Archive for the ‘Medicine’ category

May Cause Dizziness, Osteoporosis and Slow Death…

June 1st, 2009

There were some very bright people involved who confirmed my suspicions, but it was my persistence, my explorations, and my perseverance that took me to those scientists, doctors, and pharmacists. You see, the prognosis that I was given involved a very much dreaded series of events that played heavily in the death of my paternal grandmother – kidney failure.  Okay, it was mild.  Yes, it was just the very beginning stages, but, like surgery, when it involves my body, it’s major!

drug interaction awareness education Nick Jacobs SunStone consulting

After an E-mail to a very well known and highly respected physician at one of the mostly widely recognized medical facilities in the world, my suspicions were even more intensified.  Phone calls to two different pharmacist friends resulted in me getting the information that I had been seeking.  There were at least three recent studies that confirmed that ARB’s (Angiotensin Receptor Blockers) could cause renal (i.e. kidney) dysfunction, resulting in the doubling of serium creatinine, leading to death.

“Reports in the medical literature reinforce the importance of recognizing that angiotensin-converting enzyme inhibitors should be used with caution in patients with bilateral renal artery stenosis . . . Clinicians should be aware that renal failure might occur when using ARBs in these patients”…

…read one website.   Like I said, I’m not a doctor, and I’m sure that there will be plenty of opinions about these studies.

From another website:

“Chicago, IL – The addition of an angiotensin receptor blocker (ARB) to ACE-inhibitor therapy makes treatment noncompliance due to side effects more likely and ups the risks of symptomatic hypotension and renal dysfunction, suggests a pooled analysis of four randomized trials [1]. The findings are consistent with current treatment guidelines that express reservations about routinely combining the two drug classes, the authors write in the October 8, 2007 issue of the Archives of Internal Medicine.

Well, to add insult to injury, last year I had my upper and lower GI work up, just for old times’ sake.    At the end of that procedure, the doc suggested one of those purple pills.  Tonight on the news, right after the GM bankruptcy, the story went something like this: According to the Associated Press…

“Taking such popular heartburn drugs as Nexium, Prevacid, or Prilosec for a year or more can raise the risk of a broken hip markedly in people over 50, a large study in Britain found.”

Well, okay, it was Britain.  We all know that they are generally much more healthy than we Americans.  Maybe the study should have read:  “If you are healthy, you will break your hip in England.”

I know, I know.  We all have to die of something, but darn it, why does it have to be the result of stuff that is supposed to be helping us stay alive? I hate the thought of spending the equivalent of a Mercedes car payment each month to load my body up with chemicals that do more damage than Jack and Coke or Goose and Tonic.  Seriously, Aunt Martha really seemed to have it together:  Don’t take anything stronger than an aspirin.  For heaven sakes, don’t get a physical if you can avoid it, and live your life in moderation.  She’s still going strong in her eighties.

Oh, well, it’s time for my Niaspan, Plavix, Nexium, Lotrel, Toporol, Zetia, Crestor and fish oil cocktail …with a chaser of mulivitamins. To your health!

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NickJacobs.org???

April 2nd, 2009

Let me open this blog with a little housekeeping chore. Because I’ve retired from being a hospital president (Yes, they replaced me with two great people, count ’em, two.) , I’d like to change the name of this thing. It’s not that I’ve established a P-Diddy-type Twitter following where 100,000 human beings are waiting with baited breath to see what my next move will be, it just doesn’t seem right to keep calling myself a hospital president. We know who reads this thing, and we are grateful to our loyal, talented, and brilliant followers. We also know that we can link the old blog names to get you here. So, regardless of what you typed, or what gets Googled, our genius social media maven & webmaster, Michael Russell, can help to bring you home to this site.

Okay, so as a transformational advisor, a broker of sorts, most people with whom we have consulted have described me as a person who can fix things that are broken before they actually break. Maybe we should call it the “Break it if it’s not already fixed” blog. I’d love it if it was a name that would generate millions of hits and companies would fight to advertise on it.

My first thought was to use nickjacobs in the title because there is a Nick Jacobs on Facebook who teaches Aboriginal people in Australia, and he seems popular. There is another Nick Jacobs who is a professional organist, and one who is an athlete. There’s a Nick Jacobs who is a consultant and another a paramedic in London, one who had a blog who is a yachtsman, there’s my son, the commercial real estate broker, and finally, there’s a Nick Jacobs who does pornographic movies who is not my son. Actually, that Nick Jacobs’ followers would probably be the most disappointed by this blog.

