Put Your Own Oxygen Mask on First…Even if You Never Fly

 

 

All of our lives we have been taught the importance of working hard and taking care of others, but it is equally important to make time to take care of ourselves. On an airplane, flight attendants remind us during the safety drill to put our own oxygen masks on first before assisting others with theirs. That is what self-care is all about. If we don’t put on our own oxygen mask first – figuratively speaking, of course – then we will not be able to take care of the others who depend on us.

And there are so many depending on us! If you are part of the so-called “sandwich generation,” you may be taking care of aging parents or other relatives while still raising young children or teens. For you, August is consumed by a to-do list. I encourage you to start thinking about annual school physicals, making sure that your school-aged children are up to date on their vaccines and check-ups. If you are the parent of a young adult heading off to college or beyond, I urge you to have your son or daughter complete a Health Care Proxy so that you are able to speak with doctors and make medical decisions on their behalf should the need arise. (See my earlier blog post on this topic.)

But most importantly, make sure that you are taking care of yourself. Don’t skip your own annual check-ups. Make sure you undergo the recommended age-based health screenings such as colonoscopy, mammography, osteoporosis screening, and others. Follow up on any red flags that are found during your physical. Get enough rest, drink enough fluids (but limit your alcohol intake), and try to get some exercise every day.

It isn’t always easy to do! Remember when summertime meant long, lazy days, when the pace seemed to slow down both at work and at home, when families scheduled vacations and spent weeks at the shore or in the mountains? These days it seems to be more difficult to take time for ourselves.

This month, Care Answered will be taking our own advice. Our office will be closed from August 12 until August 26. Our staff will be taking a breather to relax, re-set, and reconnect with family and friends. I hope you have an opportunity to do the same this summer, even if it is just for a short spell. Time away is a great opportunity to put your own oxygen mask on first to ensure that you are fully able to take care of all those you love.

Enjoy the rest of the summer!

 

 

No Holiday from Good Health

Happy summer! I hope that you enjoyed all that June and early July had to offer…Father’s Day, graduations, Fourth of July celebrations and more! With summer in full swing, you may be thinking about vacation plans and relaxing with friends and family. But please don’t forget to take care of your health this summer.

While there’s never a good time to get sick, it turns out that there are times which are especially bad – namely, any weekend and the entire month of July.

Healthcare veterans all know about the so-called “July Effect.” This phenomenon begins every July 1 in the nation’s teaching hospitals, where men and women who have just graduated from medical school begin their very first weeks of field training. At the same time, more experienced trainees graduate and move on to even more specialized fellowship training programs or private practice.

With their lack of experience, newly minted doctors are more likely to run unnecessary or duplicative tests, may be unfamiliar with hospital pharmacies and prescribing standards, and are more prone to make medical errors. As a result, studies have shown that the death rate in teaching hospitals is significantly higher in July than other months.

A related phenomenon is the so-called “Weekend Effect.” This affects all healthcare settings, including non-teaching hospitals, and is observed all year long. It refers to the fact that many hospitals have fewer expert staff available on weekends and overnight, which coincides with the times when many medical emergencies occur. Numerous studies have shown that patients who visit emergency departments, undergo surgery or experience strokes or other significant episodes on a Saturday are likely to have worse outcomes than patients with similar medical conditions who seek care on other days of the week.

Unfortunately, accidents and illness do not take holidays. While enjoying the summer weather, remember to focus on health and safety to help avoid the need for emergency medical care. Here are a few basic tips to help you stay well:
• Stay hydrated by drinking plenty of water.
• Use sunscreen with an SPF of at least 30, especially if you are out during the warmest part of the day, usually between 11 a.m. and 2 p.m.
• Exercise extra caution around pools and water. Never leave a child unattended around water, even for a few seconds.
• Do not leave children or pets inside parked vehicles, even for a few minutes. The interior of a parked car can become dangerously hot very quickly.

