Health Care and Alcohol Poisoning During the Holidays

Drinking alcohol has significant consequences, especially if imbibing is done in excess. During the Holidays, many individuals push themselves to participate in as many parties and activities as possible. Also, during this Season is when most accidents occur due to alcoholic consumption, and the death rate also increases as a higher percentage of adults and teens are guilty of drinking and driving—definitely not smart. Plus, it’s against the law.

Another popular sport, particularly in the college age crowd, is binge drinking. According to the Centers for Disease Control (CDC), binge drinking is the most common pattern of excessive alcohol use in the United States. The National Institute on Alcohol Abuse and Alcoholism defines binge drinking as a pattern of drinking that brings a person’s blood alcohol concentration (BAC) to 0.08 grams percent or above. This typically happens when men consume 5 or more drinks, and when women consume 4 or more drinks, in about 2 hours. More info can be found at this site: http://www.cdc.gov/alcohol/fact-sheets/binge-drinking.htm .

Most people who binge drink are not alcohol dependent. According to the CDC, national surveys show the following statistics about binge drinking:

• One in six U.S. adults binge drinks about four times a month, consuming about eight drinks per binge.
• While binge drinking is more common among young adults aged 18–34 years, binge drinkers aged 65 years and older report binge drinking more often—an average of five to six times a month.
• Binge drinking is more common among those with household incomes of $75,000 or more than among those with lower incomes.
• Approximately 92% of U.S. adults who drink excessively report binge drinking in the past 30 days.
• Although college students commonly binge drink, 70% of binge drinking episodes involve adults age 26 years and older.
• The prevalence of binge drinking among men is twice the prevalence among women.
• Binge drinkers are 14 times more likely to report alcohol-impaired driving than non-binge drinkers.
• About 90% of the alcohol consumed by youth under the age of 21 in the United States is in the form of binge drinks.
• More than half of the alcohol consumed by adults in the United States is in the form of binge drinks.

According to Medical News Today, when somebody consumes an alcoholic drink, their liver has to filter out the alcohol, a toxin, from their blood. We absorb alcohol much more quickly than food - alcohol gets to our bloodstream much faster. However, the liver can only process a limited amount of alcohol; approximately one unit of alcohol every hour. If you drink two units in one hour, there will be an extra unit in your bloodstream. If during the next hour you drink another two units, you will have two units floating around in your bloodstream at the end of two hours after your drinking session. The faster you drink, the higher your BAC (blood alcohol concentration) becomes. If you drink too fast, your BAC can spike dangerously high.

Rapid drinking can bring your BAC so high that your mental and physical functions become negatively affected. Your breathing, heartbeat and gag reflex - which are controlled by types of nerves - might not work properly. You become breathless, you may choke, and your heart rhythm might become irregular. If your BAC is high enough, these physical functions can stop working, the patient stops breathing and passes out (loses consciousness). In the USA approximately 50,000 cases of alcohol poisoning are reported annually. About one patient dies each week in the USA from alcohol poisoning. Those at highest risk of suffering from alcohol poisoning are college students, chronic alcoholics, those taking medications that might clash with alcohol, and sometimes children who may drink because they wish to know what it is like, according to Medical News Today. A significant amount of additional info can be found at this website: http://www.medicalnewstoday.com/articles/215627.php .

Do you know the signs of acute alcohol poisoning? Do you know what to do if someone is suffering from its effects? Your friend who had way too much to drink, may not just be sleeping it off. If he or she is suffering from acute alcohol poisoning, as a result of drinking too much too quickly, they could die if you do not intervene. How do you tell the difference between being passed out and alcohol poisoning?

According to the Mayo Clinic, alcohol poisoning symptoms include:

• Confusion, stupor
• Vomiting
• Seizures
• Slow breathing (less than eight breaths a minute)
• Irregular breathing (a gap of more than 10 seconds between breaths)
• Blue-tinged skin or pale skin
• Low body temperature (hypothermia)
• Unconsciousness ("passing out"), and can't be roused

It's not necessary for all of these symptoms to be present before you seek help. A person who is unconscious or can't be roused is at risk of dying. If you suspect that someone has alcohol poisoning — even if you don't see the classic signs and symptoms — seek immediate medical care. In an emergency, follow these suggestions:

• If the person is unconscious, breathing less than eight times a minute or has repeated, uncontrolled vomiting, call 911 or your local emergency number immediately. Keep in mind that even when someone is unconscious or has stopped drinking, alcohol continues to be released into the bloodstream and the level of alcohol in the body continues to rise. Never assume that a person will "sleep off" alcohol poisoning.

