Tag Archives: patients

University of Washington #5 Cancer Hospital and More Genotyping Patients by Vanderbilt

A little more about cancer research and treatment….

Good news for us closer to home is that our own University of Washington Medical Center is # 5 on the leading list of cancer hospitals in the nation, according to US News and World Reports.

http://health.usnews.com/best-hospitals/rankings/cancer

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“Vanderbilt-Ingram Cancer Center (VICC) has launched its new Personalized Cancer Medicine Initiative, becoming the first cancer center in the Southeast and one of the first in the nation to offer cancer patients routine “genotyping” of their tumors at the DNA level….”

Meaning patients will receive personalized treatments based on their own body changes pushing the cancer growth.

…”Vanderbilt is further leading the nation in personalizing medicine by leveraging its sophisticated Electronic Medical Record (EMR) to use the genotype information in point-of-care decision-making.
“The EMR for each patient is automatically updated to contain the latest genome-based treatment information, so that all healthcare providers at Vanderbilt caring for the patient are fully informed and guided by the latest decision support on these advanced therapies,” said Dan Masys, M.D., chair of the Department of Biomedical Informatics.

“We know that genetic differences in humans at the molecular level not only contribute to the disease process, but can also significantly impact an individual’s ability to respond optimally to drug therapy,” said Jeff Balser, M.D., Ph.D., vice chancellor for Health Affairs and dean of the School of Medicine. “…Project, with highly personalized therapy for our patients.”

Vanderbilt’s Personalized Cancer Medicine Program is led by William Pao, M.D., Ph.D., Ingram Associate Professor of Cancer Research and an expert in lung cancer….”“…
“The Personalized Cancer Medicine Initiative is our commitment to providing the most cutting-edge treatment for our patients,” said Jennifer Pietenpol, Ph.D., director of Vanderbilt-Ingram and B.F. Byrd Professor of Oncology.
Jeffrey Sosman, M.D., professor of Medicine, noted that having the genotype information is also important to help patients avoid the side effects of traditional chemotherapy.

“We are starting to understand how each patient’s tumor may have specific mutations that cause the cancer, but some of those mutations may also make the cancer vulnerable to specific therapy,” said Sosman, who directs the center’s Melanoma Program. “Tumor genotyping allows us to personalize our approach. If a tumor is likely to respond to a targeted therapy then we can avoid the side effects of traditional chemotherapy.”

http://www.vicc.org/news/2010/08/personalized-cancer-therapy/

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Following are portions of a letter written by a woman to her parents during a time when her husband was dying of pancreatic cancer far off in another state – with her permission.

She once told me the timed painkillers he had available didn’t stop the pain for long and he would scream out to her with the pain and beg her to give him another shot early.

A concern of the hospital seemed to be that he would become addicted to the drugs.
I wondered then, as now – what different would it make if he became addicted to pain medications?
He was dying.

The good news about Vanderbilt’s Personalized Cancer Medicine Initiative is one more step in the battle against cancer.

‘Dated Monday, Nov 2 -87.
Dear Mom & Dad,

Received the money you sent me…thank you.
It helped a lot because his drugs he has to have are very costly.
Just his filled morphine shots I give him are $163.00 every two weeks, not counting his other medicine.
This is mixed with cocaine.

Brought him home Sat.
Got here about 1:30pm and so thankful to be home again.

The nerve blocks he went through have deadened many of his nerve endings leading to his cancer.
He knows he is dying.
His mind is still very alert.
Thank God.
He told the Dr while I was out of the room that he was afraid of dying.
God what suffering.

He is in God’s hands.
He is humble & has prayed so hard for God to take him.
His spirit will one day go back to the Lord who gave it & then his struggle & his pain will be over.
Cancer is a slow & painful death.

I wonder sometimes why humans have to suffer so much. There is no answer of course.

I’ll never forget the beautiful people at the hospital who gave me their support & hands & hearts that reached out to us, & before I left the hospital, I went around & thanked them all for giving me so much when God knows I needed it.

