Injuryboard Commentary - doctors

Where Do The Doctors Go?

Mike Bryant — Mon, 07 Dec 2009 09:56:00 GMT

There has been an going mantra from fans of tort reform that the main reason you need medical malpractice change is that doctors are quitting and fleeing states because of premiums. Many of the writers here at the Injuryboard have looked at this issue. There really doesn't seem to be support for the claim.

But, there are areas that are seeing reduced numbers of doctors. The question is why? A special report may have found some of them. The report found:

Doctors have been flocking to the area and surrounding Westchester County since the 1970s, drawn in part by an upper-class clientèle who demand top-notch medical care and have the means to pay for it.

The answer was that money is what drove doctors to an area. Is that why Texas , with it's high medical costs, is seeing more doctors in the area? As TortDeform recently pointed out:

Ask a doctor if they’d rather practice in White Plains, where everyone has health insurance and the doctor risks being sued, or if they’d rather practice in the California central valley (or any other poor, uninsured area) and be completely immune to malpractice lawsuits. Most doctors are going to pick White Plains because money matters.

It's time that we get beyond the myths and into what, not only makes sense, but also is the reality of what is going on. Minnesota doesn't have damage caps and it has medical facilities continuing to sprout up all over.

Originally posted at InjuryBoard by Mike Bryant

Why are Medical Bills so High?

Jon Lewis — Sat, 05 Dec 2009 13:49:34 GMT

Did you know that hospitals and physicians rarely ever receive the amount they charge for their services? Health insurance companies do not pay the actual bills invoiced by medical professionals. Why is that?

We had a client who was injured in a truck collision. His injuries were serious enough to warrant several nights in the hospital and a couple of surgeries. What were his medical bills? Approximately $72,000.00. What did the hospital and physicians get paid? $11,714.01, approximately 16% of the amount billed.

If you had a retail store, would you accept 16% of your prices? Why do hospitals and doctors? Are they over-charging, or are they getting paid too little?

What if you don't have health insurance? What happens then? Well, I can tell you that I handled collections for a hospital about 13 years ago, and if patients came in for emergency treatment and didn't have insurance, we sued them for the full amount, not 16%. Why do private pay individuals have to pay the full amount? I understand why health insurers receive a discount, but an eighty-four percent (84%) discount? What if Bill Gates doesn't want to get health insurance? He can pay any amount billed so why doesn't he receive the same discount as a company like BlueCross?

Is this a form of fraud or misrepresentation? In Alabama, BlueCross BlueShield has such a monopoly on health insurance that they dictate to hospitals and physicians what they can charge for their services. Many doctors speak poorly of BlueCross BlueShield as a result of their influence. Some won't even accept their rates as a result. Should the health insurance companies be setting the rates for medical treatment? Is that capitalism?

I don't have the answers to all these questions, but I think they need to be discussed, especially in light of healthcare reform. What are your thoughts?

Originally posted at InjuryBoard by Jon Lewis

Nine-Year-Old Florida Girl Nearly Dies from Misdiagnosed H1N1 Virus

David Mittleman — Thu, 03 Dec 2009 15:05:33 GMT

Rapid flu tests are used to determine if a patient has the illness so that doctors can immediately being treatment. However, in Hayli Murphy’s case, she almost died as a result of an incorrect diagnosis from a rapid flu test. In fact, some doctors are concerned that their peers are becoming too reliant on the rapid flu tests and are ultimately misled into not treating sick patients.

Hayli is 9-years-old and came with her mother to the emergency room on September 21, complaining of a high fever. She was given the rapid flu test, which showed a negative result. Nevertheless, Hayli’s mother brought her back to the ER the next day when her fever reached 104 degrees. Again, doctors gave Hayli a rapid flu test that came out negative. Instead, the doctors diagnosed her with pneumonia and sent her home with antibiotics. By the next day Hayli was so sick that her mother had to carry her into the ER. Finally, doctors administered Tamiflu, the antiviral used to kill the H1N1 virus, but Hayli still couldn’t get better. Instead, she spent the next 43 days in the intensive care unit, struggling for her life.

