New Mental Health Coverage

Obamacare Bumper StickerMental health has been on the minds’ of Americans in recent years, with the rise of gun violence and substance addiction, many are asking for a better solution to this epidemic.
In the beginning of this month President Obama pledged to strengthen our nation’s mental health systems by fixing Americans access to healthcare. Obama’s administration plans on preventing mental health issues by making counseling and addiction serves available to everyone. When the 2010 Affordable Care Act is fully implemented next year, millions of Americans stand to gain access to such care for the first time.
Opponents to Obamacare worry that the Affordable Care Act will be a serious strain on providers.  With the concern now on whether the providers and the delivery systems can take care of all of them, the debate over Obama’s initiative has many asking, what is really best for our patients?

For more information READ HERE

Colorful Kinesio Tape

If you have noticed more stripes and colors on athletes, chances are kinesio taping is to blame. The popularity of taping has grown in the last decade and the 2012 London Olympics have made it a household name. But how does this stuff work and is it affective?

Kinesio tape is a thin and pliable tape that is placed on areas of your body that can be prone to over extending, the tapes job is to pull on your skin to remind you NOT to over extend. Some trainers also use the tape as a tool to help improve balance in athletes and to prevent excessive extending. The taping has even been used on animals to help prevent injuries.

Research is still being done to determine the true effects of the tape, and whether it gives you a sense of stability and support or gives you a psychological edge. In the meantime kinesio taping gives us lots of pretty colors to look during sporting events and may have a bigger use in the future.

Read more about this topic HERE.

~Professional Medical Corp.

Is there a linkage between too much coffee and pregnancy rates?

Times Health Land Magazine reported a new study that claims drinking too much coffee may lower  a woman’s chances of getting pregnant. Researchers at the University of Nevada conducted an experiment on mice and concluded that too much caffeine hindered the progress of specialized cells transporting the eggs from the ovaries to the uterus. These specialized cells are in charge of squeezing the eggs around the fallopian tubes efficiently and into the womb.

Sean Ward, a professor of University of Nevada School of Medicine said, “This provides an intriguing explanation as to why women with high caffeine consumption often take longer to conceive than women who do not consume caffeine.” However, past research shows inconsistency linking pregnancy and caffeine rates.

It is advised that women who want to get pregnant should limit themselves about a cup or two of coffee a day or in other words, about 50 milligrams of caffeine intake. This is equivalent to a soda, five chocolate bars or a cup of tea.

Read more: http://healthland.time.com/2011/06/01/could-coffee-prevent-pregnancy/#ixzz1OWDkV3zC

What do you think of this new study?

Professional Medical Corp

Surgical Errors Too Common

Unthinkable errors by doctors and surgeons—such as amputating the wrong leg or removing organs from the wrong patient—occur more frequently than previously believed, a new study suggests.

Over a period of 6.5 years, doctors in Colorado alone operated on the wrong patient at least 25 times and on the wrong part of the body in another 107 patients, according to the study, which appears in the Archives of Surgery.
So-called wrong-patient and wrong-site procedures accounted for about 0.5% of all medical mistakes analyzed in the study. Although these serious errors are rare overall, the numbers seen in the study are “considerably higher” than previous estimates, researchers say.

In fact, the surgical blunders reported in the study are probably “the tip of the iceberg,” says the lead researcher, Philip Stahel, MD, a surgeon at Denver Health Medical Center. The actual number of patient and site mix-ups is likely much higher, says Dr. Stahel, describing those mistakes as “a catastrophe.”

Catastrophic surgical errors are “a lot more common than the public thinks,” says Martin Makary, MD, a professor of surgery and public health at Johns Hopkins University, in Baltimore.

“Each hospital, whether they publicly admit it or not, and whether or not it’s discoverable in a lawsuit, has an episode of wrong-site or wrong-patient surgery either every year or once every few years,” says Dr. Makary, who wrote an editorial accompanying the study. “Almost every surgeon has seen one.”

Dr. Stahel and his colleagues analyzed 27,370 records from a database of medical errors maintained by a company that provides malpractice insurance to about 6,000 physicians in Colorado. (The physicians themselves reported the incidents.)

