Wild Card Blog

Last blog of the semester, and I thought it would be great to write about preventative health care. A great way to improve the quality of health care a person receives can depend on their life choices. Here are some snippets on why prevention is important from the American Heart Association.

Why is preventive health care so important?

In 2001 an estimated 516,000 coronary artery bypass procedures were performed on 305,000 patients.

We don't fully understand all the causes of heart disease, but many population studies have identified major risk factors and strategies to reduce the risk. These are the risk factors we can modify, treat or control:

* tobacco smoke
* high blood cholesterol
* high blood pressure
* physical inactivity
* obesity and overweight
* diabetes mellitus

The decline in death rates from cardiovascular disease in the United States is mainly due largely to the public's adopting more healthful behaviors and lifestyles. This decline underscores why it's important for the medical profession to advocate prevention strategies. More and more evidence shows that fatty plaques in arteries can regress even in people with advanced disease. As our understanding of the causes of heart disease and stroke has improved, the association is directing preventive measures at health care providers, public health practicioners, community leaders, policy makers, patients and families, who can work together to implement our Primary and Secondary Prevention Guidelines.

By focusing on prevention, we can have a major impact on people's health. The American Heart Association wants all people to know their risk factors for heart disease and stroke and the goals for both prevention and treatment. This approach includes people knowing how to effectively use the many strategies available to achieve these goals. Prevention costs less than expensive medical interventions, and in the long run brings more benefits.

American Heart Association
Preventative Health Care
Retrived July 26, 2010 from:
http://www.americanheart.org/presenter.jhtml?identifier=4734

Yesterday I was holding a conversation with a coworker of mine and we started talking about being health conscience. We both agreed that people today are so use to the quick fix stigma that they don't care how they treat their bodies. My coworker has a friend that is an alcoholic while also taking insulin for Diabetes. She explained to me that her friends and her have gone to this friend to get them help and they do not want it. She also informed that this person has also had two strokes and still has not changed behavior. We also agreed on the fact that everyone believes that they will be the exception to the rule. Meaning if they know someone who smokes two packs a day for forty years and never developed any type of lung cancer they sometimes believe that that can happen to them as well. It's crazy what a person will believe in but its sad that it is also true. Until people realize that sometimes you can't be that lucky this type of behavior will continue on. I can only hope that something or someone will be able to get through to the public even if it has to come in the form of an iphone application.

Patient Perspective Blog #3

From a patient’s standpoint, it is hard for me to pick one side. There are so many things that the patient is not told from the beginning as well as information that the patient might have chosen not to inform the physician about that can lead to adverse effects. No and days we want to have an open relationship with our primary care doctor but there are still things we do not tell them and therefore cannot receive the best care possible. And in the case of emergency if this information is not in our file how will we get the best possible care.

I feel that doctors today seem to have trouble telling their patients what they need to do. For example, my maternal grandmother is considered overweight by BMI standards; however her doctor has not told her she needs to lose weight. He has only congratulated her on lowering her cholesterol levels. Why is he afraid to tell his patient the truth? I would personally respect them more for telling the truth than for omitting it. I think it stems back to the fact that if physician themselves is overweight, they do not want to look like a hypocrite telling patients to lose weight when clearly then need to as well.

As a patient I might be thinking that I don’t want to bring up too many problems and risk the chance of my health insurance skyrocketing. Sometimes patients do not want to hear the truth and would rather live in a dream world where everything is perfect. Another example, one of my relatives is grossly overweight and a diabetic; they have been switching doctors for years because they do not want them to know they are eating way too much on a daily basis. They recently had foot surgery and because of their weight and immobility the wound never closed. It actually got to the point where they were placed in the hospital and the doctors were considering amputation. Thankfully they still have their foot and this experience has put a scare into them. But are they doing anything about it at this point? They tell everyone that they have lost weight but the only person who would really know is their doctor and they have been switching every six months. This, in my opinion is clearly case of delusion that there is nothing wrong with them. But patients such as this one do it all the time. So who can we really believe is a fault, the physician or the patient?

