Global Wellness

Chiropractic Care | Lewiston, ID | Joan P. Burrow DC NMD

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It’s just [put any non-steroidal anti-inflammatory here]

The answer to those chronic aches and pains?  Take a couple of ibuprofen every few hours.  Pain becomes manageable, life is better, right?

Well, maybe not. Some British researchers took a look at data from the Rotterdam Study, which is based in the general population and contains detailed information on drug exposure (based on prescriptions filled). Notice here, that over the counter ‘exposure’ may have been missed.

The authors pulled the records of 8423 participants in the larger study without history of atrial fibrillation at the beginning of the study, and specifically looked at whether those who developed atrial fibrillation during the next few years used non-steroidal anti-inflammatory medications. The average initial age of the study population was 68.5 years and 58% were women.

During an average follow-up of 12.9 years, 857 of the participants developed atrial fibrillation.  Their conclusion?

  • Current use of NSAIDs was associated with increased risk [of atrial fibrillation] compared with never-use
  • Recent use (within 30 days after discontinuation of NSAIDs) was associated with an increased risk of atrial fibrillation compared with never-use

Here’s the link to the British Medical Journal article.

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A Sad Reality

Imagine:  You were hospitalized for some reason.  Hospitalization costs a lot, and so ‘guidelines’ tell your doctor you can only stay in the hospital so long for that problem. If they let you stay one day past the guideline, the hospital eats the cost.  So, whether you are medically stable or not, you go home or you get sent to a ‘skilled nursing facility’ for the rest of your recovery.  Ready or not, you go.

And, why?  It costs less to take care of a patient in a skilled nursing facility than a hospital.  Why does it cost less?  Because insurance don’t reimburse the facility as much.

We expect the ‘skilled nursing facility’ to have the funds to hire the staff and buy the monitoring equipment that is needed to provide ‘skilled nursing’ care despite low reimbursements paid to the facilities.

The inspector general of the U.S. Department of Health and Human Services (HHS) reviewed records for 653 randomly selected Medicare patients who were in skilled nursing care – treatment in nursing homes for up to 35 days after a patient was discharged from an acute care hospital – in August, 2011.

The findings are scary:  33 percent had a medication error, infection or some other type of harm.  2/3rds of those suffered events that caused lasting harm, and 1/3rd were temporarily harmed. In 1.5 percent of cases a patient who had been expected to survive died because of poor care.

The injuries and deaths were caused by

  • substandard treatment,
  • inadequate monitoring,
  • delays or the failure to provide needed care

The deaths involved problems such as

  • preventable blood clots,
  • fluid imbalances,
  • excessive bleeding from blood-thinning medications
  • kidney failure.

Doctors who reviewed the patients’ records determined that 59 percent of the errors and injuries were preventable. More than half of those harmed had to be readmitted to the hospital at an estimated cost of $208 million for the month studied — about 2 percent of Medicare’s total inpatient spending.

Projected nationally, the study estimated that 21,777 patients were harmed and 1,538 died due to substandard skilled nursing care in that one month period.

My opinion:  Something needs to change.  If we can’t afford to keep patients in the hospital long enough to be stable when they leave, then we need to reimburse skilled nursing facilities enough that they can truly provide skilled nursing.  Duh.

Read One Third of Skilled Nursing Patients Harmed in Treatment and follow their links to read the studies.

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Is your antidepressant worth taking?

Dr. Marty Hinz and his team at NeuroResearch in Duluth, MN presents a webinar series on Wednesdays to help practitioners like me keep up with the latest research and do the best job we can for our patients.

This week he provided some facts about the antidepressant medications on the market at this time – all statistics I’ve read before (I don’t have the references at hand to link you to the actual research.)  Here is what he said:

  • In the treatment of depression 87% to 93% of patients achieve relief of symptoms no better than a sugar pill.
  • In treatment of depression the placebo effect of reuptake inhibitors ranges up to 45% (the vast majority of depression responses observed with antidepressant administration is due to the placebo effect, not the drug.)
  • The odds of experiencing a drug side effect from a reuptake inhibitor is much greater than achieving relief of symptoms from the drug (non-placebo improvement).
  • Reuptake inhibitors deplete neurotransmitters leading to suicidal ideation, inability to stop the drug, relapse of symptoms, etc.

So, if what you are taking for depression isn’t helping or has stopped helping, or if you are experiencing those side effects, and want to try something else, let’s talk!