Today I ran into a 43 year old gentleman at a local place of business. He asked me for money for food. I started talking to him and saw that he was reading my lips. He read lips very well. He failed to understand sign language. We were able to communicate enough to exchange names, and find that he was deaf from an early age possibly from birth. He was unsure. He was looking for work. We discussed how it is hard for many deaf people to get jobs because they are deaf. I tipped him for his pleasant conversation and recognized the sadness of it all.
After this encounter with fate, I reflected on yet another deaf person that had been failed by the American health system. How this system is able to allow a hearing impaired young man get well into adulthood without proper medical attention to assist with his deafness. He should know how to sign. He should have money. He should have work. He should have health care. He should have been covered since birth.
I know this scenario all to well. I have a brother who was born deaf. The system is still failing him all around, too. He and his deaf spouse both work yet their combined salaries are at “poverty level”. Rather than the system continuing all assistance beyond 18 years of age, they encourage working versus working plus government assistance. How does the government expect him to pay money he supposedly owes them over a 10-year debt? Does he really owe them? Without steady employment and government assistance, it is impossible. Each time he applies for government help like Medicaid, Social Security Disability Income, etc., he is cast aside with uncertainty. It is truly devastating to the human spirit.
He struggles on with a part-time job at minimum wage with no benefits. I have helped him find the medical care he needs. It is a family affair. Many of his doctors give generous discounts when he “tells” them he is uninsured. This has really helped him get the medical care he needs. Over the years I have collected his records and taught him to work his way through the medical system.
His medical record is his basic communication tool along with reading lips, and writing things down. He is a master at sign language (and so many things), but none of his doctors know sign language. He requires an interpreter, but it is difficult to arrange when you are deaf and no one knows your language or how to use the TDD (telecommunication device for the deaf) phone devices or operator services. You can even do it on line. How do you get a doctor appointment? Often the emergency room becomes the primary care clinic.
If you are not heard, you are ignored or misunderstood. We must open our ears to the deaf and all people with disabilities. To be born deaf is not ever hearing anything. It makes us realize the importance of communication, another vital sign.
jueves, 31 de mayo de 2007
sábado, 26 de mayo de 2007
QUALITY WEBSITE
AHRQ.GOV
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY
“GIVE INFORMATION. GET INFORMATION.”
- “QUESTIONS ARE ANSWER” SECTION THAT EMPHASIZES ASKING QUESTIONS, ESPECIALLY THE
RIGHT QUESTIONS – VERY THOROUGH! WWW.AHRQ.GOV/QUESTIONSARETHEANSWER
- HELPS PATIENTS BUILD QUESTION LIST (PLUS YOU CAN ENLARGE THE TEXT!) – EXCELLENT!
PATIENTS CAN CREATE THE LIST AND PRINT IT OUT!
- TELLS YOU TO TAKE NOTES AT DOCTOR VISITS! BRING YOUR NOTES IN, TOO.
- TOPICS INCLUDE – TALKING TO YOUR DOCTOR, GETTING MEDICAL TESTS, GETTING A
PRESCRIPTION, PLANNING FOR SURGERY, REDUCING MEDICAL MISTAKES
- CLICK ON SECTION "CONSUMERS AND PATIENTS" FOR BASIC HEALTH INFORMATION FOCUSING ON
WELLNESS AND PREVENTION, QUALITY OF CARE, HEALTH PLANS
- AHRQ AND USPSTF HAS A GREAT GUIDE CALLED “CLINICAL PREVENTION GUIDELINES”
- ORDERED ON LINE AND RECEIVED IT IN ABOUT ONE WEEK - YOU CAN ALSO DOWNLOAD IT
- OTHER GUIDES AT THEIR SITE FOR HEALTHY WOMEN AND HEALTHY MEN, ETC.
- SEE HOW "AHRQ HELPS PEOPLE" AT WWW.AHRQ.GOV/NEWS/FOCUS/INDEX.
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY
“GIVE INFORMATION. GET INFORMATION.”
