Heart Disease: Living Up to the Gift of Life

Denying my symptoms almost resulted in a very negative outcome.

Heart Disease

Don Holmes

By Don Holmes, Personal Care Management Specialist, MedCost

December 9th is a date that holds special meaning for me. Ten years ago, I wasn’t sure I would see December 10th.

In the fall of 2007, I began to notice some occasional, uncomfortable heaviness in my chest, especially during periods of exertion. I initially attributed it to pushing a little too hard, or soreness from a previous workout.

I worked out between three to four times weekly at the YMCA. My routine usually included a 35-minute vigorous jog on the treadmill. On alternate days I lifted weights.

One afternoon after work, I went to the Y to get in an additional workout. Within 5 minutes on the treadmill, I knew something was different. Something was very wrong.

Denying the Symptoms

The heaviness in my chest began much more quickly. It was so painful that I had to stop. As a precaution, I asked the weight room attendants to check my blood pressure. The blood pressure reading was off the charts!

We waited several minutes and took my blood pressure again. It was still in the danger zone.

The attendants said I needed an ambulance, but I insisted on driving home. I told them I would see my doctor the next day. That night the pain lingered as I tried to fall asleep.

The next morning when I arrived at work, I called my doctor’s office and told the nurse what had happened. I gave her the blood pressure readings. She calmly but firmly said: “I want you to hang up immediately and dial 911. You must go to the hospital now.”

It Was Heart Disease

How could I be fit enough to work out frequently and still have this happen? I immediately went to the hospital. A heart catheterization revealed major blockages in the front and back of my heart. Doctors performed a quintuple bypass operation on me.

Heart DiseaseI didn’t realize it, but I had been in denial. In the hospital before surgery, I stared at the legal documents I was about to sign. I had to face reality.

Open heart surgery. I might not come through the operation.

I was extremely fortunate. I didn’t experience a heart attack, but it was imminent. Thankfully, the heart muscle was fine and there was no damage. But I had to make some significant lifestyle changes.

I Had to Face Reality

I gave up soft drinks, desserts and fried foods. Every day was a battle. I cut back on the carbs that were elevating my triglycerides and blocking my arteries. Potatoes, rice, breads—these were the foods I loved.

Heart DiseaseBut I had to face reality. I wanted to be around for more than one tomorrow.

I studied a lot of articles at the American Heart Association website, on how to improve my overall health and make better food choices. Their suggested workout routines were helpful, too.

These past 10 years, working at a health care administration company has reinforced my desire to live healthier. I’ve lost 20 pounds. I still work out 5 days a week, doing weights and cardio.

Living Up to the Gift of Life

Heart Disease

“Pooches on Parade” at Heart Walk

This November 11, my company is partnering with Wake Forest Baptist HealthNovant Health, Cook Medical and many others* to sponsor the Winston-Salem Heart & Stroke Walk. The “Pooches on Parade,” special honoring of heart disease survivors and veterans, live band and healthy food trucks make this a really fun morning.

Best of all, every person has a chance to walk one, two or four miles to strengthen your heart.

Activities begin at 8:30 am at Bailey Park downtown in Wake Forest Innovation Quarter.

I’ve lost several friends to heart issues. So it’s always on my mind to make good choices.

God has blessed me this past 10 years. I want to live up to the gift of life.

 

*Allegacy Federal Credit Union, BB&T, Corning, Dixon Hughes, Hanesbrands Inc., Inmar, Kimpton, Piedmont Federal Savings Bank, Stimmel, Truliant Federal Credit Union, Wake Forest Innovation Quarter, Winston-Salem Journal, 99.5 WMAG, WXII-12 and other sponsors.

 

The Colonoscopy Screening That May Have Saved His Life

Sean Yacobi’s Story

colonoscopy screening

Sean Yacobi with his wife and children

Sean Yacobi had no symptoms when he decided to get his first colonoscopy. He made the decision after receiving a MedCost letter, urging him to get screened. What happened next was a total surprise.