The errors in the database—some of which originated with other doctors or support staff, rather than surgeons—were caused by a range of slipups, including mixing up patient medical records, X-rays, and biopsy samples. All of the mistakes could be traced back to some form of miscommunication.

In one wrong-patient procedure, hospital staff confused two patients with the same first and last name who were in a doctor’s office at the same time; in another, staff members brought the wrong child into the operating room. Examples of wrong-site errors included removing the wrong ovary or irradiating the wrong organ.

“One of the worst cases I saw in this study was two patients who had had prostate biopsies,” Dr. Stahel says. “One had cancer and one did not. Clinicians mixed up the samples and the patient without cancer had a radical prostatectomy—which is a huge surgery, removal of an organ for nothing—while the patient with cancer [was] still walking out in the community, not knowing his true diagnosis.”

Overall, one-third of the mistakes led to long-term negative consequences for the patient. One patient even died of lung complications after an internist inserted a chest tube in the wrong side of his body.

Only about 22% of the mistakes led to malpractice claims or lawsuits. The database is unusual in that it contains information on all incidents (not just those that resulted in a claim), and for that reason the rate of surgical mix-ups reported in the study is likely more accurate than those in previous studies, Dr. Stahel says.

The main culprit in cases such as these is human error, Dr. Makary says. “We rely on the nurse to tell us the side of a hernia repair, and the nurse can make mistakes. We rely on the surgeon’s memory, which is fallible.” Even the best surgeons can be expected to make mental errors occasionally, he says.

Health organizations have tried to put an end to surgical mix-ups. The American Academy of Orthopaedic Surgeons has launched an initiative called “Sign Your Site” that encourages surgeons to initial the actual surgical site before operating. And the Joint Commission, a nonprofit group that accredits hospitals and other health-care facilities, has developed a protocol for surgeries that includes having a presurgery “time out”—a pause during which the surgical team double-checks that the patient and site are correct.

But these protocols “are not sufficient,” Dr. Stahel says. They only apply to the operating room, he says, and nearly one-third of the botched procedures in the study took place in doctor’s offices. Moreover, the study showed that many operating-room mistakes start out in biopsy labs or during the imaging and diagnosis process.

“A lot of wrong-side, wrong-patient errors occur outside of the operating room,” Dr. Stahel says. “We should have time-outs for labeling for samples. If the lab mixes up the sample, the consequences may be worse than erroneously cutting off the wrong leg. I think we should extrapolate time-outs to internal medicine [and] laboratories.”

Article courtesy of Amanda Gardner for Health.com.

The Cost of Crash Diets

You have a week to fit into that dress, and five pounds (O.K., 10) to drop. The plan? If you were a Hollywood star, you might eat nothing but baby food or grapefruit until then, or forgo meals in favor of liquids. If you were Kim Kardashian, you’d probably prefer a QuickTrim detox formula. Or if you were Michelle Obama, you would opt for a two-day vegetables-only “cleanse,” as she calls the regimen in an interview in the September issue of Ladies’ Home Journal.

“People could eat nothing but jelly beans and if they were eating just a small amount, they would lose weight,” says Donald Hensrud, chairman of preventive medicine at the Mayo Clinic and medical editor-in-chief of The Mayo Clinic Diet, a guide to healthy weight loss. “You might be able to get away with it for a period of time, but the more restrictive [the diet] is—and the longer you follow it—the greater the risks.”

Crash diets are a tempting way to lose weight fast, says Hensrud. But most experts agree that they’re not worth the risk. Just one week of overly restrictive dieting can cause serious nutritional deficiencies, alter your metabolism, and undercut your emotional well-being. And most crash diets only set you up to regain the weight, since you haven’t made any long-term lifestyle changes.

“When people go on really rigid, low-calorie diets, they gain the weight back,” says Katherine Tallmadge, a registered dietitian and author of Diet Simple: 192 Mental Tricks, Substitutions, Habits and Inspirations. “Their plan backfires. You might lose weight through severe dieting, but you don’t develop the habits you need to keep it off, like getting the right amount of exercise.”