Since the .com version of nick jacobs was already taken by some guy in England, we captured nickjacobs.org, and that will work for right now.

If you have any ideas, however, that you think would really rock the blogspere, let us know and we’ll check with our domain registrar to see if it is available. In fact, if you are the winner of a Name Nick’s Blog Contest, I’d be happy to consult for free BY PHONE for at least one hour of brainstorming with you about the topic of your choice: music, healthcare, proteomics, teaching, PR/Marketing, the travel business, or even physician recruitment.

Remember, Hospital Impact is already taken, and, because my last three consulting jobs have been with a newspaper, a nonprofit arts oragnization, and a chain of hotels, we don’t want to think too restrictively. Gotta earn a little money, too.

When we ran the breast center, we found that the website got more hits than anyone could imagine. The problem was that the readers were mostly thirteen-year-old boys who probably weren’t too interested in running a hospital. After Miss America had visited us, the hits went up exponentially when those two searches were combined. Somehow, I don’t think that Nick Jacobs’ Breast Center for Miss America would probably get me the type of following I’m currently hoping to attract. On the other hand?

A very good friend recently asked me to write a brief bio about what my new life is like, and it struck me that it is very much like my old life but without any restrictions. This is what I wrote:

While teaching junior high school instrumental music in the early 1970’s, Nick Jacobs made an extraordinary discovery. He learned that, by empowering his students and surrounding them with positive influences, he no longer was providing a service or even an experience for them.

What this entirely unique teaching style resulted in was a method for helping to transform students. By providing with both passion and commitment the tools needed by them to undertake their journey, his involvement with the students became a means of dramatically helping them to make whatever positive life changes they were seeking.

It was during that early period in his career that he also discovered that this formula could work to positively change lives in almost any aspect of living as he ran an arts organization, a convention bureau, and finally a hospital and research institute.

Since that time he has dedicated his personal work to helping others make their lives better, and that is exactly what he is doing in his position as an international executive consultant with SunStone Consulting, LLC.

Maybe that will give you something to chew on? Okay, something on which to chew.

SunStone Consulting. With more than 20 years experience in executive hospital leadership, Nick has an acknowledged reputation for innovation and patient-centered care approaches to health and healing.

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Engage With Grace

November 27th, 2008
The One Slide

The One Slide

Several dozen bloggers in the health care field and beyond are today engaged in a blog rally*, simultaneously posting the item below to encourage conversation about a topic that’s often avoided but needs to be addressed in every family: How we want to die. I’ve written about this before, with regard to my mother. Please try it, using the slide above as a discussion guide. It’s not that hard to have the conversation with your loved ones once you get started.

We make choices throughout our lives – where we want to live, what types of activities will fill our days, with whom we spend our time. These choices are often a balance between our desires and our means, but at the end of the day, they are decisions made with intent. But when it comes to how we want to be treated at the end our lives, often we don’t express our intent or tell our loved ones about it.

This has real consequences. 73% of Americans would prefer to die at home, but up to 50% die in hospital. More than 80% of Californians say their loved ones “know exactly” or have a “good idea” of what their wishes would be if they were in a persistent coma, but only 50% say they’ve talked to them about their preferences.

But our end of life experiences are about a lot more than statistics. They’re about all of us. So the first thing we need to do is start talking.

Engage With Grace: The One Slide Project was designed with one simple goal: to help get the conversation about end of life experience started. The idea is simple: Create a tool to help get people talking. One Slide, with just five questions on it. Five questions designed to help get us talking with each other, with our loved ones, about our preferences. And we’re asking people to share this One Slide – wherever and whenever they can…at a presentation, at dinner, at their book club. Just One Slide, just five questions.

Lets start a global discussion that, until now, most of us haven’t had.

Here is what we are asking you: Download The One Slide (that’s it above) and share it at any opportunity – with colleagues, family, friends. Think of the slide as currency and donate just two minutes whenever you can. Commit to being able to answer these five questions about end of life experience for yourself, and for your loved ones. Then commit to helping others do the same. Get this conversation started.

