Story of an accident

It is sad story of my wife falling and dislocating her elbow .

On a wintry sunny day march 8th my wife was coming back from shopping and snow was melting and freezing in the process a slippery surface has formed in our yard .In the enthusiasm brought on by the warm sun and hope of breaking the ice my wife with several grocery bags in her both hands and 2.5 inch healed shoes was breaking the ice with both feet and slipped and dislocated her elbow.She was in extreme pain and she was making noises i had not heard of.as i went out she screamed her arm was broken and to call for 911.She was complaining of pain as she could not move her fore arm as it was loose and painful.She feared the worst and did not want me to touch her.In no time .fire dept was there with the paramedics .I had helped her up and we had walked to the ambulance .Paramedics diagnosed the situation and she was put on a stretcher with a splint to hold her arm and we were on our way to the hospital.We were glad and i had gone inside to get info on my wife's prescription and the paramedics called in to the hospital emergency room while they created her medical history.
I traveled with the driver of the ambulance to the hospital.

Soon we were in the hospital.It was about 12:30 they took her X-ray of the arm and we were in for a long wait.Doctors suggested some pain killers she refused and later she agreed to take a strong pain medicine when pain had become totally unbearable.
After inspection by emergency room doctor I thought he would relocate the elbow .No such luck he showed us the x ray and she became aware of the reason for the extreme pain.Now we were in for the wait of Bone doctor to come and relocate the elbow.In the mean time her arm had swollen making it much more difficult to relocate the bone in the slot.

They had to block the nerve to relocate the arm.In less than five minuites after pushing pulling her arm was in place . Another x ray was taken to verify doctors work.
She was released from hospital at around 8 P.M

Her arm was put in an open cast so that it may heal and instructions were given not to move arm and it was projected that she would be back to work in about six weeks if everything went well.She was not happy about the loss of mobility and was afraid that she may loose her job for this injury.She was also afraid of income loss as she may have to wait for TDI( temporary Disability insurance).If one is out of work for injury many things happen.
1.In spite of income loss health insurance weekly payments keep coming ,which in our case with employer contributions for a family plan are about 120 dollars per week.
2.Hospital emergency room co-payment is Hundred dollars.
3.Doctor visits co payments are 30 dollars per visit
4. Physical therapy co payments are also 30 dollars .Three times a week that is 90 dollars.

Not only these payments are extra from weekly insurance they are also stress on people with limited incomes or high responsibilities.

So these are knowable and hospital bills put extra stress on finances .Soon we got a bill stating hospital had charged 7200 dollars for that days services and with our co payment dollars and Insurance paying about half of it ,it seems half about 3500 dollars remain hanging on our head .This is after we have made several hundred dollars of co payments and paying 6000 dollar a year part of our premiums .Other co payments fro drugs and physician payments are additional 1500 dollars per year.

I thought we were doing OK till we got balance of payment notice from the xray shop connected to our orthopedic doctor whose helper a younger physician had put elbow in place.This xray shop has billed four hundred or so dollars and insurance had paid three hundred dollars and this poor doctor was insisting that we pay the balance of 106 dollars.
Seems like a big machinery is in operation in the hospital system just to bill and harass the patients their job is to squeeze every penny of nourishment from the rocks.
I am sure they have forgotten the oath not to do no harm.

I remember that when my daughter had a major operation in Boston Children's hospital they took our insurances and never billed any excess fees for any of the services provided.We were not asked to pay even when she had gone to give her blood in case of the need.
It is time somebody makes such an approach.One of the richest groups in society should become part of the cost containment need where we can deliver great care at reasonable cost and without driving the customers crazy.

It is time cost containment was implemented in health care. Patients co payments must be limited and insurance policies with high co pays should be prohibited with no more than 10 percent of the annual premiums.

continues

Patents for drugs and innovation

Monday, March 7, 2011
about patents for drugs and innovation

Lipitor a 10 billion drug is going off the patent and Pfizer will lose the cash stream from this patent.Somehow the media is feeling sorry for them. The whole drug innovation and patent system has served the drug industry and all inventors reasonably well.
Now it has become a racket to try to increase the time for the patents by filing appeals against the generic manufacturers.We should all CELEBRATE this going of the patent with a party.Cost savings to the nation will be from this one drug will be in tune of 6 to 8 billion dollars. Worldwide savings will be even higher.

The questions have been raised by several studies in Canada where it has been found that the positive effects of lowering Cholesterol by medication is minimal for generally healthy citizens.It may be asked if we are creating Mega drugs with little benefits to the public.It is time that we study how any billion dollars in expenses for the society can benefit the nation.

This argument is not against the special care given to patients in USA.But is about public funds spent on all the systems from aggressive prenatal care to aggressive end of life care.

The money saved by one drug going generic is enough to end one major killer of humanity like Malaria (over 2 million deaths a year).

