Tag Archive for: health

Questions and Considerations When Making Myeloma Treatment Decisions

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Questions and Considerations When Making Myeloma Treatment Decisions from Patient Empowerment Network on Vimeo.

What should be considered when making a myeloma treatment decision? Expert Dr. Jeffrey Matous discusses key factors involved in choosing therapy and provides a list of questions to ask your doctor to guide optimal care.

Dr. Jeffrey Matous is a myeloma specialist at the Colorado Blood Cancer Institute and the assistant chair in myeloma research for Sarah Cannon Research Institute. Learn more about Dr. Matous.

See More from Evolve Myeloma

Related Resources:

Considering CAR T-Cell Therapy for Myeloma_ Key Questions to Ask Your Doctor

 Myeloma Treatment: Who Is Stem Cell Transplant Appropriate For

 Myeloma Combination Therapy _ What Patients Should Know

Transcript:

Katherine:

What factors impact treatment decisions? 

Dr. Jeffrey Matous:

Well, there are so many. One of the key ones is fitness, and fitness is a term that myeloma doctors use and rely on tremendously. 

And fitness, more or less, falls into a couple different categories. It’s more complex than that, obviously, but generally speaking, it’s too old or too frail, or young and vigorous and I stress to my patients that vigorous or frail is not determined by chronological age. It’s determined by your physiologic age. That’s really critical, so determining what your patient’s overall fitness is, is really important in myeloma. And then, we have to assess the risk of myeloma. I think we’ll talk about this a little bit later, because not all myeloma is the same and we treat myelomas differently depending on risk, certainly. And then, patient preference is a huge part, because there are so many ways to treat myeloma these days that we explore options with the patients and sometimes patients have pretty strong opinions about, you know, one type of treatment or the other, for example.  

Katherine:

What testing should take place following a myeloma diagnosis?  

Dr. Jeffrey Matous:

Testing in myeloma is multifaceted, because myeloma can affect patients in so many different ways. For example, it involves radiology studies to look for bone disease, urine work to see if the kidneys are affected by myeloma, a lot of blood work, and then, we also do a lot of testing to make sure that we understand the whole health of the patient, because that comes into play so much when we’re making treatment decisions in myeloma.  

Katherine:

What advice do you have for patients and caregivers related to working with their healthcare team in choosing a therapy? 

Dr. Jeffrey Matous:

Yeah. I think the big thing is to do some research on your own, but really, ask questions when you see your physician. I mean, ask questions about, for example, what are my treatment options? Are there clinical trials that might be available to me? What’s on the cutting edge in myeloma? What are the standard therapies? What are the pros and cons? And a question I often counsel patients to ask when they’re seeking other opinions is if you had 100 people like me and you treated them this way, how many would do well and how many would not do so well, and prognosis, and so forth. And then, the other thing I think is really important sometimes is gauging how experienced your physician is in treating myeloma, because we actually have data that shows that patients who are treated in myeloma centers actually fair a little better than those who are not. 

Involving a myeloma expert in your care doesn’t necessarily mean you have to get your care at that center. It just means you may want a myeloma expert on your team. Pretty much every doctor I know welcomes a myeloma person on their team, because the field is so rapidly evolving. It’s really hard to keep up with for a lot of people. 

A Word From the Registered Dietician & Nutritionist

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How Much Protein Do I Need?

Each person’s nutrient needs are a little different, and you actually have some leeway with how much of each to have. However, when it comes to macronutrients (protein, carbs and fat), it’s not the same rule. We want to get enough, without too much. There are varying suggestions on what the correct ratio is for macronutrient intake, but they typically fall within the following range:

  • 45-65% of calories from carbs
  • 20-35% of calories from fat (I’ve seen some studies show Mediterranean diets that have up to 40%)
  • 10-35% of calories from protein

NOTE that these are not percentages of food on the plate, they are percentages of CALORIES from each food group. What makes this extra confusing is that carbs and protein are 4 calories per gram where fat is 9 calories per gram. Fat is very calorie dense, which is why you aim to eat less of it by volume, than the other sources of calories. Less is more!

