tonite’s rant about health care

March 18th, 2008

i am still not sure what obama’s plan would be, but i am sure i do not want “hillbilly” in office with her shouting and her support from the drug lobbyists, and her cockamany plan to say that everyone must pay for health care, and it could even  be garnished from  wages. suppose you don’t have any wages? suppose your job was eliminated…

 have we forgotten about national health care like other developed countries?

 obama’s speech today offered, as he usually does, a new voice, a voice of hope, and not a republican in democrat clothing. he, i believe, will enable the fixing of our society, or make a serious attempt, including health care.

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Yay! For dental schools…

February 28th, 2008

Having been unemployed for over a year, I have no medical or dental insurance. Pretty scary, as Barack knows. So I decided to go to my local dental college. It was pretty amazing. All the recommendations made by my local money mongering dentist were nixed by the student and her professors who are in the business of good service and care, not retiring next year with a fat income.

Having been a health professional student myself, years ago, I admire the interest in learning, interest in providing optimal care, integrity, not to mention learning how to navigate the halls of academia, without getting lost, before you graduate.

And all at reasonable cost. Takes more time, but it is worth every minute and every penny.

Posted in Dentistry, Health, Unemployment | No Comments »

another failed job interview

February 28th, 2008

About 3 months ago I applied for a position with a 3 month asthma research project. I stayed in touch, looking forward to an interview. They wanted to interview me yesterday. Only yesterday. Well too bad, I had plans that I could not cancel or change. So, how nice. They would interview me today at 10, by phone. Guess what? No call. No call of apology. They offered the position to someone else at the end of the day yesterday. Would you really want to work for that place? This is how they treat their applicants? That was as bad as the realtors who need me and my dog to get out of my house, then they never show up. Doesn’t make you feel good about people. Stay positive. Can’t live without it!

Posted in Employment, Headhunters, Health, Interviewing | No Comments »

Incompetence in school health

February 28th, 2008

Just read an aricle in my local newspaper. (yes; some of us still like to have that rag in our hands!)  my sons (now adults) and I moved to this city from Berkeley nearly 4 years ago. I can’t say the schools are any worse here. They were very “politically correct” to a fault there. But I did do a  9 day stint as a school nurse last fall, with the schools in this city. My application took months to process, to the tune of about $200. I was so disenchanted by the poor, no, incompetent communication within the school health staff. There are apparently 99 schools in

this city, with 67 school nurses. Then why was I assigned to 17 schools, all over the city, at all educational levels? I liked my schools but the incompetence of the program appalled me. I cannot work for people that I do not respect.  

Posted in Education, Employment, Health | No Comments »

The wheel goes round and round

January 31st, 2008

It goes round and round.

Just got a message from a dr’s office (spinal pain). Not willing to see me; “nothing more to offer me” how does he know? Hasn’t seen me for over a year! WHAT? That means he doesn’t want to do charity care. His office bills independently. Nice. I just wanted a damn consult about pain and budding incontinence. And the muscle relaxants he prescribed are outdated. He can’t even do that? Oh I get it. He came to this country to get rich. I forgot. So if I can’t pay 5k out of pocket, why should he bother seeing me? So I left another message for his scheduler. I will run her ragged. Who cares? I just want a damn consult, paid for thank you, by charity care for which I was approved till june of 08. His message was for me to see my usual provider. Well, thank you, fool, but my PA at the cheap clinic is not a spine pain specialist, and referred me to YOU. And I have no insurance. So I get no help anywhere?

Not sure what to do next. I am my own patient now…after all these years of advocating for others, no one advocates for me. screwed. I am really angry.

I have been a health professional, an advocate, for nearly 40 years. And now I find myself living like a health care indigent. NO INSURANCE AND NO WORK after being laid off twice in the last 7 years. So the clinic admin person just called. She will talk to the doc again. yah sure. We shall see.

Posted in Drugs, Health, Insurance, Pharmaceuticals | 1 Comment »

Finding Work; Declining Work

January 5th, 2008

My premise is that there is less expected of health care professionals today. Is it just in this state, that I moved to 3 years ago? I think not. Professional positions that not long ago required at least a bachelors degree, if not a masters, now require an associate degree, or any educational level that provides the person with some very basic education and the employer can pay a LOT LESS in salary.

