Tag Archives: patient advocate

The Cost of Medical Care is frequently not Disclosed

Walk-in Clinics can be much less expensive than using an Emergency Room facility. Depending on the symptoms it might be worth finding the nearest walk-in clinic for some types of minor wounds or symptoms. See the book link at the end of this post for more information on emergencies and when to consider the ambulance and when to figure out which one to call (answer — ahead of time). If you live in an area with many hospitals the ambulance you call may take you to a different hospital than you might have expected.

The following article describes a new parent’s worry over a child’s cut finger and then the astonishment when the Emergency Room bill was $629 (reduced slightly by insurance company negotiation, but still astonishing). An E.R. visit is going to have a base fee just for receiving care within that setting; the band-aid was only $7. Read more: “The case of the $629 Band-Aid — and what it reveals about American health care,” (vox.com, May 13, 2016) [http://www.vox.com/2016/5/13/11606760/emergency-facility-fees-american-health-care]

Patient advocates can be helpful when chronic conditions or new diagnoses are complex.

Previously posted (2/15/2015): It’s not easy to be a patient and being patient about it isn’t easy either. Having symptoms can be frightening and navigating the health care system can be challenging and sometimes frightening too.  Patient advocates may be available at your hospital or insurance company who can assist with health care questions. Some volunteer organizations also may have patient advocacy services available. Professional patient advocates may  also be available in some areas to hire for help with handling medical issues. [ Services that a patient advocate might provide]

And more on patient advocacy and a book link and other tips for educating oneself before emergencies occur is available in another post: “If laughter is the best medicine, then self advocacy may be the second best, and a U.S. physician has written a prescription for both; a book link,”

/Disclaimer: Opinions are my own and  the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

Calciphylaxis may be caused by several different nutrient issues

Calciphylaxis usually includes an imbalance of calcium and phosphate and a deficiency of protein C may also be involved. Protein C deficiency may be caused by genetic or acquired reasons. Protein C is involved in blood clotting. Vascular and soft tissue calcification frequently is also present in patients with calciphylaxis symptoms. The mineral content of the calciphylaxis sores has been found to resemble the mineral balance of bone.

Imbalance in vitamin D and hormone D metabolism might affect magnesium levels in some unusual cases and may promote intestinal malabsorption of magnesium. However elevated magnesium is more typically found in patients who have calciphylaxis as a side effect of dialysis in end stage renal disease. The kidney disease causes an abnormal lack of hormone D because the kidneys in normal health are the only place where vitamin D is activated into the hormone D form.

These are copies of links that I was reading and Tweeted last night:

  1. Mineral substance of bone tissue and of experimental cutaneous calcinosis in rats: chemical analysis and ESR study.
  2. Calciphylaxis assoc w cholangiocarcinoma… /heparin & vit K didn’t help/ Thrombosis & protein C deficiency involved/
  3. Retrospective analysis of tissue plasminogen activator as an adjuvant treatment for calciphylaxis. /Ca P homeostasis/
  4. Calciphylaxis… “the reported median survival time is 2.6 months after diagnosis,”
  5. Aggressive calciphylaxis in end-stage renal disease… /assoc w vascular & soft tissue calcification/
  6. Calciphylaxis is a cutaneous process without involvement of internal organs… /assoc w vascular calcification/
  7. Net-like pattern of calcification on plain soft-tissue radiographs in patients with calciphylaxis. – PubMed – NCBI
  8. Is calciphylaxis best treated surgically or medically? – PubMed – NCBI
  9. Calciphylaxis in a morbidly obese woman w RA presenting w severe weight loss & vit D def. /pamidronate & D tx worked/
  10. Calciphylaxis in the absence of end-stage renal disease. – PubMed – NCBI /low vit D but tx surgery/
  11. The surgical management of renal hyperparathyroidism. – PubMed – NCBI
  12. Secondary hyperparathyroidism in children with chronic renal failure: pathogenesis and treatment. – PubMed – NCBI
  13. Vitamin D, parathyroid hormone, and acroosteolysis in systemic sclerosis. /low 25D w 2ndary hyperPTH in sunny climate

  14. Bone metabolism in celiac disease. – /following gluten free diet for 6 mo normalized 25D, calcium & PTH levels/

  15. Hypomagnesemia. Suppression of secondary hyperparathyroidism in chronic renal failure. – PubMed – NCBI

  16. Magnesium deficiency: possible role in osteoporosis associated with gluten-sensitive enteropathy. – PubMed – NCBI
  17. Recent data on magnesium & osteoporosis. “Mg def in post-menopausal osteoporosis, prob caused by Mg malabsorption.”
  18. [The significance of magnesium in medicine. (II) Disturbances of Mg metabolism & their treatment (author’s transl)].
  19. Metabolic disorders of cattle. /pellagra discussed, zinc, B6 Cu Mg def, malabsorption, iron overload can deplete B3/

Why do I care? because even though my symptoms are unusual I feel that I still deserve individualized health care. As a dietitian I was taught to look up information about any unusual diagnoses that patients might have and to provide individualized guidance if available or provide background information to help patients be able to make more informed choices about their treatment plan.

I also care because I think women deserve individualized healthcare even if we may get emotional or moody. Physical and mental illness symptoms can be related to underlying issues and simply medicating a symptom not only fails to address the underlying issue but it also fails to look for an underlying issue which can be life threatening if care is delayed in acute situations:

Whether male or female in a for-profit health industry being your own patient advocate or hiring a professional patient advocate may be life saving when navigating the increasingly complex health care system.

See the previous post for my own patient struggles with symptoms of hyperparathyroidism and calciphylaxis like sores: Secondary hyperparathyroidism and calciphylaxis symptoms; an update with lab values

/Disclosure: This information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./

If laughter is the best medicine, then self advocacy may be the second best, and a U.S. physician has written a prescription for both; a book link

There are no guarantees in life except that it doesn’t end well but a physician has written a guide that may help patients navigate through the U.S. medical system. The book “Prepare to Defend Yourself . . . How to Navigate the Healthcare System & Escape with Your Life,” (2014) by Matthew Minson, MD is a patient guide written with sensitivity and humor . . . and the cartoons are funny too. [1]

The author shares the background history of medical care and addresses how changes in the current medical industry has made individualized care of patients more difficult for physicians and for patients. The guide has helpful worksheets of information to keep on hand in case of emergencies, [2], and questions to ask before an emergency occurs (ideally, get the book now, before you need it).

The book’s publication was with the support of the Texas A & M School of Rural Public Health, “whose mission is to improve the health of communities through education, research, service, outreach, and creative partnerships.” The author completed his medical residency in Anesthesiology but since then has worked extensively in the field of emergency and disaster response at federal and corporate levels. [3]

More information about the book and copies of worksheets from the book are available on the website: preparetodefendyourself.com.

Happy April Fool’s Day, but the need for self advocacy as a patient is no joke. Arm yourself with knowledge and a side of laughter, the end result will be the same but quality of life is something to protect every day.

/Disclaimer: Opinions are my own and  the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes./