Family inHome Caregiving Blog
Although diabetes is a huge problem in this country, Federal researchers say the rates of diabetes growth (it's doubled over the past two decades) may be leveling off. Currently, 9.3% of the population (about 29.1 million people) have diabetes, according to the Centers for Disease Control and Prevention. This generated $245 billion in medical costs in 2012. A key driver of the slowing growth rate is a plateauing of obesity rates. About 95% of diabetes are Type 2, and many in this group are obese. Although the number of diabetes cases are still rising, if people can be educated that eating right and getting enough exercise can significantly reduce their risk of getting diabetes, we may be able to turn this trend around.
More and more people are getting direct results of medical tests due to a Federal rule which went into effect in April. These were once guarded by doctors and other medical professionals but the new Federal rules override a number of state laws which prevented consumers from getting direct access to this data, although there is currently a 30-day delay to give physicians time to review them before patients can. Many doctors, however, will give you a copy immediately if you ask. As a result, some laboratories and medical facilities are trying to get more consumer friendly. For example, Quest Diagnostics launched a secure patient website called MyQuest by Care360 where patients can go to review their tests within 48-72 hours or get them on a cell-phone app. This is great progress because many of us get anxious after getting tests done so it's nice to be able to get access to the results quickly.
Most people believe that asthma is caused by a reaction to pollen, food and other allergens. Researchers are focusing on another type which is a bit more mysterious called nonalergenic asthma (when the body acts in the same way with constricted airways, wheezing and coughing, but it's not due to an allergen). With a typical asthma outbreak, your immune system becomes overactive because of pollen or some other factor. With nonalergenic asthma, however, the body's immune system isn't involved. The latest study from the Columbia University Medical Center found that one factor may be related to chemicals which are included in plastic products. Another study from Weill Cornell Medical College found that when a normal type of fat in the lungs isn't present (which oddly enough occurs often in obese people), the risk of asthma goes up significantly. The number of people diagnosed with asthma jumped from 5.5% of the population in 1996 to 8.4% in 2010, according to the Centers for Disease Control and prevention. I'm glad more issue is being paid to this growing problem.
Many people aren't even aware of what palliative care, often referred to as hospice care, is. A recent report by the Institute of Medicine, the research branch of the National Academy of Sciences, found that end-of-life care needs a revamp in order to save costs and improve patient care. "What we call for is that there be an opportunity for discussions with clinicians throughout the life cycle and not just one time," Phillip Pizzo, co-chair of the panel and former dean of the Stanford University Medical School, told The Wall Street Journal. "It's part of the process of living," he said. The committee believes that one change that should be made is that you currently can't have access to Hospice via Medicare until a doctor says that you have less than six months to live. This rule should be changed if people can benefit from the extra care earlier, the committee said. It pointed out that many people are in and out of the hospital repeatedly which costs more than if they were on hospice care. Make sure than you have an up-to-date POLST (Physician's Order for Life Sustaining Treatment) and let your doctors and your family know what your wishes are for end of life care.
There's likely to be protracted litigation over the decision by Actavis PLC to stop selling a popular Alzheimer's drug called Namenda (a twice daily drug) and replace it with the same drug in a once-per-day dose called Namenda XR. The move is to thwart competition when competitors are able to make a generic version of the drug next year. The patent for Namenda expires next year. However, the patent for Namenda XR won't expire until 2029. Although it's not unusual for a drug company to try to reformulate a drug as its patent nears expiration, Actavis' move is very unusual because it plans to halt sales of the original drug this fall, prior to competitors entering the market with a generic. The company says it is doing so after positive feedback from doctors and caregivers, but the decision is likely more to do with money. There is no question the strategy is a success. About 40% of Namenda users have already been switched over to Namenda XR and nursing homes have complained about a shortage of the drug. The New York Attorney General is asking for a temporary restraining order as its lawsuit goes through the system.
New studies on artificial sweeteners have had surprising results; they may actual raise your blood sugar level instead of reducing it, increasing the risk of diabetes. Zero-calorie sweeteners have been found to alter the population of bacteria in the gut and trigger higher blood glucose levels. The researchers have also studied whether the use of no-calorie sweeteners cause you to lose weight. The study, which was published in the journal Nature, finds the opposite of jointly published guidelines in 2012 by the American Heart Association and the American Diabetes. They said that when artificial sweeteners are used judiciously they could facilitate reductions in added sugar. Although the jury is still out on this issue, it may be prudent to switch from diet soda to unsweetened iced tea.
There have been a number of breakthroughs in genetic testing which now allow people to see if they are at high risk of getting numerous diseases. However, the fact of the matter is that many people don't want to know. For instance, many diseases like Alzheimer's have no cure, so people may not want to know if they are at risk of getting it because it can cause anxiety. However, there are real positives to knowing. For instance, one woman who recently saw her mother die from Alzheimer's disease was considering having a baby. If she had just one copy of the mutation, she would develop an early-onset of Alzheimer's disease that ran in her mother's family. The doctor tested the patients eggs and found two embryos that didn't contain the Alzheimer's mutation and these were used for in-vitro fertilization. Researchers presented the case at the American Neurological Association conference as the first instance of pre-implantation genetic diagnosis, or PGD, for Alzheimer's disease. The patient told the doctor that she didn't want to know if she had the gene and did not want to be told about the results of the testing on the embryos. Still, she was able to plan to have a healthy baby and peace of mind.
Multiple Sclerosis is a terrible neurological disease which causes problems with movement, balance, coordination and thinking. However, there are things which can be done to make the symptoms ease up. Excessive salt consumption and smoking, for instance can both worsen MS symptoms. Even being in extreme heat or cold weather can be difficult. Researchers believe that exercise, getting enough sleep and maintaining a low-sodium diet can mitigate many of the more difficult symptoms of the disease. The disease impacts about 500,000 people in the U.S. and while it strikes people while they are relatively young, many people live with it for decades. About 85% of those impacted are dubbed "relapsing-remitting" which translates to attacks happening with very acute symptoms only to be followed by a long period of time with few to no symptoms. Researchers are now looking at ways to prolong those periods, and I hope they are successful.
For the first time in history, researchers have created what they are calling Alzheimer's in a dish, a petri dish with human brain cells which develop into the same structure as Alzheimer's disease. The hope is that these cells can be treated with various types of drugs, and a cure may quickly be found. Researchers at Massachusetts General Hospital got the idea to grow human brain cells in a gel and then give them genes for Alzheimer's disease. Quickly, the cells began growing plaques and tangles, signs of Alzheimer's disease. Published in the journal Nature, the study could be the first step in identifying a process whereby new drugs can be quickly tested in petri dishes and then go on to human trials if they are successful. "It is a giant step forward for the field. It could drastically accelerate testing of new drug candidates," Dr. P. Murali Doraiswamy, an Alzheimer's researcher at Duke University, told the New York Times.
Thankfully, Medicare premiums will remain flat in 2015 for most seniors. Those with high incomes will get a rate hike but the base level will remain flat at $104.90 per month. Unfortunately, the deductible for hospital visits is going up from $1,216 this year to $1,250 in 2015 and the cost of being in a skilled nursing facility is going up to $157.50 per day after the 20th day, up from $152 a day now. The Department of Health and Human Services said Medicare costs are trending lower than expected. However, they believe this is due to a weak economy which has caused many seniors to forgo medical care because of the high out of pocket costs.