I see this trend not just in my profession, but in many, many professions. Yet we are told  that our economy is strong and there are lots of jobs! Sure, for slightly more than minimum wage, very limited or no benefits, and no job security. More and more I see contracts for a limited time vs. the days of longevity meaning you can invest in a retirement plan and your position is relatively secure. I live in an “at will” state which means you sign a paper,  a contract, which states that you can be terminated, at any time, without notice, with no warning and no reason given. On the other hand, you, the employee, have the same privilege. And I have exercised this right twice this year. Why?

 Now employers are looking for “technicians” or “specialists” which in health ”professions”  in this state, means a student, or an entry level worker,  who wants to earn a few dollars, with no higher goals, ambitions for professional growth.

 In support of my observations, I must say that I have found that the attitudes of those doing the hiring and firing has become very vindictive and demeaning. Perhaps because the ones “in charge” who have been promoted to the role of supervisor or manager are not qualified, educated, nor experienced for their role. Their communication skills seem to be nonexistent. ?the old “peter principle” at work again?

Posted in Certifications, Contracts, Education, Employment, Firing, Health, Hiring, Nursing | No Comments »

Veterinary Medicine?

January 4th, 2008

I have often talked about the misuse of drugs in health care. That is, prescribing drugs we don’t need, thanks to the pharmaceutical industry “training” our health care providers. But only recently have I observed this to also be inherent in veterinary medicine. Maybe I need to find a new veterinarian?!

 I took my dog, a 10yo Tibetan Terrier, to the vet on Tuesday because she was having some diarrhea. So what did I come home with?

  • cephalexin capsules for her itchy belly
  • bordatella vaccine (for potential kennel cough, which she has never had)
  • a fecal test for ova and parasites (just in case that was the cause of the loose poop) just got a call; test normal!
  • panacur (to add to her food to kill parasites that she MAY have had; and MAY NOT have had) obviously she didn’t.
  • 8 cans of low fat food
  • a creamy conditioner to rub on her belly to take away the itching. I believe that meditation and talking to her would have worked just as well.
  • a topical spray when the itching gets crazy. She hates it. Smells and tastes like ethanol.
  • a special order for the new drug that is being pushed for allergies: atopica. I have decided that I would rather deal with the allergies in a naturopathic way.
  • biohazard fee. For what? recycling the   syringe used for the nasal inhalant bordatella vaccine?

The bill: $258.91. And I have decided not to give Sara most of this stuff. I am very sorry that I was in a naive mood and bought this junk. I was being stupid and forgetting my same anger toward the human medical industry. I need to find a naturopathic veterinarian.

Posted in Diet, Drugs, Health, Nutrition, Pharmaceuticals, Veterinary | No Comments »

Shingles Virus

December 12th, 2007

Last week  I had a holiday dinner with several older women (72 to 92).  One of their big topics of discussion was “shingles immunization” i. e. “have you had yours yet?” or “who can safely have the immunization?” I felt left out. Is this an older women’s disease? What is this? Who gets this?

 Being at least a decade younger than all the other women, and having never experienced this condition, neither personally nor professionaly,  nor did I know anyone who had, I was perplexed. Better come home and read about this, like right now! Because I will be getting questions…

So from reading professional articles,  I found out that shingles is caused by the varicella zoster virus.  This is the same virus that causes chicken pox, which so many in my generation , and even our children, were exposed to, and generally acquired, prior to the days of immunization to avoid chicken pox. Does this mean we are less likely, or more likely to acquire “shingles”? 

 I am a 61 yo mother of sons who are now 22 and 25. So not that long ago, my sons missed preschool at Stanford University because they both acquired chicken pox which was running rampant through their preschool. At the very same time, a pediatric endocrinogist at the same university,  was hard at work in the her lab in the attempt to develop an immunization against chicken pox. Now chicken pox has become another childhood disease that is hopefully on its road to extinction, or at least, major reduction.

 My crazy ability to remember minutae recalls my memories of two little guys, home from “school”, bored and itchy, itchy, itchy in their little matching hooded red bathrobes. And though I didn’t want to expose other children, we HAD to go out for walks before we all went nuts!

 Well, back to shingles. Shingles is caused by the same virus that causes chicken pox, as mentioned above. One cannot “catch” shingles from another person who has shingles, BUT if you have never had chicken pox, you could contract chicken pox from someone who has shingles. As it goes, the younger, or older, that we are, the more these viruses tax our immune system, our bodies, our lives.  After one has had chicken pox, the virus remains dormant in some cells of the body next to the spinal cord, and can reactivate as shingles. One is more likely to get shingles as one gets older and the immune system is weakened, and/or if one already has a compromised immune system due to another diagnosis.