I got a notification about getting a colonoscopy because I turned 50. I was a little anxious about my first colonoscopy to know that everything was alright. I felt fine, so I was taken aback when the doctors came in after the procedure that took longer than normal.

The doctor matter-of-factly said: “I found something. Nine times out of 10 it will be colorectal cancer.” The next few weeks were difficult because of the unknown. I got the good news that it had not spread and that they had caught it early, thanks to being screened.

I went that night, got blood work and set up with my oncologist. I felt like I needed an assistant to keep up with all the appointments.

With something like cancer, it’s typical to close up emotionally. When MedCost offered me participation in the Complex Case Management Program, I was a little skeptical. I’m a trial attorney. I wondered if MedCost was making sure I didn’t go past my benefit limits. But I found out that it’s been all about my care, and connecting the dots with all my different treatments.

I’ve had radiation therapy and inpatient surgery, followed by chemotherapy. It’s bewildering. There are difficulties beyond the illness. It’s just nice to know that above and beyond insurance coverage, MedCost’s Case Management gives you some peace of mind.

If you are dealing with medical insurance, you need support. Don’t be a lone ranger. Sometimes it’s humbling for men in general – I run my own business. It’s hard to realize I can’t solve everything on my own. If help is there, take advantage of it.

I’ve been willing to talk to MedCost people to tell them what’s going on. My Case Manager has a gentle manner that is very encouraging.

medicalYou have got to face things head on. When I talked to my gastroenterologist, he said: “It’s a good thing you came in.” I asked him what would have happened if I had waited five years for that screening. He said: “The news would not have been this good. It’s still early – you’re going to be okay.”

I’m going to focus on the finish line to get this behind me. This has made some positive changes in my life. After my surgery, when I was trying to get up and walk, I saw a lot of people who weren’t doing well. I heard people moaning in pain. Sometimes you need to see that to be thankful for what you’ve got.

I’ve got a lot to live for. God puts you with people that can help you. MedCost has been my sponsor. They got me to the screening and saved my life.MedCost

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If you are 50+ or have a family history or other risk factors for colorectal cancer, your health plan may provide a free colonoscopy. Check your health plan benefits for more details. Colorectal cancer can progress without any symptoms such as rectal bleeding or pain. Don’t wait to be screened.

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This testimony was published with permission from C. Sean Yacobi. To print, click on the title and scroll to “PRINT THIS PAGE” at the bottom.

 

 

 

Dementia Declines in US Seniors, Study Finds

dementiaA new study finds that the prevalence of dementia has fallen sharply in recent years, most likely as a result of Americans’ rising educational levels and better heart health, which are both closely related to brain health.

Dementia rates in people over age 65 fell from 11.6 percent in 2000 to 8.8 percent in 2012, a decline of 24 percent, according to a study of more than 21,000 people across the country published Monday in The Journal of the American Medical Association Internal Medicine.

“It’s definitely good news,” said Dr. Kenneth Langa, a professor of internal medicine at the University of Michigan and a coauthor of the new study. “Even without a cure for Alzheimer’s disease or a new medication, there are things that we can do socially and medically and behaviorally that can significantly reduce the risk.”

The decline in dementia rates translates to about one million fewer Americans suffering from the condition, said John Haaga, director of behavioral and social research at the National Institute on Aging, part of the National Institutes of Health, which funded the new study.

Dementia is a general term for a loss of memory or other mental abilities that’s severe enough to interfere with daily life. Alzheimer’s disease, which is believed to be caused by a buildup of plaques and tangles in the brain, is the most common type of dementia. Vascular dementia is the second most common type of dementia and occurs after a stroke.

dementiaThe new research confirms the results of several other studies that also have found steady declines in dementia rates in the United States and Europe. The new research provides some of the strongest evidence yet for a decline in dementia rates because of its broad scope and diverse ranges of incomes and ethnic groups, Haaga said. The average age of participants in the study, called the Health and Retirement Study, was 75.