- “QUESTIONS ARE ANSWER” SECTION THAT EMPHASIZES ASKING QUESTIONS, ESPECIALLY THE
RIGHT QUESTIONS – VERY THOROUGH! WWW.AHRQ.GOV/QUESTIONSARETHEANSWER
- HELPS PATIENTS BUILD QUESTION LIST (PLUS YOU CAN ENLARGE THE TEXT!) – EXCELLENT!
PATIENTS CAN CREATE THE LIST AND PRINT IT OUT!
- TELLS YOU TO TAKE NOTES AT DOCTOR VISITS! BRING YOUR NOTES IN, TOO.
- TOPICS INCLUDE – TALKING TO YOUR DOCTOR, GETTING MEDICAL TESTS, GETTING A
PRESCRIPTION, PLANNING FOR SURGERY, REDUCING MEDICAL MISTAKES
- CLICK ON SECTION "CONSUMERS AND PATIENTS" FOR BASIC HEALTH INFORMATION FOCUSING ON
WELLNESS AND PREVENTION, QUALITY OF CARE, HEALTH PLANS
- AHRQ AND USPSTF HAS A GREAT GUIDE CALLED “CLINICAL PREVENTION GUIDELINES”
- ORDERED ON LINE AND RECEIVED IT IN ABOUT ONE WEEK - YOU CAN ALSO DOWNLOAD IT
- OTHER GUIDES AT THEIR SITE FOR HEALTHY WOMEN AND HEALTHY MEN, ETC.
- SEE HOW "AHRQ HELPS PEOPLE" AT WWW.AHRQ.GOV/NEWS/FOCUS/INDEX.
jueves, 24 de mayo de 2007
DRUG DECEPTION BY OMISSION
The new drug Lybrel has been approved for contraception and menstrual period suppression in females. Every news release has been “praising” this drug that stops women from naturally menstruating. Why would anyone want to do this? Will it be targeted to our teenage women of tomorrow who are too busy for a period? How will it react with the mandatory HPV vaccine?
Out of all the reading I did, I failed to come up with concrete information on the side effects in any news articles. There was one statement, “The Lybrel safety and efficacy study was published in the December 2006 issue of the journal Contraception”. This study was supported by a grant from the drug maker. How many patients have access to this? Will the prescribing doctor have the information to pass along?
Finally at www.ocregister.com (Orange County California newspaper) there was this:
"Side effects: Irregular menstrual bleeding. Rare side effects of Lybrel included gallbladder inflammation, blood clots in deep veins, ectopic pregnancy, prolonged vaginal bleeding and enlarged uterine fibroids. There's concern over whether women might irreversibly lose bone density when periods are suppressed for a long time."
The drug manufacturer’s website has a 25 page insert that should come with the prescription called “Information for the Patient – Brief Summary Package Insert”. It states that “the symptoms associated with these serious side effects are discussed in the detailed leaflet given to you with your supply of pills”. There is a section, detailed patient labeling, that cites more side effects and risks. How many patients will receive this from their doctor who has access to 48 pages of "prescribing information"? The prescribing information has 15 pages that include adverse reactions not mentioned in the patient insert. There are also warnings, a black box warning, and precautions. The "brief summary patient package insert" is included in the prescribing information.
Clinical trials revealed that the pill was effective completely in 59% while 41% had breakthrough bleeding. So there is a 41% chance that the patient taking this medication may not get the intended results - continue bleeding and get pregnant. The patient may not realize that she is pregnant, and still be taking the drug. There is a warning about this possibly occurring with this “contraceptive stop-your-period pill”.
Does this make sense? Drug deception by omission – is it okay?
The insert closes with the following statement:
"If you want more information about birth-control pills, ask your health care professional or pharmacist. They have a more technical leaflet called the Professional Labeling which you may wish to read. This product’s label may have been updated. For current package insert and further product information, please visit www.wyeth.com or call our medical communications department toll-free at 1-800-934-5556."
Be sure to get a copy of the drug insert and prescribing information that comes with the medication from your doctor and/or pharmacist. Get out a magnifying glass to read the tiny print, and a medical dictionary to look up the medical terms. Look it up on the Internet at the drug manufacturer's website for easier reading and more details.