Of course, in a medical emergency, there is not much that you can do to avoid either the July Effect or the Weekend Effect. But there are steps you can take to safeguard your health.
• Avoid scheduling elective surgery or procedures in July. Instead, postpone elective procedures until the fall if it is safe for you to do so.
• Hire a health care advocate. If you must undergo medical treatment over the summer, having an advocate by your side may help ensure that you receive safe, appropriate care.
• If you are unable to hire an advocate, ask a trusted friend or family member to stay with you if you are hospitalized over the summer. Make sure this person writes down the names of all of your medications, tests and procedures and keeps track of the staff who are providing your care.

If you have any questions, give me a call! I’d be happy to talk to you about your healthcare needs or upcoming medical encounters. I can be reached at (516) 584-2007.

Is Technology in Healthcare Your Friend or Foe?

I recently attended a panel discussion centered on the patient experience. At this event, sponsored by New York City Health Business Leaders, leaders from the healthcare technology sector shared their perspectives on whether technological breakthroughs are helping to put the focus on patients and their experience with the healthcare system.

The truth is that sometimes, technology can be dehumanizing. The electronic medical record, which holds the promise to make your medical information shareable and available to your doctors wherever you happen to be receiving care, is a prime example. Where once a doctor’s visit was exclusively dependent on face-to-face communication, oftentimes today the doctor is focused on entering data into a computer during the appointment, reducing the amount of time spent engaging with you, the patient.

However, the panelists, who represented companies that are true healthcare innovators, were optimistic about the potential of technology to help make healthcare more personalized. Apps that can track your needs and “remember” information about you, provide you with education about your health and wellness, and enhance your access to healthcare providers and medications certainly help improve your experience as a patient.

Ultimately we all need to remember that healthcare is about people, not data and statistics, fancy diagnostic equipment or cool apps. The goal of everyone working as part of a healthcare team should be to ensure that each individual is living at their fullest potential, has access to preventive care when they are well and medical treatment when they are sick, and that care is affordable.

Whether technology furthers those goals or simply adds another layer of complexity to an already complex healthcare system remains to be seen. But like the panelists who shared their expertise recently, I’m optimistic that technology has tremendous potential to bring us closer to that ideal.

Patient Advocate Tip:

Whether you are a patient or a caregiver, I recommend that you regularly access your health portals. Ask your doctors if they have them. Many of the portals allow you to message your doctor and get a quick response.  It’s just another tool in accessing your best care (along with your trusty health notebook and copies of your past medical records of course). Questions? I’m here to help. Call me at (516) 584-2007 anytime!

When the Caregiver Needs Care, You Need an Advocate

 

 

Rick Pantuliano lives with his wife and two daughters just a short drive away from his parents’ Nassau County home. This proximity has allowed them to maintain a close relationship with his 77-year-old mother. Yet even though he is nearby, he still needed professional help when his mother’s dementia became significant enough that she required round-the-clock care.

“It got to a point where my mom needed to go on Medicaid,” Rick said. “Applying was a confusing process. I was pulling my hair out.”

His attorney recommended that he contact Nicole Christensen of Care Answered.

“She held my hand through the entire process,” he recalled. “She helped me understand every step of a very time consuming and complicated situation.”

Describing his mom, Raffaela, as a strong woman who was traditionally the caregiver for other family members, Rick related how she began to show signs of dementia about six years ago, six years after his father passed away from emphysema.

“She took care of her sick aunt, who died of cancer. Then she cared for her uncle who passed away of old age. She took care of her own mom and dad who lived with them for years. She took care of a lot of people,” Rick said. “Now it’s her turn, and there’s nobody there but me.”

Commuting from Long Island each day to his job in New Jersey keeps him away for long hours, adding to the stress of trying to ensure that his mom’s needs were being met. Nicole’s assistance helped Rick feel confident that he was arranging for the most appropriate care possible for his mom.

“I would still be at the starting line if it wasn’t for Nicole,” he noted. “She was my advocate. She walked me through the entire process and stepped in whenever I felt I was hitting a brick wall. She translated everything and made it understandable and easy.”

More importantly, Nicole’s intervention will ultimately save the family a significant amount of money. With her help, Rick was able to access funding to pay for live-in aides for his mom – services for which he had been paying out of pocket each month.

Rick worked with Nicole for about five months. She brought him to a point where he has a much better understanding of how the system works and feels empowered to handle the hurdles he faces. She reassured him recently by saying, “You got this,” when he was confronted with yet another form to fill out.