Two wonderful & beautiful Drs -Dr Stewart & Dr Wright, they cared too, what we are facing.

They are frustrated because they can’t stop this cancer.
There is no form of x-rays that will show the kind of cancer Kenneth has in the early stages, only after it’s too late.

They became Dr’s to help heal their patients & in Kenneth’s case, it’s too late but they both did everything medically possible to ease him.

They are both so kind.
They wished they could tell me that it wasn’t too late.

Both of them would meet me in the hallway & be on the way to surgery but they always took the time to stop & take my hand & talk to me.

Thank God, for the wonderful & beautiful people left in this world.
There will always be a dawn because of the beauty of their souls & it rubbed off on me.

I’ll never forget any of them. Everyone at the hospital knew me & put their arm around me & asked how I was; no matter where I was in the hospital, so many people came over to me.
God Bless them all.

I know God has a special place for them & I have in my heart.

Don’t worry about me, I’m all right.

God Bless my two parents that I so dearly love. I keep you close to my heart & the miles apart make no difference.
With lots of love, Karen”

More later… Sharon O’Hara

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Why Pay $150,000 Year for a Lung Drug if it Does Not Work?

The Apha 1 group comprises about 10% of COPDers but they are the group who has made great organizational strides in bringing public awareness to COPD (Chronic Obstructive Pulmonary Disease)
They are politically astute and I like most of the folks I’ve met in the organization.

That said… the idea of paying $150,000. a year per person for a drug that, at best, does nothing for the patient is OUTRAGEOUS!

There is little to no research being done for regular COPDers…if this study is accurate, why can’t we use that wasted $150,000. Per patient for RESEARCH?

Roll the drug manufactures out of the profit at any cost bed and use the money where it will do the most good for the most people.
Why not?!

I am including the following verbatim for obvious reasons.

Wasted drug dollars? NO!
Research dollars for the COPD majority benefit? YES!

“Pricey lung disease drugs have no benefit: study

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_100767.html (*this news item will not be available after 10/04/2010)

Tuesday, July 6, 2010
By Kate Kelland
LONDON (Reuters) – Recommendations for expensive treatments made for a genetic disorder called alpha-1 antitrypsin deficiency should be withdrawn because the drugs have no benefit, scientists said on Wednesday.

The disorder causes chronic lung disease and researchers who reviewed data from two trials on 140 patients with it found no evidence that alpha-1 antitrypsin medicines — made by various drugmakers including Talecris, Kamada, CSL and Baxter — do any good.

Based on this evidence, the researchers said the treatment, which costs up to $150,000 a year in the United States, should not be recommended by doctors and advocacy groups.

“The drug has not shown any clinical benefit, is extremely costly and has important adverse effects,” said lead researcher Peter Gotzsche of the Nordic Cochrane Center at Rigshospitalet in Copenhagen, Denmark.

“In view of the lack of evidence and high cost of treatment, treating alpha-1 antitrypsin deficiency by replacement therapy cannot be recommended.”

According to the team, whose work was published in The Cochrane Library journal, recommendations by the American Thoracic Society and European Respiratory Society that promote alpha-1 antitrypsin replacement are “misguided”.

“Both societies recommend augmentation therapy for patients with breathing problems related to alfa-1 antitrypsin deficiency. In our opinion, these recommendations are not reasonable,” said Gotzsche.

Alpha-1 antitrypsin deficiency affects less than one in 1,600 people. Those who inherit the disorder have low levels of the protein alpha-1 antitrypsin, also called alpha-1 proteinase inhibitor, which protects the tissue of the lungs from destruction by the body’s own white blood cells.

At a relatively young age, this can result in symptoms of emphysema, including shortness of breath and wheezing.

The aim of alpha-1 antitrypsin replacement therapy is to give the patient back the protective protein they are missing. This should limit damage to lungs and, ultimately, prevent early death. The protein is usually extracted from blood donated by healthy volunteers.

The researchers reviewed data from two trials involving a total of 140 people with the disorder, all of whom were at a high genetic risk of developing chronic lung disease.

