Tuesday, April 19, 2016

Changes in Who Decides Your Medical Treatment

What my husband and I perceive from recent appointments with several doctors is that doctor's no longer make the decision on what treatment is best for their patient.

Instead, they provide their patient with information and then the patient must choose what he or she wants for their lifestyle.

I liken this new way to handing a person an artist’s palette, some tubes of paint, plus pastel chalks, charcoal, watercolors, brushes, and other artist's tools, and telling the person to create the picture they envision. Or, put a person into a shop full of equipment and tools and tell the person to create what they want!!

It’s true that the good old days recalled by any elderly person, of going to your doctor and having him or her diagnose your illness and provide proper treatment has been replaced. Nowadays, the patient is questioned, is sent for tests, and then the doctor gives a diagnosis based on the tests rather than how the patient feels.
This is followed by one or more referrals to specialists ~ who then describe the problem to the patient and offer choices of treatment options  ~ for the patient to decide what is the proper treatment for them so that they will achieve the lifestyle they prefer.

Your doctor’s online Patient Portal may or may not help you with this "NEW" way of doctoring. When we asked if having a Patient Portal was mandatory, the receptionist told us it is not mandatory for a patient to have one, but doctors without a high enough percentage of patients who do have a Patient Portal are fined by the government. Whether or not that’s true, we don’t know.

What is your Patient Portal and is it important?
Yes, your Patient Portal is important to you. However, there are many types. Standardization of the technology in the healthcare services industry have been slowed down due to internal factors, such as resistance to changes in medical practice patterns, new costs to train staff and ongoing costs to maintain the validity and relevance of computerized order systems, and concerns revolving around compliance with future medical standards.

Your doctor’s office will help you set up your Patient Portal, which provides you with online access to your medical records. When you’ve mastered setting up the portal, which requires a “Signin” name and a “password”, become acquainted with how to navigate it; how it works, where you find what you want to know, how information is edited, and how to contact your medic.

HealthIT.gov has an excellent download for frequently asked questions (FAQ). Scroll to "FAQs about the Patient Portal (for Patients)" and click the Download. Save it on your computer so you can refer to it when you need answers.

Among other things, Patient Portals basically include:
  •  Appointments, past and upcoming.
  •  Tests and their results
  •  Patient's medical history & patient’s family medical histories
  •  Patients medications, current and past
Beware: Unless you’re educated in reading test results yours won’t tell you what you need to know. However, test results can be a real asset for patients who research, and research, and research until they match their symptoms precisely with a disease or disorder.

Online research can lead to organizations and groups that specialize in disorders you’ve never heard of, and therefore, be hugely beneficial ~ if you study them closely.

Nevertheless, many websites you find can also be dangerously misleading and provide false information. Proceed with caution.

Pay heed to these new changes, because whether you like them or not, it is how medical treatment works today, and it behooves the patient to understand them as fully as possible.

Saturday, October 24, 2015

Costly Facts About Medicare Observation and Outpatient Hospital Admittance

I've always been skeptical of email fowards. You know the ones, FWD: followed by some subject that holds little or no interest. However, the title on this FWD, Hospital Stay - Important please read, indicated a topic that interests me. So I read it.

Having recently been admitted to a couple of hospitals for medical observation myself, with Medicare covering all of the hospital and doctor charges except pharmacy, I didn’t believe what the writer described.

However, after doing intensive research, I found the circumstances that made his saga ring true.

Following instructions at bottom of page 40 in the 2016 Medicare & You publication, I studied the important, lengthy explanation. Are You a Hospital Inpatient or Outpatient?

Scroll down to see how it applies to this man’s experience! Observation in an intensive care unit, ICU, is not covered by Medicare. My advice? Study your 2016 Medicare & You book, because it spells out the circumstances under the various categories on admittance, including "observation", are not covered.

Read also, "Your Medicare coverage choices".

The following is the original FWD: Hospital Stay - Important please read. SENIORS BETTER READ THIS!!! from a senior gentleman in Mesa , Arizona:
"Family, Friends, Neighbors, and former Classmates, I just found myself in the middle of a medical situation that made it very clear that "the Affordable Care Act" is neither affordable, nor do they care. 
"I'll go back about seven years ago to a fairly radical prostate surgery that I underwent. The Urologist who performed the surgery was very concerned that it was cancer, though I wasn't told this until the lab report revealed it was benign.

