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Monthly Archives: November 2016

Common Complication Delays Giffords’ Recovery

An accumulation of fluid in the brain, a condition called posttraumatic hydrocephalus, has delayed U.S. Rep. Gabrielle Giffords’ transfer to an inpatient rehabilitation facility.

Although the Arizona congresswoman was transferred last Friday to Memorial Hermann healthcare system in Houston, where she was scheduled to enter The Institute for Rehabilitation and Research (TIRR), she was admitted instead to the hospital’s neurological intensive care unit.

One of the doctors involved in her care in Houston, trauma surgeon John Holcomb, MD, said that a drain had been inserted to release a buildup of fluid. Until that drain is removed or a permanent shunt is implanted, Giffords must remain in the neuro ICU.

Reid Thompson, MD, chairman of neurological surgery at Vanderbilt University in Nashville, said in an e-mail to ABC News and MedPage Today that fluid buildup is a very common problem in neurosurgery.

“In the setting of a gunshot wound, and recent surgery, it would not be unusual to build up fluid and possibly have fluid leak out — raising the risk for an infection (meningitis),” wrote Thompson, who is not involved in Giffords’ care.

The timing of the drain placement, he said, suggests that Giffords has developed a fluid leak either from inflammation in the brain or an infection.

“This creates a plumbing problem as fluid can no longer circulate out,” he wrote.

According to a Houston Chronicle story, Holcomb said over the weekend that the fluid does not appear to be infected.

If the fluid buildup does not resolve within about two weeks, Thompson explained, the drain — a potential source of infection — would have to be replaced with a permanent shunt, which would divert spinal fluid from the ventricles of the brain to the abdomen, where it is absorbed.

“I don’t see it as a setback,” Thompson wrote in his e-mail. “Rather it is part of the process from her original injury. It will, however, keep her from progressing to a rehab environment quickly.”

Although Giffords’ transfer to the dedicated rehabilitation hospital has been delayed for an indeterminate amount of time, she will continue rehab in the ICU.

Another member of the medical team responsible for her care, neurosurgeon Dong Kim, MD, said the congresswoman “looked spectacular” when she arrived in Houston from University Medical Center in Tucson, Ariz., where she’d been cared for since being shot in the head at a public event on Jan. 8.

Kim said Giffords was alert, interactive, awake, calm, and comfortable.

He added that she had very good movement on the left side of her body and did not like it when doctors shined light in her eyes, both of which are considered good signs.

Kim noted that Giffords did not have much tone in her right arm and that over a period of about 30 minutes, she did not move it. The medical team in Tucson had reported seeing her move her right arm.

Overall, Kim said he expects Giffords to do “remarkably well,” adding that the entire process, including ICU care and inpatient and outpatient rehabilitation, will probably last four to six months, regardless of how quickly she recovers.

Although her doctors are optimistic, several physicians contacted by ABC News andMedPage Today cautioned that Giffords’ future function remains uncertain.

“Sadly, this is where the long-term reality of brain injury starts to hit home,” Gregory O’Shanick, MD, medical director of the Center for Neurorehabilitation Services in Richmond, Va., wrote in an e-mail.

“As she increases her efforts towards becoming more independent with rehabilitation,” he wrote, “the deficits will become ever more apparent and frustrating since there is no surgery, no single medication, and no artificial prosthesis to reverse the injury she sustained.”

Other physicians thought it unlikely that Giffords would recover without some physical or cognitive deficits.

“I think it would be too early to ask such a question without further testing, but the reality is, most people with this type of injury usually cannot return to their previous level of functioning, especially if it was at a high level,” wrote Inam Kureshi, MD, director of the head injury program at Hartford Hospital in Connecticut.

Federal Judge Strikes Down Health Reform Law

A federal judge ruled Monday that the new U.S. health-care reform law is unconstitutional, saying the federal government has no authority to require citizens to buy health insurance.

That provision is a cornerstone of the new legislation, signed into law in March by President Barack Obama.

The judge’s decision was not unexpected, and both supports and opponents of the legislation anticipate the validity of the new health law ultimately will be decided by the U.S. Supreme Court.

The ruling was handed down by U.S. District Judge Henry E. Hudson, a Republican appointed by President George W. Bush who had seemed sympathetic to the state of Virginia’s case when oral arguments were heard in October, the Associated Press reported.