Out of all the reading I did, I failed to come up with concrete information on the side effects in any news articles. There was one statement, “The Lybrel safety and efficacy study was published in the December 2006 issue of the journal Contraception”. This study was supported by a grant from the drug maker. How many patients have access to this? Will the prescribing doctor have the information to pass along?
Finally at www.ocregister.com (Orange County California newspaper) there was this:
"Side effects: Irregular menstrual bleeding. Rare side effects of Lybrel included gallbladder inflammation, blood clots in deep veins, ectopic pregnancy, prolonged vaginal bleeding and enlarged uterine fibroids. There's concern over whether women might irreversibly lose bone density when periods are suppressed for a long time."
The drug manufacturer’s website has a 25 page insert that should come with the prescription called “Information for the Patient – Brief Summary Package Insert”. It states that “the symptoms associated with these serious side effects are discussed in the detailed leaflet given to you with your supply of pills”. There is a section, detailed patient labeling, that cites more side effects and risks. How many patients will receive this from their doctor who has access to 48 pages of "prescribing information"? The prescribing information has 15 pages that include adverse reactions not mentioned in the patient insert. There are also warnings, a black box warning, and precautions. The "brief summary patient package insert" is included in the prescribing information.
Clinical trials revealed that the pill was effective completely in 59% while 41% had breakthrough bleeding. So there is a 41% chance that the patient taking this medication may not get the intended results - continue bleeding and get pregnant. The patient may not realize that she is pregnant, and still be taking the drug. There is a warning about this possibly occurring with this “contraceptive stop-your-period pill”.
Does this make sense? Drug deception by omission – is it okay?
The insert closes with the following statement:
"If you want more information about birth-control pills, ask your health care professional or pharmacist. They have a more technical leaflet called the Professional Labeling which you may wish to read. This product’s label may have been updated. For current package insert and further product information, please visit www.wyeth.com or call our medical communications department toll-free at 1-800-934-5556."
Be sure to get a copy of the drug insert and prescribing information that comes with the medication from your doctor and/or pharmacist. Get out a magnifying glass to read the tiny print, and a medical dictionary to look up the medical terms. Look it up on the Internet at the drug manufacturer's website for easier reading and more details.
lunes, 21 de mayo de 2007
IDEAL HEALTH SYSTEM
For the ideal American health system, the goal must be provision of health care to everyone. This is a national priority. This system must be uniform and easily accessible for everyone. National (e.g. Medicare, Medicaid) and international (e.g. Britain's National Health Service) government programs in combination with the commercial sector of health service leaders are appropriate models. Using the systems and components that are successful in these entities will be the foundation.
The system will be managed through the government and insurance companies. The government seems most experienced and prepared for the task as an infrastructure already exists through the Social Security Administration and other government agencies. In addition, the information technology infrastructure is already in place. This provides the most extensive database of the nation's health care recipients that would be accessible to physicians and hospitals. This should ensure that all have access to the best comprehensive quality health care.
In order to attain the above, the employer-based model would be phased out. Purchasing health insurance from the government will subsequently be available to everyone. Each person will pay directly for services at prices comparable to Medicare and Medicaid fees. Through the Public Health Service all preventive screening will be done without charge. This will lead to a healthier people and a health system that takes care of everyone.
Great health is true wealth!
The system will be managed through the government and insurance companies. The government seems most experienced and prepared for the task as an infrastructure already exists through the Social Security Administration and other government agencies. In addition, the information technology infrastructure is already in place. This provides the most extensive database of the nation's health care recipients that would be accessible to physicians and hospitals. This should ensure that all have access to the best comprehensive quality health care.
In order to attain the above, the employer-based model would be phased out. Purchasing health insurance from the government will subsequently be available to everyone. Each person will pay directly for services at prices comparable to Medicare and Medicaid fees. Through the Public Health Service all preventive screening will be done without charge. This will lead to a healthier people and a health system that takes care of everyone.
Great health is true wealth!
miércoles, 16 de mayo de 2007
DOCTOR SEARCH ON INTERNET
Have you looked your doctors up on the Internet? When you do, you may find incomplete inconsistencies. Many web sites had no listing for several doctors I was looking up. So I looked at some others.