And he agrees. “I am basically comfortable with everything at this point,” he said.

His mom is living safely at home with 24-hour aides. Rick is thankful for the ongoing support of his wife and daughters, and for Nicole’s intervention when he needed her expertise most.

“I would highly recommend Nicole to anybody,” he said. “Unless you’re home 24 hours a day and don’t have a job and understand the ins and outs of the healthcare system, you absolutely need an advocate. Nicole is a wonderful person. She is very caring, very in tune to your needs, and she just does her job very, very well.”

 

 

Nicole Christensen on Project Independence WCWP.org with John Ryan & Ann Hirsch

Recently, Care Answered Director Nicole Christensen appeared on Project Independence, a radio program dedicated to the needs of older adults. Hear the shocking statistics she shared with hosts John Ryan and Ann Hirsch about preventable medical errors and how to be your own healthcare advocate.

Listen here:

https://northhempsteadny.gov/PI-2019-01-Radio-Shows

 

 

Helping a Loved One Manage Chronic Conditions

Six in ten adults live with at least one chronic disease, such as cancer, heart disease, asthma, stroke and diabetes, while four in ten have multiple chronic conditions, according to the Centers for Disease Control and Prevention.

While many adults are able to manage their own chronic medical conditions, as they age this can become a challenging juggling act, especially when there are multiple medical conditions being treated.

Knowing When to Help

Some people with chronic medical conditions develop tricks and habits to help them cope. These techniques may make it appear that they are managing fine, when in reality they are just barely getting by. A seemingly inconsequential issue – a minor cold, a missed trip to the pharmacy, or a skipped meal – may be all that it takes for disaster to strike. The trick for loved ones is to know when to step in with assistance.

older man looking into camera

Get Involved Early

Don’t be afraid to ask questions. Offer to accompany your loved one to doctor’s appointments if your schedule permits. This will enable you to assess whether your loved one appears to understand the doctor’s instructions and is following his or her medication regimen and dietary recommendations.

Try to encourage frank discussions about your loved one’s condition. Encourage them to be honest about their symptoms, pain, and ability to function. Listen without judgment.

When More Help is Needed

If you feel that your loved one may need more help as their disease progresses, explore all of your options. The areas in which assistance may be needed include:

  • Personal care – bathing, dressing, washing hair. A family member may be able to assist with this, or a personal care aide can be brought in to help with these types of tasks.
  • Household chores – cooking, cleaning, laundry, minor household repairs. Again, a friend or family member may be able to visit the home to help with cooking and housework. Another option is for someone to deliver pre-cooked meals or for your loved one to travel to a senior center or local club for a hot meal. Often minor repairs can be outsourced to a local handyman; ask neighbors and friends for a trustworthy referral. If more help is needed, a personal care aide may be able to pitch in.
  • Medication compliance – pill boxes, alarms, phone calls and other technological devices can help remind your loved one about which medication to take and when to take it.

An Advocate can Help

When the juggling act of trying to coordinate the multiple aspects of a loved one’s care becomes overwhelming, it might be time to consider hiring an advocate. A healthcare advocate can help you determine what care options are available and put those services into place, accompany your loved one to doctor’s appointments, make sense of complex medical information and untangle medical bills and insurance documents, arrange for in-home care or nursing home placement as needed. To learn more about what an advocate can do, call us at 516-584-2007.

Heart Month Myths and Facts that Could Save Your Life

You can be in love with your sweetheart, suffer heartbreak, wear your heart on your sleeve, or hear a heartwarming story. Yet for all the references to the heart in language, poetry, music and popular culture, there is a great deal of misunderstanding about how the heart actually functions and nature of heart disease.

Sitting just off-center in your chest cavity, your heart is a fist-sized organ that beats roughly 70 times a minute, pumping oxygen-rich blood to vital organs throughout your body. If you think of the body as a building, your heart contains elements of both the plumbing and electrical systems. An electrical impulse stimulates the heart to beat in a normal, steady rhythm. Any disruption to that electrical system will result in an arrhythmia, which can range from a harmless mis-fire to a life-threatening inability to effectively pump.