During her stay at the hospital, doctors gave Hayli a DNA-based test that proved that she was infected with H1N1. The DNA test is highly accurate, but takes more time to process. But now more doctors are urging their peers to use this type of test instead of the rapid flu test. In fact, according to some studies the rapid flu tests is only accurate 50% of the time. Furthermore, doctors urge patients to watch for the following signs in their children to determine if they might have the H1N1 virus:

· Fast or troubled breathing
· Numb or blue finger or toes
· Can’t touch chin to chest
· Symptoms improve and then return
· A fever with a rash

The Centers for Disease Control estimates that out of the 8 million people under the age of 18 who contracted H1N1 between April and October, 36,000 were hospitalized and 540 died. Please remember the tips above if you are concerned that your child has the H1N1 virus.

Originally posted at InjuryBoard by David Mittleman

Health Care By The Numbers

Mike Bryant — Sat, 21 Nov 2009 12:58:00 GMT

The Congressional Budget Office released a report this past month that found: wait for it, that if we had tort reform money will be saved. Shocking, if you stop making the negligent and the grossly negligent pay for the damage they do, they get to keep their money. Those reports don't surprise me , nor do they scare me as a trial lawyer. Because, the question keeps going back to: saves money for whom?

The only way you get savings from the system is at best indirect. That the Medical Malpractice Insurance companies will do something that they have in the past been reluctant to do, which is lower premiums, and as a result, those savings will be passed on to the health Insurance companies, who will then pass those savings onto the consumers. The other potential savings will be that all of these doctors who are prescribing unnecessary and fraudulent tests will stop doing this and there will be savings there. This is a lot of very questionable gate keepers who we are expecting to do the right thing for others and not just for themselves.

But let's look at the CBO's numbers. Surprise, they are exactly what trial lawyers have been saying; one half of one percent of the whole system. Yes, this is the shocking number that some Republicans are claiming can be used to fix the whole medical reform mess. Now, I'll admit that 11 billion dollars is a lot of money, but what does it compare to?

There is the report from Washington University, which found that in 2007 there was $2.7 trillion (yes that's a trillion) spent on health care overall. So to start with, we are really talking about numbers that need to be compared, and not just blow horned by town meeting paid infiltrators.

The same report found that there is also $68 billion that is lost in fraud. That number works out to the fraud being 80% by the medical providers ( the ones that we want to give the savings back), 10% by consumers, and balance by others such as the insurance companies themselves.

Let's look at the Insurance numbers as the American Association for Justice did recently,they found:

Today, while premiums and health care costs skyrocket, malpractice insurers have average profits higher than 99 percent of Fortune 500 companies.

The key findings of the report, which analyzes the annual financial statements of the 10 largest U.S. medical malpractice insurers, include:

The average profit of these insurance companies is higher than 99 percent of all Fortune 500 companies and 35 times higher than the Fortune 500 average for the same time period.

Malpractice insurers have seen their profit margins range from 5.9 percent to 74.8 percent, with an average of 31.2 percent.

Medical malpractice insurers have underestimated profits and overestimated losses, creating overblown insurance “crises” to garner support for limiting patients’ legal rights. Then years later after the “crises” abated, revised filings show the companies were never in the financial peril they claimed.

After overestimating losses, insurers have since reported that losses over the last five years have been approximately 13.5 percent lower than initially reported.

By overestimating losses, companies have underestimated profits. Insurers averaged about 5.1 percent higher profits last year and 12.4 percent higher profits two years ago; these levels of profits will likely rise as upward revisions are made.

Medical negligence laws were passed under false pretenses. Overblown reported losses were used by the insurance industry to justify new measures restricting the rights of those injured by medical negligence.

Yep, there is gobs of money being made, and I would bet they are funneling right into those U S Chamber ads that are calling for tort reform and fighting against a system they just love to gouge.

There are far better ways to fix this system and to pay for it without changes that deny people their constitutional protections.

Originally posted at InjuryBoard by Mike Bryant

The Attacks On The Health Care Plan: Looks Like They Were Planned Out

Mike Bryant — Sat, 21 Nov 2009 09:48:58 GMT

Are you torn with all of the health care debates? What is being talked about and what isn't? Who is behind what and what do the leaders of our country really want to do? Who has bought off who and why is anyone saying that they would rather keep things the way they are?