Short-term dieting becomes especially unhealthy below 1,000 calories a day, warns Hensrud. While dipping below that level is dangerous for anyone, the threshold for a particular person could be significantly higher, depending on age, height, weight, activity level, and body composition. The majority of women in their 30s and 40s, for example, need roughly 1,800 calories a day to stay healthy; for men in that age range, it’s about 2,200. The American Dietetic Association (ADA) defines healthy weight loss as one to two pounds per week; for each pound you want to lose, you should consume 500 fewer calories a day—or burn them off through exercise. It’s no trick to shed far more than a couple of pounds each week, but you could run up some serious nutritional deficiencies: It’s hard to get enough calcium, vitamin D, or iron on a radically reduced number of calories. You could permanently damage your organs by not providing them with sufficient working fuel. And—to be blunt—crash dieting could kill you if you lose too much fluid and your electrolytes go out of whack, says Hensrud, who has treated several short-term dieters who were hospitalized for dehydration. One of them had alarmingly low levels of potassium, sodium, and other vital electrolytes, which could cause muscle cramps, dizziness, fainting, or even a heart attack.

Even if a crash diet puts smaller numbers on the scale, the weight loss may be illusory or harmful. The first few pounds to go are usually water, and they inevitably return, says Cheryl Forberg, staff nutritionist for NBC’s The Biggest Loser. You can lose muscle mass—on near-starvation diets, the body starts to feed on protein for sustenance. And don’t be surprised if you’re more snappish: Irritability, depression, and inability to handle everyday stress are travel companions of low-cal diets.

There is a healthy way to shed a few pounds fast, merely by bumping up physical activity and making minor diet adjustments. Try eliminating processed foods, which can cause bloating if they’re loaded with sodium, and minimize overall salt intake to prevent water gain. Pig out on fruits and vegetables—especially asparagus, a natural diuretic that will help flush your body of toxins while breaking down fat, says ADA spokesman Jim White, a dietitian in Virginia Beach, Va. You should see a difference within a week. Avoid one-food plans, like cabbage soup, baby food, or vegetable-only diets, say experts. White worked with a client who spent six months on a nothing-but-watermelon diet, which he calls a sure route to malnutrition.

Bottom line: Crash diets are a quick but deceptive fix. “They patch things up instead of addressing the larger issues: cutting down portions, eating five or six meals a day to speed up your metabolism, and getting a variety of foods,” White says. “If you need to look good for a wedding or class reunion, do yourself a favor and plan ahead.”

Article courtesy of Angela Haupt for U.S. News.

Prevent Falls in the Home

Ah yes, home. The place where you can chill out, relax, unwind. But your home can be more hazardous than you think. Nearly 8 million people are injured in falls every year, either in or outside the home, according to the Centers for Disease Control and Prevention (CDC). An injury-producing fall can happen at any age—falls are the leading cause of nonfatal injuries in people ages 25 to 54. Make a few smart changes to ensure your home is the relaxing, comfy, and safe abode it should be.

Spot your pets
Sure, they’re cute. You love them. But your dog or cat may be one of the bigger household hazards when it comes to falls. Pets are responsible for more than 86,000 fall-related injuries each year, according to the CDC. Pet-related falls are more common in women, people under 15, and in people ages 35 to 54. But that doesn’t mean you have to lead a pet-free existence. Obedience training for your pooch can help. (Dogs are more likely to cause a fall than cats.) Also watch for pet dishes and toys, which are tripping hazards.

Find your inner balance
Anyone can trip, but if you’re steady on your feet you may be much less likely to injury yourself. It can help to have an exercise routine that improves your balance and leg strength. The most important aspect of the routine is that you do it standing up, says Judy Stevens, MD, an epidemiologist at the CDC’s National Center for Injury Prevention and Control. For example, try activities like tai chi to improve balance and strengthen your gams.

Read the Rx label
The more medicines you take, the greater the chance that some of them might have side effects or combine in a way that makes you feel dizzy or off-kilter. The risk goes up if the drugs affect your mind, such as sleeping pills, antidepressants, and antipsychotics. But check the label. Even drugs that you’d never suspect—such as prescription inflammation-fighting corticosteroids—can cause dizziness. “It’s really important for people to check with their pharmacist or primary care physician to make sure that the dose is right and that there are no potential interactions,” Dr. Stevens says.