The study, which began in 1992, focuses on people over age 50, collecting data every two years. Researchers conduct detailed interviews with participants about their health, income, cognitive ability and life circumstances. The interviews also include physical tests, body measurements and blood and saliva samples.

While advocates for people with dementia welcomed the news, they noted that Alzheimer’s disease and other forms of memory loss remain a serious burden for the nation and the world.  Up to five million Americans today suffer from dementia, a number that is expected to triple by 2050, as people live longer and the elderly population increases.

The number of Americans over age 65 is expected to nearly double by 2050, reaching 84 million, according to the U.S. Census. So even if the percentage of elderly people who develop dementia is smaller than previously estimated, the total number of Americans suffering from the condition will continue to increase, said Keith Fargo, director of scientific programs and outreach, medical and scientific relations at the Alzheimer’s Association.

“Alzheimer’s is going to remain the public health crisis of our time, even with modestly reduced rates,” Fargo said.MedCost

(Kaiser Health News, Liz Szabo, November 21, 2016)

Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

6 Tips for Family Caregivers

Man with walker

Ask Kathy Kenyon about what it’s like to be a family caregiver, and she’ll give you an earful.

On several occasions, doctors have treated this accomplished lawyer like she was an interloper — not the person to whom her elderly parents had entrusted health care and legal decision-making.

Kenyon wasn’t told how to identify signs that her mother, who had low sodium levels, was slipping into a medical crisis. Nor was she given any advice about how to prevent those crises from occurring.

When her parents — both with early-stage dementia — moved to the Washington, D.C. area, it took months for medical records to be transferred because Kenyon’s right to the information wasn’t initially recognized.

An aberration? Hardly, according to a long-awaited report on family caregiving from the National Academies of Sciences, Engineering and Medicine, which acknowledges that the nearly 18 million caregivers for older adults are routinely marginalized and ignored within the health care system.

“Caregivers are, on the one hand, heavily relied upon but on the other hand overlooked,” said Richard Schulz, chair of the 19-member expert panel that crafted the report and a professor of psychiatry at the University of Pittsburgh.

Deeming that unacceptable, the panel has called for extensive changes to the health care system, including a family-centered approach to care that would recognize caregivers’ essential contributions.

What might that look like, practically, from a caregiver’s perspective? The report doesn’t say, but recommendations can be extrapolated from its findings.

Your identity needs to be documented in your loved one’s medical records.

shutterstock_78284827-converted-100-by-100“We need to start by having a clear sense of who the caregiver is” so that individual can be recognized as part of a team looking after an older adult, Schulz said. Currently, this doesn’t happen routinely.

That’s beginning to change. Thirty states, the District of Columbia, the U.S. Virgin Islands and Puerto Rico have now passed versions of the Caregiver Advise, Record, Enable (CARE) Act, drafted by AARP, which calls for information about family caregivers to be included in hospital medical records.

At every doctor’s appointment with an elderly family member or friend, check that the record lists your name and phone number, and ask that you be contacted in any kind of emergency.

Your capacity to provide care to a loved one should be assessed.

man-pushing-wheelchair-250-by-283A classic example: An elderly man with diabetes and severe arthritis who weighs 220 pounds is discharged from the hospital, barely able to walk. His elderly wife, who weighs just over 100 pounds, is his caregiver and she’s expected, somehow, to help him get in and out of bed and keep him from falling.

“No one asks you if you’re comfortable doing the things you’ll need to be doing, if you have the time or what other responsibilities you have,” said Laura Gitlin, a member of the panel and director of the Center for Innovative Care in Aging at Johns Hopkins University School of Nursing.

Your job: Speak up and tell doctors, nurses or social workers what you can and cannot do.

Your capacity to provide care should be incorporated into your loved one’s care plan.