"Since that procedure, I have experienced numerous urinary tract infections, UTI's. Since I had never had a "UTI" prior to the prostate surgery, I assumed that it is one of the side effects from surgery, an assumption since confirmed by my Family Doctor.

"The weekend of March 8-9, I was experiencing all the symptoms of another UTI. By Monday afternoon the infection had hit with full force.  Knowing that all I needed was an antibiotic, I went to an Urgent Care Center in Mesa, AZ, to provide a specimen a requirement for getting the prescription. After waiting 45 minutes to see the Doctor, I started getting very nauseous and light-headed.

"I went to the Receptionist to ask where the  bathroom was, as I felt that I was going to throw up. I was told that I would have to wait for the Doctor because I would have to leave a specimen, and they didn't want me in the bathroom without first seeing him.

"That was when the lights went out. My next awareness was that of finding myself on the floor (in the waiting room) having violent dry heaves, and very confused.  At this point, I tried to stand up but couldn't make it, and they made it very clear they weren't going to let me get up until the ambulance got there.

"By the way, when you're waiting to see the Doctor and you pass out, you get very prompt attention.

"Now, "the rest of the story", and the reason for sending this to so many of you. I was taken to the nearest hospital, to emergency. Once there, I was transported to an emergency Examination room.

"Once I had removed my clothes and donned one of those lovely hospital gowns, I finally got to see a Doctor.  I asked "what is going on?  I'm just having a UTI. Just get me the proper medication and let me go home."

"He told me that my symptoms presented the possibility of sepsis, a potentially deadly migration of toxins, and that they needed to run several tests to determine how far the infection had migrated. For the next 3 hours, I was subjected to several tests, blood draws, EKG's, and demands for specimens.

"At about 7:30 [p.m.], the nurse came back to my room to inform me that one of the tests takes 1- 2 days to complete. I asked if they [the results] could be emailed, at which point she informed me that I wouldn't need them emailed because I wasn't going anywhere. I did tell her I wanted to see the doctor because I had no intention of staying overnight.

"Now, this is what I want each of you to understand. Please read these next sentences carefully.

"The doctor finally came in to inform me that he was going to admit me.  I said, "Are you admitting me for treatment or for observation?"

"He told me that I would be admitted for observation.

"I said, "Doctor, correct me if I'm wrong, but if you admit me for observation, my Medicare will not pay anything. This due to the Affordable Care Act."

"He said, "That's right, it won't."

"I grabbed my bag of clothing and said, "Then I'm going home."

"He said you're really too sick to be going home, but I understand your position. This health program is going to hit seniors especially hard.

"The doctor then left the room and I started getting dressed.  I was just getting ready to put my shoes on when another doctor [the closer] came into the room. He saw me dressed and said, "Where do you think you are going?"

"I simply said "I'm going home."

"To which he replied, quite vociferously, "No you aren't."

"I said, "Doc, you and I both know that under the "Affordable Care Act" anyone on  Medicare who is admitted to a hospital for observation will be responsible for the bill. Medicare won't pay a cent." At which point he nodded in affirmation.

"I said, "You will either admit me for a specific treatment or you won't admit me."

"Realizing he wasn't going to win this one, he said he would prepare my release papers. A few minutes later, the discharge nurse came to my room to have me sign the necessary papers, relieving them from any responsibility.  I told her I wasn't trying to be obstinate, but I wasn't going to be burdened with the full [financial]responsibility for my hospital stay.

"After making sure the door was closed, she said, "I don't blame you at all, I would do the same thing."  She went on to say, "You wouldn't believe the people who elect to leave for the same reasons, people who are deathly sick, people who have to be wheeled out on a gurney."

"She further said, "The 'Affordable Care Act' is going to be a disaster for seniors. Yet, if you are in this country illegally, and have no coverage, you will be covered in full."

"This is not Internet hype folks, this is real. I just experienced it personally. Moving right along, this gets worse. Today I went to a [required] follow-up appointment with my Arizona Family Practitioner.  Since my white count was pretty high, the follow-up was important.

"During the visit, I shared the experience at emergency, and that I had refused to be admitted. His response was "I don't blame you at all, I would have done the same thing." He went on to say that the colonoscopy and other procedures are probably going to be dropped from coverage for those over 70."

"I told him that I had heard that the "Affordable Care Act" would no longer pay for cancer treatment for those 76 and older, is that true? His understanding is that it is true. The more I  hear, and experience the Affordable Care Act, the more I'm beginning to see that we seniors are nothing more than an inconvenience, and the sooner they can get rid of us, the better off they'll be.