With arteries carrying oxygen-rich blood from the heart to the rest of the body, and veins transporting oxygen-depleted blood back to the heart, any interference with those vessels can result in serious problems. Just like a clogged pipe can spell disaster in your home, coronary artery blockages can lead to a heart attack because they prevent oxygenated blood from nourishing the heart itself, resulting in damage to the heart muscle.

With those basics out of the way, let’s see if you can separate fact from fiction when it comes to heart disease.

True or False? Men are more likely to have a heart attack than women.

It is true that men are more likely to have a heart attack than women. But there are variables. When the statistics are broken down by age and ethnicity as well as gender, it turns out that at every age, the rate of heart attacks in black women meets or exceeds that in white men. The Centers for Disease Control (CDC) says that the rate of heart attacks in all women increases dramatically, nearly doubling after the age of 65.

True or False? Breast cancer is the #1 killer of woman in America.

This is false. More women die of cardiovascular disease than breast cancer in America. More than a third of deaths of American women over the age of 20 are due to cardiovascular disease, and heart attacks kill 200,000 American women each year. This is five times as many as are killed by breast cancer, according to the American College of Cardiology.

True or False? Heart disease is genetic. There’s nothing you can do to prevent it.

The good news is that heart disease is considered preventable. In fact, there has been a 60% decline in heart disease from the 1950s to the beginning of the 21st century, according to the CDC. This is mostly due to changes in lifestyle that reduced risk factors, including a decline in cigarette smoking, greater control over high blood pressure, dietary changes emphasizing low fat foods, and improved diagnosis and treatment options.

What Does this Mean for You?

Despite the advances, heart disease remains a serious health threat for both men and women. It is important to have regular physical exams and to have your blood pressure and cholesterol levels checked. Be sure that you manage chronic conditions like diabetes that could contribute to heart disease. And adjust your lifestyle to make healthier choices: don’t smoke, avoid excessive alcohol, get some exercise every day, and stay away from fatty, fried foods. Adjusting your lifestyle is often easier said than done but YOU are worth it.

For additional tips, visit the CDC at https://www.cdc.gov/heartdisease/about.htm.

What Medical Tests Do I Need?

Your doctor may have suggested you take a medical test, while your friend suggested you take another test that helped save her life, and your brother stated that you shouldn’t take any medical tests because they’re all a scam to get your money. Who is right?

I don’t have the answer to that question. But you do!

Here are some questions to ask your clinician so you can make an informed decision:

-What will the results of the test you are suggesting tell us?

-Are you suggesting these tests based on my family history, symptoms I’m showing, or for another reason?

-I have a friend who had very similar symptoms as I have. Could “x” test be appropriate for me to rule out “y” condition?

-Would you please list for me the pros and cons of having this test (i.e. does it generally have a number of false positives. If so, can it lead to unnecessary procedures that can cause more harm than good?)

-When can I call back for those test results?

Remember no news is not good news. If you decide to have a screening or test done, ask when the results should be expected and who will provide you with the results. If you don’t hear from them, it could mean that they forgot or your file got lost. This lack of knowledge is putting your health in jeopardy. Make sure you contact them and get the results.

Information is power so I want to share with you some information from leading healthcare professionals. Consumer Reports published an article assessing the benefits and risks of medical screenings. They did all the work combing through research, speaking with healthcare experts and coming up with the findings. Below are a few of the key take-aways from their report.*

Abdominal Aortic Aneurysm (AAA) Screening AAAs can cause life-threatening bleeding. This screening is an ultrasound recommended for men 65-75 who were or are current smokers, as well as men and women in that same age group who have a family history of AAA. If an AAA is found the doctor may suggest monitoring or surgical repair.

Bone Density Screening This is a screening test to detect low bone density (osteopenia) and weak, brittle bones (osteoporosis). Generally recommended for women aged 65 but also for women around the age of menopause if they are at risk (i.e. history of smoking or family history of osteoporosis). Men can consider screening at around age 80. If osteopenia is detected, a diet rich in vitamin D, exercise and calcium are often advised. If osteoporosis is detected the clinician may suggest medication to prevent fractures.