Also, FYI – alcohol is 7 calories per gram. That’s still more calories per gram than carbs and protein. It can add up fast, hence the ‘beer belly’ that some people can accumulate even when it seems that they don’t “eat” that much.

Given this information, what is the optimal amount of protein that you should aim for? Consuming more protein than your body needs is not helpful. The average American eats twice as much protein as they need (they fill 1/2 their plate with meat!)

Protein Sources & Amounts

Health Exercises to Tap Into Your Resiliency

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The current pandemic the world is facing has caused a whirlwind of emotions, especially for immunocompromised patients, including cancer patients. Every feeling, from grief to sadness, and anger to hopelessness, has been magnified as our minds take a toll and our level of vulnerability has grown.

Right now, we are doing the best we can with the knowledge, experiences, and tools that we have. A couple of ways to utilize these tools and stay grounded during this time include meditation and exercise. Below are a list of resources, including ones I have personally used, that can be utilized to build inner and outer strength.

Walking

A great form of exercise that can be done anywhere and doesn’t require any equipment. During your walks, take in the scenery around you. Challenge yourself by quickening your pace, going up and down hills, or see how far you can go in a specific amount of time.

Yoga

Another activity that requires little to no equipment. Find free videos on YouTube or look to see if a local studio is offering online classes. Yoga allows your mind to calm and your stress hormone levels to reduce as you focus on slower movements and breath work.

Aerobics or high-intensity interval training (HIIT)

Helps improve cardiovascular health and endurance through quick movements done in rounds and can utilize the entire body. YouTube and Instagram are great places to look for these types of exercises. You can also incorporate weights (if you have them) to make it more challenging.

Strength training or weight lifting

Beneficial for both men and women, and burns more calories over time. You don’t have to be buff to lift weights or even have equipment. Buckets filled with heavy items or other things with handles, soup cans, bags of flour, a dish towel, or even body weight can be used to break a sweat. Again, YouTube and Instagram are your places for videos. Pinterest can also be helpful by searching for “body weight exercises,” or “exercises with no equipment.”

  • Mastering the form of each exercise is crucial to avoid injuries. Form > the amount of weight you can lift.
  • Do each exercise slowly. Form a mind-muscle connection.
  • Don’t forget to breathe!
  • Stretch!
  • Favorite exercises:
    • Bicep curls
    • Tricep dips
    • Bent over rows (back)
    • Rear delt flys (deltoids)
    • Upright rows (shoulders/trapezoids)
    • Squats
    • Deadlifts: Romanian, sumo, one-leg, stiff-leg (hamstrings)
    • Calf raises
    • Military press (shoulders)
    • Chest press

Meditation

Meditation is a wonderful practice that can be used to mitigate negative thoughts and distractions. This is important any time, not just during quarantine! One of the best things about meditation: you don’t have to be perfect! Meditation takes dedication and practice. YouTube has free, guided meditations that can be done in any quiet space. Some have someone spreading, while others are simply music. Apps, such as Headspace and Calm, also offer guided meditations.

Health Fraud Scam – Be Aware and Careful

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Avoiding health care scams can be as simple as not signing blank forms, not providing personal information to unknown parties, and not agreeing to schemes to make money by falsifying paperwork.

Unfortunately, there is a scammer for every medical condition or concern. People who are suffering from conditions like cancer and its harsh treatment regimen may be confused and belittled by persistent phone calls or emails but there are ways to fight back.

How it Works

Healthcare fraud is a way of billing health insurers or government programs like Medicaid out of money through a system of fake, unnecessary, or inflated bills. An unscrupulous doctor may offer you cash in exchange for your signature on a permission form that will allow him to bill for fake services.

Others, including people who show up at retirement homes or senior activity centers, may offer to provide  a medical “test” of some kind, whether eyesight or hearing, etc. The individual then bills your insurer or Medicaid an exorbitant amount for the useless service – or gets added to your monthly regimen of providers despite the service or monitoring not being necessary. A new wrinkle in this phishing scam are people who offer to provide a “genetic test” using a cheek swab at a healthcare fair, senior center, or other forum, and who have you fill out medical insurance information at the same time. They will then try to bill your insurance for the unnecessary “test” and may pursue you for the cost if your insurance refuses to pay.