So I naturally asked these dinner guests what symtoms they had. They described a “band” or a “ring” of tiny blisters, or a rash,  somewhere on their trunk or limbs, usually limited to one side. They were described as painful. What may seem to present as a relatively benign rash can result in a more serious complications. So do see a health care provider if you have something that fits this description.

 As for immunization: The Center for Disease Control and Prevention recommends that everyone 60 and over consider vaccination. While the immunization will not guarantee that you never get this condition, you will more likely have a less severe illness. Keep in mind that your health insurance may not reimburse you for this vaccination.

For more information, please check these websites: http://www.ninds.nih.gov/disorders/shingles/shingles.htm

http://www.cdc.gov/vaccines/vpd-vac/shingles/dis-faqs.htm

Posted in Health, Viruses | 1 Comment »

More About Lead Poisoning: The Basics

November 30th, 2007

Health Effects of Childhood Lead Poisoning

And now we are hearing about imported toys through the media. Is this a scare? Is it true? How do we know?  We must assume that it is true. The really alarming information is that this may have gone on for years. How do you find safe, quality toys, that are develpmentally stimulating for your children, and not just hazourdous piles of junk?

Environmental Health Hazards

Since 1950, more than 65,000 NEW chemical compounds have been introduced into common use in the western world. 84% have NOT been tested for toxicity.

Superfund sites are hazardous waste sites designated by the EPA to be a threat to human health; these may include leaking underground storage tanks or hazardous waste sites such as municipal dumps and contaminated factories or mines and mills (Chiras, 1994, p. 462nds, )More than 40 million people live within 4 miles of a Superfund site. Approximately 4 million people live within 1 mile of a Superfund site.  Lead very likely will be found in superfund sites.

Environmental Hazards of concern fall into four widely accepted classes

CHEMICAL

PHYSICAL

BIOLOGICAL

PSYCHOSOCIAL

Environmental Health Hazards

In the Home

MOLD

DUST

LEAD

Environmental Health Hazards

What is Lead?

One of the 102 elements (Are there more now? Ii have lost track) from the periodic table

A metal that is naturally found in mineral deposits.

A very stable metal that does not decay for millions of years.

Has been used in numerous products because of its malleability, low melting point, and ability to form compounds (paint, glazes, solder, to name a few)

Historical Uses of Lead

Romans: Used lead as a sweetener; Egyptians: Used lead as a cosmetic; Industry: paint, gasoline, glazes, colored newsprint

Sources of Lead Exposure in the Environment

Lead based paint and soil,oil and dust near lead industries, roadways, railroad tracks, coating the hulls of ships. Homes built before 1978. Imported cosmetics: Indian Surma, Arabic Kohl, Burmese Thanaka. Home Remedies: Azarcon, Greta. Vinyl miniblinds. Imported candies (Mexican tamarind in pots)Imported pottery.   There is lead in some cosmetics, including some “designer” lipsticks.

Other “products” containing lead:

Window blinds. Painted furniture, Leaded crystal glassware and dishes,  Bullets, Keys. Exposure to the remants of war, in water wells, and in the soil, in other countries, though we don’t know about what is here, other than the superfunds.

Sources of Lead Exposure

Hobbies and related activities- Glazed pottery making, glass blowing.

Target shooting at firing ranges, Lead soldering (e.g. electronics)Painting, Preparing lead shot, fishing sinkers, Stained glass making, Home remodeling, Car and boat repair. Cometics, some lipsticks

Sources of Lead Exposure

Occupational

Plumbers, Lead miners, Auto mechanics

Repair of radiators, in particular

Bridge, tunnel, and elevated highway construction

Today…

…Lead-based paint is the single most common source of lead poisoning during childhood.

Routes of Absorption

Ingestion

the most common route for children

Inhalation

not a common route for children

Transplacentally (In Utero) to the developing fetus

Why is lead a problem?

Lead is a neurotoxin that causes serious health problems especially for young children:

Brain damage, growth delays, learning disabilities, other serious health problems

Who is at risk?

Children under the age of 6 years

the brain is still rapidly  developing; high hand-to-mouth activity and they “live” closer to the ground

increased exposure to dust and soil,  increased exposure to carpets: a reservoir for many contaminants

Higher rate of metabolism/absorption than adults

Who is at risk?

Children with certain risk factors

iron deficiency anemia

pica

Children from low-income households (environmental and social justice concerns)because they often live in old run down homes in the poor side of town.