In one trial, patients were given intravenous alpha-1 antitrypsin or a placebo every four weeks for three years and in the other, the treatment or a placebo was given weekly for a minimum of two years.

There was no difference between treatment and control groups in terms of exacerbations of lung disease, or quality of life, the researchers found. Combining the results from the trials, Gotzsche’s team also found no evidence of a clinically important effect on lung function.

“Indeed the results suggested modest harm, or at best no effect,” they wrote in their study. They added that while the treatment might cause a reduction in the deterioration of lung appearance on CT scan, it was “not clear whether this is a clinically meaningful difference.”

http://www.nlm.nih.gov/medlineplus/print/news/fullstory_100767.html

More later… Sharon O’Hara

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The International COPD Bill of Rights

COPDers, Bloggers, Friends and Family

Read and take heart ..because, so far as I know, we here in Kitsap County do not have physicians nor a health department giving Spirometry testing for early detection COPD..but we can change that state of affairs by asking for it.

Why not?
Following is a simple Bill of Rights for COPDers on an international scale, meant to affect us wherever we live, in any country, city, county, urban or farm.
Help those who follow us…fill it out as best you can and send it in.

Patients, family and caregivers…

The Bill of Rights: Translation and Dissemination

1. Have you or your organization translated the COPD Patients’ Global Bill of Rights into your local language?

2. If you have translated the Bill of Rights, has it been posted on the ICC Website?

If no, please send a copy to ICC Executive Director Larry Grouse at lgrouse1@msn.com.

3. If you have translated the Bill of Rights, has it been posted on local Websites in your country/area?

If yes, please list the Websites where it appears.

4. Have you or your organization taken any other actions to promote or disseminate the COPD Patients’ Global Bill of Rights?

If yes, please describe.

5. Do you or your organization have any upcoming activities planned to disseminate the COPD Patients’ Global Bill of Rights?

If yes, please describe.

I. The right to receive early and accurate diagnosis
Early and accurate diagnosis is essential for COPD patients to take the necessary steps to improve their quality of life and lung health. Physicians and national health services have a responsibility to provide this early and accurate diagnosis. National health services should have reliable information about the number of COPD patients in their country. Physicians should be willing and able to diagnose COPD.

6. In your country/area, is spirometry readily available in
*private pulmonary specialist clinics?
*public pulmonary specialist clinics?
*private internal medicine clinics?
*public internal medicine clinics?
*primary care centers?
*occupational diseases clinics, e.g., clinics in factories?

7. If spirometry is not readily available, are peak flow meters readily available in the above situations? Please specify.

8. Are continuing medical education (CME) training courses in spirometry available?

9. Are national/local guidelines for diagnosis of COPD in place?

If yes, on what are they based (GOLD, PAL, PEN-WHO, etc.)?

10. How is COPD defined in curricula for training doctors, nurses, and other health care professionals?

11. Do reliable statistics exist about the prevalence of COPD in your country/area?

If yes, please describe and provide the source for the statistic.

12. What are the obstacles to early and accurate diagnosis of COPD in your area?

13. Have activities to disseminate the COPD Patients’ Global Bill of Rights improved patients’ access to early and accurate diagnosis?

If yes, please describe.

14. What is the next step in your area to improve patients’ access to early and accurate diagnosis?

II. The right for information and education about COPD
People in each country should know what COPD is, its risk factors, especially smoking, and what symptoms it causes. COPD patients should be taught what state-of-the-art care for COPD involves.

15. Is any information available about public awareness of COPD in your country/area? Public understanding of the definition of COPD? Public awareness of COPD risk factors and the role of smoking in causing COPD?

If yes, please describe and give the source of the statistics.

16. What is COPD called by the general public in your local language?

17. Have any public awareness campaigns about COPD been conducted in your area/country recently?

If yes, please describe.

18. How is COPD patient education conducted in your country? E.g., is it part of doctor visits? Are nurses involved? Are there clubs or schools for COPD patients?

19. Is reliable, medically accurate patient education material available in print and/or online in your country?

If yes, please describe.

