for uncertainty was very low.
Another patient of mine was an elderly man who took no medications. Based on his age, blood pressure, and cholesterol level, we used an online calculator to estimate that he had about a 15% chance of having a heart attack in the next decade. This is a clear indication to start a medication that helps reduce the risk of heart attacks — the chance that the benefits outweigh the risk is very high. We were approaching certainty in our medical recommendation, but he didn’t want to follow it. He likes living without medications, telling me unless the risk of a heart attack in ten years was 50% he wouldn’t consider changing. We were dealing with hypothetical situations based on statistics, but it gave us a mechanism to figure out where his thresholds rested.
My sister texted me her concerns that the blood test might be a harbinger of an obscure diagnosis — the worst-case scenario, the hurricane. She was worried. I said the most important thing was communicating with her doctor just how much the uncertainty worried her. Only then could they partner on a way to balance the need to reduce the uncertainty without exposing my niece to an array of risky tests.
The post Making health decisions in the face of uncertainty: Let your values be your guide appeared first on Harvard Health Blog.
From: David Scales, MPhil, MD, PhD http://www.health.harvard.edu/blog/uncertainty-in-medicine-and-making-health-decisions-let-your-values-be-your-guide-2016122110874
Subscribe to:
Posts (Atom)