Monday, December 31, 2012

Monday Quiz About Me: New Year's Eve Edition

Acting Balancedeat
1. What New Years resolution could you make that you know would break in less than a week.

Not eating carbs.  It would probably be good for me, but there is no way I would make it through a day, let alone a week!

2. How many of the lyrics of Auld Lang Syne do you actually know?

Those three, wait "Should Auld Lang Syne be forgot?"  That's it...well, I think "and" is after that.  :)

3. How much should a babysitter be paid for working New Years Eve?

I guess I would assume that if they agree to work on New Year's Eve I don't need to pay them more than I usually would (which is already quite a bit at $10/hour).  Do people usually pay more on New Year's Eve?  I think I will spend most of my New Year's Eves at home or at a party that includes children, so I won't have to worry about it.  I spent all of my younger years at home with a couple of girl friends for a sleepover on New Year's and I hope to continue that with my daughter!

4. What are you most looking forward to in 2013?

A new year.  This last one has kind of sucked for me.  So, it is nice to think of it ending and another one (hopefully better) beginning.  I am looking forward to instituting some changes in my life, but we'll see how that goes...follow through is what its all about.

5.  What do you do to make you more like to stick to your new year's resolutions/goals?

I am horrible at this, which is why I'm asking the question!  Please share your ideas in the comments section!

Friday, December 28, 2012

Good Riddance 2012...Don't Let the Door Hit You on the Way Out!

I don't think I've ever been so happy to see a year go away!  And that is saying quite a bit considering 2009 brought me a 2 month premature baby in February who was rehospitalized in April and got a heart transplant in July of that year.  But, still, getting the heart was good news and although the year sucked in many ways, it was a year that made me recognize how many great friends and family members I had.

This past year was full of bad news and crappy experiences dotted with good things that were few and far between.  We found out in March or so that a "bump" during a biopsy had damaged a valve in my daughter's heart that would require a second open heart surgery.  Prior to figuring out that surgery would be needed, her chest filled up with fluid and we were in the hospital for a week with a chest tube to get it drained so she could stop struggling to breathe.  In addition, she had to go on another medicine, to add to the five she was already on regularly.  About the same time, we found out that my mom's cancer was back and she was going to have to have surgery and do yet another round of chemo.  She has since done a round of chemo, started another, had a reaction about 2/3 of the way through the second one and is convinced she is terminal.  My dad's dementia got much, much worse as well during the first half of the year.  After the open heart surgery in May, we spend almost two weeks in the hospital and then a good three or four weeks at home pretty miserable dealing with the healing.  No swimming was allowed during the first two months of the summer due to the surgery.  We ended the summer with a tonsillectomy/adenoidectomy for my daughter that was horribly needed, but required another week in the hospital and another period of recovery at home.  Finally, my finances have not really improved at all despite my husband taking a higher paying job that requires him to be away from home for three to four nights a week.  This on top of the seven weeks he spends away from home during the summer at camps.  The last part of the year has been better than the first, but it still hasn't brought rose petals and champagne.

So, I'm hoping for 2013 to be better.  I'm not going to say it can't get worse, because I realize it could get worse...much worse.  But, I am going to enter the new year with some optimism that things will continue to improve.  That we will be able to go a few months without anyone in my immediate family being in the hospital for more than a few hours.  I am also hoping that I can finally find me in this crazy world that I have somehow created, but yet still do not really feel a part of in any meaningful way.  I have a job that I enjoy, but I don't have any sort of a community there.  I love the city I live in, but I don't have any real circle of friends in that community either.  I have a great family, but I often feel disconnected and rushed through the experiences I share with them.  So, I am going to do my best to change some of those things and to embrace the reality of my life while still maintaining some sort of normalcy.

I am also looking forward to all of the cliche new year resolutional goals:  getting in better shape/healthier, getting more organized, getting out of debt and on the way to financial independence/success, being more kind, etc., etc.  I probably won't be able to achieve any of those things, but I will always aim high and maybe I will get off the ground a little.

Anyways, I may post again before 2013, but thought I would get a post in here and now while I was thinking about how much 2012 has given me gray hair and tired me out.  Here's to 2013 being better.  Much, much better.

