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Archive for the ‘Medical Advice’ 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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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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OCTOBER is Breast Cancer Awareness Month

The More You Know…

Screening beginning at the age of 40 reduces breast cancer deaths by 18%.

Despite the above known fact, the United States Preventive Services Task Force (USPSTF) recommendations prioritize sparing women the potential negative aspects of having a mammogram, and in their opinion, their task is to try and maximize the number of lives saved, per mammogram. Shouldn’t they be more interested in how many lives are saved…period? Many advocacy groups are against the USPSTF recommendation draft listed below and I’m joining their ranks.

Hypothetically, if we are able to save one life, but it would take 500 mammograms, but that one life saved is yours at age 45, surviving to age 50 to start screening would likely not be an option for you. Would you be for, or against the starting age of 50 for screening? That is the issue with population based decision making processes – it takes the “person” out of it and aim for the greater good (but the greater good for who?)

 The other issue? If the information to NOT screen women until age 50 becomes widely accepted, then many women between the ages of 40-49 would honestly not even be aware of the USPSTF fine print recommendation to “individualize” screening. They just would not receive a mammogram. So what does that mean? Per the statistics above, 18% of women between the ages of 40-49 who missed the early opportunity of mammography diagnosis, would die from breast cancer. That is unacceptable…yes?

A similar decision is being made for age 75 and older – insufficient evidence to recommend screening. Majority of our “Baby-Boomers” are actually quite active and doing well…so more to follow on that topic.

However, despite my bias FOR screening mammogram to begin at age 40, it is always good practice to hear the other side of the story. Please see USPSTF explanation video below and link to USPSTF is HERE

What are your thoughts?

USPSTF Breast Ca Draft

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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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Ovarian Cancer is deadly. It is the 4th leading cause of death in women and the leading cause of gynecological cancer death. The average lifetime risk is 1 in 70 with median age of diagnosis of 63years. Like most other cancers, Ovarian Cancer is highly curable if diagnosed at an early stage, but 75% presents with more advance disease, at stage III or IV. Early diagnosis is usually very difficult, because patients often present with vague abdominal symptoms and there is a lack of good screening test with initial presentation.

Sister Mary Joseph Nodule w/Ascites

Sister Mary Joseph Nodule w/Ascites

Common Symptoms:

  • Abdominal discomfort/pain/bloating
  • Increasing girth (increase size around waist/abdomen region)
  • Change in bowel (movements) habits
  • Early satiety (feeling full after eating small amount of food)
  • Nausea
  • Sister Mary Joseph Nodes (associated with ovarian cancer and of gastrointestinal tract)
  • Ascites (fluid just under the abdominal skin, that shifts like a wave when tapped)

In addition to the basic blood, liver and kidney evaluation, some specific labs (blood work) that may assist with ovarian cancer diagnosis includes:

  • CA125 – elevated in 80% of ovarian tumors
  • CA 19-9 – low sensitivity, but could be positive in other cancers
  • CEA – elevated in 58% of advance stage ovarian cancers
  • AFP & βHCG – Measure if <30years old to help rule out other types of tumors

Ovaries-hurt-when-sneezeBecause of its presentation, diagnosis usually involves quite a number of imaging as well: Transvaginal ultrasound, CT scan and/or MRI, cystoscopy, sigmoidoscopy, endometrial biopsy if patient has abnormal vaginal bleeding, assessment of any ascites fluid, etc., Surgical exploration is also necessary to complete staging of disease (find out how advance and how far it has spread).

Treatment: As with most cancers, the treatment for ovarian cancer is dependent on the final staging, but majority involves surgery followed by chemotherapy. If not a chemotherapy candidate, then Whole Abdomen Radiation Therapy (WART) may be considered after surgery. However, WART is falling out of favor, due to the toxicity and side effect profile.

Can it be detected earlier? See videos below.

