Health and Disability

LEAKED DIPLOMATIC LETTERS sent from Colombia’s Embassy in Washington describe how a staffer with the Senate Finance Committee, which is led by Sen. Orrin Hatch, R-Utah, warned of repercussions if Colombia moves forward on approving the cheaper, generic form of a cancer drug.

In particular, Flórez expressed a worry that “this case could jeopardize the approval of the financing of the new initiative ‘Peace Colombia.’”

The Obama administration has pledged $450 million for Peace Colombia, which seeks to bring together rebels and the government to end decades of fighting that has resulted in hundreds of thousands of deaths and a shattered civil society.

However, one category of findings really stood out for me – those around care coordination. Care coordination is the lynchpin of the demonstrations, aimed at countering the system’s fragmentation caused by the separate financing and benefit structures of Medicare and Medicaid as well as the complex health needs of many beneficiaries. Yet only 30 percent of enrollees in managed care plans recalled receiving help from their health plan and/or providers in coordinating their care. And, only 54 percent of enrollees in Washington and 62 percent in Colorado (the two health home demonstrations) indicated that they were usually or always helped by someone on their care team to make a treatment plan or plan ahead to take care of their condition. These findings echoed reports over the past year from the Government Accountability Office, an Early Indicators Project in Massachusetts, a consumer survey in Ohio and our own survey of ACAP health plans. Similarly, new evaluation results of the California demonstration project released this week found that only 34 percent of enrollees reported having a care coordinator and 40 percent of enrollees didn’t even know they could get care coordination. 

Among the Insured with Medical Bill Problems, 63% Report Using Up Most or All Their Savings and 42% Took on an Extra Job or Worked More Hours.  Half of People Without Health Insurance Report Problems With Medical Bills, and They Face Similar Financial and Personal Consequences As Those With Insurance

Among people with health insurance, one in five (20%) working-age Americans report having problems paying medical bills in the past year that often cause serious financial challenges and changes in employment and lifestyle, finds a comprehensive new Kaiser Family Foundation/New York Times survey. As expected, the situation is even worse among people who are uninsured: half (53%) face problems with medical bills, bringing the overall total to 26 percent.

While insurance can protect people from problem medical bills, the survey suggests that those with employer coverage or other insurance suffer similar consequences as the uninsured once such problems occur. Among those facing problems with medical bills, almost identical shares of the insured (44%) and uninsured (45%) say the bills had a major impact on their families.

People with insurance who face problem medical bills also report a wide range of consequences and sacrifices during the past year as a result, including delaying vacations or major household purchases (77%), spending less on food, clothing and basic household items (75%), using up most or all their savings (63%), taking an extra job or working more hours (42%), increasing their credit card debt (38%), borrowing money from family or friends (37%), changing their living situation (14%), and seeking the aid of a charity (11%). These shares generally are as large as or larger than the shares among uninsured people with problem medical bills.

MCS Friends Mission Statement:

1. Provide social support and helpful information about MCS (multiple chemical sensitivities)
2. Educate others about MCS
3. Help people find ways to cope with the problems caused by MCS

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Keith Morrison brings you the story surrounding one of the most wrenching ordeals a family can go through: Deciding whether to take a loved one suffering from a traumatic brain injury off life support. There is new information that challenges conventional thinking about when that life or death decision should be made. In certain types of cases, the brain may be far more resilient than we know. 

When older relatives complain about their pains, show a little empathy, because new research suggests that as we age, we may all become more sensitive to pain. A small, preliminary University of Florida Health study has suggested for the first time that inflammation may occur more quickly and at a higher magnitude — and stays around longer — when older adults experience pain versus when younger adults experience pain.

This could mean that older adults could be at risk for developing chronic pain and may benefit from taking anti-inflammatories soon after an injury or procedure, according to the researchers.

Older adults often have a certain level of chronic inflammation in their bodies. But UF researchers found that when they induced pain in older adults, proteins associated with inflammation increased more than they did in younger participants and stayed in the bodies of older adults longer. The researchers also found that anti-inflammatory cytokines, proteins that soothe inflammation, peaked later for older adults than younger adults. They published their results were published in a previous issue of Experimental Gerontology.

“Older people go through painful procedures more often, and we wanted to research whether this accumulation of painful procedures or more acute pain episodes that older people encounter is bad,” said Yenisel Cruz-Almeida, Ph.D., MSPH, an assistant professor in the UF College of Medicine’s department of aging and geriatric research who also is affiliated with the UF Institute on Aging. “If you have enough of those in a shorter period of time, does this predispose you to have chronic pain?”

More than 10% of the female population suffers from migraines. Migraines with aura is seen in one out of three of these patients, who experience transitory neurological symptoms in connection with their migraine attacks. Previous studies raised concern with regard to a possible connection between migraines and an increased risk of silent brain infarcts and white matter hyperintensities, particularly in women suffering from migraine with aura. Silent brain infarcts and WMHs have been reported to increase the risk of dementia. “This prompted us to evaluate whether women with migraine with aura might be more likely to have evidence of silent brain infarcts and an increased load of white matter hyperintensities on their brain scans,” says research team leader Dr David Gaist of the Odense University Hospital and University of Southern Denmark.

“We found no evidence of an association between migraine with aura and silent brain infarcts or white matter hyperintensities,” says Dr Gaist. “This held true for the main analyses comparing cases with unrelated controls, and for analyses focusing on twin pairs where one twin suffered from migraine with aura, and the other did not.”

“We believe patients suffering from migraines with aura and their physicians should find these results re-assuring,” says Dr Gaist.

Chronic pain, a diagnosis including arthritis, back pain, and recurring migraines, can have a profound effect on a person’s day to day life when it goes untreated. People dealing with ongoing or long-term pain can become irritable, short-tempered, and impatient, and with good reason. Constant pain raises the focus threshold for basic functioning, which leaves the pained person with a greatly reduced ability to find solutions or workarounds to even relatively mundane problems. Something like a traffic jam, which most people would be mildly annoyed by but ultimately take in stride, could seriously throw off the rhythm of someone who is putting forth so much effort just to get through the day.

Untreated pain creates a downward spiral of chronic pain symptoms, so it is always best to treat pain early and avoid chronic pain. This is why multidisciplinary pain clinics should be involved for accurate diagnosis and effective intervention early in the course of a painful illness – as soon as the primary care provider runs out of options that they can do themselves such as physical therapy or medications. However, even if the effects of chronic pain have set in, effective interdisciplinary treatment may significantly reduce the consequences of pain in their lives. There are any number of common treatments, which include exercise, physical therapy, a balanced diet, and prescription pain medication. Ultimately, effective treatment depends on the individual person and the specific source of the pain. One thing is very clear, however: the earlier a person begins effective treatment, the less the pain will affect their day-to-day life.