ER assignment

I went to the ER at SOCH today to sit and record notes for the assignment. I figured when I walked in I would tell them why I was there and they would let me stay, this was not the case. The way the ER is set up, there is a window right at the entrance, with the initial nurse who takes down your information, and you have to go down the hall about 10 feet and make a right to get in the waiting room. When the receptionist nurse saw me I told him why I was there, and he told me I couldn't be there because it violates HIPAA laws, but he would ask security. Then a larger woman who was also a nurse came and told me what happens behind those doors is confidential. I told her I wasn't asking to go behind the doors I was just going to sit in the waiting room, but apparently that wasn't allowed either, so I was told I had to leave. I just looked up the HIPAA laws to see why I was made to leave and this is what I found: 

How Is This Information Protected 

• Covered entities must put in place safeguards to protect your health information.
• Covered entities must reasonably limit uses and disclosures to the minimum necessary to accomplish their intended purpose.
• Covered entities must have contracts in place with their contractors and others ensuring that they use and disclose your health information properly and safeguard it appropriately.
• Covered entities must have procedures in place to limit who can view and access your health information as well as implement training programs for employees about how to protect your health information.

Information meaning a patients medical information. So I guess this entity, SOCH, deems it necessary to not allow outside parties into the ER as a method to safeguard the medical information of their patients.

"Study: Triathlons can pose deadly heart risks"

I was listening to the radio this morning and they brought up an article that had been published by the Associated Press entitled "Study: Triathlons can pose a deadly heart risks." After finding it on the internet, I read it, and personally I find it a little funny that they would even do a study on something like this. The premise of the article is that triathlons place added stress on the heart, most specifically the swimming portion which is done in cold lakes or rivers. Many of the people who get involved in triathlons are not frequent swimmers, but are doing the triathlon because it is for a charity. Also, there is the problem that anyone can sign up for a triathlon. The study found that the risk of sudden death during a triathlon is 15 out of a million. I feel that this number is pretty low considering how strenuous a triathlon actual is. People who sign up for a triathlon should know that there is an inherent risk associated with participating and should adequately prepare for the stress that will be placed on their bodies. All this study proves is, if you are going to participate in a triathlon, you should properly prepare for the task.

Treating patients with multiple illnesses

This week in the New York Times I picked an article by Siri Carpenter, which discusses the problem with treating patients with multiple illnesses. In most cases when you are working with an elderly patient and they are coming to you with an ailment, it is more than likely that they have other conditions as well that don't relate to one another. The article sites an example of an 84 year old woman named Mazie Piccolo who has "congestive heart failure, an abnormal heart rhythm, arthritis, osteoporosis, high cholesterol, high blood pressure, gastric reflux, and depression." For a doctor it is very hard to treat a person like this, so what they do is treat just the ailment the patient has come in for. Instead of looking at all of her conditions, they prescribe her medication for the one disease, but this pill could worsen the other conditions. Plus, with every doctor prescribing a medication for the one specific disease, there could be a deadly concoction placed in your body when taking them all. Doctors are not afforded the information needed to treat multiple condition patients because there are no studies done for these individuals. "A 2007 study found that 81 percent of the randomized trials published in the ,most prestigious medical journals excluded patients because of coexisting medical conditions." This means that when a doctor prescribes a medication they know it will fix that problem, but are unaware of how it will interact with coexisting problems. 

Personally, I feel that when a doctor treats a patient they should look at the patient as a whole and not a set of individual illnesses, but if they aren't afforded the tools to do so, I don't know how they can. Testing should be done because a majority of elderly have multiple conditions not just one. The problem with that is, testing a prescriptions effects on multiple conditions is very costly and it would be nearly impossible to account for the hundreds of possible combinations of illnesses out there. So I feel it is almost unrealistic, but companies should not exclude patients with coexisting medical conditions so they can see the different variables at work. Doing so may help give them an idea of different effects that may occur.

Prostate Screenings

The article I found this week online at New York Times was in more of a question and answer format, and I believe it was an interactive piece that people could post questions about and the author would answer them and that is why it is in this format. It is by Tara Parker-Pope and it discusses PSA testing, a blood test, as a means for testing for prostate cancer. I chose this topic because it relates to men, not so directly to myself because I won't have to worry about this test for another 20 some odd years and by then they will probably have new more accurate tests, but my dad is in his mid 40's and will be thinking about these tests sometime in the near future. 

There were two tests done, one in the U.S. and one in Europe, both coming to the conclusion that PSA testing can be very unnecessary. Prostate cancer is very slow developing, so even if you do get the cancer their is always the chance that you live a full healthy life before you feel any full effects of the cancer. Plus the blood test isn't completely effective, just because the test indicates that you have a heightened amount of PSA's in your blood stream does not indicate that you have or will have the cancer it just means that you have a higher risk. This screening is meant as a way to catch cancer before it happens, but if it comes back positive then you could undergo procedures that leave you "impotent and incontinent." The test shows that PSA screening is effective in detecting the cancer, but "finding those cancers early doesn't reduce your risk of dying from the disease." The worst part in my opinion is that they found many people received unnecessary treatment due to the screening, which means they probably became sterile from the treatment that they didn't even need to begin with. In conclusion, doctors say that even though the test shows that this screening is not necessarily accurate it doesn't mean people should not get the test because it is effective at finding the cancer. Instead, doctors say that you should still discuss it with your physician and make the decision yourself.