• If the person is conscious, call 800-222-1222 (in the U.S.), and you'll automatically be routed to your local poison control center. The staff at the poison control center or emergency call center can instruct you as to whether you should take the person directly to a hospital. All calls to poison control centers are confidential.

• Be prepared to provide information. If you know, be sure to tell hospital or emergency personnel the kind and amount of alcohol the person drank, and when.

• Don't leave an unconscious person alone. While waiting for help, don't try to make the person vomit. Alcohol poisoning affects the way your gag reflex works. That means someone with alcohol poisoning may choke on his or her own vomit or accidentally inhale (aspirate) vomit into the lungs, which could cause a fatal lung injury.

• Much more information can be found at this site: http://www.mayoclinic.com/health/alcohol-poisoning/DS00861 .

Alcohol poisoning is a life threatening situation. During the Holidays, don’t let yourself or any friends or relatives over indulge with alcohol of any type. The festivities of the Season should not be tragically interrupted by someone who has not learned self control with alcohol. Do yourself and everyone around a favor when it comes to drinking. Slow down, or just don’t drink. And, in particular, if you are out in a crowd at a restaurant or home, have a designated driver or call a cab to take you home. You sure don’t want to be on the evening news as the next lead story of a traffic fatality.

Until next time.

Health Care and Holiday Foods

It’s time once again to break out the stretchy pants. The holidays are upon you, and you’re thinking “Let the feasting begin!” Have you noticed that as the years go by, your waist line is an indicator of your appetite? Have you been feeding at the trough so many years during November and December that you don’t even notice that your clothes are getting tighter as the season progresses? What about all those calories that get consumed once the parties, buffets, and gift baskets start flowing? Are you guilty of surfing the wave of the holidays’ food tsunami?

For many, the holidays are the most wonderful — and least heart-healthy — time of the year. Grandma’s fudge is a sentimental favorite, and the neighbor’s cake balls are a decadent habit. Indulging a little won’t hurt — but planning ahead will make for merry meals that are healthy too. Do you decorate for the holidays with a lot of color? Treat your dinner plate the same way, according to the American Heart Association.

“Half of a meal should comprise fruits and vegetables that consist of a variety of colors,” said Vilma Andari, president and founder of Nutra Health Food and a spokeswoman for the American Heart Association. “The other two quarters should be whole grains and healthy proteins.” Make your holiday meals festive and healthy with a variety of richly colored fruits and vegetables — and don’t forget the herbs and spices. “Try to work fruits and veggies into everything from soups and stews to casseroles instead of just side dishes,” Andari said. See more details at this website: http://www.heart.org/HEARTORG/Conditions/Seasonal-Heart-Healthy-Holiday-Foods_UCM_433897_Article.jsp .

‘Tis the Season to be jolly—you pack on pounds that you promise to take off next year. According to Health.com, if you simply cannot resist a calorie-laden holiday treat, at least consume it in moderation. Here are 50 holiday diet hazards you and your family should avoid, along with healthy options that only taste indulgent, found at this website: http://www.health.com/health/gallery/0,,20440821,00.html .

Your tactic for avoiding temptation may be to steer clear of all the special treats and divert yourself with only healthy foods, according to EatingWell.com. Great in theory, but not so perfect in practice. Lots of foods that are packed with antioxidants, vitamins and minerals are also full of calories. And when you're mindlessly munching as you're mingling, those calories can add up fast.