I've talked to enough people about this issue to know that many people are confused about why this is such a battle. Why the plan isn't just to sit down and to work something out and get a plan put together. It's been interesting to discuss with people the role that trial lawyers are playing in the issue and also the roles of the insurance companies. I, like many of the people here at the Injuryboard, have been out front talking about the issues every chance we get.

What was illuminating was to run across the game plan of the opposition to any change. Rolling Stone recently uncovered this interesting memo:

The 10 Rules For The Stopping Of The "WASHINGTON TAKEOVER” Of Health care

(1) Humanize your approach. Abandon and exile ALL references to the “health care system.” From now on, health care is about people. Before you speak, think of the three components of tone that matter most: Individualize. Personalize. Humanize.

(2) Acknowledge the “crisis” or suffer the consequences. If you say there is no health care crisis, you give your listener permission to ignore everything else you say. It is a credibility killer for most Americans. A better approach is to define the crisis in your terms. “If you’re one of the millions who can’t afford health care, it is a crisis.” Better yet, “If some bureaucrat puts himself between you and your doctor, denying you exactly what you need, that’s a crisis.” And the best: “If you have to wait weeks for tests and months for treatment, that’s a health care crisis.”

(3) “Time” is the government health care killer. As Mick Jagger once sang, “Time is on Your Side.” Nothing else turns people against the government takeover of health care than the realistic expectation that it will result in delayed and potentially even denied treatment, procedures and/or medications. “Waiting to buy a car or even a house won’t kill you. But waiting for the health care you need – could. Delayed care is denied care.”

(4) The arguments against the Democrats’ health care plan must center around “politicians,” “bureaucrats,” and “Washington” … not the free market, tax incentives, or competition. Stop talking economic theory and start personalizing the impact of a government takeover of health care. They don’t want to hear that you’re opposed to government health care because it’s too expensive (any help from the government to lower costs will be embraced) or because it’s anti-competitive (they don’t know about or care about current limits to competition). But they are deathly afraid that a government takeover will lower their quality of care – so they are extremely receptive to the anti-Washington approach. It’s not an economic issue. It’s a bureaucratic issue.

(5) The health care denial horror stories from Canada & Co. do resonate, but you have to humanize them. You’ll notice we recommend the phrase “government takeover” rather than “government run” or “government controlled” It’s because too many politician say “we don’t want a government run health care system like Canada or Great Britain” without explaining those consequences. There is a better approach. “In countries with government run health care, politicians make YOUR health care decisions.THEY decide if you’ll get the procedure you need, or if you are disqualified because the treatment is too expensive or because you are too old. We can’t have that in America.”

(6) Health care quality = “getting the treatment you need, when you need it.” That is how Americans define quality, and so should you. Once again, focus on the importance of timeliness, but then add to it the specter of “denial.” Nothing will anger Americans more than the chance that they will be denied the health care they need for whatever reason. This is also important because it is an attribute of a government health care system that the Democrats CANNOT offer. So say it. “The plan put forward by the Democrats will deny people treatments they need and make them wait to get the treatments they are allowed to receive.”

(7) “One-size-does-NOT-fit-all.” The idea that a “committee of Washington bureaucrats” will establish the standard of care for all Americans and decide who gets what treatment based on how much it costs is anathema to Americans. Your approach? Call for the “protection of the personalized doctor-patient relationship.” It allows you to fight to protect and improve something good rather than only fighting to prevent something bad.

(8) WASTE, FRAUD, and ABUSE are your best targets for how to bring down costs. Make no mistake: the high cost of health care is still public enemy number one on this issue – and why so many Americans (including Republicans and conservatives) think the Democrats can handle health care better than the GOP. You can’t blame it on the lack of a private market; in case you missed it, capitalism isn’t exactly in vogue these days. But you can and should blame it on the waste, fraud, and abuse that is rampant in anything and everything the government controls.