I went to the state medical board pages. I found that some doctors listed on the other web pages were not listed on the state board pages. Another doctor is listed with an active and an inactive license (several are listed like this). This doctor’s medical education and training have been done overseas. Some doctors have no residency training listed. This doctor has been in practice for 45 years, and is licensed in two countries and two other states. The doctor’s address is listed as a PO Box.
The type of information listed was different amongst the states. For instance, one state listed one line of information – license number, status of license, present location, disciplinary action (yes or no, not what), date of issue and expiration. Another state gives this plus the doctor’s education and training information, details of disciplinary legal action, other states/ countries where licensed, and board certification status. There were inactive licenses that were listed as active in another state’s information.
These incomplete inconsistencies are rather consistent. Do you know about your doctor’s background? Is your doctor properly trained and licensed? Which information is correct?
The American Medical Association (AMA) has a page with links to the state boards for licensing. Check your doctor at www.ama-assn.org/ama/pub/category/2645.html. Compare it to the information at “doctor finder” sites. Incomplete inconsistency.
I went to the state medical board pages. I found that some doctors listed on the other web pages were not listed on the state board pages. Another doctor is listed with an active and an inactive license (several are listed like this). This doctor’s medical education and training have been done overseas. Some doctors have no residency training listed. This doctor has been in practice for 45 years, and is licensed in two countries and two other states. The doctor’s address is listed as a PO Box.
The type of information listed was different amongst the states. For instance, one state listed one line of information – license number, status of license, present location, disciplinary action (yes or no, not what), date of issue and expiration. Another state gives this plus the doctor’s education and training information, details of disciplinary legal action, other states/ countries where licensed, and board certification status. There were inactive licenses that were listed as active in another state’s information.
These incomplete inconsistencies are rather consistent. Do you know about your doctor’s background? Is your doctor properly trained and licensed? Which information is correct?
The American Medical Association (AMA) has a page with links to the state boards for licensing. Check your doctor at www.ama-assn.org/ama/pub/category/2645.html. Compare it to the information at “doctor finder” sites. Incomplete inconsistency.
martes, 15 de mayo de 2007
WOMEN'S HEALTH WEEK
Ladies, it's time to schedule your screening and appointments to include:
- mammogram/ MRI for breast cancer
- PAP smear for cervical cancer
- stool check for blood (fecal occult blood test, FOBT) for colorectal cancer
- cardiology doctor for cardiovascular prevention
(get EKG, ECHO, and thallium stress test if indicated)
- bone density scan to check for osteoporsis
- counseling for smoking cessation, alcohol/drug dependence, and domestic violence
- evaluation for depression and other mental disorders if necessary.
This is in additon to a complete physical exam, and routine blood tests.
Get in 5 to 10 minutes of exercise a day at least and eat healthy! Laugh a lot and love a lot!
- mammogram/ MRI for breast cancer
- PAP smear for cervical cancer
- stool check for blood (fecal occult blood test, FOBT) for colorectal cancer
- cardiology doctor for cardiovascular prevention
(get EKG, ECHO, and thallium stress test if indicated)
- bone density scan to check for osteoporsis
- counseling for smoking cessation, alcohol/drug dependence, and domestic violence
- evaluation for depression and other mental disorders if necessary.
This is in additon to a complete physical exam, and routine blood tests.
Get in 5 to 10 minutes of exercise a day at least and eat healthy! Laugh a lot and love a lot!
lunes, 14 de mayo de 2007
TEST YOURSELF?
Many doctors are concerned that some tests like the body scan will lead to unnecessary procedures that could harm patients. Often these tests may show abnormal things that are “normal” meaning that the abnormal finding is something that is just there. It is benign, and not life threatening.
What does the doctor do when a patient comes in with a test that they have done on their own? The patient has decided that I may need this test because heart disease, and /or cancer runs in my family, plus heart disease is the number one killer. Should I have a heart scan, body scan or a virtual colonoscopy? My doctor has told me that tests like these may find things that are benign, but something serious may show up. It could be something that would turn up in a few years and possibly be life threatening, but if I check now maybe I can do something about it.
What does the doctor do when a patient comes in with abnormal test results from a test they orders and paid for themselves?