Don't assume that just because something is healthy it is also low-cal. If you like the healthy treats that sometimes show up at holiday parties, that's great! Have them—in moderation. If you'd rather sample some of the special seasonal treats, just put two or three of the most delicious-looking hors d'oeuvres on your plate and enjoy. Before you head out to party, check out these surprisingly unhealthy holiday calorie bombs and better bets to choose instead. More information can be found at http://www.eatingwell.com/nutrition_health/nutrition_news_information/healthy_holiday_food_to_avoid_and_healthier_foods_to_eat_instead .

According to Men’s Health magazine online, the average person consumes an extra 600 calories a day between Thanksgiving and New Year's, which translates to an extra six pounds of belly fat heading into January. Whether your weakness is mayo-spiked deviled eggs or rum-spiked eggnog, there are more than enough temptations to go around in these merry times. And while everybody is entitled to a bit of indulgence during the holidays, there's a fine line between festive and fattening. To help you better understand that line, Men’s Health has pinpointed the very worst of the season's eatings and suggested some satisfying alternatives that should make your New Year's resolution a little easier to attain. You can find more information at their website: http://eatthis.menshealth.com/slideshow/best-and-worst-holiday-foods .

Feeling like you want to skim some fat off your own thighs instead of the turkey's? Surprise! There are actually a lot of holiday foods that, if you prepare them in a healthful way and watch your portions, reap countless nutritional benefits and can even help you lose weight, according to FitnessMagazine.com. Find out what works best for you. There are healthy tips for preparing and eating good food located at http://www.fitnessmagazine.com/recipes/healthy-eating/superfoods/healthy-holiday-superfoods/ .

However, if you are looking for really good holiday food treats that you just can’t resist, the Food Network has some great options at their site: http://www.foodnetwork.com/holidays-and-parties/index.html .

So, if you’re waiting for that jolly old elf to show up at your fireside hearth, at least try not to consume all the cookies on the plate your kids left for Santa. If you get tempted, remember to go fat free. At least that way you’ll be able to justify your sweet tooth. And speaking of your teeth, make sure you brush before you toddle off to bed over the next few weeks. You may be going into a food coma if you over indulge, but at least your oral hygiene is better off after you take care of your smile.

Until next time.



How To Find An Asbestos Lawyer

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BRA Need Goes Beyond a Day

The topic of BRA Day, a national Breast Reconstruction Awareness Day, has been discussed on various breast cancer blogs. I've weighed in with my opinion in the comments sections but haven't developed my own post on the matter, until now.

I can appreciate the points that other bloggers make--that reconstruction isn't the big deal here. Saving lives is what's important when you get a bc diagnosis.

Yes, I very much agree. But reconstruction is not unimportant either.

To share information about my experience with the process is the reason I started this blog. It seemed important enough to me to do that, and even though I often think I might pull the plug on this virtual diary, I still come up with things to say on the topic.

Mostly that's because I'm still not done with reconstruction, a process I started more than four years ago. And I guess that's my main point. Reconstruction, like so many other things in life, is different for every person.

No one has an easy choice or an easy time with reconstruction; I'd rather we all never have to experience this or the cancer that brings it into our lives.

But I would say there is a continuum of complexity when it comes to reconstruction. The more treatment you have to have, the harder it becomes to put things back together. Specifically, women who must undergo radiation have fewer viable reconstruction options.

Implants in such a case have a high fail rate. So, even though there are very many competent implant doctors even in smaller towns, this route isn't feasible for many women.

And this is where things get tricky. Chances are you won't be able to find a plastic surgeon who can do the advanced fat flap transfer techniques who is also in-network with your insurance. It will also be very difficult to find a surgeon who has done many, many, many of these techniques close to home, unless you happen to live in or near a large city.

At the very least, this means having to travel far and wrangle a special agreement out of the plastic surgeon and your insurance to pay for the work, unless you're lucky enough for money not to matter. Then you'll need to line up local doctor support, which also can be problematic.

The information to do this is more or less out there on the Internet, but it's not easy to compile or compare. If you go ahead with a more complex route, you will feel like you wish there were more support, more information.

But I'm not sure a BRA Day is going to provide that. In fact, my guess is the aim here is much more superficial and financial.

So I don't support the day per se, but I do very much support more good, unbiased, reliable information about the trickier types of reconstruction that aren't readily available everywhere and that are often cost prohibitive.

