Frugal Nurse - Seeking better health at a lower cost

Nexium – Brand, generic, prescription or OTC

Posted on July 30, 2014 by Frugal Nurse

Which is cheapest?

As I did my grocery shopping the other day, I ran into a large cardboard brochure holder at the end of one aisle. Literally ran into it. Why do store managers place these displays where they block cart traffic? Oh, right, to get our attention.

Well, it worked. But the bright purple brochures would have attracted my eye anyway. They touted the recent release of Nexium (“The Purple Pill”®) as an over-the-counter (OTC) medication; that is, you no longer need a prescription to buy it.

The brochure tells us that Nexium is the “#1 doctor prescribed acid … Continue reading

FDA safety alert on laparoscopic power morcellators

Posted on July 25, 2014 by Frugal Nurse

Less invasive but riskier?

In April, the Food and Drug Administration (FDA) issued a safety alert about the use of power morcellators in laparoscopic procedures to remove uterine fibroids (or the entire uterus).

A morcellator works by grinding or shredding tissue into small bits so that it can easily be “vacuumed” out through a very small incision. A laparoscope, a device with a tiny camera that allows the surgeon to “see” inside the abdomen, is also used.

Laparoscopic procedures are very popular for all kinds of abdominal surgeries not only because the incisions are much smaller, but because the patient … Continue reading

How “lump-sum” cancer insurance policies work

Posted on July 23, 2014 by Frugal Nurse

This is a guest post by Kristen Reineke of CancerInsurance.com. I’ve posted previously about Alternatives to Obamacare, and critical illness plans are a relatively simple supplement to standard comprehensive health insurance plans. Cancer, specifically, is an expensive diagnosis, and my new ACA-compliant health plan not only has costly premiums, but a huge deductible (over $10,000). Most of the leading cancer hospitals in Seattle (University Medical Center, Fred Hutch Cancer Research Center, and Seattle Cancer Care Alliance) are not in my network, which could also lead to higher out-of-pocket costs. Kristen explains how these critical illness or “lump-sum” policies … Continue reading

Niacin doesn’t reduce heart attack risk

Posted on July 21, 2014 by Frugal Nurse

Latest niacin news

In yet another instance of “we thought this drug was useful until we actually tested it and found out it wasn’t”, researchers are warning us that niacin should no longer be used to manage cholesterol levels.

A popular supplement before statins were introduced, niacin has been prescribed by doctors for decades. And it’s still being used by patients who don’t want or can’t tolerate statins.

There are two reasons why niacin should not be used.

Niacin raises the good cholesterol or HDLs, but evidence has shown that a higher HDL level due to niacin therapy is

Sunscreen and vitamin D

Posted on July 17, 2014 by Frugal Nurse

Don’t avoid all sun exposure

Vitamin D just won’t get out of the news. I posted about it a couple of weeks ago, and here I am commenting again on something else I read.

Actually, a friend sent me a link to a health care blog that referred to a recently-published study out of Sweden. Swedish melanoma researchers followed almost 30,000 women (I’m not sure why just women) for 20 years and concluded:

We found that all-cause mortality was inversely related to sun exposure habits. The mortality rate amongst avoiders of sun exposure was approximately twofold higher compared

… Continue reading

Climate change and kidney stones

Posted on July 14, 2014 by Frugal Nurse

Heat waves lead to dehydration

Today in Seattle we are in the middle of a heat wave. For the Northwest, that usually means 2 consecutive days over 75°F, but actually we have been experiencing temperatures into the 90s! And most of us don’t bother with air conditioning our homes, so indoor temps can get pretty high, as well.

(Summers are getting hotter all over, aren’t they? A fun interactive website is Climate Central. Type in your city and find out how hot summers will be in the year 2100.)

As I sipped a glass of ice water to cool … Continue reading

Do you need an annual pelvic exam?

Posted on July 11, 2014 by Frugal Nurse

Yet another screening exam found unhelpful

Earlier this month, the American College of Physicians (ACP) published its recommendation in the Annals of Internal Medicine that routine annual pelvic exams are unnecessary for healthy, non-pregnant women with no gynecologic symptoms (bleeding, discharge, pain, etc.).

The ACP looked at evidence on pelvic examinations dating back almost 70 years and concluded:

… no data support the use of routine pelvic examination (excluding cervical cytologic [Pap] examination) for reducing the morbidity [disease] or mortality [death] of any condition. Furthermore, limited evidence suggests that screening pelvic examinations may be associated with pain, discomfort, fear, anxiety,

… Continue reading

First aid for bee stings

Posted on July 9, 2014 by Frugal Nurse

How do you react?

I posted about this topic last summer, but am updating it because I got stung by a yellow jacket last weekend and thought it might be useful to pass on some information gleaned from my experience.