Monday, December 24, 2012

Monday Quiz - Christmas Eve Edition

Acting Balanced
I am participating in the Monday Quiz About Me today.  I haven't posted in a while and thought this would be an easy way to ease back in to it.  I have been visiting family, dealing with end of the semester grading (still ongoing), and trying to catch my breath.  So, without further ado, here is the quiz:

1. What is your favorite Christmas tradition?
I have lots of favorites.  I love decorating the tree (even though we don't do anything too fancy) and pulling out all the decorations for the house and deciding where to put them.  I also love driving around looking at Christmas lights.  And, we have now started the Elf on the Shelf tradition with my daughter (3yo) and that has been a lot of fun!  

2. How does Santa manage to circle the world in one night?
Really fast reindeers.  And perhaps a bit of help from some Dr. Who kind of technology!  :) 

3. How does Santa deliver into your home?
He comes on Christmas Eve.  If we are at our house, we don't have a fireplace, so he has to come in a backdoor. :)  When at our in-laws, they have a fireplace, so he can come down through the fireplace.  Right now there is a pile of stuff there, so I already told my daughter that she has to clean out in front of it, or Santa will trip and fall on his way in with the presents!  :) 

4. How do reindeer fly?
In the same way that Santa has some Dr. Who type of technology, I think the reindeer have some My Little Pony magic happening! 

And now for my additional fifth question (feel free to respond in comments, especially with Pinterest links!)

5. What is your favorite Christmas food or recipe?
I love appetizers!  My favorite is probably meat and cheese trays with olives and such.  I really would like for Christmas to have no dinner - just brunch (I love breakfast food) and appetizers the rest of the days.  Meat and cheese trays, veggie trays, cheese and crackers, chips and dip, meatballs or Little Smokies in the crockpot (or both), etc.  Yum, yum...this year we are going to try to make this Crescent Roll Breakfast Casserole tomorrow for brunch!  I'll let you know how it turns out!  

Wednesday, December 5, 2012

A Positive Health Care Story

KevinMD (Kevin Pho, M.D., featured blogger at MedPage Today, says the following on December 3:
Read any news story about our health system, and it will likely be negative.

Too expensive, too many errors, dissatisfied patients, doctors complaining.

We need more positive stories, says family physician Stewart Segal.

"When our medical system works right, it is truly a beautiful thing and it works right on a daily basis across the U.S.," he writes. "You just don’t hear about it.  The beauty of modern medicine is not noteworthy and will never be highlighted by the news media.  The art of medicine is lost to most, hidden in a closet by the press and powers that be.  It’s about time that it is removed from that closet placed in the daylight for others to enjoy.  It’s about time that patients who have been well served by the medical complex let their voices be heard."

There are plenty of successes that happen every day.  It can range from medical miracles, to a simple smile of thanks that patients give their providers in the exam room.  But in many cases, you'd never know from reading the news, or watching the television.
So, I would like to contribute my own positive health care story.  Some of you may know that my daughter was diagnosed with a relatively rare heart problem at seven weeks old (and she was born seven and a half weeks early, so before her original due date).  We were immediately swept into the unknown-to-us world of pediatric medicine and I must say that our experience has been pretty positive with only a few exceptions over the course of the last four years.  We were lucky enough to get referred to Lucile Packard Children's Hospital at Stanford early on in her diagnosis and we have worked with some of the most wonderful doctors and nurses in the nation because of that.

I don't have a lot to which to compare my experience, since we were have not spent time at any other children's hospitals.  But, I will say that being at a teaching hospital has truly spoiled me.  When I go to medical appointments with my mom at her hospital (a non-teaching hospital), I feel the lack of diversity of opinion (at LPCH, there is always a team working with your child - the team is mostly made up of medical residents or fellows and sometimes even medical students, but knowing that there are multiple opinions and multiple checks really makes me feel better) and the lack of patient engagement (one of the overarching foundations of care at LPCH is family-centered care - since my daughter is young, that meant them asking me questions about her and getting my opinions on what was going on - I always feel included in my daughter's diagnosis and care - sometimes to the point of exhaustion when I have repeated the same information five or six times to different medical personnel).  I know that it is impossible to foster this type of care at all medical facilities, but I can say that having access to a medical teaching facility is truly something that can change your perspective on the health care system.