Shed some light
Sure it’s nice to cut your energy bill by dimming or turning off some lights. But don’t take it so far that your home is a hazard. Use bright bulbs when and where you need them. You can still save electricity by selecting compact fluorescent light bulbs, which are more energy efficient and last longer than conventional incandescent lights. The most important spots to light up? At the top and bottom of stairs and the entryway of rooms. Make sure you don’t have to walk across a dark room to turn on a lamp.

Get a helping hand
No matter how lithe you feel, an extra rail or grab bar and nonslip rubber mat both inside and outside your shower are good ideas. Only one misplaced step on wet, traction-free tiles can result in a wipeout. Make sure the handrails and grab bars can support your weight if you do lean on them. To ensure that they’re securely installed, it’s not a bad idea to pay an expert. When you’re climbing the stairs, keep one hand on the railing, even if you don’t feel like you really need it. Another good idea? Have a second railing installed on the other side of the stairs for a double handgrip.

Check your eyes
You can turn on every light in the house, but if your eyeglass prescription is outdated, it’s a recipe for disaster. Make sure your eye prescription is current and don’t take off your glasses or remove your contacts as soon as you hit the front door. Another common risk is to walk around the house in progressives—the type of glasses that magnify close vision for reading by having a slightly different Rx at the bottom of the lens. This type of lens can make it harder for you to notice contrast and depth, particularly when you’re climbing stairs.

Roll up the rugs
You might think rugs are safe because they offer some cushion if you fall, but statistics suggest they’re more likely to cause a fall in the first place. Getting rid of rugs, especially small throw rugs that can easily bunch up and trip you, can help. At the very least, put double-sided tape under smaller rugs to keep them from sliding.

Wear slippers
Socks and hardwood floors are a great combination for a fun slip-and-slide, but that lack of traction is exactly what you don’t want. Going barefoot gives you a bit more resistance, but you could still cut your foot or stub a toe, which could trigger a fall. The best option is to slide your tootsies into comfy slippers or shoes that have a rubber or other type of ground-gripping sole.

Clear the clutter
You don’t have to be a chronic hoarder to have too much stuff in your home. Many home hazards—from cutting your foot on a child’s toy to tripping on a throw rug—can be eliminated by breaking free from clutter. Do you really need that table busting at the seams with odds and ends? Storing items that you don’t use regularly will leave more room to keep the bare essentials at arm’s length.

Watch your drinking
Although a glass of wine may be part of your end-of-day relaxation routine, keep in mind that excess alcohol intake can increase your risk of a fall. Long-term excessive alcohol intake can cause peripheral neuropathy, a type of nerve damage that causes tingling and numbness in the fingers and feet—which can also increase the risk of stumbling or losing your footing. Mixing alcohol with some types of drugs—such as benzodiazepines—is a well-known risk factor for injury-causing falls.

Courtesy of Health.com

Monitoring Devices Help Elderly Stay at Home

In the wee hours of July 14, Elizabeth Roach, a 70-year-old widow, got out of bed and went to the living room of her Virginia ranch home. She sat in her favorite chair for 15 minutes, then returned to bed.

She rose again shortly after 6, went to the kitchen, plugged in the coffee pot, showered and took her weight and blood pressure. Throughout the morning, she moved back and forth between the kitchen and the living room. She opened her medicine cabinet at 12:21 and closed it at 12:22. Immediately afterward, she opened the refrigerator door for almost three minutes. At 1:36, she opened the kitchen door and went outside.

All this information — including her exact weight (126 pounds) and blood pressure reading (139/98) — was transmitted via the Internet to her 44-year-old son, Michael Murdock, who reviewed it from his home office in suburban Denver.

All was normal — meaning all was well.

“Right now she’s not home,” Mr. Murdock said. That he deduced because the sensors he had installed throughout his mother’s home told him that the kitchen door — which leads outside — had not been reopened since 1:36, more than an hour earlier. The opening of the medicine cabinet midday confirmed to him that his mother had taken her medicine. And he was satisfied that she had eaten lunch because the refrigerator door was open more than just a few seconds.

In the general scheme of life, parents are the ones who keep tabs on the children. But now, a raft of new technology is making it possible for adult children to monitor to a stunningly precise degree the daily movements and habits of their aging parents.