There should be wider knowledge among all health care professionals about the many different reconstruction options. There should also be more real, good information widely available for women to make a reconstruction choice or to decline reconstruction. And it sure would be nice if finding a way to pay for what you need wasn't so damn hard.

Thank You for Not Ripping Me Off

After a very frustrating day yesterday dealing with a medical provider who essentially balance bills in advance--wants at least some of the money that falls between what they want to charge and what the insurance company will pay as reasonable and customary--I want to take a minute and thank someone.

I want to thank my plastic surgeon who did a very good job on my two DIEP surgeries. She didn't balance bill me at all. Her staff worked to get an in-network exception since she also isn't in-network with most insurance. An in-network exception means the insurance company admits they don't have a doctor in-network who can do this type of work, and because of that, they will cover costs at an in-network rather than out-of-network benefit level in this case.

She took what she got from insurance this way and then what I would have had to pay through my in-network co-insurance, etc (I had none for either of these surgeries as other treatment quickly pushed me past our family's out of network max for the years) and called it good. I never saw a bill for that "gap cost," the amount between what she billed and what the insurance paid.

So I know it can be handled better, that plastic surgeons who choose to take reconstruction patients with insurance can (and should) work to get the better in-network benefit level for both them and the patient and then call it a day.

After all, they are often working with patients who have endured years of paying out-of-pocket-maximum levels on their insurance. To ask for more is simply greedy and unprofessional in my opinion.

In fact, my biggest pet peeve is "billing coordinators" who try to defend and/or explain their policies that plain and simple rip off cancer patients looking for reconstruction. Asking for any dollar more than you are due via the best insurance agreement you can work to get is wrong.

Sadly, there are a lot of them out there, especially if you need a more specialized type of reconstruction.

Reconstruction--Never, Ever a Simple Process

I've been thinking about doing a year-end push to finish up my reconstruction, but it could be that there's not enough time to work out the annoying details.

Two things made me decide to even think about trying this--there is a study about Cook nipple implants with one of the four sites nearby, and our insurance deductible will be much higher next year.

So I've been in touch with the study site, but I'm not loving their emphasis on the financial side of things. They offer a free cosmetic consultation but charge reconstruction patients a consultation fee. They'll refund it if my insurance company pays 100% of the amount they submit. Ummm, we all know that's not going to happen; it's why they insist on the fee in the first place.

Secondly, they are not in-network with any insurance. This is not uncommon for plastic surgeons, but it does make the financials a pain in the butt. I mean to the point it could easily stop you from getting anything done at all.

This place won't just help me secure an in-network exception (since my insurance likely doesn't have another local doctor doing this type of nipple) and then take what that pays them, plus my 10% co-pay under the in-network agreement.

No, they figure a cost that's 20-30% of what they want to charge (not reasonable and customary that the insurance will knock it back to) and ask me to pay that up front, before the surgery. Then they keep my money and whatever the insurance pays.

Not exactly the most honorable process, if you ask me. Clearly they want to pad what they get from insurance patients, from cancer patients. I know we're not nearly as lucrative as cash-paying, elective cosmetic patients, but to be so blatant about it strikes a sour note with me.

Especially since this is a clinical study, where I would think the doctor and his practice are getting money from the biotech company that makes the nipple.

Nah, this strikes me as too greedy. I have calls and e-mails in to Cook and the other study site directors to see how they charge.

I'll keep you posted.

Things That Make This Much Sense Should Just Happen

A fabulous post urging that 30% of breast cancer funding should be directed toward researching metastatic breast cancer, the only breast cancer that kills.

The other 30% figure signifies the percentage of women who get breast cancer that will see it spread at some point in their lives.

As the article points out, this is now my fight. Like others who have already been diagnosed and treated, prevention and detection efforts, which receive the lion's share of funding, are of no use to me.

Seriously, if great progress can be made on the metastatic bc research front in ten years with adequate funding, I say let's start yesterday.

It's a no-brainer for me to say that if my cancer ever does come back and/or spread, I'd want some good research, some cure, out there for me.

Wouldn't we all?

Thanks to Nancy's Point for steering me toward information about this effort.