20. What are the obstacles to COPD patient education in your area?

21. Have activities to disseminate the COPD Patients’ Global Bill of Rights improved patients’ access to information and education?

If yes, please describe.

22. What is the next step in your area to improve patients’ access to information and education about COPD?

III. The right for support and understanding
Friends, family, communities, health care providers, and health services need to provide support and understanding to COPD patients for this difficult disease.

23. Do COPD patients have access to patients’ clubs, support groups, and counseling regardless of income level?

24. Are services available to help COPD patients with their daily activities?

25. What support and protections are available to persons in your country/area who are caring for a family member with COPD?

26. Have there been any important pieces of legislation passed at the local/national level that provide support to COPD patients?

If yes, please describe

27. What are the obstacles to support and understanding for COPD patients in your area?

28. Have activities to disseminate the COPD Patients’ Global Bill of Rights improved support and understanding for patients?

If yes, please describe.

29. What is the next step in your area to improve support and understanding for COPD patients?

IV. The right to receive care and treatment that will benefit them
Proper care and treatment will benefit patients, improve their breathing and quality of life, and will help them contribute more to others. Effective medicines, smoking cessation counseling and treatment, and good health care are essential to provide this right, as is long-term follow up.

30. What medications for COPD are available in your country?

Are these medications widely covered by health insurance?

31. What other treatments for COPD (e.g., pulmonary rehabilitation programs, oxygen therapy, surgery) are available in your country?

Are these widely covered by health insurance?

32. Are smoking cessation clinics available in hospitals and/or primary care in your country?

If yes, are the clinics free or low-cost? Are the clinics part of a national program?

33. What other support for smoking cessation is available in your country?

34. Are hospital emergency departments equipped with medications and equipment to manage COPD exacerbations (oxygene, nebulizers, corticosteroids, antibiotics)?

If yes, are these available in rural as well as urban areas?

Are these resources available in sufficient number to meet patients’ needs?

35. In primary care dispensaries are medications and equipment for COPD treatment readily available (oxygen concentrators/cylinders, nebulisers, corticosteroids)?

36. Who cares for COPD patients in your country (GPs, nurse practitioners, specialists, etc.)?

37. How is care of a patient by GP and specialist coordinated in your health care system? What are the mechanisms for ensuring continuity of care?

38. What are the obstacles to better care and treatment for COPD patients in your area?

39. Have activities to disseminate the COPD Patients’ Global Bill of Rights improved care and treatment for COPD patients? Please describe.

40. What is the next step in your area to improve care and treatment for COPD patients?

V. The right to their fair share of society’s involvement and investment in their welfare and care
COPD patients have worked throughout their lives to earn their fair share of society’s involvement and investment in their welfare.

41. Are any statistics on quality of life of COPD patients available in your country?

If yes, please describe and provide the source.

42. What are the obstacles to ensuring that COPD patients in your area receive their fair share of society’s investment in their welfare and care?

43. Have activities to disseminate the COPD Patients’ Global Bill of Rights improved patients’ attainment of their fair share of society’s investment in their welfare and care?

If yes, please describe.

44. What is the next step in your area to ensure that COPD patients receive their fair share of society’s investment in their welfare and care?

VI. The right to advocate with other COPD patients and supporters for improved COPD care and COPD prevention
COPD patients know how important good care is to their lives. They also know that every effort should be made to prevent others from suffering from this disease. It is their right and responsibility to advocate at every level for improved COPD care and prevention.

45. Are there COPD patient organizations in your country?

If yes, please describe.

46. Are patient groups linked with or otherwise in collaboration with medical associations in your country?

If yes, please describe.

47. What are the obstacles to advocacy by COPD patients in your area?

48. Have activities to disseminate the COPD Patients’ Global Bill of Rights improved COPD patients’ ability to advocate for themselves?

If yes, please describe.

49. What is the next step in your area to improve COPD patients’ ability to advocate for themselves?

VII. The right to safe air and environment
Unsafe air and environment are particularly harmful to COPD patients. All health care professionals have an obligation to protect their patients from conditions that are unsafe to their health. Patients and health care providers have an obligation to fight for their rights to safe air and environment.