The purpose is to provide enough supervision to make it possible for elderly people to stay in their homes rather than move to an assisted-living facility or nursing home — a goal almost universally embraced as both emotionally and financially desirable. With that in mind, a vast spectrum of companies, from giants like General Electric to start-ups like iReminder of Westfield, N.J., which has developed a system to notify families if loved ones haven’t taken their medicine, are looking for a piece of the market of families with an aging relative.

Many of the systems are godsends for families. But, as with any parent-child relationship, all loving intentions can be tempered by issues of control, role-reversal, guilt and a little deception — enough loaded stuff to fill a psychology syllabus. For just as the current population of adults in their 30s and 40s have built a reputation for being a generation of hyper-involved, hovering parents to their own children, they now have the tools to micro-manage their aging mothers and fathers as well.

Wendy A. Rogers, a psychology professor at Georgia Tech, who has studied such systems and seniors’ reactions to them, recalled a man who went into high alert when a sensor system showed a high level of activity in a room of his mother’s home. He called her to find out what was wrong — and it turned out that she had decided to paint the sunroom.

“I think the critical question is: Is this something the parent wants?” said Nancy K. Schlossberg, a counseling psychologist and professor emerita at the University of Maryland. She compared monitoring technology for elderly people to the infamous “nanny cams” — hidden cameras some parents use to spy on their children’s baby sitters. “Big Brother is watching you — there’s something about it that’s very offensive,” she said.

The decision, she said, must ultimately be made by the aging parent. “It has to be negotiated with the parents,” Dr. Schlossberg said. “You want to keep the relationship co-equal. If it’s not an agreement with the parent, it can be a very destructive thing.”

The system Mr. Murdock persuaded his mother to install is called GrandCare, produced by a company of the same name based in West Bend, Wis. It allows families to place movement sensors throughout a house. Information — about when doors were opened, what time a person got into and out of bed, whether there’s been any movement in a room for a certain time period — is sent out via e-mail, text message or voice mail. He said his GrandCare system cost $8,000 to install — about as much as two months at the local assisted-living facility, Mr. Murdock said — plus monthly fees of about $75. The company says that costs vary depending on what features a client chooses.

In addition to giving him peace of mind that his mother is fine, the system helps assuage that midlife sense of guilt. “I have a large amount of guilt,” Mr. Murdock admitted. “I’m really far away. I’m not helping to take care of her, to mow her lawn, to be a good son.”

His mother, Mrs. Roach, was nervous at first when her son brought up the idea of using the system. “I didn’t want to be invaded,” she said. “I didn’t understand the system and was concerned about privacy.” Now that it’s in place, she said, she’s changed her mind: “I was all wrong. I’m not feeling like I’m being watched all day.” And she really enjoys the system’s feature that lets her play games and receive photos and messages from her children and grandchildren. (She never learned to use e-mail.)

Mrs. Roach has no major health issues that require the kind of watching she is getting, and oddly enough, that is the ideal scenario. Elinor Ginzler, senior vice president for livable communities at AARP, said it’s best to discuss using such technology long before a parent’s health has slipped to a point where she might actually need it. “You frame it that way: ‘We’re so happy that things are going so well. We want to make sure to keep it that way. Let’s talk about what we can do to make sure.’ ”

What often follows is pushback. After all, this is not a generation known for its ease with technology.

“My parents’ first reaction to technology is, ’Get it away from me,’ ” said Rachel Meyers, 45, of Brooklyn, whose father, an 80-year-old retired math professor, put at the top of his course syllabus each year: “Do Not E-mail Me.” When her mother, who just turned 84 and lives with her husband in Minneapolis, developed kidney disease, Rachel and her far-flung siblings worried about how to ensure that she was taking the complicated regimen of pills needed daily for her condition.

Their father was not going to be a reliable enforcer. “My father is going to be in his own cave reading a math book with his socks and sandals,” Ms. Meyers laughed. “He is not that guy.”