1. Repeat the test
2. Refer the patient to a specialist
3. Do more tests to check it out
4. Scold the patient and say “It’s okay. There’s nothing to worry about.”
What does the patient do?
What does the doctor do when a patient comes in with a test that they have done on their own? The patient has decided that I may need this test because heart disease, and /or cancer runs in my family, plus heart disease is the number one killer. Should I have a heart scan, body scan or a virtual colonoscopy? My doctor has told me that tests like these may find things that are benign, but something serious may show up. It could be something that would turn up in a few years and possibly be life threatening, but if I check now maybe I can do something about it.
What does the doctor do when a patient comes in with abnormal test results from a test they orders and paid for themselves?
1. Repeat the test
2. Refer the patient to a specialist
3. Do more tests to check it out
4. Scold the patient and say “It’s okay. There’s nothing to worry about.”
What does the patient do?
MISSED DIAGNOSIS
I read an article today about doctors missing diagnoses especially with cancer - OVER 50%!!
Are you getting the right treatment? A recent study* of 307 closed malpractice claims revealed that many missed or delayed diagnoses in outpatients lead to serious harm, some fatal. In this study, 30% resulted in death! Adverse outcomes occurred in 59%.
The most missed diagnoses were cancer (breast and colorectal primarily), infections, fracture, and heart attacks. Fifty-nine percent of errors were associated with cancer diagnosis - or should I say misdiagnosis? Most of these malpractice claims (59% again) showed that diagnostic errors were significant.
The most common reason for failure to diagnose was failure to order the right test (55%). The other reasons were:
-failure to follow up (45%)
-failure to obtain a complete thorough medical history and physical
exam (42%)
-wrong interpretation of medical tests (37%)
Some cases were cited where the doctor failed to check the test results, or to tell the patient the results.
This data is truly mind blowing! Though a small study, it carries a lot of weight. The percentages are phenomenally high! How can this be happening in the most medically advanced country in the world? The fact is, it's happening. It is more common than we think - hidden, not talked about. What can you do to keep it from happening to you?
Has your doctor discussed preventive tests for cancer detection? Of course, you should have a routine complete medical history and physical exam first. Using this information your doctor will know what tests you may need. If cancer runs in your family, you really want to consider preventive cancer screening.
The medical history and physical exam give your medical facts. Findings on physical exam may suggest cancer for which testing is needed. Some tests considered for routine cancer screening are:
-mammogram, MRI - breast cancer
-PSA (prostate specific antigen) - prostate
cancer
-colonoscopy - colon cancer
-stool blood check - colon cancer
-PAP smear - cervical cancer
-complete blood count - blood cancer
-CT or MRI scan - lung cancer, brain cancer
-pelvic sonogram - ovarian cancer
-body scan (neck to buttocks and in between) - body (this scan shows other things ,
too).
Screening tests save lives. Talk to your doctor. Be sure your doctor goes over the test results with you and explains EVERYTHING! Leave with your questions answered! Be sure to follow up with your doctor, too, to prevent any delays.
Get a copy of your test results. That way you will know if you were told everything and that the information is accurate. Research your results and diagnosis. Things you don't understand, ask again. Getting a second (and sometimes tiebreaker third because you were told different things by each doctor!)opinion is a reasonable research tool, also.
Patients must be their own advocate and take charge of their health. Health maintenance and prevention are so important to one's quality of life. Make it an important part of yours!
Remember to do your own monthly breast exams for both sexes, and monthly scrotal check for the males.
Great health is true wealth!
(*from AHRQ, Agency for Healthcare Research and Quality, publication "Research Activities" February 2007 from study in Annals of Internal Medicine, 10/3/06)
Are you getting the right treatment? A recent study* of 307 closed malpractice claims revealed that many missed or delayed diagnoses in outpatients lead to serious harm, some fatal. In this study, 30% resulted in death! Adverse outcomes occurred in 59%.
The most missed diagnoses were cancer (breast and colorectal primarily), infections, fracture, and heart attacks. Fifty-nine percent of errors were associated with cancer diagnosis - or should I say misdiagnosis? Most of these malpractice claims (59% again) showed that diagnostic errors were significant.