(9) Americans will expect the government to look out for those who truly can’t afford health care. Here is the perfect sentence for addressing cost and the limited role for government that wins you allies rather than enemies: “A balanced, common sense approach that provides assistance to those who truly need it and keeps health care patient-centered rather than government-centered for everyone.”

(10) It’s not enough to just say what you’re against. You have to tell them what you’re for. It’s okay (and even necessary) for your campaign to center around why this health care plan is bad for America. But if you offer no vision for what’s better for America, you’ll be relegated to insignificance at best and labeled obstructionist at worst. What Americans are looking for in health care that your “solution” will provide is, in a word, more: “more access to more treatments and more doctors…with less interference from insurance companies and Washington politicians and special interests.”

-------------------------------------------------------------------------------------

Reading this list, it seems clear that there are a group of people who don't want to get anything done. The people who ran the country for eight years and put profits in front of people and drove many parts of the economy into the dirt. It is made up of people who scream capitalism all the way to the bailout window. People who need to either come to the table and talk sense or get out of the way and let those who care about the consumer put together something that will truly make a difference.

Originally posted at InjuryBoard by Mike Bryant

LAT: Headed to the Emergency Room? Bring a book...

Paul Kiesel — Tue, 10 Nov 2009 19:13:07 GMT

From the Los Angeles Times:

The stereotype of hospital emergency rooms crowded with patients waiting endlessly to be seen by a doctor is true, according to a new study in Tuesday's edition of Archives of Internal Medicine. The conventional wisdom that throngs of low-income, uninsured people who use the ER as a substitute for primary care visits are to blame, however, is wrong.

First, a few statistics:

In 1997, the median wait time for ER patients was 22 minutes. By 2006, it was 33 minutes.
Per capita use of ERs was 40.5 visits per 100 people in 2006, up from 34.2 visits per 100 people a decade earlier.
The proportion of ER patients deemed to be suffering from a real medical emergency fell from 26.9% in 1997 to 18.3% in 2007.
The percentage of ER patients who lacked health insurance remained between 16% and 17% between 1997 and 2006.

These and other statistics were gleaned from data on 151,999 patient visits to emergency departments recorded in the National Hospital Ambulatory and Medical Care Survey. The survey includes four triage categories – emergent (patient should be seen within 14 minutes), urgent (15-60 minutes), semiurgent (61 minutes to two hours) and nonurgent (anywhere from two to 24 hours).

Though wait times got longer for everyone, the problem was worst for emergent patients – their median wait times increased by 4.6% per year, the study found. Waits for urgent patients grew 2.8% per year for urgent patients, 3.9% per year for semiurgent patients, and 1.6% for nonurgent patients.

Put another way, only 56.6% of emergent patients saw a doctor within the time recommended by triage staff, compared to 100% of nonurgent patients. Overall, the proportion of patients who got to a doctor within the “triage target time” fell from 80% in 2000 to 75.9% in 2006, the study found.

One theory to account for increased ER wait times is that more people who can’t afford to go to a regular doctor wind up coming to the ER instead, where federal law guarantees they’ll be treated regardless of ability to pay. The survey data corroborated this to an extent, finding that 17% of uninsured patients in the ER were classified as nonurgent, compared to only 13.9% of people who had private insurance. That works out to about 567,000 extra visits each year.

Click here for the rest of the article.

Originally posted at InjuryBoard by Paul Kiesel

Ghost-writers Hired by Drug Companies Write Journal Articles, Then Find the Medical Authors

Rick Shapiro — Wed, 28 Oct 2009 22:45:41 GMT

An amazing series of documents were unsealed by a court in a dangerous drug injury case involving Prempro, a hormone drug. Injured plaintiffs argue that the drug causes breast cancer and other medical problems, but the bomb drop is not the allegations, but what drug giant Wyeth did to "help" create medical journal articles about the safety of its drug.

But the court documents reveal scandalous email and correspondence which purportedly shows that Wyeth "fraudulently and intentionally polluted the scientific literature related to hormone therapy in general and their hormone drugs in particular" in that Wyeth hired ghostwriter physicians or scientists to “author” biased scientific and medical journal articles-but the articles were largely written before the “author” was on board.

