Feisty patients live longer.

Feisty and Educated patients THRIVE!

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POSITIVE COMMUNICATIONS

Good relationships are an important to a positive experience.

Surgery, cancer, bad diagnosis, or simply going to a doctor can be a very emotional experience and you need to be able to communicate with your medical team.  Do not take for granted that they know what is important to you and your family.

Open communications:

Client and partner should set aside time and talk over each other’s needs and expectations.

Client and advocate should sit and talk with doctor face to face.

Explain what things are important to you and why.

Your medical team is concerned about your safety and emotional needs.  You must let them know what your needs are and how they can help.

Creative positive feelings at the hospital:

Always introduce yourself to people who you meet or come into your room.  Ask if you can use first names (if you want to).

Take the initiative in setting the atmosphere YOU want (chatty and relaxed or more calm and quiet).

Ask questions in a direct, positive way.  Make requests pleasantly.  Try not to demand.  Don’t hesitate to request more information when you want it.

Information to obtain for informed consent if a problem arises:

Every situation is unique.  Education in advance gives you background information, but information about specific problems can only be obtained at that time.  Relax and ask for help understanding the situation.  Speak up if you need more information or disagree.

The following questions should help obtain information you need in order to make a wise decisions:

1. Tell me more about this drug or procedure.  Explain the reasons this is the best drug or procedure for me.
2. 2. What are the expected results?  Will I be better off for taking it or having it done? Or is it a routine procedure?
3. Are there other options?
4. Tell me more about the known side effects and liabilities?
5. Will its benefits outweigh the side effects?
6. What is the risk if I don’t take it or have it done?  How long can I wait before deciding?

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Top Empowered Patient tips for 2010

By Sabriya Rice, CNN Medical Producer

STORY HIGHLIGHTS

• To be an empowered patient, do more than the minimum — take charge of your health care
• Get a second opinion; at the very least, it educates you
• Ask questions, but also be prepared for the answers
• There are resources available If you need discounted or free health care

(CNN) — Being an empowered patient means doing more than the bare minimum. It means taking an active part in your own health care.

Over the past year, we’ve brought you the extraordinary stories of ordinary people who took health problems into their own hands — from a young girl who diagnosed her own condition in science class, to a wife whose memory of a disco tune saved her husband’s life.

Your actions, however, don’t have to be extraordinary: It’s often the little, everyday things that mean the difference between a good health care experience and a bad one. Several common themes run through the stories of the people we’ve profiled. Here are the top lessons that emerged that can help you to become a more empowered patient in 2010.

1. Don’t believe everything you hear (get a second opinion)

“Getting a second or even third opinion is critical, says Dr. Angelo Cuzalina, president-elect of the American Academy of Cosmetic Surgery (AACS). “The extra effort and additional consultations will undoubtedly educate you further… which is always self-empowering.”

2. Ask a ton of questions

You’ve heard the phrase “there’s no such thing as a stupid question,” and experts couldn’t agree more.

To make sure you get all of your questions answered:

• Take a list with you. Let’s face it, doctors are often rushed these days, so it’s up to the patient to be as prepared as possible. One good rule of thumb is to write down your questions beforehand, and take them with you. This can save both you and the doctor time.

• Schedule time for questions. When possible, try to schedule an appointment that gives you enough time to get all of your questions in. “Tell the receptionist you’d like an extended session,” recommends Dr. Linda Reid Chassiakos of the David Geffen School of Medicine at the University of California, Los Angeles, adding that “many providers set up longer visits at day’s end where you can have their uninterrupted attention.” Once you’re there, get the stuff that’s really troubling you out of the way first. “If you save the questions about the burning pain in your groin for a ‘by the way’ at the end of the visit, there won’t likely be time to address your real issue fully.”

• Be prepared for answers. Asking the right questions is great, but it’s equally important to be prepared for the response.”When the visit concerns a potentially serious problem, anxiety, fear, disbelief and denial are omnipresent … the chance of you hearing exactly what the doctor says and remembering what you are supposed to do about it are slim,” bioethicist Art Caplan says. He suggests bringing along someone you trust to be a second set of ears; if no one is available, bring a tape recorder and ask the doctor for permission to record what you are being told.

3. If you are going to use the Web, search smart

According to research from the Pew Internet and American Life Project. eight out of 10 Internet users have searched the Web specifically for health information.

