3 Reasons Why You Must Keep Your Own Health and Medical Records

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By CK Wilde for 3GenFamily Blog

Over the past 19 years since my first son was born, we have had a number of doctors care for us. Dr. G, our first pediatrician, was reassuring and supportive even when I was 2 hours late for the first baby check up.

When Dr. G accepted a partnership opportunity 80 miles away, we moved to Dr. H who gave my children friendly, practical care until it was our turn to move away.

Dr. H gave us a referral to Dr. B, a distinguished, elderly man trained in Europe. I really appreciated Dr. B’s concern and care when it came to treating my son’s asthma.

Unfortunately, our insurance carrier changed and I was forced to find a different doctor who was accepted by the plan. That’s how Dr. F entered our lives.

Every time we made a change, I dutifully requested that my sons’ medical records be sent to the new doctor. Dr. F inherited two files that were over 2 inches thick. The last time I saw a complete file was during an office visit for my youngest son two years ago.

(Here’s the Health Record organizer I recommend.)

Reason Number 1 – Medical Records Get Lost or Destroyed

Recently, it was time to changed doctors again. I requested copies from Dr. F’s staff and paid $50 for them photocopy the entire files.

What I got was only 10 pages for each son!

The doctors’ staff insists that I got everything they had.

So, what happened to all of those old records?

I can only suppose that someone was cleaning up the doctors files and moved ours to some unlabeled box in a storage facility. Or, perhaps they shredded them (California has enormous penalties for failing to destroy medical records properly).

HIPPA, the Health Insurance Portability and Accountability Act, requires information it defines as “protected health information” to be maintained by the physician for at least 6 years from the date of its creation or the date it was last in effect. The earliest date in the records I received was 1997. So Dr. F’s staff had actually kept records going back more than 10 years.

Isn’t that good enough?

Not always.

Reason Number 2 – Memory Fails & Doctors’ Notes are Impossible to Read

My oldest son recently came down with a sinus infection at college. He needed to tell Health Services if he had any reactions to medication. I recalled he had some issue with one antibiotic a long time ago. But which one was it?

I couldn’t remember the name so I searched the records I received. Dr. F’s scribbles were impossible to read. How I wish I had kept a set of records myself. The benefit claim forms that the insurance company sends don’t have any of these kinds of details.

So my son had to take the medication he was prescribed and hope for the best.

We lucked out. Number one son is recuperating nicely. But, there could have been a problem. All I had to do was make a legible note in a binder and put it in a safe place. But I didn’t because I thought I would remember.

My father tried to capture his key medical issues on pieces of note paper. I found a few of these notes in his tax paperwork for 2005. But, Dad didn’t have these papers with him the times he was hospitalized in the past two years.

My father wasn’t always able to tell the hospital doctors his medical history. It is clear from the records I have that they were in the dark about it. He ended up having multiple tests and x-rays over and over again because of it.

Reason Number 3 – Doctors Don’t Always Communicate With Each Other

In my post, Google Doesn’t Belong in the Health Records Business, I mentioned that my Dad’s family doctor did not always get records after my Dad’s hospitalizations because she was not affiliated with that hospital.

The hospital would assign a doctor to my father. Dad would protest that he had a doctor. They would explain that she couldn’t attend him that their hospital. My father would be angry and frustrated. The hospital staff would just call him difficult.

Eventually, I convinced my father to switch doctors so that he would have a family practitioner close to where he lived. With the help of the nurse at the retirement community, I arranged for my father to consult with two of the doctors who made visits to the community. He wasn’t sure which doctor he wanted as his primary care physician so we arranged for him to meet both doctors and then decide.

I requested my father’s medical records from his original doctor but her staff did not want to release them. The office manager said she would only release his medical records to another doctor. (Note: Each individual has a right to his/her own medical records.) They said they were afraid he would lose them and it would be too much work to copy them again.

Frustrated but unable to do much by long distance, I suggested to my father than I would give his old doctor one of the names of the new doctors, have the file sent, and then he could choose from the two new doctors. The nurse at the retirement community promised to get the file to the right doctor when it arrived.

Dad had a “meet and greet” with one of the doctors. Still no medical record for the new doctor to review. The other doctor had an emergency that day and canceled office visits.

