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Archive for the ‘Communication’ Category

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

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October is Breast Cancer Awareness Month. Although breast cancer is only one of many cancers, I am pleased of the exposure that the many “pink” ribbon brings. It gives me hope that other cancers can have a similar banner of awareness…in the near future. Despite our many progress and technological advances in medicine, cancer remains the second leading cause of death in the United States. For example, Breast Cancer has over 220,000 new diagnosis annually, and over 400,000 deaths each year. Many are surviving a longer time thank in the past.

  • Overall, cancer has taken on a more “chronic” long term debilitating effect, for those who survive initial treatment and are then diagnosed with recurrence/metastatic disease.
  • One the most feared symptom in this category of patients is pain. Overall, 50% to 70% of people with cancer experience some degree of pain, which usually intensifies as the disease progresses.
  • Less than 50% of these patients receive adequate relief of their pain, either because they are afraid to ask because they fear “addiction”, or physicians are unlikely to prescribe adequate medication to attain relief that will allow the patient continued good quality of life.
  • Suboptimal pain control can be debilitating and caregivers are often times unsure how to address this issue.

pm_general_cp_pain_approachThe World Health Organization program for cancer pain control recognizes that 1 in 5 patients with cancer has uncontrolled pain and has a ‘three-step ladder’ for the rational use of analgesics including morphine (recommended adaption to 4-step-ladder – see HERE).

Analgesic pain 4Morphine has long been the ‘gold standard’ for the treatment of severe cancer pain. However, its side-effects, particularly sedation/drowsiness, and cognitive impairment have led to ‘opioid rotation’ to alternatives such as methadone and hydromorphone. The one I like to use most in uncontrolled pain situation is the 72-h transdermal patch for Fentanyl, which offers advantages of reduced side-effects and increased convenience over oral morphine. Another novel pain medication is Intravenous (IV) strontium-89 and bisphosphonate therapy which are effective for both short- and long-term control of metastatic bone pain.

Pain Management Physician Review

Patient Discusses Pain

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

 

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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

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October is Breast Cancer Awareness Month and it is that time of year again, when American Cancer Society seeks our support. The Making Strides Against Breast Cancer Walk is being held in many cities throughout the United States. Have you joined a team and offer your financial support?

breast pinkThis could be a template for all other cancers. Imagine for a moment, if there is a walk for a specific cancer every 2 weeks…that would be awesome right?! Prostate Cancer, Colon Cancer, Gastric Cancer, Lung Cancer, Thyroid Cancer, Brain Cancer, etc.,… Imagine the societal impact and the health benefit for the participants too? A walk every 2 weeks…Why not? Just imagine…

Learn more about upcoming American Cancer Society Breast Cancer walk in your city, by clicking HERE and also see the videos below. Who knows, maybe you will see me at one of these walks…be sure to say hello! 🙂

ACS 2015

ACS Video

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

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Recently, a friend of mine had teeth extractions and when the bill was reviewed while waiting, there was an over-charge. The billing was done in anticipation of how many teeth would be removed, not after the procedure for the actual number removed. In one case, there was a charge for tooth #9, that was not even there (yes, in this procedure they charged per tooth…strange).

It caused me to wonder, how many patients actually check and question their medical and dental bills? (Watch VERY important videos below).

My nurse gave me an article that was written in the Washington Post about healthcare markups for the uninsured. Some interesting points includes:

negotiating-hospital-bills “Fifty (50) hospitals in the United States are charging uninsured consumers more than 10 times the actual cost of patient care, according a research published [recently]. All but one of the facilities are owned by for-profit entities and the largest number – 20 – are in Florida.”  Gerard Anderson, professor at the John Bloomberg School of Public Health noted,  “This means, when it cost the hospital $100, they are charging patients on average $1000. It would appear that these facilities are price gouging, simply because they can.”

Of note, other consumers who would be charged this ridiculously high rates are patients whose hospital are not in their insurance company preferred network of providers, patients using workers compensation and those covered by automobile insurance policy. Most patients covered by private, government and programs such as Medicare do not pay full price, because these entities negotiate lower rates. Location in big cities does not account for these high prices either, as hospital in the suburbs/rural area can be quite expensive.