Dr. Oz’ brief review of Ovarian Cancer

Patient Education video w/diagrams

SEPTEMBER is Ovarian Cancer Awareness Month. For additional information you may also contact:

National Ovarian Cancer Coalition
2501 Oak Lawn Avenue, Suite 435
Dallas, TX 75219
(888) OVARIAN (682-7426)
(214) 273-4200
nocc@ovarian.org
www.whyteal.org External Links Disclaimer Logo
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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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A diagnosis of Cancer is a life changing event.

Once treatment is complete, the Fear of the Cancer Coming back (recurring)… is VERY common among cancer survivors…know that you are not alone.

recurrence1Many will attest that cancer diagnosis and treatment is (was) the most difficult thing to deal with.  HOWEVER, once the treatment is completed – surgery, months of chemotherapy, and weeks of radiation therapy, or a combination thereof – it is rather uncommon for a physician to use the other “C” word … Cure, because, the other “C” word would mean the cancer will never come back.

You see…no one can make such a guarantee. Oncologists (cancer doctors) truly does not know and cannot risk giving such a guarantee. Statistics can be given, but that too can be dangerous, as it truly depends on the patient’s personality. If the patients is an optimist (glass half full) then they will always think of being on the positive side of the equation, but if a pessimist (class half empty) then may be more self defeating.

Many patients live in ultimate dread of that post-treatment cancer evaluation/check-up. The mammogram for breast cancer, PSA’s for prostate cancer, colonoscopy for colon cancer, CT scans for lung cancer, the endoscope for head and neck cancer, the pelvic exam for gynecologic cancer, and so on, and so forth can be crippling. Patients often share that their thoughts include questions such as:

  • What if the cancer comes back?
  • What if I must go through those dreadful treatments again?
  • What if it becomes painful?
  • What if it comes back in a different area?
  • What if I ultimately die from this cancer?

New LifeSuch thoughts can be quite burdensome and may lead to heart palpitations, panic and anxiety attacks. These symptoms can occur days (and sometimes weeks/months) leading up to the follow-up appointments. Some patients may resort to living life to the fullest (sky diving, international travels, fulfilling bucket lists, etc.,) while others may abandon living (no plans for the future, no long term savings/retirement, depressed, etc..,). Both responses should be addressed.

While we can definitely do a better job at addressing the individual needs of each survivors… we are lacking the resources and staff. The Oncology community is working very hard to make a change. In the meantime, patients and their family can use an advocacy approach…how can they address their personal fear of cancer recurrence? What can they do to decrease some of the symptoms they are experiencing?

Stay tuned…next week we will review a few strategies to address some of the more common symptoms brought about by the Fear of Cancer Recurrence…

Consider the video below…more next week!

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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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We have become a very busy society.  Everything moves fast and the demand for “faster” is on the rise. Attention spans are limited to a few minutes and “waiting” and “patience” will soon be removed from our vocabulary, garnering looks of disbelief, and ultimately tagged as “bad” words.

While I am in great favor of advancement, prompt customer service, and completing the task at hand quickly, there is something to be said for a doctor’s visit that is slower and specific to one’s needs or ailments. Physicians have great demands on their time as well, and their services are in danger of becoming similar to assembly lines: patients must be seen quickly and passed along to the next section to meet Relative Value Units (RVU’s) for reimbursement.

PAUSE.

touch1Things must be slow enough in a clinic, such that a patient is touched – a Physical Exam (PE) focused or otherwise should be performed. I am bewildered by reports of folks being seen by healthcare providers and not even being touched/examined. Gathering vital signs (blood pressure, respiratory rate, temperature, etc.,) and the history are only portion of a doctor’s visit.

Digital health is the new wave, as patient call in with their questions and symptoms and a likely diagnosis is given over different media platform. However, take note of the disclaimers…

So, what type of physical exam should be expected at a Physician’s office? Well, it truly depends on the complaint or reason why you visited in the first place. Some are more direct than others.

Complaints of:

  • touch2Abdominal pain or discomfort – look, palpate, press the abdominal region
  • Cough – listen to lungs, heart, look in the mouth, feel neck nodes, etc.,
  • Back pain – look at skin, palpate area (bone, muscles, etc.,)
  • Earache – look in the ear, look in the mouth, palpate the neck nodes, etc.,
  • Breast pain – breast exam including visual, palpating, eval under arms, above clavicle and neck nodes…

The bottom line is: When someone sees their healthcare provider any reason, at the very least, a focused physical examination should be performed. No excuses. AND, if they do not, speak up and ask why!

