Tag Archives: physician

Now go save a life – yours – Spirometry early detection testing

Spirometry is the easy, fast, inexpensive method to check for early detection COPD (Chronic Obstructive Pulmonary Disease) and enable the patient to STOP the developing COPD in its tracks. 

So, tell me – why don’t primary care doctors give the test when it could save lives from the third leading cause of death in the US?  In addition, stop the long, slow smother…

When will the Public Health get involved?

The doctors I asked were candid and claimed most patients will not change their environment even if their environment was the cause of the COPD to avoid the further continuation of the beginning of COPD.

Maybe the doctors I spoke to are right.  Maybe the patients have not seen what happens to the COPDers who go on to develop other medical conditions.

Perhaps some patients would not make the changes needed but others would if given the opportunity to decide.  However, without offering the test , the doctors chose for them.

I found the following straightforward Spirometry information when I was goggling for something else.

 

Spirometry is an affordable and reliable method for pulmonary function testing. This test carries no risk, requires only four minutes of patient time, on average, and is the only test available to the primary care physician for the early detection of chronic obstructive pulmonary disease (COPD including emphysema and chronic bronchitis), asthma, and other chronic lung diseases.

The National Asthma Education and Prevention Program (NAEPP) recommends spirometry as an essential component of asthma diagnosis and treatment in the primary care setting, yet fewer than 20% of primary care providers report routine use, a proportion that is even smaller among pediatricians than family physicians and internists.

    National guidelines for asthma and COPD recommend routine spirometry and research has shown that nearly one-third of pediatric patients are misclassified in terms of asthma severity without the objective measurements of spirometry. Learn more here (KING 5 NEWS Seattle).

The COPD Foundation call spirometry the gold standard for initial pulmonary function testing allowing detection of the disease at an early stage, when it is most amenable to treatment and perhaps reversal. Nonetheless, about 40% of primary care doctors do not have a spirometer in their practice and of those that do, one-third do not use them routinely.

    Starting in 2009, the Healthcare Effectiveness Data and Information Set (HEDIS) requires spirometry testing in the assessment and diagnosis of COPD. These HEDIS measures are required as part of the National Committee for Quality Assurance (NCQA) Accreditation Process for Commercial Health Plans.

The truth about spirometry

Myth: Spirometry has dubious value.

Reality: The National Lung Health Education Program (NLHEP) states that spirometry is one of the best clinical tests available for detection of lung disease and is better than blood pressure as a predictor of heart disease.

Myth: The test takes too long.

Reality: Spirometry can be completed in the primary care office in four minutes, on average.

Myth: The equipment is bulky and expensive.

Reality: While previously true, machines today are smaller for portability and available for under $2000. Hand-held office spirometers are developed with user-friendliness in mind, making them acceptable for use in a variety of primary care settings.

© 2009 University of Washington

interactive Medical Training Resources

University of Washington

Box 354920

Seattle, WA 98195-4920

T: 206-685-9699

F: 206-616-4623

imtr@u.washington.edu

http://depts.washington.edu/imtr/spiro360/about_spiro/

Thanks for reading…Now go ask your doctor about a Spirometry test.

Sharon O’Hara

Do Lung Doctors in Kitsap County Neglect Support Group Patient Education, part 2

Obstructive Sleep Apnea is serious.  A recent Swiss study shows that even a short break in using the CPAP is harmful:

“Within 14 days, they had significant increases in heart rate and blood pressure, and deterioration in vascular function.  The results suggest that even a short break in CPAP therapy has a negative effect on the cardiovascular system … OSA patients need to continuously use CPAP….” …according to US News and World Report.  Presumably, that goes for those of us on the BIPAP machine too.

Then there is  …

  1.  Lack of treatment can lead to mental confusion, dementia and Alzheimer’s.

A physician could have answered the questions that ensued.

  1. New Medicare rules say the patient must be on the machine 4 hours a night for the entire CPAP or BIPAP rental period – no matter what – or lose the machine.

As a patient with RLS, I take meds for – Mirapex that no longer works – that is worrisome.  The fact is sometimes I cannot stay in bed where the only relief from RLS is to stand up and/or walk.

When I asked about the 4-hour Medicare rule when a person has other medical conditions, I was told I had to make the choice – the BIPAP or RLS. – Not a choice at all for me and many patients like me.

A plus here is that the last session was so bad that I spent the entire night standing up using my laptop at the kitchen counter and came to the conclusion  I think a food allergy may play a part in my RLS problem.  I will talk to my doctor about it.

Harrison has a superb respiratory department team – professional people, open and transparent.  Patients need to be educated and Harrison is stepping up with professionals educating us….but we need more physician involvement to answer the tough medical questions for pulmonary support group patients.  In Kitsap County, it is past time for physician pulmonary education now.

COPD and Sleep Apnea is a huge medical dilemma where ignorance might well be bliss for the patient…but not in the long term.  What happens when we do not get oxygen to our organs?

For starters, we lose brain cells without the oxygen to sustain them.  Our lessor organs begin to fail because the larger organs grab the available oxygen first.

Incontinence is only one of many issues that can occur from lack of oxygen to organs…

No doubt, most of my brain cells are long gone so I have one less thing to think about.  My point here is to suggest you not to lose yours if it can be avoided.  Patient education is key to having the best quality of life possible with any medical condition and we NEED lung support group physician involvement.

http://pugetsoundblogs.com/copd-and-other-stuff/2011/08/13/do-lung-doctors-in-kitsap-county-neglect-support-group-patient-education/

The U.S. National Heart, Lung, and Blood Institute have more about sleep apnea treatments.