Meanwhile, I continued to badger the office manager to release my father’s records.

Dad’s records eventually arrived, but not before he was hospitalized again. More tests, more x-rays.

You Need to Protect Yourself and Your Family

My family has had its share of doctors’ visits since the time my children were born. Most of those have been routine checkups. Never in all that time has any medical professional ever suggested I keep a binder to keep track of things.

My latest experiences tell me that I really need to get a binder together for my family. After doing some research, I settled on Jakoter Health Organizers.

Jakoter Health Organizer

The Jakoter Health Organizer includes a sturdy binder, 75 separate pages to record important information, pocket pages to hold instructions, notes and charts, even business card holder pages to keep all of your doctors’ business cards handy.

Click this link to see more information about the Jakoter Health Organizer.

Are you carrying around stacks of doctors’ business cards in your purse just in case you will need them? I was. The business card pages in this kit are a way to lighten your load and still be prepared.

This organizer was created by an enterprising mom, Laura Heuer, who needed a way to deal with the overload of details about her son who had severe reactions to antibiotics given for a strep throat. Her son eventually got better. Out of her struggle to stay organized and on top of issues, the Jakoter Health Organizer was born.

Please check it out. Having organized health records will make it easier to communicate with your doctors, prevent unnecessary procedures and help your doctor make better diagnoses.

Today is a great day to get started.

© 2008 CK Wilde. All Rights Reserved. Please feel free to link to this post but you must have prior written permission to reproduce this post either whole or in part. Please use the comments to request permission.

Five Easy Steps to Shrink Your Risk of Age Related Macular Degeneration (AMD)

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By CK Wilde for 3GenFamily Blog

A Good Friend Remembered

A good friend of ours died the third week of December. We just received a note from his daughter responding to our holiday card. Unfortunately, it never reached him.

We sent cards every year even though we were never quite sure our friend could read the card. AG, now in his 60’s, had worked with my husband some years ago. Macular degeneration wiped out his sight, and his ability to make a living as a computer programmer.

His vision problems were already underway when he attended our wedding 20 years ago. He soldiered on, working from home and adapting his life to his condition.

When his vision decreased to the point that he could not drive, he rode his bicycle for shopping and errands. AG amazed me with insistence on doing things for himself. He was determined to maintain his independence. Eventually, even bicycle riding became impossible.

Women Are More At Risk

While it’s true that women are more at risk of developing macular degeneration than men, AG had two other high risk factors working against him: smoking and high blood pressure. And, based on what we know about his cooking and eating habits, nutritional deficiency was a distinct possibility.

You are also more likely to develop AMD if you are over 60, have a family member who has it, are seriously overweight, have other cardiovasular problems, have light eyes and spend a lot of time in bright sunlight. Whew! We fit in several of those categories. That’s scary.

Five Easy Steps to Healthy Eyes

Fortunately, there are some very easy things you can do right now, no matter what your age is, to prevent Age Related Macular Degeneration from happening to you.