See the Hospital list HERE

Only 2 states, Maryland and West Virginia, set hospital rate charges for procedures. Federal government does not regulate prices that healthcare providers can charge. Of course, these sky rocketing medical bills can lead to damaged credit scores, bankruptcy, or worse yet, avoidance of needed medical care.

Do consumers now have to shop around for best health care cost for a procedure? As the commercial noted, shopping around for other things, not just your car, especially if uninsured or in one of the above categories, may be to your benefit.

Watch VERY important videos below.

Unfair Hospital Charges

Negotiating Hospital Bills 

Read Rose’s story HERE

Hospital-Bill-Total

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

 

 

 

 

 

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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

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It use to be that a cancer diagnosis lead to high mortality (death) rates and survivorship came at an extreme cost of post-surgical disfiguring features, neuropathy and other late effects from chemotherapy and radiation therapy as well.  With improved technology and clinical applications of (bench) research, many patients are surviving and doing much better than generation past. As survival continues to improve, quality of life, including fertility preservation has become increasing important to patients and their families.

fertility-preservation

Sperm Banking

I recently received my seasonal St. Jude magazine with the featured topic of preserving fertility. It was great to know that fertility preservation options are now being offered to children undergoing cancer treatments or those who are survivors.  Per their report, “…[it is] estimated that half of adolescent and young adult male cancer patients are at increased risk for infertility, with about 10% of female childhood cancer survivors having acute ovarian failure and an additional 15% entering menopause prematurely.”

fertility

Egg Harvesting

It was noted in their report, that St. Jude Children’s Research Hospital is currently the only hospital in the U.S. to cover the expense associated with harvesting and storing sperm and eggs until patients reach age 35. That policy eliminates one of the greatest barriers to fertility preservation for many childhood cancer patients:cost. This is GREAT news!

I remain and avid supporter of St. Judes Research Hospital!  Hope to be a visiting professor/clinician there one day. If you are looking for a charity to support, please consider St.Judes!

stjude1

 

 

Fertility Preservation for Young Women with Cancer

Fertility Preservation Options

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

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Seeking a second opinion is often exercised in many areas of life. It is often quoted that:

  • 70% of people consider a 2nd opinion for home improvement
  • 55% of people would consider a 2nd opinion on vehicle repairs.
  • What about Cancer diagnosis? How many get another opinion?

second-opinion-cartoonWhen it comes to cancer diagnosis and other serious chronic diseases, a second opinion is not only ok, it is recommended!

Your treating physicians should not mind, and in most cases, a good physician may even recommend that a second opinion be obtained. This recommendation is NOT a bad thing! As physicians, we are often very comfortable with our recommendations, but understand that there may be other ways of accomplishing what is best for you, the patient.

***Cancer is often a scary and frightening diagnosis! It is my recommendation to NEVER go to an appointment alone, if at all possible.***

PREPARING FOR A 2nd OPINION

Don’t wait too long after diagnosis – time is of the essence! Once you have completed your 1st set of appointments (or even during the process):

  • Tell your physicians that you would like to have a 2nd a opinion. They may recommend another hospital or physician and may assist with arranging an expedient 2nd opinion appointment. Alternatively, you may do this on your own, by seeking recommendations elsewhere/trusted sources
  • Sign release forms and/or gather all of your relevant medical records—including biopsy/pathogloy/test results, blood work, or any imaging test (CT scans, MRI, US, Mammograms, etc.,). This will prevent the need to repeat these exams – save time and money!
  • Create a list/time line of all the symptoms that lead to your diagnosis, if any was experienced
  • Write down and bring a list of all the medications you are currently taking (prescription and over the counter)
  • Write down and bring a list of all your questions. If you do not know what to ask, consider the things discussed at your first oncology appointment…AND please bring someone with you!