Your abilities and limitations need to be recognized and addressed in every care plan that’s developed for your loved one. If you work from 7 a.m. to 3 p.m. and a parent needs help toileting, dressing and eating breakfast in the morning, for instance, that gap needs to be acknowledged and discussed.

There’s a lot at stake: Unrealistic expectations about caregivers’ capacities put the health of seniors — and caregivers’ own health — at risk.

You should get training in medical tasks for which you’ll be responsible. 

shutterstock_78284827-convertedMore than half of family caregivers don’t receive training in the tasks they’re expected to perform for loved ones at home: dressing wounds, changing catheters, administering medications or managing incontinence, for instance.

Although the CARE Act calls for training to be provided in hospitals and rehab centers, this isn’t happening on a widespread scale, yet.

Nothing substitutes for hands-on instruction, usually from a nurse. Be sure to reach out to hospital, rehab or home health nurses and ask for help understanding what you need to do and how to do it.

You should be connected with community resources that can be of help.

istock61894164A variety of resources for caregivers are available in many communities: local Area Agencies on Aging, which offer assistance accessing services; centers on independent living, which help people with disabilities; and disease-focused groups such as the Alzheimer’s Association, among other organizations.

But too often, “it’s not at all clear where families should turn when they get a diagnosis,” Gitlin said. “No one tells them who they should contact or which resources might be most helpful.”

Ask for this kind of information from your physician’s office, discharge staff at a local hospital and people you know in the community. The government’s Eldercare Locator is a good place to gather names of local organizations that may be of help.

You should be given access to medical records and information.

Misunderstanding of the medical privacy act known as HIPAA (Health Insurance Portability and Accountability Act) is common and creates barriers to family caregivers getting information they need to oversee a loved one’s care.

discharge-shutterstock_122948044-converted-225-by-233In fact, medical institutions are obligated to hand over information when an older adult has granted a caregiver a durable power of attorney for health care decisions or a HIPAA authorization specifying that they receive access to medical materials.

In written testimony to the government, Kenyon said she was once told she couldn’t walk down a hall to see her father in a sleep center because doing so would violate HIPAA. That was an ill-informed interpretation of the law.

While there’s no easy solution, standing up for yourself is essential. “Advocate for your rights and make sure your caregiving contributions are recognized and supported to the extent they can be,” said the University of Pittsburgh’s Schulz. “You’re an important person in the health care system.”MedCost

(Kaiser Health NewsJudith Graham, September 29, 2016)

 Kaiser Health News, a nonprofit health newsroom whose stories appear in news outlets nationwide, is an editorially independent part of the Kaiser Family Foundation.

Federal Study Helps Seniors Stay at Home

seniors stay homeA federally-funded project that researchers say has potential to promote aging in place began by asking low-income seniors with disabilities how their lives at home could be better, according to a study released Wednesday.

At the end of the program, 75% of participants were able to perform more daily activities than they could before and symptoms of depression also improved, researchers said in the journal Health Affairs. 

Called Community Aging in Place, Advancing Better Living for Elders, or CAPABLE for short, the program was funded by the Center for Medicare & Medicaid Innovation.

The seniors who took part were each paired with a team for five months that included an occupational therapist, who made six visits; a registered nurse, who made four; and a handyman, who worked a full-day at the participant’s home installing assistive devices and doing repairs, according to the study.

The nurses and therapists helped participants identify three achievable goals for each member of the team and identify what barriers had to be overcome. For example, the therapist might survey a house for safety issues such as unsafe flooring, poorly lit entrances and railings in disrepair.

seniors stay homeThe therapist then worked with the elderly person to identify assistive devices, repairs or modifications that could help achieve the participant’s goals. Next, the therapist created a work order for the handyman that prioritized those goals within a $1,300 budget for each dwelling.

Spending on assistive devices and home repairs ranged from $72 to $1,398 for each participant, the researchers said.