"We can have an impact on this debacle by letting everyone in Congress know that their responsibility is to their constituents, not the president and not the lobbyists. We need to let them ALL know that they are in office to serve and to look after the BEST INTERESTS of "we the people," their employers, and not to become self-serving bureaucrats who serve only out of greed. And if they don't seem to understand this simple  logic, we'll fire them.

"REMEMBER: Demand [that]your hospital admission is for TREATMENT and NOT for OBSERVATION! Don't believe this? Ask your doctor.


"Lord, keep your arm around my shoulder and your hand over my mouth.”

My advice? Study these: 
Are You a Hospital Inpatient or Outpatient? and ,"Your Medicare coverage choices".
When you need help, these agencies have typically provided information about their state's SHIP programs. First, Locate your local Area Agency on Aging by visiting Elder Care Locator. Once on the site, enter your zip code or city/state, and your local agency should populate.

Also, towards the bottom of the search results, the contact information of the SHIP programs in that territory or state are typically displayed.

Another resource that you may find useful in locating SHIP information for your locality is,

Good luck!

Saturday, September 5, 2015

Rainy Weather Ends Danger to Ross Creek Cedar Grove in Montana

September 3, 2015, courtesy of US Forest Service:

The Northern Rockies Wildland Fire Management Team has assumed command of all fires in the Napoleon and Clark Fork Complexes and will manage them as the Clark Fork Complex under the command of Diane Hutton.

  • The Clark Fork Complex is a collection of the following fires:
  • Scotchman Peak (IPNF): 2057 acres Whitetail (IPNF): 1870 acres
  • Sawtooth (KNF): 2465 acres Marten Creek (IPNF): 6 acres
  • Napoleon (KNF): 8957 acres Government (KNF): 399 acres

Yesterday’s Activities [9/2/15]: There was an uptick in fire activity on Wednesday as sunshine and moderate winds caused hot areas to show themselves. Fortunately the activity was concentrated well within the fire perimeter or on flanks with little chance of growth. Infra-red photography showed growth across the Complex was limited to 20 acres on the west edge of the Sawtooth Fire.

On the Whitetail Fire crews started water-barring constructed fire-lines to prevent erosion from forecasted rainfall. Supervisors worked with Resource Advisor Lydia Allen to devise a rehabilitation plan for the area. Equipment continued construction of a contingency line along the private boundary south of the Napoleon Fire and north of Highway 200.

Crews pushed their mop-up activities deeper into the area west of the Highway 56 corridor. The focus of work on Wednesday was on the contingency line along the boundary of Eagle View Estates, northeast of the Sawtooth Fire. The work included structure protection and the strategic placement of pumps and hose-lays.

The final night shift was completed on Thursday morning as fire conditions along Highway 56 no longer warrant making engines work through the night.

Today's Planned Actions [9/3/15]: Additional sunshine on Thursday will likely "liven up" some of the fires, but the activity should be mostly interior single-tree torching on the Sawtooth and Napoleon Fires.

Firefighting activities will be similar to Wednesday with additional mopping-up of hot spots and the expected completion of the contingency line south of the Napoleon Fire. Structure protection will continue in the Eagle View Estates subdivision.

The Temporary Flight Restriction around Whitetail Peak that had prevented conflicts between Complex aerial operations and other aircraft will be lifted today. The Team will continue to demobilize crews and equipment to "right size" down to an organization that is appropriate for the present fire activity and forecasted future weather.

Forecasted Weather: Showers and thunderstorms will be passing through the area on Thursday. There is only a 20% chance of a wetting rain (greater than one-tenth of an inch) from these storms. Winds will be light on Thursday except for erratic gusts associated with thunderstorms. Meteorologist Scott Carpenter is feeling increasing confident that a wide-spread low pressure area will bring between ¼ and ½ inch of rain on Friday night and Saturday.

Evacuations: The following area in Montana is under a Pre-evacuation Notice: all residences south of mile mark 20.5 along the Highway 56 Corridor to the Highway 200 intersection, including Angel Island, Bull Lake Estates, Eagle View Estates, East Fork Bull River Road and the South Fork of Bull River, also the residences north of Highway 200 from mile marker 6 to the Highway 56 intersection (approximately 4 miles); and the residents of Old Bull River Road. A Level 1 Evacuation Order is in effect for an area in Bonner County, Idaho. This area is bounded by the State Line on the east, River Road (south of the Clark Fork River) on the north, the main fork of Johnson Creek on the west and the Shoshone/Bonner County Line to the south. Level 1 is a pre-evacuation notice that informs residents that they should have plans in case the fire moves in their direction.

