Sometimes It's Worth Paying Extra
Do you dream of driving a Hyundai? When you were a teen, was a Pinto your dream car? Of course not. Most of us realize we get a lot safer car by paying for one with airbags, or even better a Volvo. And when we have kids, we start to realize that the investment is worth it.
Why is it that so few people I know think that way about health care?
Tara Parker-Pope addressed this issue head on in an article she wrote in the Wall Street Journal last year. You should read it .
Ms. Parker-Pope highlights what most people don't consider. What is it worth to stay alive, to diagnose if you are at especially high risk of a heart attack or cancer?
Look at last year's expenses. Some of these tests don't seem so costly, even if you had to pay out of pocket.
In "Before It Happens To You" I make the case that an echocardiogram, a test to look at the heart with ultrasound, should be a standard test at 50, perhaps even more than a colonoscopy. Diagnosing an abnormal heart can lead to treatment that can save your life.
The next time you wonder whether it is worth paying to get optimal care, look at your car keys. What do you drive?
The End of Life is Scary
An obvious title to a posting; but many aspects that aren't considered are particularly scary. I consulted with a patient who had very bad lung disease. His lungs were so bad that he could hardly get oxygen into his blood nor rid his body of carbon dioxide. The slightest extra problem, even something as little as a cold, could destroy his tenuously balanced condition and land him on a ventilator. Based on his condition, he would probably never be able to come off of this machine. That means he would never breathe on his own, and he could never eat or talk either.
He seemed to understand this, and told his internist (and me) that he would not want to be on a ventilator even if he were about to die. That is not how he would want to spend the last hours, days or weeks of his life.
When the time came, one of his children talked him out of it. He couldn't bear to let his father die, so he pushed until his father agreed to use the ventilator.
Whose decisions are these? Do we really let people make decisions that are best for them, or do we push them to make particular decisions that we believe should be their preferences? Are relatives without medical training able to work through the process of deciding about end-of-life care? Who is around to help at this crucial and scary time?
The Truth Spreads Slowly
The feedback I am receiving about my book "Before It Happens To You" continues to be very positive. Thanks to each of you who have contacted me to show how much the book has impacted your life.
Truth is, this book is only the first step. The goals focus on making sure that people get the information and have the tools necessary to command and realize optimal health.
Those in the know, those with power, and certainly those with financial resources know how to get the best possible health care. Either reading my book or downloading my ebook could be your first step to realizing the same goals.
Tough to Hide from this Data
Last month I wrote about my frustration associated with a study we recently completed that is proving more difficult to publish than I expected. The drug, nesiritide, makes people feel better when they are so short of breath from a weak heart (heart failure) that they need to be hospitalized, but our study suggests that using this medicine may increase the risk of death 1-6 months later.
We completed another study last week which will prove less controversial while reinforcing the concern about the safety of this medicine. This study is one that I am not at liberty to discuss until November, but when the data are presented, the medical community will see that this drug should probably be considered dangerous until proven safe in a new and larger study.
When you get a new prescription, ask your doctor whether the medicine has been tested to know with certainty that it is not associated with the risk of death, despite its obvious short-term benefit. Your must communicate that you are realistic and understand that not everyone responds to every drug the optimal way, but at the same time, make sure you are treated with medicines proven safe and effective. The only time to take chances is when your risks from your underlying medical condition is so great that you must gamble.