Annual Physical Examination

Focused History & Exam for Headache

Complete Physical Exam

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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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If you have never had a Computed Tomography, which is also called CAT or CT Scan, it will only be a matter of time before your physician recommend one. CT scan is painless and is considered a more advance/sophisticate X-ray machine. However, unlike an X-ray that shows only “2-dimension” images, CT Scan uses “3-dimensions” and allows us to see inside your body (see below).

One of the many fear, is that too many CT scans can cause cancer. However, as noted in this recently published article, the benefits of CT scans far outweigh the risks of the reasons why the CT Scan was ordered in the first place.

Excerpt from Medical News:

Like a donut - open at top

Like a donut – open at top

“In recent years, there has been widespread media coverage of studies purporting to show that radiation from X-rays, CT scans and other medical imaging causes cancer.

But such studies have serious flaws, including their reliance on an unproven statistical model, according to a recent article in the journal Technology in Cancer Research & Treatment. Corresponding author is Loyola University Medical Center radiation oncologist James Welsh, MS, MD.

“Although radiation is known to cause cancer at high doses and high-dose rates, no data have ever unequivocally demonstrated the induction of cancer following exposure to low doses and dose rates,” Dr. Welsh and co-author Jeffry Siegel, PhD, write.

CT showing tumor in a child

CT showing tumor in a child

Studies purporting to find a cancer link to medical imaging radiation have other flaws besides the questionable LNT model. For example, two recent studies suggested possible increased cancer risks from low-radiation doses associated with pediatric CT scans. But these cancers likely are due to the medical conditions that prompted the CT scans, and have nothing to do with the radiation exposure, Drs. Welsh and Siegel write.”

Read more HERE or http://www.news-medical.net/news/20150701/Low-radiation-doses-from-CT-scans-do-not-cause-cancer.aspx

No need to fear CT scans! There are so many other proven cancer causing elements you should be aware of – smoking, alcohol, obesity…and much more. Pay attention to and fix what you can!

 

Video: What is a CT Scan?

Video: Patient’s experience

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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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More than any other substance – SUGAR – is linked to:

  • Obesity
  • Type-2 Diabetes
  • High blood pressure
  • Heart diseases
  • ??Cancer??

In 1822 the average American consumed about;

  • 9 grams of sugar per day
  • ~45 grams every 5days (the amount in ONE 12oz can of soda, in 2015).

We went from 45 grams every 5days to now, we consume 45 grams every 7 hours or approx 150 grams per day!  Consuming 150 grams per day or 756 grams of sugar every 5 days is a lot of sugar (see video below for understanding measurements).  So what is the recommended normal daily intake?

Men = 36 grams per day (not 150+ grams)

Women = 20 grams per day (not 150+ grams)

Children = 12 grams per day (well…the actual grams today is rather large for kids too!)

sugar1How many cans of soda do you drink per day? How many cups of juice? They both have about the same amount of sugar! YES Indeed!

Given the way sugar acts on the brain, research is finding that sugar may be as addictive as cocaine and alcohol, so quitting (or decreasing the amount consumed) may not be as easy as one may imagine (take a moment to watch the videos below).

Sooo….Now you know!

What are you going to do?

Take back control…check the labels of the things you consume (cereal, sodas, milk, bread, etc.,). You would be surprise of the items that contains sugar.  With the recommendation of roughly 30 grams per day…one soda is over the daily limit.  I try to stay below 40 grams per day…it is a challenge, but I’m doing it most days. If you must have some sugar, reach for an apple instead…at least you will have the benefit of the fiber. So, what are you going to do?

And remember – everything in moderation! (Even during your 4th of July Celebration – bummer! ;-)) Enjoy!

sugar-is-addictive

HOW MUCH SUGAR IS IN A CAN OF SODA?

THE SUGARY TRUTH

IS SUGAR TOXIC? 60 minutes

 

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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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