Doctor in Iraq

When we talked about Doctor Pryor in class, something that was never brought up but I was thinking about was the brothers comment on how he was still trying to find out what happened to his brother. The brother mentions trying to track down a fellow doctor on the internet who had posted about the incident online, but had no success. It almost seems as though the army is trying to cover it up, although I'm sure they only give the minimum information to all families, when an individual dies, and never give them the full facts. I found this part of the article interesting though because I see the family as being somewhat anti-war as well, because they did not want him to go back into the war plus Pryor himself showed feelings of antiwar when talking about the kids being in war. So, I still can't understand why they would dishonor his wishes of having a normal burial. It is possible that they are opting for an army memorial because they want to get rid of those anti-war feelings and believe he died for a purpose and it could also be that they want some clarity on how he died.

Sleeping

I work full time overnight at BJ's in Manahawkin. Working overnights means that I rarely sleep at a regular time, two nights a week I sleep regularly, 3 days a week i sleep between 8 am and 2pm, and 2 days a week I sleep from 5-10pm. So when I saw the title of this article "Distractions may shift, but sleep need don't" I thought I would check it out to see what I am doing to my body. 

It turns out that the article didn't answer this question for me directly, but I did find it interesting. This article, unlike any article I have read thus far, was geared less towards the medical information and more to the life of the author. She included a poem, quotes from peter pan, and her personal experience with putting her children to sleep. It turns out the average person, from adolescence through teenage years, requires about 9 hours of sleep per night. But as you get older it becomes more and more difficult to get to sleep at early hours. This is due to your bodies seratonin levels, which turn on later after puberty, meaning you don't get tired until later. I can only imagine how screwed up my circadian rhythm is  because I have no rhythm to my sleep patterns. I have always been a big fan of sleep to, I was never one for falling asleep in the middle of the night, I liked going to sleep relatively early. With the distractions of computer and televisions in kids rooms these days though, I am sure it is increasingly more difficult for children to sleep. When I become a parent my kids definitely won't have a TV in the room.

Day of Scholarship

On the day of scholarship I went to four sessions, but I'm only going to talk about 3. The first session I went to was "Police Suicide an Evolutionary Perspective," by far the most interesting session of the 4. In this session he applied the theory of suicide, hypothesized by Decatanazaro, to the suicides of police. Decatanazaro says that you will commit suicide if we are not reproductively successful in heterosexual relationships, or you perceive yourself to be a hinderance on the genetic success of your relatives. Christopher DeSantis the person speaking in the session explained that he found police have many marital problems as a result of their jobs. They have a high incidence of divorce and because of their status in society they have an us versus them mentality. They tend to abuse alcohol, which applies to the theory because it affects family relationships. Plus, their position requires to make split second decisions, which they can be scrutinized for, this also places a burden on the family because the name is now associated with the wrong decision. 

The second session I sat through was " Hip Hop and Identity: Examining African American Teens." I didn't find this to apply to our class or interesting, so I'm not going to write about it.

The third session was "Encouraging Communication in a course on Consciousness," which applied to our class because she talked about her class where she required her students to post, our class does this as well. She started by giving a little background on the psychology course she teaches. Also, she described two problems she has in her class, everyone comes from different majors, and only 2 or 3 people get involved in class discussions consistently. For her class she decided to give them online homework, requiring 2 posts per week on a set of questions she posted, and 3 entries per week for journals on their own lives. I think she felt this would increase class discussion, but it didn't turn out that way. In the end of the semester she took an anonymous poll in class to see why there wasn't as much class discussion as she had hoped.  People were dissatisfied with limited topics and felt journal entries were to much and uncomfortable to write. This semester she made journal entries optional and added more topics. So far there has been more class discussion, but she doesn't attribute it to the changes. She feels it just has to do with the group of students this semester.

The last session I sat through was about the Institutional Review Board, "Its Role and Function." This pertained to me because I plan on getting my doctorates and will have to do studies that they will be approving. Their main objective is to protect the rights of the subjects you will be using for testing, and to promote research investigations designed to develop or contribute to knowledge populations. The speaker went through the different parts of the proposal, emphasizing that the goal of the researcher is to maximize the possibility of compensation, while minimizing the risk. How much risk and benefit are involved in the study play a major role in the approval of the proposal. 

Free Antibiotics

It has been an abnormally busy past week for me so I am just getting to my posts now, I apologize for the tardiness. 

In the article "Free Antibiotics May Contribute to Drug Resistance" by Tara Parker-Pope, she brings up the recent country wide pharmacy give-aways of antibiotics. This has doctors worried that bacteria will become resistant to the drugs if people continue to take them to solve every health issue they encounter. We have all heard that bacteria evolve quickly and develop resistances. For example, anti-bacterial soap and agent which many bacteria have become resistant to. Another example is Mersa the staff infection bacteria that is drug resistant. Therefore, this issue can be very serious because we want to be able to take medication that works. If we continue to take antibiotic anytime we get the sniffles than eventually our antibiotics will be obsolete. Plus, antibiotic should not be taken for colds and flus because they are viral not bacterial, but free medication is to tempting, so people take the antibiotics to fix their virus. People must be careful with there drug use or it will affect their health for the future.