The Web is a wonderful resource for any empowered patient, but it can also be a pit of misinformation. “Remember that anyone can create a Web site about ‘health’ or ‘medical treatments,’ ” says Dr. Rhonda Medows, commissioner of the Georgia Department of Community Health.

On the other hand, a proper search can render information that is useful, even cutting-edge. “Read medical literature to learn the documented facts about your procedure of interest,” advises Cuzalina of the AACS. “It’s worth it when you get facts that are supported by empirical evidence.”

Here are some tips for surfing for health information on the Web:

• Check your URL. Dr. Jennifer Shu, a pediatrician and Living Well expert for CNNHealth.com, says it’s best to narrow your search to specific URLs. “Look for sites that end in .gov, .org or .edu, which generally provide credible information.” But don’t just stop there. Shu says that if your Internet research turns up something interesting or useful, share it with your doctor. “When patients do this in my office, I can confirm the information they have is medically sound, or suggest other sites that may be either more accurate or easier to understand.”

• Protect your privacy. “Health insurance is a very personal transaction, so don’t give out personal information,” says Sande Drew, a patient advocate and consultant for Ehealthinsurance. She says to look for sites that allow you to initially search anonymously, prompting you to enter only your ZIP code, date of birth and gender.

• Compare and contrast. In many instances, you can check prices, hospital ratings and what services are offered online before your visit. “When a serious medical condition or emergency occurs, customers typically rush to the closest hospital, which may not be the best hospital,” says Dr. Archelle Georgiou, president of a health care strategy firm in Minneapolis, Minnesota. Web sites such as Hospital Compare, My Health Compare, Health Grades and Ucompare Health Care allow you to compare hospital quality and patient satisfaction. Knowing your preferences in advance can help you decide quickly how to proceed if you ever need to rush to the emergency room.

4. Free and discounted care is out there

“In today’s tough economic times, everybody is bargain hunting, trying to save pennies here and there,” says UCLA’s Chassiakos. But beware of scams, she warns. “If a bargain is too good to pass up, be prepared that there may be a catch.”

Here are some ways to find dependable help:

• Pay what you can. The Department of Health and Human Services provides assistance through federally funded health centers. You pay what you can afford based on your income level. The services include everything from preventive care to dental work. http://www.findahealthcenter.hrsa.gov/

• Find an advocate. When you get laid off and lose your health insurance, you may need someone in your corner. Several groups specialize in helping people find affordable insurance and free care, including: Coverage for ALL Ehealthinsurance Healthcare Advocacy, Patient, Patient Advocate Foundation and Patient Services Incorporated.

• Get prescription drug help. If you can’t afford health insurance, or if your insurance doesn’t include good prescription drug benefits, look for $4 generic drugs at many major supermarkets and drug store chains. Also, your state may offer a discount drug program. You can also check these private groups that offer prescription assistance:Chronic Disease Fund, Family Wize discount drug card, Health Well Foundation, Needy Meds, Partnership for Prescription Assistance, Rx Assist and Rx Hope.

. If you’re voluntarily or involuntarily laid off from your job, or if you experience a large reduction in work hours, you may be eligible for COBRA, a program that allows you to keep your employer’s insurance. But there’s one big catch: You have to pay the premium in its entirety, which can sometimes be upwards of $1,000 per month. As part of the congressional stimulus package passed earlier this year, people who involuntarily lost their jobs can have the government pay 65 percent of their COBRA premiums. Several rules apply. For more information, go the Department of Labor’s Web site: http://www.dol.gov/ebsa/cobra.html

5. Paying attention can save your life

You know your body better than anyone else. If your gut tells you something just isn’t right, then listen to it.

Read more on how important it is to listen to your instincts: http://www.cnn.com/2009/HEALTH/04/16/ep.emergency.room.kids/index.html

Here are some other ways paying attention can make a difference:

• Know your medications. Keeping track of what medications you’re taking is crucial. Medows, from the Georgia Department of Community Health, recommends writing a word or two on the bottle to remind you of what the medication is for. “Life can get too complicated to depend on memory alone to keep track of everything,” Medows says.

• Track your progress. If your treatment involves a prescription, change of diet or physical therapy, make sure you understand what you have to do each step of the way before you leave the doctor’s office. “Clear communication is always a challenge. It’s even harder when the stakes are your health,” says Caplan, the ethicist. Write down the steps and keep track of how long before you should see improvement and when you should schedule a follow-up appointment.