A medical journal PLoS Medicine posted about 1,500 of the documents on a website (www.plosmedicine.org/static/ghostwriting.action ). It was through the action of the medical journal and the New York Times that the court decided to unseal a massive number of documents which reveal exactly how the ghostwriting was done for the drug manufacturer-reaching the suggested conclusions well before a “reputable” doctor was ever part of the “study” findings as the study's author.

As further related in an article in Trial Magazine, American Association for Justice, October 2009, PLoS Medicine editors wrote an editorial that stated

"the story told in these documents amounts to one of the most compelling expositions ever seen of the systematic manipulation and abuse of scholarly publishing by the pharmaceutical industry and its commercial partners in their attempt to influence the healthcare decisions of physicians and the general public."

Here is how the ghostwriting generally occurs:

1. A drug manufacturer hires a professional medical writing or communications company which prepares a preferred title, outline and a possible draft of an article;

2. The drug company or its ghostwriters later find the names of proposed medical or scientific authors for the pre-determined article including its slant or bias;

3. The outline or draft is sent to the selected author for approval.

Can we imagine the day that newspaper advertisers write the headlines for newspaper’s and direct the content of the news stories? Or, if Newsweek magazine allowed the advertisers to dictate the topic of stories in exchange for ads in the magazine? But, the Medical journal ghost-writing issue is really more dangerous—as physicians are regularly prescribing medications based on the questionable results of ghost-written articles. It is fairly sickening.

In the Prempro litigation, Wyeth claims that the author, even if pre-selected, substantially controlled the editorial review of the originally ghostwritten articles and that there was no inaccurate science. The attorneys for the victims argue that the drug company exercised clear control over the message of the articles and that ghostwritten articles either downplay, dismiss or minimize a particular drug's adverse health effects. But, according to one physician, Adriane Fugh-Berman M.D, quoted in a Science Daily article, she was approached to be an “author” and the ghost writers often use an “intermediary” medical education company and the true party behind the article is fuzzy or obscured. Fugh-Berman believes that the current voluntary standards for declaring conflicts of interest to readers of medical journals and audiences at medical conferences are inadequate, and that a public database detailing physicians’ and researchers’ conflicts of interest is needed.

The most distressing part of the Prempro ghostwriting scandal is that physicians around the country must do research on the safety and on the health effects of prescription and over-the-counter drugs and look to journal articles as a respected source of information. If peer reviewed medical articles that downplay safety or health concerns seem legitimate, how is a family doctor or internist to know the difference in an unbiased, valid medical journal article or one that is simply ghostwritten on behalf of a drug manufacturer? The answer is there is no easy way to make this determination from reading a journal article that appears in any respected magazine or publication.

One of the ghosting company's indicates it attempts to "develop a consensus statement from [an expert] forum that would be endorsed by a national organization such as the American Heart Association."

A brochure released as part of litigation over health effects of Paxil, an antidepressant drug, also described a program that helped sales representatives facilitate having articles ghostwritten. The brochure said that publishing such articles "will benefit the sales force by expanding the database of published data to support Paxil."

PLoS Medicine in the above-referenced editorial has attacked the process of ghostwriting and called on medical journal editors to "decide whether they want to roll over and just join the marketing departments of pharmaceutical companies" or police the entire process in a more transparent way. Universities and medical journals have policies on ghostwriting but the policing of the process is far from reaching a level of transparency so that consumers as well as physicians can rely upon findings in a medical journal article.

This may require congressional action, because "self-policing" has a snowballs chance of gaining traction. U.S. Senator Charles Grassley has written a letter in August 2009 to the National Institute of Health asking for an investigation of this particular problem and specifically he noted that one or more ghostwriters were actually researchers who had obtained federal funds under NIH grants.

My Take: This is a troubling and growing problem that requires further investigation in order to keep the public safe from dangerous drugs. It has been only recently that the drug companies were forced to stop providing gifts and meals to doctors to foster prescriptions and the systematic "infection" of planted journal articles may be the next area requiring reforms.