Through her work as director of community initiatives at the Metropolitan Jewish Health System in Brooklyn, Ms. Meyers learned about a medication management system called MedMinder. It is basically a computerized pillbox. The correct daily dosages of her mother’s 10 different medications are arranged in boxes. When it is time to take them, the pillbox beeps and flashes. If she takes them, Ms. Meyers gets a phone call in Brooklyn saying, essentially, Mom took her pills. Her siblings, including a brother who lives in Australia, get e-mail notifications.

But if her mother doesn’t take the pills within a two-hour window, the system starts nagging. It calls her. It flashes and beeps. Then Ms. Meyers gets a phone call in New York with a message saying her mother missed her dose. “So that’s been interesting,” Ms. Meyers said. “I can call and say, ‘Hey Mom, have you taken your medicine?’ She’ll say, ‘No, I’m on my way.’ I’ll say ‘Do it as a favor for me and take it while we’re on the phone.’ She’ll take it.”

Usually it all works out. But “what does get us into hairy, difficult emotional ground,” Ms. Meyers said, is when her mother’s daily routine changes and her children neglect to reprogram the pillbox to keep up with the shift. For example, as the dialysis began taking a toll, her mother began sleeping later in the morning, but the MedMinder still expected her to take her pills at 7.

“The machine is beeping and she’s not up yet,” Ms. Meyers said. “We get stuck in our own busy lives” and forget to reprogram it. “She says, ’I don’t want it any more.’ Now we’re in a defensive place.”

However, in an interview, Ms. Meyers’s mother, Harriet Meyers, said she had come to appreciate the contraption. “At first I was rebellious. I said, ‘Look, I’m lining up my pills, Rachel.’ I said, ‘I know what I’m doing.’ ” But now she looks at it differently. “I decided to try and now I’m hooked.”

Several academic studies have been undertaken to see just where the line between loving watchfulness and over-intrusion might be drawn. Researchers at Georgia Tech have created an experimental house (called the Aware Home) outfitted with various sensors and motion detectors as well as systems that provide support for medication and memory. They brought in older adults to see how they felt about the devices. “They were quite positive about the idea,” said Ms. Rogers, who is a director of the university’s Human Factors and Aging Laboratory. But the key, she said, is control. The older person is much more amenable if he or she “can control who has access to the information and what information they have access to,” she said.

Other research suggests that having the monitors in place may be enough to give family members peace of mind, and that they are less likely than one might expect to spend time poring over the information. Kelly Caine, a researcher at Indiana University, is just completing a study that found that for all the handwringing over whether to install monitoring technology, the people who received the information from such systems “rarely checked in on the older adults using the monitoring technology more than once per day.” The findings are preliminary, cautioned Ms. Caine, the principal research scientist at the university’s Center for Strategic Health Information Provisioning.

Adult children who call parents to check up on them have learned to be careful about how they phrase their questions. “I personally don’t make it so that I’m watching,” Mr. Murdock said. “I don’t say, ‘Mom, I was looking and you didn’t do this.’ I say, ‘Mom, are you O.K.? I noticed you didn’t take your medicine.’ It’s a balancing act, but it’s an easy conversation. It’s not like I’m calling every day saying, ‘Did you do this or did you do that?’ ”

Other families have also found that the systems reduce the need for nagging conversations. Ray Joss, 91, of Flushing, Queens, has been using a sensor-based system called QuietCare that she found through Selfhelp, a social services company in New York that helps seniors use technology to allow them to live independently. She says that she and her son, who lives in New Jersey, don’t have to dwell on her well-being in conversations because the monitoring system has already let him know how she is. “We talk about other things rather than just how I feel. He doesn’t have to ask me.”

Despite their increasing familiarity with the technology, many elderly people draw the line at cameras.

Susan Oertle has been using a wireless monitoring system called BeClose to check on her aunt, who was recently widowed and had no children of her own. Though the 83-year-old woman recently broke her hip and suffers from a lung condition that compromises her breathing, she is still fiercely independent and likes to stay up till 1:30 a.m. Thanks to wireless sensors in her aunt’s bed, Ms. Oertle can roll over in the middle of the night and notice an e-mail message flashing on her phone reassuring her that her aunt went to sleep. But enough is enough. If there had been cameras to monitor her, Ms. Oertle said, “I think she would have had a bird.”

Courtesy of NYTimes