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By Dr. Keith Block on September 30, 2011.  http://blockmd.com/

Benefits of Yoga and Mindfulness for People with Cancer

Many people facing a diagnosis of cancer are looking for ways to release stress and tension. Yoga and mindfulness training that is, practices intended to cultivate present-moment awareness and relaxation are two of the best-studied options in this regard. But can such practices really help people with cancer?To answer this question, in this blog, I examine some of the most recent research findings concerning the potential benefits of yoga and mindfulness after a cancer diagnosis.

First off, there is little doubt that yoga can play a key role in helping you relax and enjoy a better quality of life, as indicated by a meta-analysis published online ahead-of-print in the March 9, 2011 issue of “Evidence-Based Complementary & Alternative Medicine.” This analysis included a total of 10 studies in which cancer patients practicing yoga were compared to those not practicing yoga or receiving nothing more than “supportive therapy.” Based on comprehensive psychological assessments and pooling the findings from all ten studies, the yoga groups showed statistically significant lower levels of anxiety, emotional distress, depression and overall stress, when compared to the cancer patients in the control group.

Yoga incorporates a blend of elements: relaxation, meditation, imagery, controlled breathing, stretching and movement. Of my patients who practice yoga and/or mindfulness training on a regular basis, most report a greater sense of calm and improved sleep. Also, yoga can help with recovery from cancer treatments. For example, breast cancer patients may experience limited arm motion due to scarring from surgery and radiotherapy; yoga can increase flexibility as well as range of motion in the affected arm.

I mentioned above that better sleep is among the frequently reported benefits of practicing yoga. Exercise and sleep do seem to go hand in hand. Over the years, I have met many people who swear by this interrelationship: the better their exercise habits, the deeper and more satisfying their sleep tends to be. And because cancer patients frequently have problems with sleep, there is good reason to consider sleep as one of the worthwhile benefits of an integrative physical care program that includes yoga and possibly mindfulness training as well.

Researchers at the M. D. Anderson Cancer Center in Houston, Texas, recently conducted a randomized trial of cancer patients practicing Tibetan yoga, which involves a combination of movement and meditation. Reporting in a 2004 issue of the journal “Cancer,” Lorenzo Cohen, Ph.D., and his M.D. Anderson colleagues found that those patients who practiced Tibetan yoga for seven weeks had better overall sleep quality compared with lymphoma patients who did not practice yoga. The yoga-practicing patients went to sleep faster, slept longer and used less sleep medication than their non-practicing counterparts.

All of the patients in the yoga group reported that they found the program was beneficial, and more than half the group said they practiced at least twice a week during the follow-up period. While there was a trend toward improvement in such factors as fatigue, depression and anxiety, the only statistically significant difference between the two groups was sleep quality. As might be expected, patients practicing Tibetan yoga also had better energy levels and less daytime sleepiness.

Developed over thousands of years, the movements of Tibetan yoga are gentle and subtle. The two forms used in the intervention group, called Tsa lung and Trul khor, involve controlled breathing, visual imagery, and maintaining awareness of the present moment. Dr. Cohen hypothesized that Tibetan yoga might serve as a stress-reduction practice for people with cancer ? much like going to the gym is for many people who sit behind a desk all day. Based on the study’s outcome, he concluded that Tibetan yoga is particularly useful for people receiving and recovering from chemotherapy. In addition, one of the key findings in studying cancer patients who practice Tibetan yoga is that they also have more favorable cortisol profiles. This is very important, as cortisol is a stress hormone associated with chronic anxiety, depression, poor immune function and a worsening prognosis for breast cancer patients.

A recent study of the effects of Mindfulness-Based Stress Reduction (MBSR) found that these practices led to statistically significant reductions in blood pressure, heart rate and respiratory rate, along with a more relaxed, present-moment awareness. The MBSR training also led to a statistically significant effect on the morning cortisol level, as reported online ahead-of-print in the October 2010 issue of “Western Journal of Nursing Research.”

More research is needed to determine whether the favorable effects of yoga and mindfulness training on cortisol levels hold true. However, if other studies find such an effect, it could very well be that such practices would help extend survival in people with cancer. My belief is that any practice that improves the quality of life and overall functioning of a person is worth pursuing, not only because quality of life itself is a worthwhile goal, but it has, in fact, been associated with improved survival.

For more information on how to optimize your health, visit lifeovercancer.com

Photo credit: MyNeChimKi