Copyright © 2011 HealthDay. All rights reserved.

http://www.nhlbi.nih.gov/health/dci/Diseases/SleepApnea/SleepApnea_Treatments.html

http://health.usnews.com/health-news/family-health/sleep/articles/2011/08/12/sleep-apnea-makes-quick-return-when-treatment-stops

Better Breather’s meeting Wednesday… http://www.harrisonmedical.org/home/calendar/4897

If anyone needs a ride, let me know…the car is super clean.

Thanks for reading… Sharon O’Hara

 

 

We all cheer for the GREAT MEDICAL CARE  already in Kitsap County…and for more Pulmonary Physician support group education.

When the Power Goes Out – Is Kitsap County a Cold and Lonely Place For COPDers?

When the Power Goes Out – Is Kitsap County a Cold and Lonely Place For COPDers?

We had one battery charged lantern and I kept the box handy on the counter because I knew the lights would come on any minute and I could quickly put it away again. Two days later, the lights came on and I put it away.  The laptop puddled in place – a good reminder that better power days were ahead…same with the lamp.  The two drawers full of old candles were not lit…I do not want to inhale candle fumes.

The little shortwave radio was meant as a Christmas present but I’ve kept it – the so welcome sound and information was my connection to the world.

I didn’t know it when I shot this photo but less than two hours later, the tireless power wonders will have restored our power.  It was so very cold….and it felt balmy when the temperature inside finally came up to 50 degrees.

No, only for those on life giving machines such as the C-Pap and Bi-Pap machines – they have nowhere to go to plug in their life sustaining machines.   Seniors on a concentrator bleed-in usually can’t carry the heavy machines.

The plus during the last two day power outage was to discover all the people helping others in a tight fix.

My husband, the Old Guy, spent most of the two days out in the cold trying to fix the generator.

The discovery that the tube he thought would fix it, didn’t,  led to more cell calls to the generator tech folks and ultimately to another  Kitsap County Angel –Ward’s Radiator Shop in Chico.

It turned out that all we needed was an expandable plug that Wards said should work temporarily until he can solder it in this summer.  It worked and is still working!  But not until after the wonderful power workers fixed our power and we went on the emergency source heat pump. Thank you, Ward’s Radiator Shop in Chico!

Our inside temperature dropped to 40 degrees and by the second night the Old Guy fixed our old portable Honda generator and asked if I wanted it hooked to a portable heater or use it on my bi-pap and concentrator.

Well.  Having taken the Mountaineering course at Olympic College some 35 years ago and learning some survival skills,  I didn’t see the sense of blowing 41 degree air into the 98 degree body I’d carefully kept warm by layering.  And, once in bed, I stayed warm and didn’t need a heater.

Question:  Was my concern and decision against blowing 41 degree cold air into my airway wrong?

Would the cold air have been warmed enough by a warm core or would my core have begun to cool to reflect the cold air blowing in?

As it was, many of us went without the machines that keep our airway open and (for some) that keep our vital blood/oxygen numbers up.

Funny thing: With good reason, the Old Guy complains, moans, and groans whenever I ask him to get something out of the freezer and puts on heavy gloves to do it – he has Raynaud’s Disease in his fingers.

During the two day power outage, he spent hours in the below freezing weather working on the generator and never said a word…just went to work trying to fix it…and couldn’t wear the thick, warm gloves.  ‘Caregivers’ is an overdue story for another time.

Bainbridge Seniors at the Senior Center have plans to provide a place to go and I hope they coordinate with oxygen companies to assist those on machines to keep their airways open and for those on concentrators and oxygen.

http://pugetsoundblogs.com/copd-and-other-stuff/2011/01/09/cold-in-silverdale-bi-senior-center-rocks/

My bi-pap was ordered after a Sleep Apnea study in 2001and Lincare supplied my Respironics Duet on 3 August 2001, according to Mike DiMatteo of Lincare, and our insurance paid it off in February 2002.

In 2010, my secure sense of well-being went to the bottom of rattlesnake canyon in a hand basket when a home study showed my sats dropped into the basement while asleep, way below good oxygen levels.  I fell through the cracks in our system and I can’t be the only one.

We have stuff – serious stuff that needs fixing and that is another story for another time.

As I see it, oxygen companies are caught in the bind of Medicare, Medicaid and patients and one flaw has been lack of communication between patient, physician and Oxygen Company.

Patients talk to your doctor – its vital your sats stay up while awake and how much leeway do we have if they drop when we’re asleep?  We need oxygen to our organs and the brain is a vital organ.

While I had the friendly and helpful Mike DiMatteo on the phone, I asked him about offering help with the Bainbridge Senior Center seniors planning a safe haven when the power goes out.  Mike said he would be glad to offer whatever help/advice they needed.  I’m sure most of Kitsap’s oxygen companies who supply these machines will help too.

Someday the rest of Kitsap County will follow the Bainbridge Senior Center seniors lead and provide assistance for those who need help when the power goes out. For some seniors, just a viable power plug can make the difference between life and death.

A super plus is the great event next Wednesday at Harrison Silverdale speaking to this very subject of emergency assistance for those of us on oxygen, concentrators, BiPap and C-Pap – all respiratory folks.

COPDers and caregivers – Mark Wednesday, 19 January on your calendar – Full details tomorrow.

More later… Sharon O’Hara