Elective Deliveries: A Sign of a Healthcare System Out of Control

My husband is always getting on me about the number of tabs I have open in my browser at any one time. I think one time I had more than 100 open.

Within the past few days, at least 10 of those tabs dealt with the same topic: medical tests and procedures that we either don’t need or that don’t work. There are simply too many for a single blog, so I’m focusing on one here and will write more about others in the coming days.

The lucky winner? Births.

Seems like an obvious medical procedure, doesn’t it? Baby is delivered when mom goes into labor or, if problems develop or mom goes over her due date, labor is induced. So why, as  Kaiser Health News recently reported, are 10 to 15 percent of U.S. babies  delivered early without medical cause, up to 40 percent in some hospitals?

Early delivery increases the risk that the baby will have feeding and breathing problems, infections, and developmental problems, requiring a stay in costly neonatal intensive care units. It also increases the risk that mothers will need caesarian sections (indeed, many of these births are scheduled c-sections).

Why the early deliveries? Convenience for … Continue Reading

fraud get better health healthcare costs healthcare reform healthcare system; ineffective procedure payment Uncategorized waste

A Product Label for Pregnancy


I just learned that the European version of the FDA is holding a three-day meeting this week to review the safety of the most commonly used contraceptives in the world: combined estrogen/progestin birth control pills (full disclosure: my husband works for a pharmaceutical company that sells this type of contraceptive). The French government recently announced that it is not going to pay for these oral contraceptives and want some taken off the market because of a perceived increased risk of venous thrombosis, blood clots that can travel to the lungs.

In addition, the FDA recently required manufacturers of these drugs to add a “black box” warning about the increased risk. However, two well-designed studies found no increased risk between these third- and fourth-generation contraceptives and earlier generation birth control pills.1,2

The reality is that all forms of estrogen-containing contraception, whether pill, patch, or ring, carry a risk of blood clots. Generally, 6.29 women out of 10,000 women using these forms will experience a clot versus 3.01 in nonusers.3 The risk is highest, however, in women over 35 who smoke or have hypertension.

Plus, those supposedly “safer” birth control pills have side effects that cause women to stop taking them, such … Continue Reading


The Hidden World of Depression

The teenaged daughter of a good friend was just hospitalized for depression. Yes, depression.  Not cancer. Not some runaway infection. Although in my mind, depression is both. A cancer that destroys your life from the inside out and an infection that, if not treated early and well, becomes resistant to the best therapies and turns septic.

I talked about my own depression a bit in an earlier blog. But the situation with my friend’s daughter  reminded me again of how differently we respond to a mental illness than a physical illness.

For instance, as this girl was being driven to the hospital, her brother left her a voice mail telling her, basically, to “buck up.” To get her act together and “beat this.” Once the girl was out of immediate danger, her grandmother emailed and said she hoped she could “get her life on track” since she had so much promise.

Um, people. This girl was not out stealing cars, shooting up drugs and failing school. She was caught in what I can tell you from personal experience is a quicksand of apathy and pain into which, unless you are by the miraculous combination of medication and therapy pulled out … Continue Reading


Ballistic Trauma–and 26 Dead

It’s called ballistic trauma. That’s the medical terms for getting shot. With a gun. Any gun. But these days, I’m thinking, we need to come up with some new term, something that describes the unimaginable horror that happened in Newtown. And Aurora. And Blacksburg, And about 15 other places in the past few years.

Do you know what happens when a bullet enters the the human body?

I didn’t either until I looked it up. Nor did I realize that there’s actually a field of study called “wound ballistics,” devoted to measuring and tracking the gruesome results that come from the kinetic energy of a bullet fired into a living thing.

There are two reasons for such study: to identify the best way to kill someone, and to help surgeons better understand the damage a bullet causes so they can try and repair it. You can actually read a chapter about this, courtesy of the Department of Defense.

Here’s what the chapter says: “With the perfection of guns that could shoot high-velocity missiles came the observation that the resulting wounds appeared as though they had been caused by an actual explosion within the body. External signs of injury were often … Continue Reading


Tooth Saga — Week 3

When last we left each other, it was August 10 and I was waiting to hear if I’d be released from the hospital where I’d been incarcerated for 4 days receiving IV antibiotics for a dental infection-turned-cellulitis. I was, indeed, released that day.

