Monday, October 27, 2008

The future of health care?

No matter who wins the presidency, there will be some major changes in health care in the coming years.....are they going to get it right?

I have been a Registered Nurse (RN) for over 32 years (ugh!) and have worked in several different areas. My first job was working with handicapped and developmentally delayed children, then I worked general medical and surgical floors in a couple of fairly large suburban and urban hospitals. I've worked in cardiac and intensive care as well as a cardiac monitoring center. I've worked in dozens of nursing homes. In addition to direct patient care, I've done utilization review and case management for an insurance company, a physician's group and a large, nationally known hospital. Currently I work for a company that has several electronic products for doctors, nurses, case managers and others in health care fields.

I've also been an avid reader and researcher of several medical issues including new drugs, vaccines, and devices; the pharmaceutical industry; the management of diseases like heart disease and diabetes; and various other health related issues. With the Internet it is possible to get more information and varying opinions, which allows one to make informed opinions.

It's very disconcerting to see some of the issues and realize that the very people that are making these bad policies are likely going to be the ones that will advise our next president. The very people that advocate drugs, drugs and more drugs are going to be making their recommendations. The people that are advocating treating diabetics with high carbohydrate diets, the people that are in favor of treating cholesterol levels that have no influence on heart disease, the people that are claiming fat is bad for us and grains are good, and the people that want to vaccinate everyone against everything (even if the vaccine isn't effective or the risk is minor).....these are the people that are going to be having their say about what the future of health care should be.

Are we going to hear from the people that have been damaged by unnecessary and/or ineffective treatment? Are we going to hear from those that have serious doubts about the healthfulness of certain diets? Are we going to hear from those that believe that currently the health care industry is broken? That the FDA. ADA, AMA and others are in the pockets of the pharmaceutical industry? Probably not.....and even if we do, they will be the minority and ignored.

Our costs are out of control because of poor policies. Our costs are out of control because anyone with insurance can get almost any test, drug or device they want. Our costs are out of control because there is too much emphasis on something that doesn't matter (high blood cholesterol) while something else is ignored (high blood sugar), and the ignored factor is much more dangerous and damaging!

Saturday, October 11, 2008

PRA update

Today isn't the greatest day, but things could be a lot worse. Right now my left knee and my right hand/wrist are bothering me. Not enough to take pain med for, but enough to notice.

Over the past few months I've been doing well. In early summer my symptoms started to intensify, but still not too bad. I had been having trouble with my stomach and difficulty swallowing, so my doc did a repeat gastroscopy to see if I might be having a reaction from the Doxycycline I'd been taking for the PRA. Fortunately I didn't have what he was concerned about (Eosinophilic esophagitis), I had another stricture, which was dilated. After the scope I restarted the Doxy and have been doing well on it.

Since the first of August I've been taking Doxycycline 100mg twice a day on Monday, Wednesday and Friday only. This dose seems to be keeping symptoms mostly at bay without upsetting my stomach.

Over the past 2 weeks I've also been trying something different. My doc had given me Voltaren, which is an anti-inflammatory or NSAID (non-steroidal anti-inflammatory drug). Voltaren has been on the market for a long time, and according to my doc, safer than the newer NSAIDs. I'm not convinced of this....they all seem to cause problems related to heart disease. Because of this, I decided to try and get off the Voltaren and switch over to plain aspirin.

Aspirin is not felt to be a drug that leads to heart disease, in fact it's used to treat heart disease. I've also done some research and it appears that aspirin works just as well as the prescription NSAIDs. So, a couple of weeks ago I stopped my Voltaren and started taking aspirin. I'm taking the "enteric coated" aspiring, which makes it less upsetting on the stomach as it's not broken down until it hits the intestine. I also make sure to take it with food and lots of liquid to make sure it doesn't get stuck in my esophagus.

So, right now I'm taking aspirin 2-3 times a day at most and doing fairly well. I'm still having some pain, but mostly quite tolerable. I've also been using Arnica gel on my hands, and other areas as needed. It seems to be working, but doesn't last too long.

Thursday, October 09, 2008

Does this make sense? I went to the local library today to register to vote....yea I know it's late, the deadline (tomorrow) kinda snuck up on me.

So anyway, I go into the library, get a form, fill it out, seal it and give it to one of the clerks. Nice, simple, no problem.

Now.....I figure as long as I'm there I should ask for a new library card. Here in NC the cards are by county, and I've moved to a new county.

So, I go back to the clerk, who pulls up something on her computer, asks for a photo ID and at least 1 item that shows my current address....and a phone number.

So I can vote by just filling out a form, but I have to prove who I am to borrow a book??