We need to reduce human suffering and improve quality of life not extend marginal lives by few hours in vegetative state.Given the choice like all informed people we will choose life of Independence over life dependent on even inanimate machines.

Duff Wilson writing for New York Times states that ten drugs with sales of 50 billion dollars will go of patent this year.We have a potential of saving 40 billion dollars now on per year.If we look at the benefits from this protection ending we could wipe out many diseases from the poorest parts of the world so in a global village we will protect us from those diseases becoming epidemics .

The new drug innovation should be speeded and efforts be mad that new drugs be reasonably priced to benefit the patients otherwise we will have two tier service and cost for medical care.I was checking that the drug cocktail needed as first line of defence against Aids is 3500 hundred dollars per month in US and in India though it is very difficult for people without health care to afford the drugs a months supply is 40 us dollars per month.We will be hard pressed if poorer nations did not honor our drug patents to protect the lives of Its citizens.

In USA we had paid Bayer several billion dollars for Cipro for the Anthrax scare while a Pharmacology specialist friend had told me that drugs could have been manufactured by National health services for only a few million dollars and stored for use in case of eventual emergency .If it would be still under patent protection royalty could be paid to the rightful owners. He told me that Cipro was not under any such protection.

Pricing confidentiality clause and its cost to us.

Many of the hospitals,Insurers and suppliers connected with healthcare delivery have Pricing confidentiality clauses in their sales agreements. These clauses are simply ways to have unfair pricing in the market place.Many times large insurers feel that they have advantage in the marketplace as they get better pricing from the large companies for the size and scope benefits.In reality many times winners and loosers are picked up in devices on the cost and connection basis.

In the public interest while sixty percent of health care dollars are being spent by tax dollars .It is important in order to protect the week and to keep the costs in control all charges be made public and scrutinsed.

Many Doctors and other health care providers are very dedicated people and serve the community well.To reduce the cost of health care In america we will have to do the following
1.Use technology only when it improves the outcome of the healthcare.
2. Use IT and its processes for communication, data sharing and prescription and compliances help.
3.Combine ER and primary care to reduce costs for ER by providing primary care at the ER.This as pre thought not after thought.
4.Giving each patient a usb stick with healthcare data .to save time and costs in ER.
5.

Patient specific Education and diversity

Most of the EMR's are starting to recognise Diversity in creating patient Demographics.

One of the fastest growing demographic groups in our society are bi/multi racial category.Traditionally language defines us more than the ethnicity.It is true even in America for the new immigrants.As the immigrants become more English language proficient. Ethnicity start taking priority over language, suddenly Colombians who themselves identify as the people of that nation start seeing themselves as black ,white or native people.In a strange way we find that as Moroccans and french speaking Quebec people loose their french they are lumped away from each other with Germans and may be with blacks.

The main reason for this strange mix of data is US Census which has been taken every ten years from the inception of our nation.This flawed census ethnic data is least useful for Meaningful use in creation of EMR and its mandate.We recognise that Irish whites from Boston may have least in common with Hasidic Jew from southern Spain. This need to collect a detailed ancestry record is an effort to find our unique health traits and help the patient(us).

I was told by a very reputed heart Surgeon of Indian descent that natives of India in US should lower their Cholesterol below 160 as we have narrower arteries .This type of information while not currently available could be norm if we collected ethnicity specific data for the patients.

An anomaly has been found the Hispanics Live five years longer than Whites in America even while the health care availability and Obesity is worse in their population.It is also an opportunity for us to study what factors make it possible for them to live longer and could we duplicate those conditions.It has been speculated that diet though high in meat and fat content may play some role as well as involvement in the society.

For Diversity organizations it is a challenge as well as opportunity to be part of the Discussion of EMR software for better outcome.

LET US NOT MISS THIS OPPORTUNITY.

Can Polio Be Eradicated? A Skeptic Now Thinks So.NYT,

Donald Mcneil writes in NYT article that now Octogenarian Donald Henderson who is believed to be the strongest force in elimination of Small Pox. He at times is very skeptical that Polio can be eradicated in a short time.

Polio has a strange history now it is eliminated from 99 percent of the population. Yet polio Occurs in India ,Pakistan and Nigeria.Other reason is it is very difficult and arduous process to identify patients with it.To immune patients you have to use oral drops three times.

Dr. de Quadros, a former director of the Pan American Health Organization, has his own mantle: “The Man Who Found the Last Case of Smallpox in Ethiopia and Chased Polio and Measles Out of the Western Hemisphere.” It was the conversation with Dr Quadros which changed the mind of Dr Donald Henderson. With commitment of Bill Gates and his foundation ,WHO and help of group of eminent scholars and scientist it is time and Dr Henderson believes that stars have lined up for elimination of Polio.