About the Editors: Shapiro, Cooper Lewis & Appleton is a law firm which focuses on injury and accident law and we have experience handling dangerous drugs and prescription drug errors. Check out our case results to see for yourself. Our primary office in based in Virginia Beach, Virginia (VA) and we have another office in Elizabeth City, North Carolina (NC). Our injury attorneys also host an extensive injury law video library on Youtube. Furthermore, our lawyers proudly edit the Virginia Beach Injuryboard and Norfolk Injuryboard as a pro bono public information service.

Originally posted at InjuryBoard by Rick Shapiro

The Doctor Is In and He Says Tort Reform Isn't the Cure

David Mittleman — Wed, 28 Oct 2009 16:26:12 GMT

Even doctors are starting to speak out about our insurance crisis. I recently read a post online by Rahul K. Parikh, M.D. that had me nodding my head. Dr. Parikh went straight to task and took on the proponents of "tort reform" (Crooked Justice) with the following line:

"There's nothing "sure or quick" about changing medical liability laws that will improve healthcare or its costs. Defensive medicine adds very little to healthcare's price tag, and rising malpractice premiums have had very little impact on access to care."

Why does he get it? It's because he's willing to look at the facts and put people first, not profit, not even his own profit. First, he noted that no matter how you look at it, malpractice lawsuits aren't the major factor in rising health care costs. As Dr. Parikh put it:

malpractice costs account for less than 2 percent of healthcare spending. Saving 2 percent of the over $2 trillion we spend on healthcare isn’t going to bend the cost curve.

Second, malpractice lawsuits are not frivolous. By and large, if you're willing (both as a client and a lawyer) to go through the incredible expense of suing a doctor or hospital, something truly significant has probably happened to you. Dr. Parikh reviewed a Harvard study published in the New England Journal of Medicine. He nails it on the head when he says:

Most of the suits were not frivolous: Almost two-thirds of cases involved errors by doctors.
Seventy-three percent of injuries in which a doctor committed an error resulted in payments. Seventy-two percent of cases in which there was an injury not due to physician error did not result in payment. Those conclusions do not paint the picture of a medical-legal system burdened by ambulance-chasing lawyers and their litigious clients.

Yes, that's right. Lawsuits were more likely to result in payment when the doctor made an error. Lawsuits were more likely to result in no payment if there was no error. Where's the frivolity? It's PR propoganda.

What isn't propoganda is the following. Tort reform will not save lives. Giving doctors and hospitals less incentive to improve practices and maintain care at high levels only puts us in jeopardy. Maybe that's what the doc meant when he wrote:

So for those who push tort reform as a panacea for a sick healthcare system, working to prevent injuries is a much more noble pursuit than writing up baseless arguments for the back pages of a newspaper.

Originally posted at InjuryBoard by David Mittleman

Autoimmune Disorders in Women: What to Look For and What to Tell Your Doctor

David Mittleman — Sat, 24 Oct 2009 10:00:00 GMT

Here is a daunting fact: one in five Americans has an autoimmune disorder, which occurs when the immune system attacks itself. Moreover, about ¾ of those with an autoimmune disorder are women, or about 22 million women total. However, there is an even more disturbing trend amongst women with autoimmune disorders: 40% of those who are eventually diagnosed with an autoimmune disorder were initially told that they were “too concerned with their health”. Essentially, a large percentage of women with serious immune problems are passed over and told they’re hypochondriacs.

However, armed with some simple information, you could prevent yourself from falling into the category of women who suffer needlessly. In fact, health experts say that the best way to protect yourself is to educate and empower yourself by learning names, risk factors, symptoms, and treatments for the seven most common illnesses women face.