The other thing I would say about my experience with the health care system has been an incredibly positive experience with our health insurance provider,  Blue Shield of CA.  I have heard horror stories from other families about fighting with their insurers, getting huge bills that have to be negotiated, having huge debts from transplant experiences.  We have had none of that.  We were refused an RSV shot at one point, but appealed and got it reinstated.  I had one bill that was mislabeled for my daughter's original ambulance transport that took a few phone calls back and forth to get handled.  I was sent one bill in the mail while it was being negotiated (and almost passed out when I saw how much it was for), but was never contacted beyond that.  Other than that, I have never had anyone question coverage for any item - and she has had more than her share of medical procedures, therapy, etc. over the last four years.  I don't know if this is typical for Blue Shield of CA or a reflection of our hospital billers being good at their jobs, but either way, it has been an incredibly positive experience.  The only bad thing is it makes me very, very scared to change or lose my job because I don't ever want to lose this health insurance!

My daughter is doing well.  We have had some bumps along the road to be sure.  But, over all, I always feel secure in the fact that she is getting the absolute best care at LPCH.  I also feel that I have been treated with respect and compassion throughout the experience, something that means a ton in a situation like this.  I wish that everyone could have such positive health care experiences and I guess that is one reason why I am so interested in health communication and patient advocacy.  There are places and people out there who are doing amazing things and I want individuals to be able to find those places and people and have successful health care and successful relationships with their health care providers.

So, there it is - my positive health care story!  I encourage others who have had positive stories to share theirs as well.  I think KevinMD is correct - the medical system is taking a bashing in the mainstream media, but we can rally online media and show that there are a lot of very positive stories out there and hopefully through that, figure out a way to turn around the negatives that do exist and are often highlighted.

Tuesday, December 4, 2012

Winner, Winner, Chicken Dinner

I do not consider myself to be a lucky person.  In fact, I am usually more inclined to think that losing makes me stronger and to take my lot in life and move on.  But, lately, I have been entering online blog contests as I see them.  Nothing substantial - just when I come across something that I think would be a good thing to have, I take a few minutes to enter the contest.  Usually via Rafflecopter, so it isn't difficult.  And often, it will introduce me to new blogs and/or new Pinterest pages and/or new Facebook pages that I soon fall in love with.  So, why not?

Well, this week has been my lucky week!  So far, I have been notified that I won a Ubooly from Mom in Management (one of my favorite blogs), which is going to become a Christmas gift for Bean (she will love it - although, we may not be able to get our phone/iPad back from her) and today I found out I won the Winter Kids Craft prize from a new blog I discovered recently: Projects for Preschoolers.  The prize is a combination of things for me (a planner, journal and notepads) and things for Bean (crafts supplies, etc.).  I love, love, love the Laura Kelly designs stuff and I have not got a new wall calendar for 2013 yet, so it will be perfect!  I am super excited about both things and can't wait to get them and try it all out.  Thanks to Jen at Projects for Preschoolers and Daria at Mom in Management!

So, for this week, I will consider myself lucky!  What about you?  Have you won anything lately?

Comment on: Hospitals Offer Wide Array Of Services To Keep Patients From Needing To Return - Kaiser Health News

As a follow up to my November 15 Comment on readmission rates, I thought I would also comment on this:  Hospitals Offer Wide Array Of Services To Keep Patients From Needing To Return - Kaiser Health News.

This article offered a few more specific instances of successful follow-up care offered to patients that seem successful in avoiding readmission.  Some of the things I talked about in the November 15 post were identified in this article:
Robert Wood Johnson University Hospital in New Brunswick, N.J., has nurses visit high-risk patients at their home within two days of leaving the hospital. 
This is such an important thing to have available, especially for elderly or less-mobile patients.  My mom is going through a really rough time right now and while I was at her chemo appointment with her last week the nurse advised her to talk to the nutritionist as a way of getting some ideas for keeping weight on during the chemo treatments and keeping her energy up.  My mom was extremely resistant solely because she HATES going to the hospital and has to go out there practically every week (and often two times during a week) just to get the necessities for her chemo treatments taken care of.  The last thing she wants to do is go again to see a nutritionist.  So, in the nurse's defense, she said, "how about a phone appointment?"  But, my mom also doesn't hear very well, so she hates doing things over the phone.  So, a follow up in her home or better yet, during her hour long chemo appointment when she is stuck just sitting there anyways seems like a reasonable accommodation.  But, it probably is not going to happen and she will miss out on that information.