Closures: An area closure order exists on the Idaho Panhandle National Forest around the Scotchman Peak Fire. A closure order on the Idaho Panhandle National Forest that closes the 332 Road, the 1066 Road and the 1021 Road at the intersection with the 332 Road, in the local area remains in effect.

The Idaho Panhandle National Forests and the Kootenai National Forest have instituted area and trail closures around many of the fires in the Clark Fork Complex; please consult the websites for the respective Forests at the Idaho Panhandle
http://www.fs.usda.gov/ipnf or the Kootenai
http://www.fs.usda.gov/kootenai for the latest updates. Closures on the Idaho Panhandle will likely last through the Labor Day Weekend to ensure public safety.

For the latest fire information and photos, visit http://inciweb.nwcg.gov/incident/4531/.

Stay current with the Idaho Panhandle National Forest on Facebook:
https://www.facebook.com/USFSIPNF and the Kootenai National Forest at http://www.fs.usda.gov/main/kootenai/home.

This ends fire reports.



Saturday, August 29, 2015

Official Update on Fires Near Ross Creek Cedars

Just received from official Clark Fork Fire Information <clarkfork2015@gmail.com>

"Fire is still one half mile to the southwest of the Ross Cedar Grove. The fire managers feel pretty good that it would survive if the fire does push that way as it is protected with natural barriers and high humidity where it is located.

"They are also planning to put sprinklers in around the trail.

"Don't forget those trees have survived 1000 years of fire including the 1910 and 1889 fires!"

Comprehensive Map of the region.

The harrowing tales those rugged Montana homesteaders told about surviving the 1910 holocaust in those mountain valleys are in Volume 1 of Behind These Mountains, a trilogy of northwestern Montana. To read their accounts free here, Chapter 18, 1910 Fire.

Due to Forest Fires Montana Hwy. 2 Is Closed Between Essex and Libby, MT

A portion of Montana Hwy. 2 is closed between Essex and  Libby, MT in the Kootenai River Valley. Unconfirmed reports claimed Ross Creek Cedars, the ancient grove near Bull Lake is afire aren't true, fire management officials say.

The latest official information, posted 2 hours ago, is at InciWEB.

As soon as it's received, I'll post the current status I requested from Clark Fork Complex command officials.

Friday, August 28, 2015

Wildfires in the West Expected to Burn Until September 28, 2015

Fires are expected to burn in The Clark Fork Complex until September 28th, according to the latest estimate posted approximately half an hour ago on  inciWeb, Incident Information System.

Comprehensive Map of the region.

Ross Creek Cedars near Bull Lake, in neighboring Lincoln County, may be spared according to latest information that said the Scotchman Peak fire is one mile from the ancient grove.

Friendsof Scotchman Peaks Wilderness 

Fire Update:

"Infrared technology was able to cut through the smoke and give fire managers a picture of what the fires have been doing under their blanket of smoke over the past few days. The Scotchman's Peaks Fire is now measured at only 1920 acres, a decrease from previous measurements. It continues to burn islands on the interior of the fire and up on the steep, rocky slopes beneath Scotchman #2. Activity on the southern edge of the fire, near Clark Fork, has nearly ceased....
"The Napoleon Fire has continued to grow to the south in un-burned areas below Pillick Ridge, and is now measured at 7,896 acres. Crews have laid hoses along the Pillick Ridge trail, which will be used to knock heat down between Highway 56 and Gin Gulch, where the fire has crossed the ridge. We hope that the firefighters can continue to ensure the safety of homes along the Bull River. 
"The Sawtooth Fire is now measured at 2010 acres. Although two large spots grew together recently, it has (thankfully) not made any progress towards the Ross Creek Cedars.