50. Is indoor smoking regulated in your country/area?

51. Is outdoor air pollution monitored in your country/area?

52. What regulations exist to ensure outdoor air quality/clean air in your area?

53. Are automobile emissions standards in place in your area?

54. Are open fires for indoor cooking or heating widely used in your country?

55. What are the obstacles to safe air and environment exist your area?

56. Have activities to disseminate the COPD Patients’ Global Bill of Rights led to improved air quality in your area?

If yes, please describe.

57. What is the next step in your area to improve air and environmental quality?

My answers to the above questions next time.

More later… Sharon O’Hara

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Early Detection COPD Spirometry Thrives in Trichur, India

The Pulmonary Club of Trichur, India is again ahead of us here in Kitsap County. Following is the announcement of their second patient, physician meeting and the date of the third meeting. Of major importance is that they did Spirometry testing for early detection on twenty more patients.

Early detection seems to be an important theme for the pulmonary physicians in India and they’ve stepped up to the plate of preventative medicine and early detection for COPD. Congratulations to your dedicated pulmonary doctors in India!

{The second meeting of the club for COPD patients was held on 28 Mar2010 at Trichur.

Patients had interaction among each other and further clarified by medical faculty.
Spirometry was done for 20 patients and a few more were registered.

The concept of early diagnosis and relevance of spirometry was stressed.

The next meeting for patients is scheduled on the first Sunday of May.}

Dr V P Gopinathan
For Pulmonology Club,Trichur.

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Lungs Win the Fight Against Fat

If we are in a boxing match, Fat in one corner, and Lungs in another, Fat wins every time.
Why?
Fat takes up the chest room Lungs need to expand and for lung patients, fat compromises our ability to breathe.

The fat v lungs slammed home to me a couple weeks ago when a granddaughter, taking a new class on her way to becoming an RN, told me she just learned that each pound of excess fat is fed by SEVEN MILES of blood vessels.

I went online that night and found an airport-scanned photo (Digg) of a 250-pound woman next to a 120-pound woman. Fat filled her stomach and chest crowding her lungs and heart. Heaven knows what all that fat is doing as it surrounds and crowds the kidneys, bladder and other organs….it cannot be good!

Look, fellow Tubby’ettes and join me. To date, I have lost 133 miles of excess blood vessels supporting nineteen pounds of excess fat.
Regular Tubby’ettes is lucky if their health is not yet compromised.

Lung patients, easing the fat surrounding our lungs will not change the PFT numbers, but we are bound to feel a sigh of relief from our lungs as the fat around them retreats and they can finally expand to capacity and add to our quality of life.

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Obesity and the lung: 5 • Obesity and COPD
Thorax 20 08;63:1110-1117 doi:10.1136/thx.2007.086827
Abstract
Chronic obstructive pulmonary disease (COPD) and obesity are common and disabling chronic health conditions with increasing prevalence worldwide. A relationship between COPD and obesity is increasingly recognized, although the nature of this association remains unknown. This review focuses on the epidemiology of obesity in COPD and the impact of excessive fat mass on lung function, exercise capacity and prognosis. The evidence for altered adipose tissue functions in obesity—including reduced lipid storage capacity, altered expression and secretion of inflammatory factors, adipose tissue hypoxia and macrophage infiltration in adipose tissue—is also reviewed. The interrelationship between these factors and their contribution to the development of insulin resistance in obesity is considered. It is proposed that, in patients with COPD, reduced oxidative capacity and systemic hypoxia may amplify these disturbances, not only in obese patients but also in subjects with hidden loss of fat-free mass. The potential interaction between abnormal adipose tissue function, systemic inflammation and COPD may provide more insight into the pathogenesis and reversibility of systemic pathology in this disease.”
• Review series
1. F M E Franssen1,
2. D E O’Donnell2,
3. G H Goossens3,
4. E E Blaak3,
5. A M W J Schols1
1. 1
Department of Respiratory Medicine, University Hospital Maastricht, Maastricht, The Netherlands
2. 2
Division of Respiratory and Critical Care Medicine, Department of Medicine, Queens University, Kingston, Ontario, Canada
3. 3
Department of Human Biology, Nutrition and Toxicology Research Institute (NUTRIM), Maastricht University, Maastricht, The Netherlands
1. Dr A M W J Schols, NUTRIM School for Nutrition, Toxicology and Metabolism, Department of Respiratory Medicine, University Hospital Maastricht, P O Box 5800, 6202 AZ Maastricht, The Netherlands; a.schols{at}pul.unimaas.nl
• Received 15 February 2008
• Accepted 30 April 2008
• **************************
• http://digg.com/health/Body_Scans_of_a_250_lbs_Woman_vs_120_lbs_Woman
More later… Sharon O’Hara