I have also noticed the confusion with generic medication names being used versus the licensed medication names.  The docs and nurses often refer to the meds by the names the licensed names, while the names on the bottles are the generic names.  There usually is a reference, albeit often small, to the licensed name, but it often goes unnoticed.  For example, when my mom had her chemo appointment, the nurse told her that for nausea she could take not only her usual dose of her Zofran, but could take an additional dose of Compazine in between the Zofran dose times.  When we got back to my mom's I went through her myriad of medicine bottles to pull out the Zofran and Compazine and it took me a really long time because they were both generics and I didn't realize the names would be different.  I think a lot of times, my mom doesn't take the Compazine because she can't locate it easily and it isn't something she takes all the time.  With my daughter (heart transplant recipient), we always have to answer questions about what she is taking when we go into the clinic or get admitted to the hospital and I often have to ask them for dosages of drugs instead of the names because I don't recognize the names. Our labels are a bit better than my mom's as they will typically say "generic for ______" in the same size type as the generic name, but they are often so long and complicated that I would never recognize them.  This, I'm sure, can lead to some confusion in both administering drugs as well as reordering them.

I am not sure what the answer to all of the problems in our health system are, but I do think that the expense of individuals NOT doing their follow up appropriately will be worse than whatever the expense is of figuring out and implementing solutions to some of these problems.

Monday, December 3, 2012

Debating with the Danielle's: Hunting: Yay or Nay?

Today I am participating in a new meme from over at "We Have It All".  I love the idea of friendly debates via many different blogs, so I thought I would get involved.  And this topic happens to be one that I have an opinion about, so it worked out well.

I grew up in a pretty anti-gun family.  I was never really sure why, but my parents and older siblings really seemed to dislike guns a lot.  I started dating my current husband while in college and his family was the complete opposite.  They were a gun family.  They belonged to a shooting range.  They had multiple guns and did reloading at their house.  They hunted and spent most weekends at the range.  Truthfully, I was fascinated by the whole thing.  It was like some kind of taboo being broken when I visited there.  But, I was also uncomfortable with the guns.  I tried going shooting with them a few times, but I just didn't enjoy it at all.  But, I was impressed with the technical knowhow that shooting required and the bonding that happened over the barrel of a gun.

Personally, I don't have anything against hunting.  I am a meat eater and I know that hunting is a much less abusive way of eating meat than the mass production that takes place at corporate farms.  And, I obviously eat that meat at times.  So, hunting that results in meat that can be eaten is totally fine with me.  I don't like dead things - so, I don't want to be involved in the process or know what the animal looked like before being processed, but I don't have a problem with people who can do that.  In fact, I appreciate them for allowing me to eat meat without having to deal with that part of the process.

There is a type of hunting that I don't totally understand or respect - that of "big game hunting".  I guess it's just a way of proving one's supremacy, but shooting some beautiful animal (or even not so beautiful, but incredibly impressive, like a rhinoceros) to put its head or skin on one's wall seems ridiculous to me.  I am saddened when I see an animal like a zebra or lion or rhino lying dead next to some guy and his gun.

So, I guess my "yay" or "nay" depends on the type of hunting that is being done.  Going out and shooting some ducks or dove or a deer in order to process the meat for meals seems okay to me (although shooting the bird of peace always seemed a bit too ironic), but doing the same with a rare and beautiful animal like a zebra does not.

I think we would all be better off if we knew exactly where our meat had come from (for those of us who still eat meat) and how it was processed, etc.  And hunting allows an opportunity for that to happen for some.

Saturday, November 24, 2012

Recipe: Easy, Peasy Salsa Chicken

I read this recipe in a Weight Watchers magazine and thought it sounded so easy and so good!  If there is one thing I hate, it is a complicated recipe.  I will often choose recipes by the number of ingredients and/or the number of steps included in them.  So, this one really struck me as something that I can do AND that would taste good.  I was thinking it would be good over pasta as well.