They studied 234 adults older than 65 who participated in CAPABLE, all eligible for both Medicare, the government health insurance plan for seniors, and Medicaid, the government health insurance plan for low-income people.

All participants had trouble with routine tasks in a group of eight known as activities of daily living. They include bathing, dressing, using the toilet and walking across a small room. On average, participants had trouble with 3.9 tasks at the start, but improved to just two by the end of the program.

Researchers said they could not conclude that the participants’ improvements were due to the CAPABLE program because the project was funded without a control group to make scientific comparisons.

(Kaiser Health News, Rachel Bluth, September 7, 2016)
KHN

 

The Life-Saving Resource Ignored After Heart Attacks

childrens hospital readmissionsCHARLOTTESVILLE, Va. — Mario Oikonomides credits a massive heart attack when he was 38 for sparking his love of exercise, which he says helped keep him out of the hospital for decades after.

While recovering, he did something that only a small percentage of patients do: He signed up for a medically supervised cardiac rehabilitation program where he learned about exercise, diet and prescription drugs.

“I had never exercised before,” said Oikonomides, 69, who says he enjoyed it so much he stayed active after finishing the program.

Despite evidence showing such programs substantially cut the risk of dying from another cardiac problem, improve quality of life and lower costs, fewer than one-third of patients whose conditions qualify for the rehab actually participate. Various studies show women and minorities, especially African Americans, have the lowest participation rates.

“Frankly, I’m a little discouraged by the lack of attention,” said Brian Contos, who has studied the programs for the Advisory Board, a consulting firm used by hospitals and other medical providers.

ManWithHeartNow, though, advocates say cardiac rehab may gain traction, partly because the federal health care law puts hospitals on a financial hook for penalties if patients are readmitted after cardiac problems. Studies have shown that patients’ participation in cardiac rehab cut hospital readmissions by nearly a third and saved money.

The law also creates incentives for hospitals, physicians and other medical providers to work together to better coordinate care.MedCost

(Kaiser Health News, Julie Appleby, August 31, 2016)

KHN

 

 

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How to Turn Health Care Data into Dollars

Is your company one of the growing numbers of US employers using health care data to manage expenses?

Just as employers keep a close watch on profit and loss columns, the same analysis is now available for companies’ health care costs. Big data is increasingly driving improved, better coordinated care to improve employee health while managing spiraling expenses.

We know this is a complicated topic (just like health care). That’s why we’re offering a free white paper examining the role of big data in health care and how employers can achieve true quality, cost-effective outcomes.

Between 1999 and 2015, employer-sponsored health premiums rose 203%.[i] Managing employee health costs is becoming more and more difficult every year.

Big data compiles massive amounts of data from multiple sources, yielding key metrics and predictive analytics for health care providers. Providers can then leverage this into interventions that provide high quality, cost-effective care. And employers who receive regular reports on trends can work with a benefits administrator to better manage those costs while supporting employee health outcomes.

Jane’s Story

diabetic, advanced analytics, big dataHere’s an example of how MedCost applies this analysis. Jane,* a 42-year old female member with moderately-controlled diabetes, has health benefits through her job. Jane’s biannual visit to her Primary Care Physician (PCP) documents her routine lab work, prescriptions and referrals for preventive screenings.

Between PCP visits, this diabetic member gets the flu, causing severe increases in blood glucose levels. When Jane goes to the Emergency Room, the ER doctor increases her medication dosage. After she goes home, Jane’s personal blood glucose meter shows an alarming drop in her blood sugar levels. Jane calls her PCP, who adjusts her dosage to prevent more complications. Jane’s next checkup is planned in six months.

Was all the data communicated from the hospital’s electronic records, the lab vendor’s system, payer claims and her home monitoring glucose meter? Will the PCP be able to verify that Jane actually obtained her preventive mammogram or flu vaccine prescribed before the ER visit?