  1. Stop smoking. Not only will you reduce your risk of AMD, you will reduce your risk for a long, long list of health issues. If you still smoke, you know what I am talking about. My annual bout of bronchitis mysteriously disappeared after I quit smoking.
  2. Eat a colorful, balanced diet. Leafy greens, bright colored fruits and vegetables, eggs, lamb, poultry, fish, nuts and seeds and whole grains contain antioxidants, vitamins and minerals that nourish our eyes. The key nutrients are Vitamins A, C, E, Zinc, Selenium, Lycopene, Beta-Carotene, Lutein and its cousin, Zeaxanthin. A recent study found that one egg a day substantially increased the amount of lutein in the bloodstream of post menopausal women in the study with only a very modest increase in cholesterol. Can’t eat that much? Supplements can help, too. Here is a link to the Mayo Clinic’s complete list of supplements for the eyes.
  3. Stop eating processed baked goods. Put down that danish and slowly back away from the table! Ditto for cookies, cakes, crackers and chips. There is evidence that hydrogenated fats double your risk of progressing to advanced stages of AMD. And they are terrible for your cardiovascular system. As an added bonus, you may find that you have an easier time with your weight and more stable blood sugar. My sugar highs and lows are gone. (Yes, I do miss a gooey cinnamon bun every now and then.)
  4. Wear sunglasses that block UVA, UVB and blue light. Do you remember the “BluBlocker” sunglasses ads on TV a few years back? I thought it was just slick marketing. It turns out that yellow or amber tinted glasses block blue light and really do reduce glare so that you see more clearly. Blue light is believed to react with the pigments in the retina to produce free radicals causing waste products to build up in the retina if not cleared out by antioxidants. The studies are mixed on whether blue light causes macular degeneration. It may be that people with light eyes have less protection because there is less pigment in their eyes to block those wavelengths. It makes sense to me to wear UV/Blue blocking sunglasses while out in bright sunlight since UV has been associated with the development of cataracts. Not long ago I bought a pair of sunglasses that were gray instead of amber. I really notice the increased glare compared to my old pair of amber sunglasses. I’m switching back to amber.
  5. Get regular eye exams. If you are over the age of 40, seeing your eye doctor every two to four years is recommended. Over 60 years old, the recommendation for eye doctor visits is every one or two years. (More if you have problems.) There are several tests that the doctor can use to check the health of your retina and the macula (the small part of the retina responsible for clear vision.) If your doctor offers Optomap, make sure to get it. The Optomap is a computerized camera that takes a wide angle picture of the retina. It allows your doctor to get a really good view. It doesn’t require dilating your eyes with drops so that you have trouble seeing for several hours. Because the digital image of your retina is stored in the eye doctor’s computer, he can compare older images with the newest ones to look for changes – much better than working from notes in your chart. With early detection, you can take steps to stop the progression of AMD . . . and keep your sight.

Does It Matter Where Your Son or Daughter Goes to College?

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By CK Wilde for 3GenFamily Blog

Our local newspaper added a ton of heat to the controversy that rages this time of year about which college a high school senior should attend. The headline read: Forget the Ivy League: Most Valley CEOs Went Public.

Right now, high school seniors everywhere are polishing essays to impress those soon-to-be bleary eyed college admissions staff, many of whom will read more essays than ever before. Our children born in 1989 (4 million babies born) and 1990 (4.2 million babies born) are part of a boomlet almost as large as the late baby-boom year of 1961 when 4.3 million babies were born.

Consequently, colleges are seeing more applications than previously and turning down top candidates they would have welcomed just a few years ago. Admissions directors expect this to continue until the end of the decade.

Ever resourceful and upbeat, many high school guidance counselors are countering with the mantra, ” It doesn’t matter where you go to college. A top student can succeed anywhere.”

The MercuryNews article by Mark Schwanhausser seems to support that, too. The statistics on Silicon Valley CEOs does show that the majority attended public universities. Most have two or three degrees, though, with an MBA and/or a Ph.D in engineering being the most common.

The CEOs who were interviewed for the newspaper article often remarked that they chose their schools for reasons other than getting to the top of the corporate ladder. But, then the author threw parents everywhere a curve ball.

He asked recruiters for Cisco and Intel where they look for college graduates when they recruit for jobs. Both recruiters readily admitted that they do their searching at 30 to 40 of the “absolutely best schools in the United States.” Companies know that the tough screening process at certain schools makes their job easier. This quote from one recruiter is highly revealing,”Finding great talent at other schools is possible, but it takes more work.”

So if you want to work for one of the best technology companies, you’ll have an easier time getting an interview if you go to one of the “top schools” because recruiters focus their efforts there.

You can find a ranking of the top schools from US News and World Report. But, you’ll need to pay $14.95 for the premium online edition to see all of the ratings for all of the colleges. Another resource is the CollegeBoard.com. In addition to overseeing the SATs, the CollegeBoard has expanded into college planning, college search and college financing (beware of the sales pitches here.)

But, you may be asking, what about Steve Jobs and Larry Ellison? They both dropped out of college and are doing just fine. Does anyone really need college at all? Why not just get started on building up job experience? How the heck do you advise your son or daughter when they ask for your ideas about this?

Here’s my take on it: Attending college is an incredible opportunity to study something that interests you and to sample topics you haven’t tried before. (Steve Jobs credits a calligraphy class with igniting his sense for design.) Most careers today require at least a college degree. If you don’t have one, at some point you get passed over for promotions. Your teen should plan on a graduate degree if he/she has aspirations to climb the ladder of success in technology.