1. Polycystic Ovarian Syndrome—the most common type of hormonal disorder among women of reproductive age, and one of the leading causes of infertility. It stems from having levels of androgens, a male hormone, that are too high. The most common symptoms are irregular periods (or none at all), more hair on the face, chest, back and limbs, moderate-to-sever acne, baldness, and rapid and substantial weight gain that seems impossible to control. There is no single way to diagnose PCOS, but your doctor can check your reproductive organs for signs of mass growths using a pelvic or vaginal ultrasound. However, it is your responsibility to first inform your doctor that you have the aforementioned symptoms. Otherwise, the doctor may never know that there is a serious problem because the illness is so easily written off to bad diet, lack of exercise, or other “simple” explanations for seemingly benign symptoms. While there is no cure for PCOS, it can be controlled with birth control pills and Metformin to help regulate the hormonal production.
2. Fibromyalgia—doctors aren’t sure what causes this painful disorder, which results in symptoms that include pain, numbness and exhaustion, and often begins in early or middle adulthood. While there is no lab test or physical exam that can find fibromyalgia, doctors can do a tender-point exam, which identifies places in the body that are painful to the touch despite no immediate physical signs. The test is positive if 11 out of the 18 spots tested come back positive. There is no way to cure fibromyalgia, but sufferers can take over-the-counter pain medications to quell the pain. Furthermore, stretching, exercise, and massage can ease pain as well.
3. Chronic Fatigue Syndrome—at least 1 million Americans are believed to have CFS. However, doctors are unsure what causes the extreme fatigue that is common to the disorder. Some studies indicate that it could be related to dormant viral infections, hormonal imbalances, and stress. The common symptoms include decreased physical or mental activity that doesn’t improve despite long periods of rest. Loss of concentration and unexplained muscle pains are also common symptoms. In order to diagnose a patient, doctors must rule out other conditions that cause similar problems, such as Lyme disease or thyroid problems. While there aren’t any treatments or cures, Ritalin has been effective in some patients in reducing fatigue. However, the treatment is still experimental.
4. Lupus—there are four types of Lupus, however the most common is systemic lupus erythematosus. SLE is a nightmare: a malfunction in the immune system causes the body to attack itself, including wreaking havoc on the skin, joints, lungs, kidneys, nervous system, and blood. Doctors suspect that hormones play a vital role in the development of the disorder, particularly because women are usually diagnosed between the ages of 15 and 45. Overall, lupus seems to strike during or following a pregnancy. The most common symptoms include fatigue, fever, joint pain and stiffness, chest pain, memory loss, and skin lesions. A diagnosis of lupus is confirmed if a patient has at least four symptoms: a facial rash after exposure to sunlight, painless mouth sores, kidney disease, swelling of the lining around the lungs and heart, and low counts of red blood cells, platelets, or white blood cells. While there is no cure for lupus, mild cases can be treated with over-the-counter painkillers. Moreover, anti-malarial drugs have proven useful in stopping the progression of the disease, while corticosteroids counter inflammation in the joints and lining of the heart and lungs. Overall, doctors suggest leading a balanced life since emotional stress seems to trigger episodes of lupus.
5. Multiple Sclerosis—MS strikes when the immune system attacks the protective covering of cells in the brain and nervous system. Eventually the destruction of the cells causes a breakdown in communication between the brain and body. Women are three times as likely to develop MS, and most scientists believe there is an environmental link like exposure to viruses or toxins. Classic symptoms include numbness or weakness in the limbs, dull pain, fatigue, and vision problems. Despite these symptoms, it is difficult to diagnose MS and to distinguish these symptoms from others that are related to other diseases like Lyme disease. However, tests for these other diseases can help rule out any other options and ultimately narrow the diagnosis to MS. Currently, those with milder symptoms from their MS are treated with corticosteroids. Other sufferers with more serious symptoms are put on an immunomodulator drug that helps prevent a complete relapse in muscle weakness and other symptoms. Exercise is also a crucial component in maintaining strength, muscle tone, coordination, and balance.
6. Rheumatoid Arthritis—RA attacks the lining of the joints through the immune system and can cause swelling, aching and potential deformities. The symptoms are easily detectable: simple activities, such as climbing the stairs or opening jars, can cause tremendous pain. It is difficult for doctors to diagnose RA, however, blood tests can reveal an antibody that is related to RA. Treatments include alpha inhibitors, or drugs that fight the inflammatory proteins. A second treatment is called DMARDs, which help to slow, reduce, and prevent joint damage. Finally, corticosteroids can cut inflammation around the joints, but become less effective over time.
7. Irritable Bowel Syndrome—simply stated, sufferers experience serious bowel problems including gas, diarrhea, and constipation, as well as abdominal cramping and pain. Doctors can usually pinpoint the problem by using the “Rome criteria”. In other words, if a patient experiences 12 weeks of symptoms out of 12 months, they most likely have IBS. The treatment is also very simple: eat more fibrous foods. Furthermore, some patients have found relief by using peppermint oil, a natural antispasmodic that can ease abdominal pain.