Let’s start a viral movement driven by the change we as individuals can effect…and the incredibly positive impact we could have collectively. Help ensure that all of us – and the people we care for – can end our lives in the same purposeful way we live them.

Just One Slide, just one goal. Think of the enormous difference we can make together.

(To learn more please go to www.engagewithgrace.org. This post was written by Alexandra Drane and the Engage With Grace team. )

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The Valley of Death

November 20th, 2008

Sharon Begley wrote for Newsweek Magazine an article entitled Where Are the Cures? Scientists call the gulf between a biomedical discovery and new treatment the “valley of death.” This has been a topic about which I have written several times. As a relative newcomer to the world of scientific research, my journey has been somewhat perplexing and always disconcerting. Every day articles, web stories, and scientific papers cross my desk touting the amazing discoveries that are being made at the basic research level. When I query my insiders, however, they point out that these discoveries very rarely ever get to the public for their care and treatment.

Some of the reasons behind this gap in medical science lead back to a broken system with inappropriate incentives locked firmly into place. How do we get the basic discoveries to be translated and moved into actual treatments?

Why are so few of the discoveries making their way to both treatments and cures? It is because our system of NIH-sponsored science is set up to discover things; plain and simple. Once the discovery is made, articles can be written, which is the sought after reward in academia since these publications lead to more grants from the NIH, and so the circle goes round and round.


Image Credit: Corbis

The obstacles to translational research in which the studies actually move from the scientist’s bench to the patient’s bedside are so intense that they are referred to in some areas of the scientific community as the “valley of death.” According to Begley’s article, “The valley of death is why many promising discoveries-genes linked to cancer and Parkinson’s disease; biochemical pathways that ravage neurons in Lou Gehrig’s disease-never move forward.”

The author challenges the incoming Obama administration and Congress to take a look at this daunting dilemma and to begin to revamp our biomedical research system by creating what Richard Boxer, a urologist at the University of Miami, and Lou Weisbach, a Chicago entrepreneur, call a “Center for Cures” at the NIH. Interestingly enough, the model that they endorse is exactly what was created here in Windber where multidisciplinary teams of biologists, proteomic and genomic scientists, technicians, and biomedical informatics specialists work together with Walter Reed Army Medical Center to move a discovery to an actual cure.

Of course, with the cuts made to the NIH funds, creating anything new that is unfunded could take away from basic research, and limit hopes for these cure discoveries. The article explains that while the NIH budget was doubling, new drug approvals fell from 53 in 1996 to 18 in 2006. What’s wrong with this picture? Twice the money, less than half the discoveries.

The sad case, however, is that even those organizations that try to establish these new world order cure centers are not funded by the NIH because of this fundamental design to enhance only basic research. The article ends with this: “I’d be willing to put up with potholes in exchange for a new administration spending serious money to take the discoveries taxpayers have paid for and turn them into cures.”

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As Close to Home As You Can Get

October 15th, 2008

Yesterday afternoon the realities of humanism, mortality, and fear attempted to take me out for about the one millionth time in my life. A phone call came from a loved one casually explaining that the doctor had potentially discovered a problem that needed further examination. When the office called for an appointment to have the scan done, they were told that it would be approximately a week before there was an opening in the schedule.

As an insider, I knew that a certain number of slots were held each day for emergency or unscheduled procedures. Not unlike the hotel that holds back a room or two from the 1-800 reservation list, just in case a preferred guest or luminary comes through the doors, flexibility is something that hospitals have to embrace at some level.

Taking the Hell out of Healthcare by Nick JacobsOnce again, as an insider, a call to the department resulted in an immediate invitation to come in for the test the very next day.

My route to health care management was a particularly unique and circuitous route, and it left me asking the question, “why does it have to be this way?” I’ve personally done everything that I can to make it humane, patient centered, and sensitive.

If you or your loved one wants to know the inside story on how hospitals work, take a look at my new book, “Taking the Hell out of Healthcare.” It really can help. It is a simple “how to” book aimed at the everyday person who is having to deal with this complex and sometimes difficult world of health care.

My passion and personal commitment has always been to patient advocacy, transparency, and human kindness. Find out how to make the system work for you.

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In Their Own Words: Patients, staff and physicians on their experiences at Nick’s Planetree hospital

October 5th, 2008

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