Bees, wasps, yellow jackets, hornets, and fire ants all belong to the same order of insects, Hymenoptera, so their venoms cause similar reactions if you are stung or bitten.

People’s bodies react in one of three ways:

85-90% experience a small local reaction—pain, redness and some swelling just around the sting site
10% experience what is called a “large

First aid for the Fourth of July

Posted on July 4, 2014 by Frugal Nurse

This is a reprint from last year’s post. Happy and safe Fourth to everyone! FN

Every year around the Fourth of July, hospital emergency departments and fire departments get ready.

By July 5, most large communities have reported property damage—fires, mostly—and bodily damage—burns, missing fingers, blindness.

As a reminder to everybody to be careful around fireworks—my preference is to avoid them altogether—the San Diego Fire Department put together this great public service video demonstrating the danger of ~~explosives~~ fireworks.

I would also refer you to some of my relevant first aid posts:

First aid for eye injuries
First aid for

Another post on vitamin D

Posted on July 2, 2014 by Frugal Nurse

The latest stand on vitamin D screening

Over the last year and a half, I’ve written several posts on vitamin D, and here’s another one.

Last week the United States Preventive Services Task Force (USPSTF) released its draft recommendation statement on vitamin D screening. (After a short comment period, a final recommendation will be made later this year. Rarely do these differ from the draft versions.)

Screening for vitamin D levels in healthy adults was given an “I” grade, or insufficient evidence.

The U.S. Preventive Services Task Force (USPSTF) concludes that current evidence is insufficient to assess the balance

… Continue reading

Health care apps – Skin cancer detection

Posted on June 30, 2014 by Frugal Nurse

health care apps skin cancer I was browsing through some smartphone apps last week and I ran across one called Doctor Mole. At first I thought it had something to do with the garden pest—I have an infestation of moles plowing through my vegetable garden every evening, so they are much on my mind.

I thought, “Yes! An app to tell me how to get rid of moles!”

Nope. Wrong kind of mole.

But I was still interested. I had heard of these skin cancer tracking apps, so I decided to take a look and see what was available and how they work. My … Continue reading

Be informed – Medicare and “observation” status

Posted on June 25, 2014 by Frugal Nurse

When is a hospital admission not an admission?

Answer: When, for Medicare patients, it’s coded as “observation” status only.

Before the days of discharging patients ASAP (or not admitting them at all), doctors used to frequently admit patients “for observation.” It signified that a patient was not critically ill, but his or her condition warranted careful watching, i.e. observation.

Unfortunately for the last decade or so, that term has come to have a very specific meaning with very specific financial consequences. But most patients still consider it a casual phrase that doesn’t mean much, and that ignorance can end up… Continue reading

DHA (omega-3) fortified foods – Worth the price?

Posted on June 23, 2014 by Frugal Nurse

dha omega 3 fortified foods Every time I pick up a half gallon of non-organic, low fat milk (whichever brand is on sale) I have to reach over the more expensive product—the organic, DHA-fortified cartons of milk.

I first noticed this trend to fortify milk with DHA, a form of omega-3 fatty acid, a couple of years ago. You can also buy DHA-fortified eggs, breakfast cereals, orange juice, or DHA-fortified baby formula and baby foods.

DHA is marketed as “supporting” brain health, so what parent wouldn’t want to pay a premium price to fortify their child’s brain? What adult doesn’t want to avoid the dreaded … Continue reading

Dr. Oz – Pitchman for profit

Posted on June 20, 2014 by Frugal Nurse

Called before the Senate

Over a year ago I wrote a post dissing Dr. Mehmet Oz for his overuse of the word “miracle” on his TV show. As I said, there are no miracles when it comes to getting and staying healthy—just common sense, hard work and perseverance.

But those things are boring and don’t make good television, do they? Talk shows (and that’s really all the Dr. Oz show is) need to keep ratings high. They need to excite viewers and encourage them to buy the advertised products, or ratings fall and advertisers pull their support.

Fortunately for those … Continue reading

Do you have AFib?

Posted on June 18, 2014 by Frugal Nurse

Or have you seen the commercials?

Not too long ago I posted about Big Pharma’s approach to marketing a new drug:

Give the condition (disease) a catchy nickname
Create a website as a credible sounding organization or foundation
“Increase awareness” of this “new” disease through radio and TV ads
Provide “helpful” self diagnosis quizzes to encourage “talk to your doctor” visits

Ever since direct-to-consumer marketing of prescription drugs was first allowed by the FTC almost 20 years ago, I’ve watched Big Pharma perfect this technique. They spend millions of dollars promoting each new drug.

The most recent condition/drug to … Continue reading