At MedCost, Jane’s case would be carefully monitored by her nurse health coach. If there is an issue, her nurse health coach would follow up.

white paper

Chronic illnesses like Jane’s need expert support to prevent worse outcomes and resulting higher costs. And advanced analytics can now identify patients and populations at risk for developing certain conditions prior to the actual onset of illness.

 The white paper, Transforming Data into Dollars, offers an understanding of factors influencing the need for advanced analytics solutions, including an example using the MedCost Care Management programs.

Here are other insights from the white paper:

BENEFITS OF ADVANCED ANALYTICS  
   
1.     Accurate Reporting Normalized measures based on industry-accepted tools of evaluation yield best results for your employees.
2.     Maximized Outcomes Your company will rate higher on the Analytics Sophistication Scale and outperform industry peers.
3.     Healthier Employees Potential risk for developing conditions can be identified and prevented.
4.     Lower Costs Wise management of expenses creates a sustainable long-term cost trend.

  We’ve identified high-risk employees, improved health results and minimized costly hospital visits using precise data analysis in a sample case study that illustrates these key benefits. Download our white paper to learn how.

white paper

*Actual patient data not used.

[i] “Recent Trends in Employer-Sponsored Health Insurance Premiums,” Kaiser Family Foundation, January 5, 2016, http://kff.org/infographic/visualizing-health-policy-recent-trends-in-employer-sponsored-health-insurance-premiums/ (accessed June 16, 2016).

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Hospital Costs Surge with Increased Opioid Abuse

Every day, headlines detail the casualties of the nation’s surge in heroin and prescription painkiller opioid drugsabuse: the funerals, the broken families and the patients cycling in and out of treatment. Now, a new study sheds light on another repercussion — how this public health problem is adding to the nation’s ballooning health care costs and who’s shouldering that burden.

The research comes as policymakers grapple with how to curb the increased abuse of these drugs, known as opioids. State legislators in New York,Connecticut, Alaska and Pennsylvania have tried to take action by adding new resources to boost prevention and treatment. In addition, President Barack Obama laid out strategies last month intended to improve how the health system deals with addiction.

Published Monday in the journal Health Affairs, the study measures how many people were hospitalized between 2002 and 2012 because they were abusing heroin or prescription painkillers, and how many of them got serious infections related to their drug use. It also tracks what hospitals charged to treat those patients and how the hospitals were paid.

(Kaiser Health NewsShefali Luthra, May 2, 2016)

Kaiser Health News

 

 

Some Businesses Save By Offering Employees Free Surgery

Lowe’s home improvement company, like a growing number of large companies nationwide, Save health costs, employer health plansoffers its employees an eye-catching benefit: certain major surgeries at prestigious hospitals at no cost to the employee.

How do these firms do it? With “bundled payments,” a way of paying that’s gaining steam across the health care industry, and that Medicare is now adopting for hip and knee replacements in 67 metropolitan areas, including New York, Miami and Denver.

Here’s how it works: Lowe’s and other employers pay one flat rate for a particular procedure from any of a number of hospitals they’ve selected for quality, even if they are a plane ride away. And, under the agreement, the hospital handles all the treatment within a certain time frame — the surgery, the physical therapy and any complications that arise — all for that one price.

(Kaiser Health News, Michael Tomsic, WFAE, April 22, 2016)

Kaiser Health News

 

 

Largest US Health Insurer To Exit Most ACA Exchanges in 2017

ACA, health insurance, health exchangesUnitedHealthcare will operate only in a “handful” of health insurance exchanges in 2017, down from 34 states this year, company officials said Tuesday.

The company did not provide the anticipated details in its first-quarter earnings announcement released Tuesday morning or in a subsequent teleconference with securities analysts. But a spokesman confirmed Nevada and Virginia would be among the states where it will retain a presence. In the past week, UnitedHealthcare said it would leave Georgia, Michigan, and Arkansas.

(Galewitz, Kaiser Health News, April 19, 2016)
Kaiser Health News