Children with poor nutrition

But in addition, ALL families refurbishing older homes and unaware of the risks to their children

Recent immigrants

How Do We Identify Children with Lead Poisoning?

Lead poisoned child may not look or act sick.Lead poisoning has no symptoms (problems show up later on in school, when it may too late to correct the problem or gain lost educational time). The only way to know is to look for lead poisoning  with a blood lead screening test

Health Effects of Lead Poisoning
(particularly in children)

Learning disabilities, Behavioral problems, slowed physical growth, systemic effects on kidneys and blood forming organs

BLOOD LEAD SCREENING:
WHO & WHEN?

Blood lead screening should be required for:  Any child at risk for lead poisoning.(When:-Ages 12 and 24 months, or as needed-Any time 12-72 months if not tested before-Any time 12-72 months if change in risk for lead poisoning

Blood Lead Screening @ 12 & 24 months: WHY?

Prevents lead poisoning: identifies child with low level; family education prevents blood lead level (BLL) rising to higher/poisoning levels

Why aren’t high-risk children being screened for lead poisoning?

Not ordered by primary care physician, uninsured children not getting comprehensive health care, parents unaware to act as their own advocates, and some providers just don’t believe in neurotoxins in our environment (“we don’t have a problem where we live”).

What is lead poisoning in children? Markowitz definition

“…a disorder characterized by subclinical and biochemical finding in largely asymptomatic children.” (Markowitz. 2000. Lead poisoning. Pediatrics in Review. 21(10): 327-335.

Centers for Disease Control definition

A blood lead level as “low as 10 mcg/dL … associated with harmful effects on children’s learning and behavior.”

How much is a µg/dL (microgram/deciliter) ?

Microgram: A penny weighs about 2 grams. Imagine cutting a penny into 2 million pieces. One microgram would weigh the same as 1 of those 2 million pieces.Deciliter: A deciliter is equal to about ½ cup. Or, you’d get 1µg/dL concentration if you flooded a football field with 2 feet of water and added 1 tablespoon of sugar Message: It takes only a small amount of lead to cause a lot of harm.

There is No Safe Blood Lead Level

IQ score decreases 1/4-1/2 point for every 1 µg/dL rise in Blood Lead Level:

BLL of 4 µg/dL = loss of 1 IQ pointBLL of 12 µg/dL = loss of 3 IQ pointsBLL of 16 µg/dL = loss of 4 IQ pointsBLL of 20 µg/dL = loss of 5 IQ pointsBLL of 28 µg/dL = loss of 7 IQ pointsBLL of 32 µg/dL = loss of 8 IQ pointsBLL of 40 µg/dL = loss of 10 IQ points

Society Impact of an Average Decrease of 4 IQ Points:

50 % less children with IQ > 125Twice the expected number of children with IQ < 80

How Do We Treat Lead Poisoning?

Health Services: Identify elevated blood lead level (EBLL); case management of child/family until resolved (average = 1/1/2 yrs)Environmental Services: Identify lead hazards in the home. Housing Services: Remove lead hazards in the home

Lead Poisoning Case Management

Lead poisoning educationIdentification of lead sourceNutrition educationStrategies to minimize lead exposurePlan of careAssess other health/social concernsReferral for Public Health Investigation or Environmental Investigation through local health departmentTreatment

Remove sources of leadChelation EBLL > 45 µg/dL

Strategies for Reducing Lead Exposure

Frequent hand washingWash toys oftenWet mop floorsWet wipe window sillsWipe your feet outside or take shoes off before entry

Strategies for Reducing Lead Exposure

Frequent vacuuming with a HEPA vacuum cleanerIncreasing dietary intake of iron and calcium (but not in the same meal because iron and calcium compete for absorption by the body.Frequent mealsTake iron with vitamin CRun cold water through the pipes for a few minutes before using water

Lead Poisoning
Case Management

Environmental Services

Environmental Investigation of home by registered environmental health specialistChild focusedTesting procedure

XRF-real time resultscollected samples sent to certified lab for analysis.

Lead Poisoning
Case Management (who would do the case management?)

Housing Services

Review Environmental Investigation results with families/ownersDesign plan for remediation in conjunction with the ownercheck to see if financial assistance is available for remediation by the local public housing departmentReferral to enforcement as needed

There is a national model of combined services under one umbrella (Health, Housing, Environmental though it may not be available where you live)

So back to the “superfund”. we are all at risk. where do we think we are dumping industrial toxic wastes, and what are we dumping: computer equipment, cell phones, batteries. Close to your back yard. We are all at risk.