Something I'm Curious About

After you've been treated for breast cancer, does your medical center/health care provider order an annual screening mammogram, or do they order a diagnostic mammogram?

I ask because I recently discovered my new medical home has a protocol of always ordering a diagnostic rather than screening mammogram for yearly followup of all people who have had breast cancer.

I was told that even if a doctor orders a screening mammogram for me, if the person who schedules the mammogram sees that I had breast cancer, he or she will change the order to a diagnostic mammogram. Something about the radiologists preferring it this way.

So what's the difference between them? As it was explained to me and as I've experienced it, with a diagnostic mammogram, the radiologist tech trots the results down to the radiologist, who reads them on the spot and either gives you the all clear and lets you go or keeps you there for further imaging such as an ultrasound or MRI. By contrast, you leave after a screening mammogram, the radiologist reads it when she/he gets to it and your doctor gets back to you with results sometime after that.

The other huge difference is that since 2010, screening mammograms have been covered 100% with no co-pay. That's not the case for diagnostic mammograms--all your deductibles and co-pays and co-insurance apply.

Which is a big deal for someone like me, someone for whom mammograms don't work anyway.

I'd prefer to skip mammograms and their radiation completely, but every health insurance I've ever had makes me get one to prove I have dense breasts, which means you can't tell what's going on in there with a mammogram.

What I need is an MRI, which I can use a failed mammogram to get. But why should I have to pay for that mammogram if there's no reason to? After all, I need to save that money to pay the several hundred dollars I'll still have to shell out every year for an MRI.

I thought we were supposed to be moving toward individualized health care, a protocol like this belies those claims. After all, if a patient tells you mammograms don't work for her but we still need one to get the MRI, why would you order the cadillac version? Just to charge her?

Actually, this is one instance I would call medical waste. A diagnostic mammogram should only be used when there is stong suspicion of an immediate issue. When I turned up six years ago for my first-ever mammogram because I felt two huge lumps, that should have triggered a diagnostic mammogram. Some quick turnaround and followup testing would have been useful all the way around. But I'm guessing I didn't get the diagnostic mammogram because I didn't have any history of disease at that point.

I also didn't know then that mammograms are useless for me and for up to 40 percent of other women.

I know this now and am finding it both frustrating and expensive that medical professionals act like they don't know.

I offered this constructive criticism to my medical providers: The protocol should be always order screening mammograms since they are free, unless specific cases would benefit from a diagnostic mammogram. The health care provider should then have to explain why the person would benefit and then also explain there will be a cost for this type of mammogram over the screening mammogram.

That would at least give me a chance to tell them they're full of it and get what I need.

Mammograms Aren't Always Enough

Now that it's no longer October, I will post my annual awareness message about mammograms and how they aren't enough for many women.

This year when you schedule your mammogram and show up for the test, don't stop there. When you get the little postal card that says you're okay, pick up the phone and call the doctor who ordered the exam.

Ask your doctor or the nurse to send you or read you the entire radiologist report. If it mentions you have dense breasts (sometimes stated as "scattered fibroglandular densities"), ask your doctor if you need a follow up test such as an ultrasound or MRI to actually see inside your breasts.

The problem is that both breast density and cancer show up white on a mammogram. I've heard it said that "you could hide a Buick" inside breast density and never know it's there. So if you have dense breasts (up to 40 percent of women do), it could be preventing a good reading of your mammogram. And, no, density has nothing to do with how large or small your breasts are. It's generally a fact of being younger (premenopausal), though it can apply to older women, too. As we age breast density turns to fat, and fat is easy to see through on a mammogram.

More and more states are passing laws that make health care providers inform women if they have dense breasts, and for good reason--not only does this make reading a mammogram difficult, it also increases your chance of developing breast cancer.

Having to think about, then schedule and get a mammogram every year is not fun, but the fact is if you stop there, there's a chance you aren't getting the effective breast surveillance you might think you are.

This article provides more information and also states that there is contention around the issue, but as one whose two, 2.5 cm cancerous lumps didn't show at all on a mammogram but were revealed by an ultrasound, with a followup MRI showing even more areas of concern, I think you can guess where I come down on this.