Fat Airport Scan

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Patients Be Aware. Mistakes Happen

Prescription Mistakes Happen – Patients Be Aware

I have never doubted that any prescription I have filled is the right one. Until now.
On Thursday, I learned to doubt. I discovered a medication I had been taking for a couple weeks was not the medication I should have been taking. The right one was the second prescription filled. The reason I know that is that the new pills did not look the same.

Patients and caregivers be aware and double check that the prescription you get is the right one. We cannot assume our newly filled prescription is the right one.
Ask your doctor and pharmacist how best to double-check. No one wants patients getting the wrong medication, least of all us. Patients – be aware. Mistakes with prescription medications can happen. The mistake can be deadly or worse. Check and double-check that the medication filled is the right one.
s
Patients must learn to question and double-check that the prescription and treatment is the proper one.
Mistakes happen but being aware might make the difference. In future, I will open the new refills immediately to be sure they are the ones I have been taking. I could have looked closer at the label… the drug names were close – one had an “o” and the other had an “a” …
I have been taking a high blood pressure drug for several weeks as a test to see if it worked and that I had no reaction from it. The blood pressure was down on my next doctor visit and had not noted any adverse reaction to it either and was given a I had the new script filled and continued to use what I had left.

Sometime last week, the skin on my upper right side became tender and sore. I developed a rash on my upper right arm and broke out in what appeared to be dark, fluid filled bug bites in the middle of bright red patches. The right side of my neck was and is stiff and sore. The rashes and pain spread we drove to the ER.
The new thing is Shingles and I was prescribed medications based on the list of medications I already take and gave the list to the doctor.

A prescription error happened but I did not discover it until last Thursday when I opened the new bottle of blood pressure medication and saw it was not the same drug.

The dilemma: the ER doc had prescribed two medications based on other medications, including the new one for high blood pressure. I would not begin taking an unknown drug not knowing the consequences.
I called the pharmacy. The pharmacist checked and said the drug I ‘should’ have been taking was the second one. He asked if I had any of the other pills left, no, but I did have the empty prescription bottle and yes, I took both to the pharmacy the next day.
The point here is not to moan about a mistake. The point is to bring awareness to patients that we must not assume anything.

What happened could have happened in any pharmacy …mistakes happen. I am sure the pharmacy has already set in new check guards so it does not happen again.

An error was made and joined an amazing set of circumstances and medical conditions that began with COPD (Chronic Obstructive Pulmonary Disease) way back about 1995.

Folks…make sure the medication prescribed is the same one you get.
More later… Sharon O’Hara

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The Strange Ways of Sleep Apnea

Sleep Apnea is a strange medical condition usually requiring a CPAP OR BIPAP machine to draw in room air through filters into a hose attached to the facemask we have harnessed to our head. The facemask confines the air and pushes it through the open airway into happy air gulping lungs. The machine lets us sleep.

The latest and greatest news first is that a small clinical study showed the CPAP machine might help the heart function better in sleep apnea patients. http://www.medpagetoday.com/MeetingCoverage/ASE/tb/14658

What did the study indicate about the BIPAP patients? That is a good question to ask Harrison Medical Center’s lead Sleep Specialist, Daniel Moore, at the next AWAKE sleep support group meeting on the 17th…

Another study shows something amazing to me…

In an eight-year study funded by the National Heart, Lung and Blood Institute, the moderate to severe sleep apnea patients appear more likely to die from any cause, regardless of age, gender, race, weight, smoking history, or other medical conditions…

“… It is still unknown whether treating sleep apnea reduces risk of death and cardiovascular disease. …

(SHHS) enrolled more than 6,000 men and women ages 40 years and older at multiple centers around the U.S. to determine cardiovascular and other consequences of sleep-disordered breathing…. researchers found similar relationships between sleep apnea and deaths related to coronary artery disease.

They also found an association between the lack of oxygen that results when patients with sleep apnea momentarily stop breathing and all-cause mortality. But they found no relationship between mortality and waking due to apnea….

…the researchers cautioned that the study had several limitations. …might have introduced some bias into the study…. they noted that this study was the largest of its kind to date…. carefully collecting data on sleep, breathing abnormalities, and a wide range of other health factors….

…”Given the high and likely increasing prevalence of sleep-disordered breathing in the general population, additional research in the form of randomized clinical trials should be undertaken to assess if treatment can reduce premature mortality associated with this common and chronic disorder,” the authors wrote.”
The authors are Dr. Naresh M. Punjabi and co-investigator, David M Rapoport.

Punjabi N, et al “Sleep-disordered breathing and mortality: A prospective cohort study” PLoS Med 2009; DOI: 10.1371/journal.pmed.1000132.

http://www.medpagetoday.com/Pulmonary/SleepDisorders/15574?impressionId=1251401547027

More later… Sharon O’Hara

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Harrison Medical Center Loved To Death?

EDUCATE PATIENTS!

The more educated the patient becomes in their disease and treatment, usually the fewer panicked runs to the emergency room and a huge savings in future medical and hospital costs.

One example is the oximeter, a great tool for lung patients. Using it, patients learn for themselves how pursed lip breathing can bring their blood oxygen levels up.

It is not enough to tell a patient…show him or her.

Rachael Pritchett wrote a not-surprising article:
http://www.kitsapsun.com/news/2009/may/10/charity-and-climbing-costs-bring-recession-home/#comments

“The Cost Of Care
Tom Kruse, Harrison’s vice president of strategy and business development, points to stalled plans to enlarge Harrison’s Silverdale campus. The hospital recently announced plans to cut staff and close its behavioral health unit.
The big-picture solution is to fix a health-care delivery system that Kruse said is “fundamentally broken.”…
Rather than universal health care, Kruse said a system that replaces the current one should have patients who are accountable for their own health through good habits; physicians who are cost-conscious without letting quality suffer; and insurance companies that profit less.”
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Absolutely make patients accountable for their own health.

First, EDUCATE patients to the likely future health consequences of (smoking) for one example. Don’t ‘tell’ them, SHOW them.

Make complacent doctors responsible for suggesting early detection testing to their patients! (Spirometry is only one one example)

I bought my own oximeter for $300 and practiced until I proved to myself I could bring my own numbers up from the basement 70’s to the safe blood/oxygen range of the 90’s attic.

How?
By sitting very still, eating and drinking nothing and a total focus on pursued lip breathing as I watched my numbers climb from the 70’s to the low 90’s.

I wore the oximeter on a string around my neck until it trained me. These days my blood/oxygen ranges in the high 90’s.

I do know the ‘Exertion number’ play and understand it. Unfortunately, it is subjective and means different things to different people.

The oximeter is precise and proves to the patient using it that she/he CAN manage a shortness of breath situation that previously sent them to the very expensive emergency room.

EDUCATE PATIENTS!
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Comments
Posted by familien1 on May 10, 2009 at 11:05 a.m. (Suggest removal)
“… the system is broken at both ends, both for Harrison and for the people .. can’t get to a doctor except through the emergency departments.” …

Safety net for whom?

“… Harrison .
“We are the safety net for the community,” Cochrell said.”