Last week, White House officials said a negative ruling would not affect the implementation of the law because its major provisions don’t take effect until 2014, the AP reported.

Virginia Attorney General Kenneth Cuccinelli, a Republican, had filed a lawsuit in defense of a new Virginia law barring the federal government from requiring state residents to buy health insurance. He argued that it is unconstitutional for the federal law to force citizens to buy health insurance and to assess a penalty if they don’t.

The U.S. Justice Department said the insurance mandate falls within the scope of the federal government’s authority under the Commerce Clause. But Cuccinelli said deciding not to buy insurance is an economic matter outside the government’s domain.

By 2019, the law will expand health insurance access to 94 percent of non-elderly Americans. Advocates say that between now and then, it will also provide Americans with many new rights and protections.

Key provisions include:

  • Health plans may no longer deny coverage to people based on pre-existing health conditions.
  • Health plans that cover dependents must permit children to stay on a parent’s family policy until age 26.
  • Insurers may no longer place lifetime dollar limits on essential benefits.
  • New health plans must offer preventive services such as mammogramsand colon cancer screenings without charging a deductible, co-payment or coinsurance. (This provision does not apply to existing plans that are “grandfathered.”)

Tips to Protect Yourself From Medical Identity Theft

What is medical identity theft? In this serious and growing problem, someone else uses your personal information to obtain medical goods or services. Medical identity theft affects consumers, health care providers, and insurance organization. According to the Federal Trade Commission (FTC), medical identity theft accounts for about 3 percent of all identity theft, and the World Privacy Forum claims it’s the most difficult form of identity theft to correct.

When you are the victim of medical identity theft, incorrect information about diagnoses and treatments may appear on your medical records, potentially affecting your health care providers’ decisions about your care and treatment. Also, in addition to paying for treatment you didn’t receive, in some cases you might be denied treatment or coverage because of fraudulent medical or insurance information.

But there is some good news: HIPAA (the Health Insurance Portability and Accountability Act) regulations and the Identity Theft Protection Act, already in place, give you many of the tools you need to get errors corrected at your doctor’s office and with your insurance provider. Of course, like any crime, you’re better off preventing it from happening in the first place.

Spotting Medical Identity Theft

Among other signs, the FTC states that you may be a target of a potential medical identity theft or fraud if you are charged for medical services you didn’t receive. Keep a calendar to track your appointments, treatment dates, and any hospital admission and discharge dates. If the explanation of benefits from your insurance provider or Medicare isn’t exactly right, clear up the error as soon as possible.

Medical receipts, prescription drug information, health insurance forms, and any documents bearing your health care providers’ names might be all a clever thief needs to begin off-loading other medical claims to you. If you don’t need to keep medical documents, shred or burn them, and peel off labels from your prescription medications before recycling the containers.

Legal Protection to Combat Medical Identity Theft

The Identity Theft Protection Act of 2005 requires any commercial, charitable, educational, or non-profit organization that acquires or uses sensitive personal data to provide significant administrative, technical, and physical safeguards to prevent that data from being mishandled.

The same act that allows consumers to place a freeze on their credit reports also requires any covered entity to investigate suspected misappropriation of personal medical data and to do everything possible to correct resulting inaccurate medical information and billing problems.

Tips to Prevent Medical Identity Theft

  • Take your photo ID to all doctor appointments. Bring an ID along with your insurance information and any other documents, such as a Medicare card, so you can provide it. An FTC law known as the “red flags rule” encourages doctors and other health care providers to require proof of identity before providing services. You can write “See ID” on the signature line of your Medicare card, just as you can on a credit card, so your health care provider will be prompted to verify your identity. Also, when you’re asked to sign any paper at your doctor’s office, review the document first and be sure any erroneous information is corrected immediately.
  • Don’t divulge medical or insurance information too freely. Sometimes you’re smart to be suspicious, especially of someone contacting you by phone. If you get a caller asking you to take a health care survey and requesting your health care provider’s name or your insurance information, hang up, and then call to alert your insurance provider. Also, be suspicious of health care providers and equipment suppliers who use telemarketing or door-to-door sales tactics, put the wrong diagnosis on a claim “so Medicare will pay,” or advertise free medical consultations for people with Medicare.
  • Report any ID card loss immediately. If you lose your Medicare card or suspect it may have been stolen, call Social Security to get a replacement. Likewise, if you lose your insurance card, let your provider know right away.
  • Review all of your insurance documents. Insurance information and statements of benefits can be confusing, and medical identity thieves know that many people don’t read them carefully. However, these documents are one of the first alerts that you may be a victim of medical identity theft. Read your statements and if they don’t seem right, call your insurer’s office. Before you call, verify that the phone number on the documents you have matches the one on your insurance card.