Factor in here the combination of environmental justice and social justice, not to mention health care justice which we surely do not have in this country right now. What part of our population do you think is most susceptible to lead poisoning? And why?

If you are concerned about childhood lead poisoning, ask you child’s pediatrician, nurse practioner, physician assistant, or nurse. Don’t accept an answer “Oh; don’t worry, Mommy” Tell the provider that you want the simple blood test ordered (a fingerstick)  if you feel that your child is at risk. And don’t stop there. Call your local health department (public health nursing, environmental health, or housing offices).

The last word: yes you can buy lead testing kits at your local hardware store. But they have been proven to be innacurate. The only way to be sure about your child’s blood lead level is to ask your health care provider for a blood lead test for your child.

 I realize that I have referred to pets in my blog before. But I feel that this is important since we live pretty intimately with our pets. Yes; they can be have lead poisoning as well, depending on their environment. If you are concerned about neurological dysfunction in a pet, do ask your veterinarian to test your pet.

 And please do not take “no need” as an answer from your pediatrician or vetrinarian.

Posted in Health | No Comments »

Do We Really Need These Drugs?

November 28th, 2007

Until I was hospitalized 1 1/2 years ago for a perforated ulcer,  I was only on one daily Rx medication: the  one pill for keeping my hereditary “borderline” blood pressure under control. However, my “provider” felt she needed to add a calcium supplement to prevent osteoporosis and aspirin to prevent a heart attack and a decongestant, in lieu of just standing upright and blowing my nose. And then, during the hospitalization, Protonix was added (I can live with that). As was Norvasc which resulted in severe hair breakage and loss. I just dumped that one. And a bunch of drugs that caused fluid retention and more drugs to cope with constipation (which I never experienced). Lots of drugs prescribed; few that I took.

Now why did I need all these drugs, and even more that I just didn’t take? Well you know my bandwagon about the pill pushers in this country. And why did I even have a perforated ulcer? Too many inappropriate drugs prescribed for back pain., osteoporosis, nasal congestion!  (I have idiopathic scoliosis and a spinal fracture which didn’t bother me at all for many years when I lifted heavy  bags of books).

So now, without health insurance (yes; one of the 47 million Americans), I am trying more and more to reduce any of this junk, these chemicals, that I put into my body. Why? The side effects. And the cost!  Maybe it is my BP med that is making me a little tired , not the aging process? By the way, the insurance company DID NOT PAY FOR ALL OF MY HOSPITALIZATION AND MEDICAL CONSULTANT EXPENSES.  Surprised? I had to. After a “lay off” due to downsizing at work, with no income, and no insurance. (even though I had worked as a manager for a HEALTH insurance company!). Who pays for all these medications? I go to a local neighborhood clinic that is low cost, for the blood pressure med. But anything else? Well check into Partnership for Prescription Assistance (PPA). They have been most helpful with the drug that will prevent another ulcer.

 As a health professional, I have encountered patients/clients/members who are on as many as 21 medications each day. This is incredible. Who is monitoring this regimen? How can  people keep this straight? How do you do this? And what is really necessary? And what interacts with what other medications?   Contraindications? And what are the side effects? And who is helping to monitor this? No one. Does your doctor/provider/”prescriber” have time to do this? Of course not. And what if all these medications have the resultant side effect of confusion?

 Oh! The answer! Health insurance companies are now providing programs like healthy living support programs that  have nurse case managers who give advice to “members”. The nurse case managers are the gate keepers who help the “members” manage their medications (often from many states away) and keep costs down for the insurance companies (don’t go back to your doctor’s office! that will be a bill that the insurance company will be expected to pay). Just call me, your case manager. the nurse case manager  can talk with you after he/she enters your data into 47 computer  screens.

 So what to do? Think about who you vote for in the next election, and why. No; we don’t need another layer of bureaucracy. We need a WELL THOUGHT OUT PROGRAM FOR NATIONAL HEALTH INSURANCE. So that we can be as progressive as other developed countries. This is just one little step. Think about this.  Don’t just go along with a candidate who says she/he supports health care. You need to look way beyond that kind of statement. What is really in mind? What kind of program? Managed by whom? Who will be in charge? Who will do the oversight? THINK!

Posted in Drugs, Education, Health, Insurance, Nursing, Pharmaceuticals | 3 Comments »

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