Archive for January, 2017

It’s Okay. I’m over it now.

January 24th, 2017

In the last three years, I’ve had a flu shot every year, two types of pneumonia shots, a shot for Hepatitis C, one for shingles, and another one for Tetanus and whooping cough, but none of them stop me from becoming disease-ridden with the dreaded flu at least once a season. For the past eight years, I’ve been blaming it on flying in airplanes filled with recirculated coughs and sneezes, but all of my work in the past three weeks has not been in the sky.

OK, I do work in hospitals, those capricious breeding grounds for hundreds of unusual infections, but I’m pretty careful when I’m in those places.

It is always intense. In fact, the intensity of this condition hasn’t changed much in 30 years. The only thing I can figure out is that my childhood allergic asthma attacks, or playing professional trumpet in smoke-filled clubs for 20 years have resulted in some type of permanent damage to my lungs. When even the littlest cold attacks my immune system, it takes every white blood cell that I can muster from my entire body to keep those sniffles from blossoming into full-blown pneumonia. (I’ve had pneumonia about six or seven times, too.)

It was about 10 years ago when a radiologist friend said to me, “Hey, Nick, do you remember breaking your ribs because they’ve definitely been broken.” Did I remember breaking my ribs? The answer to that had to have been, no, but do I remember coughing so much, so hard, so loudly, and so forcefully that the chandelier started to swing? Do I remember the dog hiding in the other room? Do I remember being banned to a Lazy Boy recliner in the basement as my sit-up bed? Yes. I do remember those things very well.

It always starts out the same. There’s a little tickle in my throat that makes me sound like Barry White or some ripped guy with washboard abs at the other end of 1-900 phone number. (Not that I would know how someone like that sounds.) But I do know how Barry White sounds, and he drives the ladies crazy. Then, by the next morning the sneezes, continuous nose dripping, and mild coughing begin. By about 7:30 p.m. that night, I’m fully immersed in humidifiers, neti pots, flannel jammy pants, gallons of fluid, Tylenol, cough drops and cough medicine, tissues, and soft animal pillows to hold against my chest to ease the pain caused as I try not to crack more ribs.

Sometimes I cough so hard it seems like losing consciousness would be a blessing, but it’s only a cold.

In my work in healthcare, it always amazes me that we can do proteomic analytics to determine what proteins are spreading cancer or heart disease. We can look at individual microbes to ascertain what’s happening with our microbiome and digestion. We can look at the 300 genes that control the metabolism of our medications so that we take the right drugs, but we can’t figure out the common cold or flu.

How many times have we heard, “The Centers for Disease Control did not guess correctly on the strain of flu this year for your flu shots?” Good luck with that. I heard this morning that 400 stray cats have been quarantined in a warehouse in New York City because they have a new version of the swine flu. I’m sure I do as well. Too bad I’m allergic to cats, or I’d go hang out there, too. Here kitty kitty kitty.


Integrative Medicine is Becoming More Popular

January 10th, 2017

According to a recent article published by the American Hospital Association, Integrative Medicine is becoming more popular in the healthcare industry, and the major force behind this movement is primarily coming from the patients themselves.

Integrative care programs, such as acupuncture, energy medicine, and tai chi, have garnered increased acceptance among the general public, and an increasing number of hospitals and health systems are adding these integrative therapies to their menu of options.  The AHA confirms that the primary reason for this increase is actually due to individual patient demand.

Massage, music, humor, and pet therapy along with mindfulness, yoga, and acupuncture are all being more widely accepted because clinicians are incorporating these therapies into their traditional Western Medicine practices in a coordinated way.

According to the AHA, comprehensive outpatient centers specializing in Integrative Medicine operate at a high cost, and, for the most part, do not have adequate reimbursements.  Consequently, many of these centers are still dependent upon donations.

It’s been my experience that, depending on the health system’s size, location, and other factors such as economic well-being, they offer either comprehensive outpatient integrative centers or integrative services in inpatient settings. Either way, the providers have to deal with reimbursement challenges for these programs.

It is customary for many Insurers to cover acupuncture and in many states, they also provide reimbursements for massage therapy. But the primary source of payment in Integrative Medicine is still from the patients who are asked to pay for them out of pocket. In some cases, like at Highlands Hospital, in the inpatient setting, the services are offered to the patients without any charges.

Because the various treatment modalities offered in integrative medicine are still not taught in traditional medical schools, there are physicians who continue to be skeptical about their use, but the amazing results that can emanate from these programs are becoming more and more widely accepted and acknowledged.

One reason for the acceptance of these programs is the increasing number of evidence-based scientific papers that are being submitted to and accepted by traditional medical journals each year. There have been over 19,000 papers submitted on the effectiveness of acupuncture alone.