"In case you missed the announcement yesterday, FSPW received a request to help feed firefighters at the Lakeside Restaurant in Trout Creek, MT. If you would like to help out, please call the Lakeside Restaurant at (406) 827-4458."
The fires in Kootenai (KNF) and Idaho Panhandle National Forests (IDP) include individual fires are the Scotchman Peak (IDP), Whitetail (IDP), Marten Creek (IDP), Sawtooth (KNF), Napoleon (KNF) and Government (KNF). The Northern Rockies Wildland Fire Management Team, under the command of Diane Hutton, are managing all fires in the complex. All of the fires were started by a lightning event that ran across the geographic area. Evacuations along Highway 56 run from milepost 2.7 to milepost 14. Additional resources remain difficult to obtain due to the unprecedented number of fires in the north western states. Firefighter and community safety are the top priorities for all fire suppression actions.

Additional information is in Becky Kramer's August 26th assessment of the Ross Creek Cedar grove.

For an overall assessment of wildfires, read this Bloomberg Business article which gives you their realistic viewpoint. It includes the following:

"The Forest Service, the countrys largest wildland firefighting agency, has spent $800 million trying to control the flames this year, and its only August. As such, 2015 is on track to become the 15th year in a row the agency has laid out roughly $1 billion on firefighting alone. Expenses in some areas are equal to or greater than the value of the threatened property$200,000 to $400,000 per home, according to Bozeman (Mont.)-based Headwaters Economics. Yet the Forest Service doesnt have much choice: It cant just let communities burn. So the service and its partner agencies keep putting out the flames, even though years of study have shown that doing so only leads to even hotter, more devastating fires later."
One quote in the article states,
“If you always do what youve always done, youll always get what youve always got, says Tom Harbour, who, as the chief of the Forest Services fire department, sets the agenda for dozens of other federal, state, county, and municipal agencies and is effectively Americas wildland fire chief. One hundred million people in the West can no longer expect to just pick up the phone, dial 911, and have a Hotshot come and save them.”
The harrowing tales those rugged Montana homesteaders told about surviving the 1910 holocaust in those mountain valleys are in Volume 1 of Behind These Mountains, a trilogy of northwestern Montana. To read their accounts free here, Chapter 18, 1910 Fire.

Thursday, August 27, 2015

Freeman HS Alumni Received Special Recognition at Navy Week in Kansas City, MO

Roy Vanek, Senior Chief Explosive Ordnance Disposal, assigned to Explosive Ordnance Disposal Group (EODGRU) had a prominent role in the success of Navy Week, held in Kansas City, MO.

On August 17th, America's Navy wrote, "[Sailors from] The world's largest Navy arrived to the "City of Fountains," Aug. 17, 2015 to begin Kansas City Navy Week, a week-long series of community and
outreach events."

Vanek received special recognition from Vice Admiral William Hilarides, commander of the Naval Sea Systems Command, and Mayor Sly James for his performances.

Video #1 and Video #2  feature Roy and his EOD crew. 
Roy wrote, "The first video is of me giving an interview with the reporter in a bombsuit.  The second video is a photos of me and my team diving in the aquarium and interacting with the kids.  I'm the diver in the full wetsuit with the long sleeves and pants." Spectators watched the  exciting events taking place inside the aquarium.

Navy EOD is this is a dangerous job, requiring both intelligence and courage. Many Kansas City news media published stories depicting one of Roy's more enjoyable assignments. Two stories are in America's Navy, "EOD Sailors Make a Splash at the Kansas City Sea Life Aquarium", and here .

After parting from his classmates and football team members when he graduated from Freeman High School at Freeman, Wash., Roy joined the Navy EOD 19 years ago, when he was 17.

Newsroom America  published the following story, written by By Mass Communication Specialist 1st Class Jennifer Gold, Navy Office of Community Outreach.

EOD assignments have taken Vanek all over the world. Some of his assignments have been guarding the President of the United States, and guarding visiting foreign dignitaries. Additionally, he has participated in many critical EOD missions, and also trained EOD units in other countries.
KSHB (NBC) August 18, 2015,
Action News Midday.

WDAF (FOX) August 21, 2015 FOX 4 News at 6AM

Freeman High School can be proud of the part their school system played in Senior Chief Explosive Ordnance Disposal, Roy Vanek's success.

Independence School District, August 18, 2015, (
Article and Photos), Highly-Skilled Navy Explosives Technicians Meet ISD JROTC, PLTW Students.

The Examiner, August 20, 2015, By: Mike Genet
Navy team visits schools to promote
STEM studies.
Recently returned from Guam, where he met his wife, Chubasca "Bas", they are currently stationed in San Diego, CA. Vanek has numerous relatives and friends in the eastern Washington, northern Idaho, and western Montana region, all of whom, like the nation, appreciate his service.