The most common reason for failure to diagnose was failure to order the right test (55%). The other reasons were:
-failure to follow up (45%)
-failure to obtain a complete thorough medical history and physical
exam (42%)
-wrong interpretation of medical tests (37%)
Some cases were cited where the doctor failed to check the test results, or to tell the patient the results.
This data is truly mind blowing! Though a small study, it carries a lot of weight. The percentages are phenomenally high! How can this be happening in the most medically advanced country in the world? The fact is, it's happening. It is more common than we think - hidden, not talked about. What can you do to keep it from happening to you?
Has your doctor discussed preventive tests for cancer detection? Of course, you should have a routine complete medical history and physical exam first. Using this information your doctor will know what tests you may need. If cancer runs in your family, you really want to consider preventive cancer screening.
The medical history and physical exam give your medical facts. Findings on physical exam may suggest cancer for which testing is needed. Some tests considered for routine cancer screening are:
-mammogram, MRI - breast cancer
-PSA (prostate specific antigen) - prostate
cancer
-colonoscopy - colon cancer
-stool blood check - colon cancer
-PAP smear - cervical cancer
-complete blood count - blood cancer
-CT or MRI scan - lung cancer, brain cancer
-pelvic sonogram - ovarian cancer
-body scan (neck to buttocks and in between) - body (this scan shows other things ,
too).
Screening tests save lives. Talk to your doctor. Be sure your doctor goes over the test results with you and explains EVERYTHING! Leave with your questions answered! Be sure to follow up with your doctor, too, to prevent any delays.
Get a copy of your test results. That way you will know if you were told everything and that the information is accurate. Research your results and diagnosis. Things you don't understand, ask again. Getting a second (and sometimes tiebreaker third because you were told different things by each doctor!)opinion is a reasonable research tool, also.
Patients must be their own advocate and take charge of their health. Health maintenance and prevention are so important to one's quality of life. Make it an important part of yours!
Remember to do your own monthly breast exams for both sexes, and monthly scrotal check for the males.
Great health is true wealth!
(*from AHRQ, Agency for Healthcare Research and Quality, publication "Research Activities" February 2007 from study in Annals of Internal Medicine, 10/3/06)
sábado, 12 de mayo de 2007
VACCINE VALIDITY
In this week’s New England Journal of Medicine the results of a trial for a quadrivalent (covers 4 strains of the virus) vaccine for HPV (human papilloma virus) were released. HPV has been shown to cause cancer of the cervix. About 70% of the cases are caused by strains HPV-16 and HPV-18. The vaccine works on four strains – HPV-6/11/16/18. “Conclusion: In young women who had not been previously infected with HPV-16 or HPV-18 those in the vaccine group had significantly lower occurrence of high-grade cervical intraepithelial neoplasia related to HPV-16 or HPV-18 than the placebo group.”
Does this mean that the vaccine should be mandatory law for eligible young females? What about the young males that may harbor this cancer causing virus? The article states in the second sentence that Pap smear tests have “led to a significant decline in mortality from cervical cancer in developed countries, such programs are costly and have not been effectively implemented in most developing countries”. It is hard to believe this new vaccine by Merck will cost less than a Pap smear, or that it will be covered by insurances like the Pap smear. Furthermore it only covers 4 strains of HPV. What about the other strains? Is it still possible to get the cancer if the vaccine is taken? Makes you go hmmmm. The article states that “the quadrivalent vaccine is prophylactic, not therapeutic.”
Though the vaccine was found to reduce cancer of the cervix, it still occurred in some who had gotten the vaccine. It occurred more in those who did not receive it. One case was found to be from another strain, HPV-52. At the beginning of the study about 11% in the placebo group (did not receive vaccine), and about 11% in the vaccinated group had abnormal Pap smears. It is unclear if these were the same ones that developed cancer. Since the vaccine does not cover all strains, but reduces the overall number of cancer cases, should it be mandatory for young teens? Has there really been enough research to warrant this?