While most of these autoimmune disorders cannot be cured, they can still be controlled via simple methods. Be forthright with your doctor if you experience symptoms that you believe could be related to an autoimmune disorder. Most importantly, be persistent! If your symptoms bother you and interfere with your daily life, there is probably a more serious problem that needs further attention.

Originally posted at InjuryBoard by David Mittleman

Real Story Of Health Care Denial

Mike Bryant — Sun, 11 Oct 2009 21:42:52 GMT

I recently got a email from MoveOn.Org. It was interesting and alarming to say the least:

I'm at the end of my rope. What CIGNA is doing to me is—well, it's outrageous.

I have a brain tumor. Doctors are ready to help me. But CIGNA has been blocking me from getting testing and treatment for two years, while almost doubling my premiums.

Then, this week was the kicker. CIGNA's pharmacy called to say that the co-pay on the medicine that helps control my debilitating head pain is skyrocketing from $10 to $1,115. That's not a typo. They're making me pay one hundred times what I'm paying now, in addition to my $753/month premium.

I can't afford that. So when the pain comes, I won't have any defense. I'll spend hours in the fetal position, out of my mind with pain.

When my story went public a couple of weeks ago—with the help of over 100,000 MoveOn members—CIGNA said they would pay for a test I'd been asking for at Cleveland Clinic. It was a step in the right direction. But after two years of denials, and with a long course of treatment ahead of me, I knew better than to just take them at their word.

So I asked questions. But they wouldn't offer any explanation for why they denied my coverage for so long, or any assurance that they had changed their procedures so I wouldn't face the same unjust denials again. And I began to wonder if they were more interested in just sweeping my story under the rug than actually helping me.

When I got this latest news from CIGNA's pharmacy on Tuesday, I kept asking myself, is this a mistake? Or is this happening because I went public with my case? Are other CIGNA customers receiving the same phone calls?

I used to give CIGNA the benefit of the doubt, but after years of unexplained denials, I've had enough. So I'm asking for your help again. For myself, and for everyone else who is suffering, I am asking CIGNA for answers.

And I think it would help if thousands of people like you were to join me in demanding them. I'm writing them a short letter with a simple question: Why? Can you add your name to my letter?

http://pol.moveon.org/dawn/?id=17402-5489780-L4fXb0x&t=1

Here's what I've written to Dr. Jeffrey Kang, CIGNA's Chief Medical Officer:

As you probably know, your company has denied me needed care for two years while I suffer from a debilitating but treatable brain tumor. I pay my $753.47 premiums. I follow the proper procedures. But CIGNA refuses to give me the care I need.

Instead, you keep increasing my prices. First my premiums rose by hundreds of dollars, and now my prescription costs are going up by more than 10,000%.

What makes you think you can treat sick people this way? When will you stop doing this to me and the thousands of people like me who are suffering? And if you solve this latest problem, how do I know you won't do this to me again next week—that you're actually changing your ways and not just trying to make your PR problem disappear?

Please answer these questions. I need to know, for the sake of my health and my life. Many others have signed this letter too, to support me and make sure I get answers.

Respectfully,
Dawn Smith

Thanks for all you're doing. I don't know where I'd be without MoveOn members' help.

Most sincerely,
Dawn

It was from a woman who has been battling with Cigna for two years over coverage for her brain tumor. So I looked deeper into the story and saw that there has been some national press on the issue. That following her diagnosis four years ago, she has seen increases in her premiums , in her co pays and denial after denial after denial.

This is the story that needs to be talked about in the health care debate.

http://www.youtube.com/watch?v=aiIBs0mZb9o&feature=player_embedded

My guess is that Cigna and the health care opponents won't want to.

Originally posted at InjuryBoard by Mike Bryant