Electrocardiogram (EKG) and exercise stress tests These are done to check for signs of heart disease or arrhythmias. They are recommended for those at high risk for heart disease or those with suspected heart disease or symptoms (i.e. shortness of breath or chest pain) as a diagnostic tool. But for other low-risk people with no symptoms, these tests may lead to inaccurate results and unnecessary procedures.

Lung Cancer Scan This low-dose CT scan images the lungs. It is recommended for adults 55-80 with a “30 pack-year history” (smoking a pack a day for 30 years or two packs a day for 15 years) who currently smoke or quit within the last 15 years. It has been found to detect lung cancer early and prevent death for those at highest risk.

Remember, it is always advised that you speak with your doctor for specific recommendations on the screenings and medical tests that are indicated for your unique situation. If you need help selecting a healthcare provider or need an advocate to ask these questions and coordinate care, we can assist you. Give us a call at (516) 584-2007.

*For information and more in-depth information on these screening see Consumer Reports’ January 2019 article “Too Many Tests?”

 

 

 

 

 

 

 

 

 

Your Health is Worth a Shot

Think vaccines are only for kids? Think again. The development of vaccines revolutionized preventive medical care and virtually eradicated disease like smallpox and polio. And they remain an important part of the preventive health regimen for adults as well as children.

Which vaccines do you need as an adult? The answer will be influenced by your age, underlying medical conditions, risk factors, travel plans and the environment in which you live and work. Here is a rundown of some of the vaccines that are commonly recommended for adults:

Influenza (Flu Shot)

Generally, everyone over the age of 6 months should receive a flu vaccine annually. The best time to receive your flu shot is before flu becomes prevalent in your area, usually in the early fall. However, it is not too late to get a flu shot for this year. And it is important to do so; last year, the flu was responsible for 80,000 deaths in America, and it has already killed 13 children in the US this year. A flu shot will help protect you and those you love.

vaccination needle next to an adult's arm

Pneumococcal vaccine

The pneumococcal vaccine can help prevent serious infections in the lungs, blood or brain. The vaccine is recommended for those over 65, as well as individuals with chronic health conditions such as heart disease, cancer, lung disease, kidney disease, liver disease, diabetes or sickle cell anemia.

Tetanus or Tdap

A tetanus booster is required every 10 years. Tetanus is a serious illness that leads to severe muscle contractions. It is also known as lockjaw. It is preventable in individuals who are up-to-date on their vaccines but can occur in unvaccinated people. The bacteria typically enter the body through a wound.

Those who have not received the Tdap vaccine as children should consider getting the Tdap booster, which protects against tetanus, diphtheria and pertussis, also known as whooping cough, which is making a resurgence in children and adults.

Shingles

If you have ever had shingles, or know someone who has, you know how agonizing the condition can be. Caused by the same virus that causes chicken pox, shingles results in a painful blistering rash that often wraps around the torso. The shingles vaccine is recommended for adults 50 and over, including those who have already had shingles.

If you plan to travel internationally

If foreign travel is in your future, you should speak to your doctor about which vaccines are recommended for the areas you plan to visit. Hepatitis A, Hepatitis B, and the meningococcal vaccine may be among those recommended for you.

Live in a Nursing Home?

If you live or work in a nursing home, or work with patients in a doctor’s office or hospital, you may need to receive the measles-mumps-rubella vaccine, especially if you were born after 1957 and do not show signs of immunity in a blood test.

Some exceptions

For every rule, there is an exception. Your general health, lifestyle and the presence of any underlying medical conditions might preclude you from receiving certain vaccines or require you to receive others. It is important to have an open conversation with your doctor or healthcare provider about which vaccines are appropriate for your specific situation.

Learn more

The Centers for Disease Control and Prevention (CDC) offers an interactive quiz to determine which vaccines you may need. https://www2.cdc.gov/nip/adultimmsched/

The National Foundation for Infectious Diseases offers an infographic explaining common adult vaccines. http://www.adultvaccination.org/what-vaccines

Worth a shot

Nobody likes getting shots; it brings back childhood anxieties and phobias for many. But when you consider the benefit of avoiding painful, debilitating illness, getting your recommended vaccines is worth a shot.