Side effects? The primary side effect reported was due to pain at the injection site. There were other side effects reported. This is mentioned in the article, but there is a separate supplement that documents these. In the supplementary appendix the most common were “gastrointestinal disorders”, “infections and infestations” and “general disorders and administration site conditions”. Others included “injury, poisoning and procedural complications”, “musculoskeletal and connective tissue disorders”, “immune system disorders”, and more. “Nervous system disorders” were the leading system side effect. The specific details of these conditions were omitted. The article itself mentioned neck pain and seasonal allergies. It seems the information from the supplement should have been front and center. Hmmm.
The clincher is that some women became pregnant during the study. They had already received the vaccine. Pregnancy complications and congenital defects in the babies were reported in the supplementary appendix.
Ironically, the last page of this supplement to the article was a chart for Pap smear management. The chart showed what to do for abnormal Pap smears, a “mandatory regimen for triage of abnormal Papaniclaou (long word for Pap) tests to colposcopic exam.” Colposcopic exam, colposcopy, is a test to check for cancer. It seems that Pap tests are still reliable, safer, and more cost effective.
This article, the supplement, and tables were hard to decipher. This is how I interpreted the results after reading it several times. It would be interesting to know how many doctors will pass all this information along to their patients of whom this will be required. After full disclosure, it should be up to the patient (and her parents) – Pap smear to check for early cancer or HPV vaccine to possibly prevent cancer. Hmmm.
Vaccine validity or more drug deception?
Does this mean that the vaccine should be mandatory law for eligible young females? What about the young males that may harbor this cancer causing virus? The article states in the second sentence that Pap smear tests have “led to a significant decline in mortality from cervical cancer in developed countries, such programs are costly and have not been effectively implemented in most developing countries”. It is hard to believe this new vaccine by Merck will cost less than a Pap smear, or that it will be covered by insurances like the Pap smear. Furthermore it only covers 4 strains of HPV. What about the other strains? Is it still possible to get the cancer if the vaccine is taken? Makes you go hmmmm. The article states that “the quadrivalent vaccine is prophylactic, not therapeutic.”
Though the vaccine was found to reduce cancer of the cervix, it still occurred in some who had gotten the vaccine. It occurred more in those who did not receive it. One case was found to be from another strain, HPV-52. At the beginning of the study about 11% in the placebo group (did not receive vaccine), and about 11% in the vaccinated group had abnormal Pap smears. It is unclear if these were the same ones that developed cancer. Since the vaccine does not cover all strains, but reduces the overall number of cancer cases, should it be mandatory for young teens? Has there really been enough research to warrant this?
Side effects? The primary side effect reported was due to pain at the injection site. There were other side effects reported. This is mentioned in the article, but there is a separate supplement that documents these. In the supplementary appendix the most common were “gastrointestinal disorders”, “infections and infestations” and “general disorders and administration site conditions”. Others included “injury, poisoning and procedural complications”, “musculoskeletal and connective tissue disorders”, “immune system disorders”, and more. “Nervous system disorders” were the leading system side effect. The specific details of these conditions were omitted. The article itself mentioned neck pain and seasonal allergies. It seems the information from the supplement should have been front and center. Hmmm.
The clincher is that some women became pregnant during the study. They had already received the vaccine. Pregnancy complications and congenital defects in the babies were reported in the supplementary appendix.
Ironically, the last page of this supplement to the article was a chart for Pap smear management. The chart showed what to do for abnormal Pap smears, a “mandatory regimen for triage of abnormal Papaniclaou (long word for Pap) tests to colposcopic exam.” Colposcopic exam, colposcopy, is a test to check for cancer. It seems that Pap tests are still reliable, safer, and more cost effective.
This article, the supplement, and tables were hard to decipher. This is how I interpreted the results after reading it several times. It would be interesting to know how many doctors will pass all this information along to their patients of whom this will be required. After full disclosure, it should be up to the patient (and her parents) – Pap smear to check for early cancer or HPV vaccine to possibly prevent cancer. Hmmm.
Vaccine validity or more drug deception?
jueves, 10 de mayo de 2007
DRUG DECEPTION
“BREAKING NEWS. Oxycontin executive admits to misleading public…” and doctors. The newscaster comments, “Does this mean they lied?” Yes, it does. Same story, different day. What else is there to say…
martes, 8 de mayo de 2007
Health Channel
Medical information on TV is limited and stagnating. Sixty seconds on the news. Two minutes on the talk show after commercials on prescription medication. Outdated show on this channel, and outdated repeat on that channel in between the new show. Watch some on this channel then click and click to different channels to connect your medical news for today.