The other reason for more widespread acceptance is the now recognized positive patient outcomes. In my experience as a hospital CEO, we have seen integrative therapies shorten the patient’s length of stay and reduce the need for pain medication while improving the patient’s overall care experience.

Dr. Angela LaSalle, director of integrative services at Parkview Health System in Fort Wayne, Indiana, Dr. Kelly Warshel, director of palliative care services at the Chan Soon Shiong Medical Center at Windber, Dr. Leonard Wisneski, Chairman of the Integrative Health Policy Consortium, and Dr. Mimi Guarneri, President of the Academy of Integrative Health and Medicine are just a few of the physicians with whom I have worked to create “healing environments,” for patients.

This type of total care is integral to the overall quality of the patient experience. We have seen time and time again where Reiki, music, and mindfulness practices can decrease patient’s anxiety, and with less anxiety, the immune system has a greater opportunity to work properly.

In my experience, when we compared such benchmarks as lengths of stay, pain medication use, or patient satisfaction for patients who received integrative therapies as compared to those who did not the patients almost unanimously reported a decrease in both, pain and anxiety.

As we look for ways to decrease the use of drugs and become more active in our own health and wellness efforts, it is apparent that integrative care practitioners who combine traditional medicine with the integrative therapies are providing extremely meaningful care to their patients.

I remember hearing a prominent integrative physician state the following, “Acupuncture may not work for every patient in every situation, but the great news is it can’t hurt you.  Even if it’s done incorrectly, it releases endorphins.”


Contemplating the advantages to healthy living

January 3rd, 2017

One of my first experiences back in 1992 as the new chief communications officer of a major health system was arranging for our organization to have a presence in a local health fair.

The group that arranged this event had to fill a hall that was roughly the size of afootball field. Consequently, there were some rather creative participants.

When I stopped in to see how our booth looked, I noticed an exhibitor’s booth about 20 yards away with a waiting line that extended to the front of the building.

At our booth we were giving away stress balls and ballpoint pens that looked like hypodermic needles. I wondered what they were giving away that would draw that much attention?

As I made my way over to their display, I saw that it was not a health booth, it was a booth representing a cemetery. They were selling cemetery plots. (OK, that seemed a little strange for a health fair.) The catch, however, was not the Astro turf plot on display; it was the hand-out. They were distributing T-shirts that read, “Eat right, exercise, lower your stress, and you’re still gonna die!”

In the spirit of mortality recognition, I came across a recent report from the Center for Disease Control that elaborated on some changes in the estimated number of potentially preventable deaths from the five leading causes of death here in the United States. These changes occurred between 2010 and 2014.

Number one on the list was cancer deaths. According to this chart, cancer deaths decreased by 25 percent which seems pretty encouraging. Especially when you consider that most probably 75 percent of those deaths were caused by some type of environmental contaminant being absorbed by our bodies.

The next area of decrease might have come from all of the public service announcements, improvements in blood pressure medications, and reduction in salt intake in prepared foods.

Regardless, something must be working here, too because stroke deaths have decreased by 11 percent.

A not-so-impressive change, but a change none-the-less also occurred in heart disease-related deaths which have decreased by 4 percent.

The only two increases in these top five were deaths from chronic lower respiratory disease (such as asthma, bronchitis, and emphysema) which increased 1 percent, and deaths resulting from unintentional injuries where there was a 23 percent increase.

Let’s take a closer look at this statistic.

If 28,000 people died of drug overdoses, and if over 33,000 were killed in automobile accidents, and firearms killed more than 32,000 people, what percentage of those deaths were unintentional?

Considering the fact that 2.6 million people die each year in the United States and 50 percent of those deaths come from cancer, heart, and strokes, we have to go back to my original T-shirt statement: “Eat right, exercise, manage your stress, and you’re still gonna die.” But the question becomes, “Can you die older and healthier by acting smarter?”

In Japan, Switzerland, Singapore, Australia, Spain, Iceland, Italy, Israel, and Sweden, people live on average four years longer than we do. They live at least three years longer than us in another 20 countries. These statistics place the United States as 31st in life span internationally, but we spend more on medical care in this country by far than any other country in the world.

Could it be that 78 million of us are overweight? Or maybe it’s because nearly one-third of our population, about 900,000 people, are either diabetic or pre-diabetic?

Forty-two million of us still smoke and more than 30,000 of us shoot each other to death? It may also be because we eat too much red meat and never ever exercise?

I’m not the answer guy, but I sure have plenty of ideas about this. Eat right, exercise, lower your stress, and you’re gonna live a lot longer and a lot healthier until you get your T-shirt.