Monitor Your Privacy and Your Health

Most people realize that maintaining good health — managing weight and keeping the body strong and mind active — means making an effort every day. Avoiding medical identity theft doesn’t require daily vigilance, but in order to avoid problems, you should perform regular “check-ups” to be sure no one is posing as you. Be sure to monitor your insurance provider’s regular statements. Although you can also request a complete copy of your medical records from your health care provider, it can be expensive — ask about the cost before you formally request it.

6 Ways to Boost Women’s Health

To look and feel your best at every age, it’s important to make smart lifestyle and health choices. Here are six simple things that women can do every day (or with regularity) to ensure good health:

Health Tip #1: Eat a healthy diet. “You want to eat as close to a natural foods diet as you can,” says Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill. That means a variety of fresh fruits and vegetables and fewer processed foods. Eat whole grains and high-fiber foods and choose leaner cuts of meat, fish, and poultry. Include low-fat dairy products in your diet as well — depending on your age, you need between 800 and 1,500 milligrams of calcium daily to help avoid osteoporosis, Dr. Novey says. Avoid foods and beverages that are high in calories, sugar, salt, and fat.

Healthy eating will help you maintain a proper weight for your height, which is important because being overweight can lead to a number of illnesses. Looking for a healthy snack? Try some raw vegetables, such as celery, carrots, broccoli, cucumbers, or zucchini with dip made from low-fat yogurt.

If you’re not getting enough vitamins and nutrients in your diet, you might want to take a multivitamin and a calcium supplement to make sure you’re maintaining good health.

Health Tip #2: Exercise. Heart disease is the leading cause of death among women in America, but plenty of exercise can help keep your heart healthy. You want to exercise at least 30 minutes a day, five days a week, if not every day. Aerobic exercises (walking, swimming, jogging, bicycling, dancing) are good for women’s health in general and especially for your heart, says Sabrena Merrill, MS, of Lawrence, Kan., a certified personal trainer and group fitness instructor and a spokeswoman for the American Council on Exercise.

Health Tip #3: Avoid risky habits. Stay away from cigarettes and people who smoke. Don’t use drugs. If you drink alcohol, do so in moderation. Most women’s health studies show that women can safely consume one drink a day. A drink is considered to be about 12 to 14 grams of alcohol, which is equal to 12 ounces of beer (4.5 percent alcohol); 5 ounces of wine (12.9 percent alcohol); or 1.5 ounces of spirits (hard liquor such as gin or whiskey, 80-proof).

Health Tip #4: Manage stress. No matter what stage of her life — daughter, mother, grandmother — a woman often wears many hats and deals with a lot of pressure and stress. “Take a few minutes every day just to relax and get your perspective back again,” Novey says. “It doesn’t take long, and mental health is important to your physical well-being.” You also can manage stress with exercise, relaxation techniques, or meditation.

Health Tip #5: Sun safely. Excessive exposure to the sun’s harmful rays can cause skincancer, which can be deadly. To protect against skin cancer, wear sunscreen with a sun protection factor (SPF) of at least 15 if you are going to be outdoors for more than a few minutes. Even if you wear sunscreen faithfully, you should check regularly for signs of skin cancer. Warning signs include any changes in the size, shape, color, or feel of birthmarks, moles, or freckles, or new, enlarging, pigmented, or red skin areas. If you spot any changes or you find you have sores that are not healing, consult your doctor.

Health Tip #6: Check for breast cancer. The American Cancer Society no longer recommends monthly breast self-exams for women. However, it still suggests them as “an option” for women, starting in their 20s. You should be on the lookout for any changes in your breasts and report any concerns to your doctor. All women 40 and older should get a yearly mammogram as a mammogram is the most effective way of detecting cancer in its earliest stages, when it is most treatable.

A woman’s health needs change as she ages, but the basics of women’s health remain the same. If you follow these six simple healthy living tips, you will improve your quality of life for years to come.