I believe that it is important to find the best ranking school with the best fit for your student’s needs. Definitely look at public schools but don’t ignore private colleges and universities because of cost. See my post on financial aid.

By the way, Larry Ellison of Oracle and Steve Jobs of Apple are both wildly successful without college degrees because both started their own companies and led them to major success. No one asks to see their diplomas. They have proven they can produce results.

But, a new college graduate will be measured by the name of the school on the diploma. America’s top corporations will all vie to hire from the so called top 40 or 50 schools. So, the answer is yes. It does matter early in their careers if they dream of sitting at a desk at any of the Fortune 500.

Ultimately, anyone can succeed with a willingness to work. My favorite no BS book on the subject is:Automatic Wealth for Grads . . . and Anyone Else Starting Out

Michael Masterson may not be as well known as Bill Gates but offers solid tips from his real life experiences working for others and owning his own companies. This former Peace Corp volunteer and college professor has insights that are right on target. You may even want to check it out for yourself. I did and learned a lot!

Thanksgiving With Dad — How Do You Convince Someone to Accept Help?

 The mood was relaxed and happy on the five hour flight from California to New Jersey. It was Thanksgiving Day. The sun was just beginning to set on what must have been an unseasonably warm day on the East Coast. I smiled to myself. The plane had arrived ahead of schedule. I would be at my father’s home in time for dinner with him.

The airport shuttle driver let me off outside the patio of my Dad’s place. I could see Dad was sitting motionless in his recliner in the corner of the room. Only the kitchen light was on, but I could easily peer into this tiny garden apartment in an independent senior living community. It had been my father’s comfortable home for the past year.

The TV was off. Dad must have fallen asleep, again.

I knocked on the glass patio door and eventually woke him from his nap. He was overjoyed to see me. But, his mood went from gleeful to glum in only a minute. “I’m sorry. I’m afraid I don’t have dinner for you,” he said.

In our phone conversations over the past few days, my father had chatted cheerfully about preparing his favorite dish, baked turkey legs, for us for Thanksgiving.  He had discovered a great recipe by accident and wanted to share it with me.

“I guess I fell asleep and didn’t hear the timer,” he continued. ” The turkey legs were totally burnt even though I had them in a low, 250 degree oven.”

“How long do you think you overslept?” I asked.

“Oh, it might have been six hours,” Dad said sheepishly.

“That’s ok. You have some hamburgers in the freezer that we can make, right?” I said trying to sound upbeat. (Did I hear that right, six hours?)

I walked into the kitchen to start preparing the hamburgers. The stove was dirty. Pots had boiled over and burnt remains littered the trays under the burners. I peered into the oven. It was just as dirty. The entire apartment smelled like burnt food. This was a major change since my last visit.

I tried to hide my uneasiness as the realization began dawning on me that Dad was not able to safely cook for himself anymore.

“Gee, Dad, it looks like you had a few pots spill over,” I said.

“Yeah, pots boil over from time to time. It’s no big deal,” he growled.

“Looks like you could use some help with the cleaning, Dad. ”

“I’m doing fine by myself! I don’t have extra money pay for cleaners. I have barely enough to live on! ” Dad’s growl had turned into a shout.

Lowering my voice, I turned to him with a big smile, “I know you have done a really great job managing your money. It is looking like you could use a little help here, that’s all.”

That was the beginning of a weekend-long argument.  I gave my father all sorts of suggestions for ways he could get help. He rejected every one.

We met with a non-medical in home care provider.  Dad turned pale when he heard the hourly rate.  I got out the rate sheet for the additional cleaning services that the senior apartment complex offered.

“That’s too much! Dad shouted.

Finally, I hit upon the idea of Dad purchasing the meal plan from the dining room. Together, we figured out how much he spent on food. It looked like buying dinner on the meal plan would not cost much more than he was already spending.

I reasoned and cajoled. Dad finally agreed that he would enjoy getting his evening meal from the dining room.  All that was left to do was for my father to sign up for the plan on Monday. He said he would do it.

I left for the airport on Sunday evening with a light heart.

