Be prepared – Learn basic first aid

One of the advantages of being a nurse/mom is that I can tend to a wide variety of illnesses and injuries without seeking medical help. I have probably saved my family a lot of money over the years!

Anyone can learn the basics of providing first aid. I taught American Red Cross First Aid and CPR classes for years, and I highly recommend taking a class, whether you are a parent or not. Even kids as young as 13 or 14 can take the classes.

Spring is a good time to sign up for a class. Once schools are out … Continue reading

The kindness of strangers

Yesterday I posted about the bomb blasts in Boston and questioned how the enormous medical bills would be paid.

Later, I was surprised to read an article on NBC News online that seemed to answer my question, at least in part: “Bomb’s medical costs could be in the millions, experts say.” The reporter gave an initial—and probably low—estimate of about $9 million.

According to a health economist quoted in the article, “It’s probably on the magnitude of $40,000, $50,000 (per person for emergency-room care). But for the people who will be hospitalized for weeks, you could easily be looking at Continue reading

Tragedy’s heavy toll

Like many others, I’m still trying to understand Monday’s horrific bombings at the Boston Marathon. Who did this, and why?

What I do know is that our emergency response and medical teams are the best in the world; I used to work in the OR of a large, level-one trauma center and have seen these teams in action. The injured will receive swift and highly-skilled care without regard to pre-existing conditions or insurance status.

However, a different team, the patient accounts personnel, will work quickly to document victims’ names, addresses and insurance carriers (if any).

It seems a second tragedy … Continue reading

Lights out for better sleep

Light triggers chemicals in our brains that wake us up. That’s why it’s so much easier to rise and shine in the summer than in the winter.

But I used to dread the long summer days when light would sneak into my bedroom and wake me up before 5 am. I couldn’t find curtains or blinds for my bedroom window that adequately blocked the morning sun. Finally, I invested in some heavy, black-out drapes, the kind used in hotels. They aren’t very decorative, but they help me sleep longer in the morning.

Artificial light also disrupts our sleep. It mostly … Continue reading

Should smoking be considered a pre-existing condition?

That is the opinion of the health exchange boards in Washington, D.C., California, Connecticut, Massachusetts, Rhode Island and Vermont (so far).

Each state (and D.C.) that creates a health insurance exchange under the Affordable Care Act (ACA) has an exchange board that is responsible for establishing certain rules and guidelines. Some definitions in the federal reform law have proved to be ill-defined and open to interpretation, such as “pre-existing condition.”

Most insurers that sell individual health plans charge smokers higher premiums because smokers … Continue reading

Vitamin D – Yes, no or maybe?

The sunshine supplement

Last week I learned that my vitamin D level is slightly below normal. My physician recommended that I take a daily vitamin D supplement of 1000 to 2000 IU.

I didn’t want the test, but what’s done is done. Now I need to decide what the test result means to me, and if I should follow my doctor’s recommendation.

A few years ago, vitamin D was the new wonder supplement. Various studies associated a low vitamin D level with an increased incidence of all kinds of diseases, including multiple sclerosis, rheumatoid arthritis, prostate cancer, breast cancer, … Continue reading

Check and check again

Medical errors happen

The other day I saw my doctor for an annual exam.

This year I was determined to ask my doctor NOT to order a vitamin D level.

I have had my vitamin D level tested for the last three years and it costs me approximately $100 out of pocket. (It is not considered preventive by the Affordable Care Act.)

Earlier this year, the health advocacy group Choosing Wisely recommended against routine screening for Vitamin D level in healthy adults. Well, I am a healthy adult, and my previous vitamin D levels have been normal—albeit at the lower … Continue reading

Look behind the front

The news media recently picked up a report from the Centers for Disease Control (CDC) that stated: “…11 percent of school-age children…have received a medical diagnosis of attention deficit hyperactivity disorder.” Boys are diagnosed twice as often as girls.