Wild Card Blog

Wild Card Blog:

Given free rein on writing about whatever I choose to. I found this article about Bill Gates recently donating money to Nigeria to help with polio outbreaks that are occurring. In 2009 Nigeria had about 256 polio outbreaks and they are happy to report that only three have happened this year so far. The article did not state how much money the foundation contributed but it did state that in the past 17 months there has not been a single record of the virus affecting the Kano state.

Polio is a contagious, historically devastating disease that was virtually eliminated from the Western hemisphere in the second half of the 20th century. Although polio has plagued humans since ancient times, its most extensive outbreak occurred in the first half of the 1900s before the vaccination, created by Jonas Salk, became widely available in 1955 (kidshealth.org).

Polio is a viral illness that, in about 95% of cases, actually produces no symptoms at all (called asymptomatic polio). In the 4% to 8% of cases in which there are symptoms (called symptomatic polio), the illness appears in three forms:

• a mild form called abortive polio (most people with this form of polio may not even suspect they have it because their sickness is limited to mild flu-like symptoms such as mild upper respiratory infection, diarrhea, fever, sore throat, and a general feeling of being ill)
• a more serious form associated with aseptic meningitis called nonparalytic polio (1% to 5% show neurological symptoms such as sensitivity to light and neck stiffness)
• a severe, debilitating form called paralytic polio (this occurs in 0.1% to 2% of cases)

People who have abortive polio or nonparalytic polio usually make a full recovery. However, paralytic polio, as its name implies, causes muscle paralysis - and can even result in death. In paralytic polio, the virus leaves the intestinal tract and enters the bloodstream, attacking the nerves (in abortive or asymptomatic polio, the virus usually doesn't get past the intestinal tract). The virus may affect the nerves governing the muscles in the limbs and the muscles necessary for breathing, causing respiratory difficulty and paralysis of the arms and legs (kidshealth.org).

I think it’s wonderful that Bill and Melinda Gates use their fame and fortune to create a foundation that gives to those, whether they are a country or a high school senior the opportunity to do great things. Because of their work the virus is almost destitute in the country of Nigeria. People are starting to not worry about losing loved one to a disease that can be stopped with the right vaccinations. Hopefully more people will start to help other countries as do Bill and Melinda Gates.

References:

Google (2010, June 7) Nigerian leader lauds Bill Gates on polio, healthcare AFP retrieved from http://www.google.com/hostednews/afp/article/ALeqM5huKSzPKuqtYzJMy5Oa810tdLxY9w

Klein, J. Dowshen, S. (2007) Polio retrieved from: http://kidshealth.org/parent/infections/bacterial_viral/polio.html

What does qualtiy mean to me?

Healthcare quality in my opinion cannot be answered efficiently without thinking about the cost containment aspect. With managed care taking over the United States, insurance companies everywhere are thinking of ways to control cost without upsetting consumers. This can lead to ridiculous obligations a consumer must face in order or receive adequate if not great healthcare. Within Ransom's book, there are Six IOM's: Safe, Effective, Efficient, Timely, Patient Centered, and Equitable.

Safe should be the apex of the healthcare system, no one wants to receive treatment in a facility where more than less of the patients have died due to unclean procedures. There are standards of care that hospitals strive for to boost such safety awards. Providing safe care is a paradigm to keeping people healthier and considering the facility a quality facility. Effective healthcare, means doing everything possible to help the patient so that they do not have to return. long term patients are notorious for bed sores do to little to no movement for hours on end. In order to increase their quality of life and perhaps the longevity of life, having employees move them around or even getting them out of bed will help with the quality of life they are currently living with.

Efficient and timely go hand and hand with improving quality within a healthcare facility. The quicker a patient is in and out of the hospital the more money can be made to turning that bed over to someone else. With all of the improvements in technology, doctors are able to diagnose and treat quicker than before. Technology has helped the quality of healthcare to improve from the patients perspective. They can now possible treat a tumor months earlier due to technology than they would of maybe five years ago. Patient centered and equitable, are great ways to show compassion to a patient and help them to feel like they are not just another number.

Every single IOM is harder to reach when cost containment comes into play. By having to decide what procedures they will and will not cover; insurance companies are drawing a line and making the consumer choose between what they offer and nothing else at all. With the current healthcare reform, insurance will have to change their ways hopefully, now that the government is putting forth a competition aspect.