On Monday, I phoned to remind him to sign up for the meal plan. He began to waffle. Maybe he would wait until December. Maybe he would wait until he finished the food in the freezer. Maybe he would wait until . . .

Of course, I knew these were just excuses. For each one, I countered with a reasonable argument. Dad thought up another.  He wasn’t going to do it and I was too far away to exert the same kind of influence I had when I was physically there.

A November 2007 study by the National Alliance for Caregiving and Evercare found that the long distance caregivers spend an average of $8728 per year out of their own pockets to help an elderly family member. Local caregivers spend somewhat less — approximately $5000 annually.

And, it is no surprise to me that the largest percentage of this expense is going to provide care attendants, followed closely by medical expenses and long distance travel. I had already been spending money for travel to see my Dad. Once your parent needs care, but cannot or will not pay for help, the family may need to provide it. Those of us who work are forced to rely on paid helpers to to assist with eldercare. Bu, this can have a negative financial impact on the family members paying for care.

Fate took a different turn with my father. Later that week, he developed a nose bleed that the nurses at the retirement community could not stop. His trip to the hospital ended up lasting over three months.

The nurses also reported to the managers that Dad was having trouble keeping up the apartment. The managers said they would refuse to allow him back into his apartment when he was released from the hospital for his own safety.

Now instead of convincing him to eat in the dining room, I had to convince him to move to the next level of care. To be continued . . .

Medicare Part D – Open Enrollment Ends Dec. 31- Don’t Miss It!

What’s all the fuss about the Medicare Prescription Drug Program?

Open enrollment started on November 15th and runs to December 31st. This is the time when anyone can change from one plan to another without paying a premium penalty. If your parent is already enrolled in a program, you may be wondering why you need to worry about this.

Medicare and health care advocates in every state are trying to get the word out that the rates are changing. There are major rate increases coming to the most subscribed plans, while some of the smaller plans are decreasing rates. Here in California rates in some plans are increasing by 31%.

All seniors should reevaluate their Medicare Drug plans to see if it still makes sense to stay where they are.  They can check Medicare’s website for help with choosing a plan that covers the specific prescriptions that they need at a cost they can afford. It is important to do it now before the enrollment period ends.

Can there really be that much of a difference?

Yes.

This year doing nothing could be very expensive for your parent. Monthly premiums could increase substantially. Or, you may discover that required medications are not covered by your plan. 

And, of course, there is the highly confusing problem of the “donut hole.” I don’t know who invented this “cute” name but it is a gap in coverage that can take a lot out of your pocketbook.  Here’s how it works:

You enroll in a plan and pay a monthly premium. You pay for your prescriptions until the deductible is reached. Once you have met the deductible of $265, the basic prescription drug plan will pay 75% of your drug costs and you will pay the remaining 25% until your total drug costs reach $2,400.

Then, you are responsible for 100% of your drug costs between $2,401 and $5,451.25. This gap in coverage, the “donut hole”, requires that you pay $3050.25 out of your own pocket before Medicare pays any more for you.

While this is happening, you are still paying your monthly premium. If you get to December 31st without going past $5451.25 prescription costs, there is no additional help. You start the new year meeting the deductible again.

Once your total drug costs reach $5,451.25, the basic prescription drug plan will pay 95% of your additional prescription costs and you will pay up to 5% (or a small co-payment) of your remaining drug costs for the rest of the calendar year.

Each insurance company that offers Medicare Drug coverage has the option to add benefits. Each company can also determine which drug they will or won’t cover. Some companies will pay for certain generic drugs during the coverage gap while others pay nothing.

There are so many plans, with different options,  that vary from state to state, that you need to evaluate before you sign up.  It’s just plain confusing!

Fortunately, every state has Health Insurance Counseling and Assistance Programs. You can find someone in your area to provide free counseling about the plans that would be right for you. You can attend workshops on choosing the best plan.

Before you contact the Health Insurance Counseling and Assistance Program in your area, it’s a good idea to figure out your total drug costs for the past year and make a list of your regular prescriptions so you can compare it with the list of approved drugs for each plan.

It’s work to do this, I know. It is so tempting to just stay with the plan your parent already has.

Don’t do it! Make time now for your parent (or yourself) to find the best plan that is available. You’ll be glad you did.