Spent the next 4 days getting worse and experiencing the kind of pain that I last experienced 16 years ago while in labor, when I nearly broke the anesthesiologist’s arm until he got the epidural in. Only this time there was no epidural, just increasingly worthless opioids. Finally landed back in the hospital Tuesday with an abscessed jaw infection requiring surgical incision and drainage.

Can I just say how much fun the past 3 weeks have been? In 3 weeks, I’ve been on three antibiotics (oral and IV) two steroids (also oral and IV), multiple Vicodin prescriptions, dilaudid (thank god for IV dilaudid), morphine (didn’t even touch the pain), and handfuls of probiotics (got to keep that c.diff at bay). I’ve lost 7 pounds (not complaining) but I also lost all that great muscle definition from my hard work at the gym this summer.

I’ve lost more work time than I care to count, met and got … Continue Reading


Tooth Saga—Day 4. Parole?

Sitting in the hospital room waiting with bated breath and fingers crossed for the warden (i.e., doctor) to do rounds and finally agree to break me out of here. Honestly, I’m getting out with or without his approval. Do you know how ridiculous it feels to be in an inpatient when you’re not really sick? And there are people all around me who are really, truly, seriously, sick? I mean their faces are the color of their sheets and they can’t go to the bathroom themselves and they need help eating. Here I am popping up and down, going for walks, teasing the nurses, and writing “going stir crazy” on my white board under the part that says “Patient is at High Risk For:”

I’m tired of being woken at 3 a.m., for another antibiotic or steroid infusion; tired of bad coffee; tired of fluorescent lights. And I think I’ve got Stockholm syndrome; for some reason, I keep finding myself back in bed like an invalid.

To be fair, the nurses and aides here are great. They truly are amazing and if I were really sick, I’d want to be here. My docs seem fine, although both are pretty flummoxed … Continue Reading


Infected Tooth–The Saga Continues

For those of you who have stuck with me so far, let me update you once more. This time from the comfort of my hospital bed, an IV line in my arm, a rerun of How I Met Your Mother on the TV.

The good news is that my dinner will be delivered shortly. The reason that is good, is that I was told no food or water since about 11 a.m., when the CT scan showed a pretty nasty infection around the jaw muscle that might require surgery.

Doctor just popped in. . .we’re holding off.

The bad news is that I’m stuck here for at least another 24 hours! Oh, and can I just share once more the comment from yet another doctor about the, um, curious juxtaposition of antibiotics? (See previous blog if you’re just getting started here).

Next time, Debra, speak up! (assuming you can open your mouth, of course).



Of Infected Teeth and Misplaced Compliance

I’m sitting in the emergency room at my local hospital, the victim of a tooth infection run amuck. While most people might be frustrated at the waiting and scared at the situation, I’m mostly curious.

Curious about how things are run here, what they’re doing right, what they’re not doing right. Here’s the main thing I can report: There really is no privacy in the ER. I can hear everything the staff says, the reports over the radio, and, from the vantage of my room, see everyone coming and going. I know that a 10-year-old girl with nausea and wooziness was brought in a while ago; she’d taken some NyQuil earlier in the day and had a cold. I know that about 45 minutes ago my nurse asked someone else to ask my doctor if I could have pain med (30 minutes after I first asked for the pain meds). Oh, and still no pain meds.

I liked being wheeled in my bed to the CT scan. Felt like a queen. Even kind of enjoyed the warm sensation of the contrast dye. But then, I’m a bit weird.

My husband just texted me. . .”Have you seen the CT scan?” … Continue Reading


Why Do Rick Perry and Rick Scott (and Several Other Governors) Want to Walk Away From Free Money?

Imagine you are in the audience for the Oprah show with 49 other people. (Ok, I know it’s off the air, but bear with me on this). Oprah announces she is giving everyone in the audience a car. Not only that, but she will pay for all expenses related to the car—insurance, gas, maintenance—for three years. After that, you just need to pay for gas; she will still cover at least 90 percent of the costs into the foreseeable future. All you have to do is promise to give rides to people who don’t have cars.

 Would you turn down the car?

 Well, that’s exactly what several state governors, including those in Florida and Texas, say they will do—turn down federal funding to expand Medicaid eligibility in their states. The Medicaid expansion is part of the Affordable Care Act (ACA). It calls for states to expand coverage to most adults with incomes up to 133% of the federal poverty level (now $15,000 for a single person and $31,000 for a family of four). The federal government will cover the full cost for these additional beneficiaries for the first three years, gradually reducing its share to 90 percent by 2020. You … Continue Reading