Remember the crawler at the bottom of the screen. Oh, you missed that there was a bird flu outbreak in Pakistan today, and that HPV vaccines will be required for teen women (what about the men?). These are the ways we learn about some of the most important news we should know. It concerns our health and public safety.
If only we had a dedicated medical TV CNN (instead of just Dr. Sanjay Gupta’s excellent show on early weekend mornings, or his occasional special). You know, like the sports channels by sport, the cartoon channels by age (and now one for the boomers!), the movie channels, government channels, and on and on. Where is the “MTV” of medical channels? Discovery Health has been carrying the TV health media for years. There should just be more!
The TV box is probably the most used medium by which folks get their news and information. It is certainly a way to get information to people. The most used information source is one of the least used by the cutting edge medical field. This was noted in my research paper, “Building an American Health System”, in 2002. This is 2007, and it’s pretty much the same, maybe even less.
A medical TV channel (actually several would be optimal) would be great! A daily health news show would be a great start towards 24-7 medical TV. Envision yourself clicking to the heart channel, or to programs with content about specific diseases. You could learn more about that high blood pressure you are trying to control, and how you can monitor it at home. Topics on maintaining good health, and prevention of disease would be a click away. And if you missed a show, it would be shown again and again.
Health and medical coverage on TV is surely lacking in this consumer driven health conscious society. We can watch as much sports, cartoons, movies, news as we want, but we still have to piece together our medical news and supplement it with the written word, or health care providers’ spoken word. And radio.
Great health is true wealth. Medical TV would make us even richer.
Remember the crawler at the bottom of the screen. Oh, you missed that there was a bird flu outbreak in Pakistan today, and that HPV vaccines will be required for teen women (what about the men?). These are the ways we learn about some of the most important news we should know. It concerns our health and public safety.
If only we had a dedicated medical TV CNN (instead of just Dr. Sanjay Gupta’s excellent show on early weekend mornings, or his occasional special). You know, like the sports channels by sport, the cartoon channels by age (and now one for the boomers!), the movie channels, government channels, and on and on. Where is the “MTV” of medical channels? Discovery Health has been carrying the TV health media for years. There should just be more!
The TV box is probably the most used medium by which folks get their news and information. It is certainly a way to get information to people. The most used information source is one of the least used by the cutting edge medical field. This was noted in my research paper, “Building an American Health System”, in 2002. This is 2007, and it’s pretty much the same, maybe even less.
A medical TV channel (actually several would be optimal) would be great! A daily health news show would be a great start towards 24-7 medical TV. Envision yourself clicking to the heart channel, or to programs with content about specific diseases. You could learn more about that high blood pressure you are trying to control, and how you can monitor it at home. Topics on maintaining good health, and prevention of disease would be a click away. And if you missed a show, it would be shown again and again.
Health and medical coverage on TV is surely lacking in this consumer driven health conscious society. We can watch as much sports, cartoons, movies, news as we want, but we still have to piece together our medical news and supplement it with the written word, or health care providers’ spoken word. And radio.
Great health is true wealth. Medical TV would make us even richer.
Patient Advocate
The “Vital Signs” of patient advocacy:
TRUST
CARING
COMMUNICATION
COMPASSION
EDUCATION
INFORMATION
KNOWLEDGE
A patient advocate is someone who cares for and helps monitor patient's medical care. You should be your own patient advocate as well as an advocate for loved ones, friends. Doctors should act as their patients’ advocates. This seals the patient-doctor bond and assures them that they will get everything they need in a timely manner.
TRUST
CARING
COMMUNICATION
COMPASSION
EDUCATION
INFORMATION
KNOWLEDGE
A patient advocate is someone who cares for and helps monitor patient's medical care. You should be your own patient advocate as well as an advocate for loved ones, friends. Doctors should act as their patients’ advocates. This seals the patient-doctor bond and assures them that they will get everything they need in a timely manner.
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