According to the March/April 2012 WW magazine, you bring 1/2 c. salsa verde (a fave of my hubby's) to simmer in a skillet.  You then stir in 3/4 c. shredded cooked chicken breast (I am always looking for recipes to use up the roasted chicken you can get at Costco) and 1/2 c. rinsed and drained canned black beans (another fave of hubby's).  You cook this for 4 minutes and voila!  This recipe only makes 1 3/4 c. (recipe was written for one) so if you are cooking for a family, you probably want to bump everything up about 4 or 5 times what reads here.  But, it sure sounds good!

I think I will give it a try this week as I have all the ingredients on hand (a pretty amazing feat for me)!  If I do, I will post some pictures and a review!

Thankful for NOT being in a hospital room this Thanksgiving, but feeling bad for everyone who is...

This news story about kids spending Thanksgiving in a hospital room in Rochester NY caught my eye when it appeared on the Donate Life blog for a few reasons.  First, we spent last Thanksgiving (2011) in a hospital room with Bean recovering from pneumonia.

Second, one of our close online heart transplant friends - a little boy close in age to Bean and also on a similar timeline transplant-wise (he received his heart about a month after Bean received hers) is spending this year in the hospital with fevers from unknown causes.  Finally, we had a clinic visit the day before Thanksgiving and I saw many, many families coming and going to visit their children in the hospital at Lucille Packard.

Being in the hospital pretty much stinks in general, but being there on a holiday is really bad.  The story doesn't fully capture the disappointment of eating a Thanksgiving meal out of a to-go container (and that only if you have a good friend like I did who was willing and able to bring it by on her own holiday travels) or leftovers from someone else's meal.  The hospital tries to make the most of it, with a special menu for both patients and visitors.  But, it is still institutional food served in institutional containers.  As the mom in the article states, it does become your "normal" after a while, but I don't think normal makes it good or less disappointing.  It is just normal to be suffering that disappointment.

I will say I was happy to be there on Thanksgiving and not Christmas.  So far, we've spent the following holidays in the hospital:  Easter, Fourth of July, and Thanksgiving.  Oh, and if you count it, Cinco de Mayo.  :)  We have a bunny and coffe cup we were given at Sutter Memorial in Sacramento in 2009.   I watched fireworks from the roof of Lucile Packard in 2009.  I ate a Boston Market Thanksgiving dinner at Lucile Packard in 2011.  And we watched a Stanford University's mariachi band play in the lobby of the 3rd floor of Lucile Packard in 2012.  All in all, they are not horrible memories, but the memories from holidays spent at home with family and friends are obviously much, much better!  I think in a way, you don't really have "holiday memories" for the ones spent in the hospital - there, it is just another day.  So, those who spend multiple holidays in a hospital really suffer a loss in their lives.

I am sure to spend another holiday or two in the hospital in the coming years - it is pretty much inevitable with a child who received a heart transplant and now has a leaky valve.  But, for this year, I am thankful to be at home instead of a hospital room!

Wednesday, November 21, 2012

Happy Thanksgiving - Now, go eat your weight in food!

Thanksgiving is honestly one of my favorite holidays.  There is no stress of buying the perfect gift or even getting the perfect card.  Although there is a lot of cooking involved, it is all pretty normal, everyday food that requires no special talent to make correctly (unless you're one of those crazy foodies who does weird things to normal foods - but, if that is the case, you do that by choice), and everyone feels totally fine sitting around after eating way too much and watching football and then eating more.  That, my friends, is my kind of holiday.

This year is a little less joyful as my mom is going through chemo and doesn't seem to have a very good appetite right now, my dad has dementia and will need someone to help him eat, my husband is sick with a cold, and I'm exhausted after spending the week helping out my parents.  But, I am thankful that we will have an excellent meal made in my sister's amazing new kitchen that was just finished about a month ago, that both parents will be present, despite their ailments and that our daughter is in good health.  Last year, I spent Thanksgiving in a hospital room at the Children's hospital where she receives care.  She was diagnosed with pneumonia and poor oxygenation two days before Thanksgiving and we were there until two days after Thanksgiving.  So, this year, despite all it's negatives, is much better than last year.

