Monday, December 09, 2013
Amy Docker Marcus, WSJ, Nov 19, 2013, talks about the wave of genetic testing in the country.
To know or not to know--that is the question.
A big home test company recently trailed off on offering testing--because the results would not be interpreted by a physician, among other reasons.
People who do get tested can in some cases become what the industry calls "patients in waiting." They wonder with every twitch if "their" fate is coming true. They know they have a genetic propensity.
BUT--they may never ever get the disease.
One little girl tested for cystic fibrosis--she kept going to the doctor--he would say she looks fine. Her parents were afraid to expose her to colds in preschool--what to do, what to do.
Cystic fibrosis is a good example of a condition that really has no cure. They even came up with a long technical name for the "pre" CF condition. But even patients with this offiicial sounding name--CRMS--are in limbo and may never get the disease despite all the worrying, doctors, and uncertainty.
Another thing they test for is a genetic disease of the heart muscle called hypertrophic cardiomyopathy. These pre-patients can get a defibrillator implanted--but, as one doc said, for a condition that may never materialize, this is hard to justify.
Friday, December 06, 2013
She told them to call her husband and he would come get her. But no.
We had a similar experience after a house fire--my daughter had been in the house--her room was totaled--she had some soot in her throat--the paramedics insisted on an ambulance while we followed in a car--$800. It would have been a $12 cab ride if we had gone that route--or we could have taken her in my sister's car.
It's against the law--at least out here in AZ--to force treatment on someone who refuses it. This includes ambulance or chopper transport. I did let the paramedics take her. I was pretty stressed at the time--I came home to a fire with firemen in the house, etc.
The NYT (Dec 4, 2013) had a story by Elisabeth Rosenthal featuring a swim teacher who fell and broke three teeth. She accepted an ambulance ride--$1,772.42.
Ambulance rides used to be free--a municipal service. Now, they are private businesses.
They are anything from fire depts, to hospital-run, to volunteers. The quip is that if you have seen one ambulance company, you have seen one ambulance company.
Medicare rides alone have gone from $2 billion in 2002 to $6 billion now.
Even under that Obamacare thing, you will make a copay under most of the plans--more than $200 as a rule.
Some companies also gauge if your situation was a true emergency--going to the ER instead of a low care place can make it one. Sometimes you need to be admitted to the hospital for it to be an emergency.
In other words--crapshoot. And you are paying something, usually a lot. One woman went 2 blocks for $900.
Thursday, December 05, 2013
In this one, a young girl of about 8 was crazy-thirsty all the time--she drank gallons a day, her teachers were sick of her asking to go to the wash room, etc. She hid the water bottles from her parents. She wet the bed. They kept taking her to the pediatrician--they tested for diabetes--nope--OK, go home.
This went on for years.
Then she got a horrible headache--another specialist (finally) and of course, tons of imaging. This doctor had an inkling--it was a rare brain tumor made up of germ cells that should have dispersed in the womb--it was pressing on her pituitary gland and that region and causing the thirst. They did a biopsy and finally chemo and radiation. She will have to take drugs for life--but she is functional--even philosophical about it.
Now--if my kid drank a couple of gallons of water a day, I think I would doctor-shop more. I hope I would.
I know I would put the weird symptoms in a search engine and see if somewhere this computed.
Don't be afraid of offending your doctor--it's your body--get it fixed if you can!
Wednesday, December 04, 2013
But they are something to prevent or look out for if you plan to "start" exercising--say after January 1.
They were written up in the WSJ on Dec 3, 2013.
First, the symptoms. You take off running or doing some unfamiliar power walking or something and get shooting pains in the bone running from knee to foot down the front of your leg. And I mean SHOOTING.
Not only is your shinbone irritated but fibers of tendons and muscles are torn. This can happen most often if you switch up running surfaces--grass, to asphalt, to cement.
To prevent this, start off slowly. Try for a 15% increase in activity per week. Warm up--maybe even a hot compress.
Get your footwear from a store where they know their cookies. Be sure you are fitted properly. And replace shoes every 300-400 miles.
Shin splints affect both legs. If only one leg hurts--it could be a stress fracture.
If you get shin splints, you can modify your routine--but you don't have to quit. I remember my father saying they get better if you run--and they seemed to.
Tuesday, December 03, 2013
I will try not to overdo it.
But 13,000 people get Christmas injuries. Come on, can't we tighten up?
AFC/Doctors Express has some tips for avoiding some disgusting problem in the next few weeks.
First, packaging. That hard plastic covering on things--it can slash you to ribbons. Ribbons, I say! This accounts for 6,000 ER visits a year. Use a scissors. And throw away packaging before kids can chew on it.
Don't climb roofs or shaky ladders to put up decorations. Do you need the Centers for Disease Control to tell you not to stand on the top of a ladder?
Those little button batteries--poison.
Scooters, skateboards--helmets, please.
Do not put a crispy tree in your fireplace. Good grief--why not just coat yourself in gas and light a match?
And carving--carve away from yourself. Keep knives dry. And keep the tots at bay. Picture their little faces at slippery knife level.
Just think, be smart! Oh--and don't have real holly. My cat once at one berry and cost me $300 at the vet.