WHAT TO EXPECT

  •  The hospital/clinic may repeat their review of the pathology report to confirm the diagnosis
  • They will provide additional details about the type of cancer and its overall stage (a description of where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body)
  • Perspective from experts in different oncology disciplines, such as medical oncology, radiation oncology, and surgical oncology
  • Discussion treatment options (sometimes doctors may disagree with the original diagnosis or the previous proposed treatment plan – different chemotherapy, different radiation therapy approach, no chemotherapy or radiation, different type of surgery, etc.,)
  • The availability of clinical trials that you may want to consider
  • The favorite question most of my patient like to ask me – “What would you recommend if I was your…___(fill in the blank/relative)” … It never hurt to ask the same!

This is by no means an exhaustive list of recommendations in preparing for a 2nd opinion, but it is a start – for a blog *smile*.  Apply these recommendations to any other serious diagnosis. If possible, ask  questions before any surgeries or serious treatment. Oh, by the way, your research on the internet does not count as a second opinion!

Again, take someone with you on your appointments!

God’s speed!

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

 

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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org and click on “Cancer Information”

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THIS IS PRICELESS! PLEASE READ THIS SHORT, QUICK SUICIDE RISK ASSESSMENT GUIDE. Click HERE

suicide_speak_reachAs physicians, we are all about trying to save lives. We want our patients to maintain good cholesterol, manage their diabetes and high blood pressure (or eradicate the need for medication through a life style dietary change and exercise), fight cancer with the weapons we have on hand (surgery, chemotherapy, radiation therapy, etc.,)…life is beautiful…and we fight with our patients to help them live the best lives they can…

Therefore, it always saddens our heart, when a life is lost through a patient’s own hands – SUICIDE. Can we find the needle in the haystack and help these patients before it is too late? An algorithm is being developed to do just that – and the U.S. Army is leading the way. Since 2004, the US Army noted a sharp increase in soldiers’ suicide rate, exceeding that of their civilian counterparts.

JAMA Psychiatry published an article in JAN 2015 titled, “Predicting suicides after psychiatric hospitalization in US Army soldiers: the Army Study To Assess Risk and rEsilience in Servicemembers (Army STARRS).” You may read the abstract HERE  and more about the article HERE  

Take a look around at you – yourself, family, friends, co-workers, colleagues, (including children…especially teenagers) etc., Anyone at risk for suicide? What are the warning signs and why are they important? Take a moment to read the suicide risk assessment guide below.

Say something kind to someone today…give an encouraging word…you never know the difference you may make!

THIS IS PRICELESS! PLEASE READ THIS SHORT, QUICK SUICIDE RISK ASSESSMENT GUIDE. Click HERE or cut and insert this link  https://view.officeapps.live.com/op/view.aspx?src=http%3A%2F%2Fwww.mentalhealth.va.gov%2Fdocs%2FSuicide_Risk_Assessment_Guide.doc

1-800-273-8255 National Suicide Prevention Lifeline (USA)

WARNING SIGNS OF SUICIDE

FACES OF  BEAUTIFUL SOULS (caution, emotionally wrenching…)

RANDOM ACTS OF KINDNESS

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org and click on “Cancer Information”

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MARCH IS COLON CANCER AWARENESS MONTH!

What would you do…if you could truly prevent hearing the double “C” word = Colon Cancer?

Take a moment to watch these very educational videos – this may save your life!

About Colon Cancer

Colonoscopy Procedure

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Liver in the Body

Inside your abdomen

The Scope It Out 5K run/walk is a way to support the Chris4Life Colon Cancer Foundation. Their goal is to bring awareness to this preventable form of cancer and to permanently eliminate the threat of colon cancer through discovery of a cure.

You can register to support a team by following link.  Go to https://fundraising.active.com/fundraiser/ASBCCancerMinistry
to donate and/or register to join the team.
 
To Register as a team member – Click ‘Register Now’, fill out all necessary information and choose the ‘Team Member’ category. Then select the team name, ASBC Cancer Ministry (Gaither), from the drop down list to register. Please consider donating to our ASBC team instead of “yourself”. 
 
To Donate to team ASBC Cancer Ministry –  click on ‘Donate Now’. Your tax deductible donation will be made towards ASBC Cancer Ministry Team. Thank you!

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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