For how long?

Harrison Medical Center is the community ‘lifeboat.’

As Harrison (lifeboat) continues to take folks aboard far beyond the weight limit of the lifeboat’s ability to stay afloat, at some point the lifeboat will sink and all aboard will drown.

Harrison might be forced to close her doors and be of no benefit to anyone.

I do not have an answer or solution…other than to say EDUCATE the patients on what they can do to best help themselves, thus making fewer panic trips to the emergency room.

I have made trips to the er in the last few years, but not for COPD. It is the subsequent medical conditions.
Nevertheless, without a community hospital, insurance is a moot point. The long term seems to be that one hospital after another will close their doors.

So. Harrison Medical Center…whatever you do, do it fast, will you?”

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The Swine Flu and Compromised Imune Systems

The flue can and does kill.

The very young and those with a compromised immune system may not be able to fight off the Swine Flu but prevention is the key to life for the vulnerable, not panic – prevention. Talk to your doctor. She/he can best advise.

People with the already compromised autoimmune systems are not doomed but should take precautions … and just as everyone else, wash, wash, wash those hands!

Rachel Pritchett wrote a good article and received some outstanding comments, including from patients. http://www.kitsapsun.com/news/2009/apr/30/three-kitsap-samples-being-tested-swine-flu

I have included my comments here but a great comment and explanation is from one of “us” – a patient with a compromised immune system and she offers valuable information. Woodswoman

To my comments:
“Wear a mask in public – or not.

We will all die sometime, of something but the folks with the weakened autoimmune systems do not have to be in a hurry and dance mask-less in public daring the Swine Flu to ‘gotcha.’

Be careful, use common sense and have a good time…

I will add the hand sanitizers (with alcohol) are a staple in the car and we use it every time we get in the car from shopping.
The common sense caution might be the reason we rarely get a cold and any colds are mild and short lasting.
http://www.ahrq.gov/clinic/ptsafety/chap12.htm

My healthy husband and I get flu shots every year…he must, if possible, not bring the flu home.
The flu shot takes about two weeks to work. It does not guarantee a person will not get the flu, but may lessen the symptoms.

Family and friends will not come over if they are sick and I am careful where I go.
I have to REALLY want to go somewhere in a crowd when I know sick people are probably present, including Harrison Medical Center Emergency Room.

Comments? Experiences welcome…

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Rome, Italy – COPDers First World Conference

How about a jaunt to Rome, COPDers?
I am happy to tell you the FIRST WORLD CONFERENCE of COPD PATIENTS is June 14, 2009 in Rome, Italy!
For the COPD collector of Firsts, save $50 by registering before May 29, 2009 and join “23 of the most respected experts in COPD patient care from all over the world along with committed COPD patients, educators, activists, and public health officials. Participate in the endorsement and dissemination of the global COPD patient’s bill of rights!”
For more information about the First World Conference of COPD Patients, email copd@evolvegroupinc.com.
Additional conference information is available at www.internationalcopd.org.
…
Lawrence Grouse, MD, PhD
Executive Director
International COPD Coalition
Dedicated doctors, patients, caregivers and probably most everyone in the lung world have worked years toward this first of its kind, a COPD historic conference.
The 4th leading cause of death in the U.S. and 5th leading cause of death in the world is beginning to emerge into the light of day and new knowledge will come to life.
In the meantime, COPDers, ask your doctor about getting into a pulmonary rehabilitation program.
The two I have been through are:
Capri Heart & Lung Institute
2601 Cherry Ave 111, Bremerton WA 98310
(360) 479-3886

Harrison Medical Center Rehabilitation
1780 Nw Myhre Rd G210, Silverdale WA 98383
(360) 337-8980
When I went through Capri’s program almost all their stationary bikes were the recumbent exercise bike…nowadays they have one recumbent stationary bike.
The rehab folks at both are good but the two water rehab technicians at Harrison Silverdale are extraordinary in their care, expertise and empathy for their patients and patient rehabilitation is a leading path back to life…in my opinion.

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