CSI-MIAMI: NOT A CHOICE SOURCE OF WILSON'S DISEASE INFORMATION

The critical issue in this week's CSI-Miami was Wilson's Disease, which caused the severe illness and death of several young show characters.  Unfortunately, if that program's viewers depended on the information conveyed  in that one hour show, they would have been seriously misled.

While Wilson disease does affect young people, it is inherited from both parents (not just one parent) who carry a genetic mutation, which causes this disease of copper metabolism involving liver function, neurologic disorder, movement disorder, speech disorder and conditions such as personality changes and depression.  While the disease may be fatal, competent medical evaluation at a center of excellence should lead to a proper diagnosis and treatment and a normal life expectancy.

Need information about Wilson disease?  Check out these links [1], [2] and [3] which will provide reliable current data about this uncommon condition which may be life-saving.  If someone in the family has Wilson's Disease, share the information you obtain from these links and other expert sources with the appropriate family health care providers and join the Wilson's Disease Association.

THE SPIRIT SUSTAINING HEALTH CARE REFORM
 

As my television showed a drove of national political candidates belittling each other, proclaiming their consultant-generated views on what Americans want and "need," calling for changes in  national governance, and voicing harsh criticism (coupled with parroting of their contributors' demands for destruction of President Obama's championed Affordable Care Act),  I thought of a different era in which a successful American political leadership understood that all individuals are people, created in a holy image, not subservient chattels whose major purpose in life is to make their owners rich. 

Reflect on these words (italics - below) from a humble, brave, ethical, heroic American. Take a moment and consider the difference between the spirit conveyed in these words and that  which come to us from the recent presidential primary debates, uttered in a small mean way.  The American president understood and transmitted the true meaning of freedom and died defending it, as did Rev. King whose memory Americans celebrated yesterday.  

Read on and click on the link----

"And upon this act, sincerely believed to be an act of justice, warranted by the Constitution, upon military necessity, I invoke the considerate judgment of mankind, and the gracious favor of Almighty God."

[The Emancipation Proclamation

January 1, 1863

A Transcription
By the President of the United States of America:
A Proclamation.
Whereas, on the twenty-second day of September, in the year of our Lord one thousand eight hundred and sixty-two, a proclamation was issued by the President of the United States, containing, among other things, the following, to wit:

"That on the first day of January, in the year of our Lord one thousand eight hundred....]

HOW DO LIONS CHOOSE DINNER?

If you have watched television nature programs, you may have seen videos of lions attacking relatively easy  game: animals which are very young, very old, sick or separated from the pack.  Defenseless against the predatory lion, the young, old, sick and socially isolated are easy prey.

In my experience negotiating health care contracts- and studying the practices of health insurers -  I observed similar corporate behaviors. Individual underwriting of pregnant women, in states such as Texas, resulted in their inability to obtain maternity coverage at a point when they needed it the most.  Newborns with congenital diseases, which might cost millions of dollars in health care services, led to cost-shifting. Underwriting made those with significant (and sometimes insignificant) health histories unable to obtain insurance or to afford the insurance offered to them (one insurer representative claimed that the company represented had very few HMO members who were over the age of 24). And those, seeking individual health insurance policies, were offered coverage which only the very rich could afford.

Take a look at the article from Kaiser Health News, "Health Law's Individual Mandate, Essential Benefits Draw Headlines."  You may find that my metaphor - of predation - is not far off base. The difference is that the insurers, their lobbyists and those in our government, whom their political contributions support, tread our nearby streets, state capitol hallways, and Congressional venues not far off jungles. 

MEDICALLY NONCOMPLIANT: ANYONE YOU KNOW?

Medconditions.net supplies a definition of noncompliance: "Patient or client refusal of or resistance to medical, psychological, or psychiatric treatment. (APA, Thesaurus of Psychological Index Terms, 8th ed.)" 

Any experienced physician will tell you that noncompliant patients present serious problems. It is difficult to tell whether a recommendation or prescription is helping the patient because the physician doesn't really know whether the patient is following the recommendation or has filled (or is taking the prescription or treatment in a manner consistent the doctor's instructions).  Is the patient's heart function deteriorating because the medicine is not working or is the patient not taking the medicine?  Is the patient getting sicker because of the medicine or in spite of it?  Is the patient's back pain worsening because there is increasing structural damage to the spine or back muscles or because the patient is not performing the exercise program that, if he or she had gone to the physical therapist, would normally have improved the discomfort?


Ten questions:
1. Are you a patient who doesn't follow the doctor's advice because you have good reasons not to trust the doctor's competence?
2. When the doctor gives you a prescription, do you go to the internet to research the drug or program before filling it?
3. When the doctor gives you a prescription for a generic drug, do you insist that the pharmacist provide the branded version because your insurance will pay for it and the branded drug is better?
4. Do you ask the pharmacist (or has the pharmacist been found) to give you less than the amount of the drug prescribed (i.e., fewer pills) to save money?
5. Do you cut non-scored pills into two or more pieces so that, by taking half a pill daily they will last longer,to save money?
6. Do you take the prescription drug every day as prescribed, or do you skip days?
7. Do you borrow pills from friends, or give some of your supply to friends who are running short?
8. Do you store your pills in the bathroom medicine cabinet (warm, well-lighted and moist) or in a cool dark place which may be a little out of your way?
9. Do you ask the pharmacist for pill bottle caps which are not child resistant because you keep the bottle in your purse or nightstand (including when you visit grandchildren) and find it a nuisance to open the child resistant bottles?
10. Do you put all your pills for the next week in one bottle (such as an old unlabeled medicine container) and take them out as needed?

Note: some of the links which follow are to opinions which may conflict with mine, which also follow.


Comment: 1. If you don't trust the doctor's competence, find another doctor quickly. 2. If you research the drug on the internet (at a reputable site which provides verifiable authoritative evidence for its opinions and information) you may qualify as a patient who pays attention, not a non-compliant patient. 3. The doctor's generic prescription is equivalent in effectiveness and you are wasting money and driving up the nation's health bill. 4. The pharmacist should fill the prescription as written or call the doctor to verify that the doctor agrees with your request. 5. Not only are non-scored pills not suitable for breaking or cutting (the active ingredients may not be distributed evenly throughout the pill and you may get more or less drug than you expect) but your total dose may not be correct. See link above for a conflicting opinion. 6. Skipping days needs to be discussed honestly with your doctor because you are not getting the treatment program the doctor expects. 7, Giving or taking pills may harm yourself or someone near and dear to you because the pills may be out of date, another strength, or perhaps inactive pills bought on the internet. 8. Some medicines seriously degrade in warm moist well-lighted environments and may actually damage you (i.e., your kidneys). 9. Kids experiment by taking grandparents' pills and get sick. Get child resistant caps and always use them. Don't be responsible for the illness or death of a child. 10. The unlabeled or incorrectly labeled bottle full of pills is the bane of emergency department doctors: they have to figure out what the pills are, whether you have taken them, and how they were prescribed. Keep pills in clearly marked original containers.


HAPPY SAFE HEALTHY NEW YEAR.