I will say that I will NOT be participating in the Black Friday madness (really, can we call it Black Friday anymore with stores opening at 8 p.m. on Thursday?).  It is an event I view with much disdain ever since working retail during my college years.  For those who have to work those events, the dread will surely ruin the holiday for some (if their work schedule doesn't ruin it for them).  For any of you planning to participate, I have a few pleas for you:

  1. Don't act like you didn't realize there would be a crowd - there will be lines, there will be pushy people (heck, you may be one).
  2. Don't physically or emotionally abuse your fellow shoppers or the store workers.  Is it really worth saving $100 to make others feel horrific either physically or emotionally?  If the answer for you is yes, seek help.
  3. Don't force your friends and/or family to go with you.  It is cruel and it will ruin the holiday for some of them!  Find friends and/or family who WANT to get up at some ungodly hour and go to an overcrowded store to stand in line.
  4. Don't sacrifice your holiday for your consumer items.  I just saw a news story that showed people camping out in front of Best Buy.  Some said they have not had a Thanksgiving dinner at home in years.  Seems like you've missed the point of the holiday...
Okay - if, after all that, you still feel compelled to shop - go to it!  I will be happily sitting around, eating leftovers and taking my mom to a chemo appointment (well, I won't be happily doing that, but it is what I will be doing).  

Improving Hospitals - the Small Things...

I realize this isn't going to come as a surprise to many people. No one likes the hospital, really. And, being someone who has spent a fair amount of time in them in the last few years, I would say there are some good things that hospital have done recently to improve things. But, overall, they are still an institutional setting that are not terribly attractive places to spend any amount of time, whether as a patient or as a patient's advocate/caretaker. I find there are a few things that stand out to me as problematic and possibly fixable.

First, hospitals are a place of waiting. You wait for everything. Whether you are staying overnight or just visiting a doctor or picking up a prescription - it all requires a wait it seems. It seems to me that the waiting is often happening in a space that is not very conducive to waiting. I mean, sure, they're called "waiting" rooms, but really, they might as well be called "rooms with nothing to do but read magazines no one is interested in reading, ever." Some of the recent waiting rooms I've been in lately have not even had a TV. And those that do have a TV often have a channel on that no one really cares to watch. In addition, the seating is sometimes totally uncomfortable. There never seems to be any food or drinks available without leaving, which you can't really do because you are waiting for someone or something. I just think that waiting rooms could be designed better. First of all, there should never, ever be another waiting room without a wi-fi connection. Ever...In addition, there should be some kind of snack availability. Machines that require change are a pain, but are better than nothing. I would love to have a little snack bar there with someone staffing it, or better yet, a free coffee and snack bar for those waiting. What a grand thing that would be and how much it would improve the whole hospital experience...

Second, hospitals are not very restful places. There is so much noise, so much light and so much activity at all hours. Who can recover from any illness or surgery in that atmosphere? As a person who stayed with my daughter for months while she was in the hospital, I was totally exhausted. Sometimes they try to make it a little more conducive - turning off lights and turning down the monitor noises, but it is still rather disconcerting to have people coming in and out at all hours. And when I was in the hospital post my daughter's birth, I remember the bed being horribly uncomfortable. Like a bad mattress on one of those 1970s hide-a-bed couches everyone hated to be stuck on at their relatives' house during the holidays. Why would that be a place for someone to recover and get better. I was convinced it was so I would want to get out of there ASAP. But, the combination of the noise and the constant activity and the uncomfortable bed made me constantly exhausted.

Finally, hospitals are primarily for sick people. Sick people should be put in situations that make things easier, not more difficult. My mom is in chemo right now. She is often weak and sick and just plain not feeling well. In addition, my dad has dementia and severe mobility issues. Their hospital has no valet service and usually the handicapped parking is completely full and what you can get is not that close to the entrance. They used to have valet parking, but they got rid of it. People are constantly double and triple parked, dropping people off. Others, who look completely miserable, are stuck standing out by the curb waiting for someone to come and pick them up after retrieving their car from the far-reaches of the parking lot or parking garage. There aren't even benches out near the loading zone. I think hospitals should have valet parking (our children's hospital does and Lord knows it has been a life-saver many times) and/or a shuttle to cars in the parking lot that are beyond walking distance. They could do it by page if they are concerned about able-bodied people using it. But, my mom is no longer able to go to the hospital on her own because they have made it so incredibly inconvenient for her.