FROM BILL GATES TALKING ON CHARLIE ROSE ONE FEELS THAT THERE IS NO FEATHER HE RATHER HAVE THAN ELIMINATION OF POLIO, SECOND DISEASE TO BE ELIMINATED .
for HUMANITY SAKE I HOPE HE GETS IT.

First in Asia. Transexuals along with others to be flight attendants,The Tribune , Chandigarh.

I thought i would like to share this news in Tribune a daily English language News paper from Chandigarh.

Transsexuals flight attendants
KUALA LUMPUR: A newly formed Thai airline is employing transsexuals as flight attendants, in a bid to provide them equal opportunity. "Ketoeys" or ladyboys, who are highly visible in mainstream jobs in Thailand, will work as flight attendants on the Asian routes of a charter airline "PC Air", starting April this year. PC Air earlier decided to hire males and females for the job but later changed its plan after it received more than 100 applications of transgenders, media reports said. — PTI

My niece and her blog about homosexuality

I am very impressed by writings of my 16 year old niece in India.She is a new blogger Kudratduttachaudhary.blogspot.com.

In India gays and lesbians are not integrated in society like they are being done in USA.Even basic understanding of sexuality is many times very limited.

Hijra's or Khusra are normally Hermaphrodite,that means people having male and female sexual organs or not developed sex organs.They have had there own colonies and make a living by dancing and entertaining others.Some of them work as male prostitutes.
and though accepted have a very low status in society.Traditionally as no hormonal and surgical solutions were available to this group of people they supported each other and created Strong community.members of this group are some times called as the third sex.In that sense they are much different than Homosexuals in America.

Homosexuals are people who like people of the same sex as there partners. Physiologically they are clearly male or female.It is a choice may be based on some psychological or hormonal variation we do not yet understand.

Kudrat might be thinking of the third sex as she has used those words.She is encouraged by the Acceptance of Homosexual soldiers in American Military as a major change.
Talking about Taboo subjects by a young person is always commendable.
here is her blog


HOMOSEXUALITY ....start accepting !
Everything around us offers variety, that’s why all of us are DIFFERENT , because our likes and dislikes are varied ,there is difference in our opinions and also there is a HUGE distinction in how we PERCIEVE life . But no matter how assorted all of us are, we all are binded together under a common term called HUMANITY .
We all are humans , irrespective of the fact that somebody is a girl or boy ,black or white ,hindu or muslim, gothic or preppy, straight or bisexual or maybe something else ,our ways of life or even our thinking cannot segregate one section of the society from the other . From a lot many years we have been hearing or rather experiencing cases of discrimination on the basis of caste ,colour and creed .If you were a BLACK or BROWN you were not considered fit to access the privileges of the fairer community .If you were a girl ,you were not considered INTELLEGENT enough to compete with the stronger sex. We all brag about living in the TODAY’S time and proudly being a part of the 21st century , which I presume would have opened our thinking capsule and brought a sense of equality towards ‘everybody’ in our minds.
Sadly , all of my presumptions are proved false by the ongoing conditions around me .Thankfully we have feminists and other social activists to fight against discrimination against women and the coloureds ,but what concerns me is that do we have ENOUGH support and a felling of acceptance for people who are generally graded as “THE THIRD SEX” ?
The answer to this is that, many of us calling ourselves advanced are scared of GAYS AND LESBIANS ,for reasons best known to individuals themselves .Many a times we would maintain distance from them just because they are not the ones belonging from the COMMON genders. I mean if we deeply look into the case, and analyse the differences between them and us all I can point out is the BASIC VARIENT that they are attracted to their own gender .The the weirdness of our reaction makes them fear to come out with the truth and live openly with their INDIVIDUAL IDENTITY. Many of us would frown at the thought of someone known to us being a gay but the question is that was this their own CHOICE ?
Tomorrow your son can be a gay to, does that mean you would behave the same way like you would do NOW after meeting someone belonging to the third sex ? The good news is that now it has been legalised in our extremely cultured nation ,which found HOMOSEXUALITY as something corrupting the minds of the population .As a fact many kings of the historical legacy were gays, but were married to women to save the name of the family thus, spoiling an innocent girl’s life and therefore forcing her to enter into an extra marital relation .
I am grateful to people who made consensual sex between homosexuals LEGAL .I mean how can we CRIMINALIZE one’s physical demands and acts of satisfying them with someone who feels the same.
It’s supposed to be a free world and in that, NARROW thoughts which classify homosexuality as vulgar and cheap have no place and room for survival .
THIS IS FOR ALL OF YOU, START EMPATHISING ,START ACCEPTING .......................
TOMORROW YOUR PRODUCE CAN BE A HOMOSEXUAL TOO AND IT ISN’T SOMETHING TO FROWN ABOUT BUT SOMETHING TO BE REFLECTED UPON ...
HOMOSEXUALS ARE A VITAL PART OF THE HUMANITY ........
Posted by Kudrat Dutta Chaudhary at 1:42 AM