Some experts in pediatric psychology and psychiatry are concerned that ADHD is being diagnosed too hastily and treated too recklessly with prescription medications, specifically Ritalin, Adderall and Concerta. Sales of these drugs reached $9 billion in 2012. Overall health care costs related to ADHD are in the tens of billions of dollars—and will increase right along with the diagnoses.

Are there … Continue reading

Welcome spring (and hay fever)!

I love that first warm touch of spring. But the red, itchy eyes and drippy nose I can do without.

In 2011, the Centers for Disease Control (CDC) reported that 16.9 million adults and 6.7 million children were diagnosed with hay fever. Every year, Americans spend billions of dollars on prescription and over-the-counter allergy medications in the quest for relief.

I suffer from hay fever, too, but I am not a fan of most of the available medications. Prescription drugs are expensive, and require a costly visit to the doctor. Over-the-counter drugs (and there are dozens of them!) are pretty … Continue reading

Obamacare: A double whammy for some

A few days ago, more bad news came out about the cost of individual health insurance in 2014. The Society of Actuaries (the financial risk experts that determine insurance costs) reported that next year insurance companies must anticipate paying out at least 32% more in medical claims.

The Affordable Care Act (ACA) will require insurance plans to provide more comprehensive coverage (essential benefits) and cover millions more people with pre-existing conditions. There is considerable doubt about how many young, healthy people and how many small businesses will participate in the insurance exchanges. If they don’t, premiums will rise even … Continue reading

Pass the salt

Two reports last week reminded Americans—again—that we are eating too much salt (sodium), and the media gleefully passed on the news—again—that what we eat is killing us.

Possibly. But it’s not helpful to focus the blame on salt, when it alone is not the problem.

The American Heart Association (AHA) reported that, on average, adults consume 4,000 mg of sodium every day, or about twice what’s recommended. The United States Dietary Association (USDA) recommends no more than 2,300 mg/day (about 1 teaspoon); the AHA advises less than 1,500 mg/day.

In a coordinated analysis, researchers from Harvard Medical School concludedContinue reading

The Z-Pak deception

Several years ago, when my son was in middle school, he developed a nasty sinus infection. He didn’t have a fever, and I suspected it was a viral infection that would run its course unaided. I told him this, but he was unimpressed.

Partly to make him feel better, and partly because I wanted my diagnosis confirmed, I made an appointment for him to see our pediatrician.

I had a good relationship with our pediatrician. We shared the same philosophy of watchful waiting and not rushing to order unnecessary tests and prescribe unnecessary drugs.

Unfortunately, it was his day off. … Continue reading

What is the Quack Miranda Warning?

This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

You have probably seen this warning many times, but perhaps never paused to consider what it meant. Or, maybe you haven’t seen it, because it usually appears in very fine print and is only obvious if you are looking for it.

What is it, what does it mean, and why is it important?

In 1994 congress enacted the Dietary Supplement Health and Education Act (DSHEA), effectively allowing any product under the broad classification of … Continue reading

Surviving the health care jungle

Three years ago, my husband nearly died because of a series of medical mistakes. Although no one was guilty of clear medical malpractice (grossly negligent care resulting in harm), the hospital’s attempts to cut costs, a physician’s careless instructions, and a firewall of inflexible receptionists who refused to let me speak with a doctor led to a 911 call, a trip to the ER, and a 3-day stay in the ICU.

Luckily, he survived. But the resulting medical bills, as you can imagine, were enormous. And completely preventable.

Would it shock you to know that in 1999 the Institute of Continue reading

Man the lifeboats

Under the Affordable Care Act (ACA), small businesses and individuals will be offered “robust” coverage and “affordable” premiums on the soon-to-be-running health insurance exchanges.

By grouping together these two traditionally under-served populations, the risk pool will become large enough (theoretically) to allow everyone (most notably those with pre-existing conditions) access to health insurance, and will help keep premiums affordable (again, theoretically).

But there is a problem: small businesses are jumping ship.

According to the National Review Online, “Small firms and the specialized insurers that serve them may have found the lifeboats (to borrow Texas governor Rick Perry’s comparison of … Continue reading