Over all, hospitals are places of miracles nowadays. My daughter had a heart transplant and a valve repair and is still doing quite fantastic. My mom has had cancer multiple times, only to beat it each time with a combination of surgery and chemotherapy. Doctors and nurses are amazing people who do amazing work. But, hospitals, as a place, could do better. And often, it isn't the big things that matter, but the small things. A nice place to wait, some quiet and inactivity overnight, and recognition that people going to a hospital need help - valet, shuttle service, etc.

Thursday, November 15, 2012

Comment on: Hospital guidelines not linked to readmissions | Fox News

I thought this was interesting considering all the recent discussions of lowering costs of Medicare tied to the readmission rates.  The article: Hospital guidelines not linked to readmissions | Fox News discusses a study that finds that the readmission rates may not have as much to do with what the hospital does as was previously assumed, and I would agree.

Being someone who has dealt with both a child and a parent being in the hospital with something like Pneumonia, I can see the vast difference in the follow-up care between the two (assuming most individuals on Medicare are older adults).  When we brought home Bean from the hospital after having been in with pneumonia, we were told to go see the pediatrician within 48 hours.  We had a follow-up chest X-ray done to make sure the pneumonia was staying gone.  All this required driving from our home to the pede's office to the X-ray place and back home again.  We did another follow-up appointment about 48 hours after that as well.  As individuals who drive regularly, this was relatively easy for us (we also have flexible jobs thankfully).  But, for my mom, who doesn't drive anymore and has a husband with dementia and mobility problems, getting back to follow-up appointments requires that she finds someone who can not only take her to the appointment, but also find another person to "watch" my dad while she is gone or someone who is willing to take him along and sit in the car the entire time if he is having a low-mobility day.  That also means she has to go into the doctor alone.  None of this is easy for her.

I imagine she is not that unique in this respect.  And for individuals like my dad, he has to have someone who can help him with medicines and getting to a follow-up appointment is a true investment in time and effort.  My point here is that if, as the reference to the Reuters article says:
Another recent study suggested that many factors outside a hospital's control can cause a patient to need rehospitalization. For example, the person's ability to keep up with their medications at home, or to make follow-up visits to a personal physician (see Reuters Health article of October 19, 2012, here:
is correct about it being more a question of follow-up, Medicare could save a lot of money by figuring out a way to provide more services that allow for people like my mom and dad to get the follow-up care they need without it becoming a burden on them or others who are helping with care.  Sometimes, phone calls may work.  Other times, maybe in-home visits would be more economical and helpful.

I think that the health system has become a difficult to navigate and expensive, not just for the health care itself, but even to access that healthcare, undertaking because of bureaucratic and corporatist requirements placed on individuals working within that system.  Access to healthcare may mean less hospital visits in the first place and certainly less readmissions, which seems to be a concern.  In this age of technology, it seems that basic follow-up visits could easily be more mobile in nature.

Again, I focused on older individuals in this post because that is the majority of Medicare recipients.  But, I can see problems with younger people as well who lack flexibility in their jobs to take additional time off for follow-up appointments or who can't afford to get prescriptions filled right away after a hospital stay, etc.  The mobile follow-up for health care is obviously not the silver bullet of solutions, but it seems to me it may be one possible solution for this cost of readmission.

Tuesday, November 13, 2012

Book Review: Our Husband by Stephanie Bond

Our HusbandOur Husband by Stephanie Bond
My rating: 3 of 5 stars

I actually enjoyed this book a lot and if possible, I would give it 3 1/2 stars. It isn't deep and it isn't terribly surprising, but I thought the characters were likable. The plot line is predictable, but it is sort of like watching a fun sort of Lifetime or Hallmark movie - you know everything is going to work itself out, but its worth reading to see the characters figure it out for themselves. It was a great light read for me during a time when I had a lot going on.

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