Medical equipment, from oxygen tanks to catheters to shower chairs, may be provided by scammers who bill your healthcare insurance despite the item being either unnecessary or absurdly high-price. If you accept medical equipment, be sure it’s recommended by your regular doctor, that it’s necessary, and that you shop around for the best price rather than just signing an authorization that allows the provider to bill any amount.

Home health aides may be assigned to your home and billed to your insurance but never show up to provide a service. Keep an eye on your billing statements to be sure this sort of fraud is not showing up on your account, and call your provider if you see anything suspicious.

How to Avoid Healthcare Scams

To protect yourself from such scams use tools at your disposal, such as reverse email lookup, confirm website addresses and compare them to actual government websites you find on your own, or call your health insurance provider if you’re suspicious about a bill, a caller, or an unwanted package of medical equipment. Here are other tips to follow:

  • Never sign a blank healthcare or medical form that authorizes payment in exchange for a treatment (such as that described above) that was not planned and authorized by your usual medical team.
  • Do not accept unnecessary equipment that you did not order and do not use, like braces, apnea devices, or orthotics.
  • Watch your billing statements for any unauthorized charges, and report any that are unusual.
  • If you think a doctor is doing unnecessary tests or surgeries, get a second opinion. This can be a way to bill for services that you don’t need.
  • Check your billing statements to ensure that the procedures noted are exactly what you received because some scammers are able to change the name of a procedure, such as a biopsy, to collect more money.
  • Providers may also try to “unbundle” procedures and charge more for each step rather than a “package” price. Watch for this more expensive billing practice on your statements.


Related issues

Healthcare can be a confusing part of life to navigate, as many of us have multiple doctors, copayments, coverage issues, deductibles, drug coverage, and more to learn about. Unfortunately there is a scammer looking to work every angle and take advantage of anyone, so beware of the following healthcare related scams:

  • Anyone who calls to tell you it’s necessary to buy a new health insurance card or pay over the phone for a new Medicare card immediately and wants your credit card and/or social security number and personal information (you can call 1-800-MEDICARE to check the person’s identity and validity of their call before providing any information);
  • Confusing medical discount plans with medical insurance – discount plans are “club” like groups that claim to offer discounts on doctor visits, drugs, and medical devices but they are not the same as insurance;
  • If you receive Medicare you do not need additional insurance provided through the Healthcare Marketplace, and anyone who wants to charge you a fee for helping to make a decision about coverage offered through the Healthcare Marketplace is a scammer and should not be given a credit card number, bank transfer, or paid with gift cards, and
  • Anyone who claims to be “from the government” and threatens you with a financial penalty for not being up to date on insurance is a scammer and should not be told any personal information such as social security number (you can call the Federal Trade Commission at 1-877-382-4357 to ask about or report fraudulent schemes).

10 Body Signals Warning Health Problems

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Most often, we don’t worry about our health until we start to experience severe symptoms. Things like headaches, stomach aches, and fatigue have become too common that many people think they’re just normal. Well, most of the time they are. And even the healthiest individuals can suffer from occasional discomfort and pain.

However, we should always be aware of what our body is trying to tell us.

Below are 10 ways our body signals that we should be more concerned with our health:

Unexplained Weight Loss

Drastic weight loss is something to be worried about, especially if you haven’t changed anything in your diet. Most often, it indicates an underlying condition.

Health problems associated with unintentional weight loss are overactive thyroid, rheumatoid arthritis, diabetes, inflammatory bowel disease, chronic obstructive pulmonary disease (COPD), depression, endocarditis, tuberculosis, and cancer. As you can see, all these are chronic illnesses that require immediate and proper treatment. If you’ve lost more than 10 pounds without exercise or diet changes, it’s time to check in with your doctor.

Stomach Pain

You can have stomach pain for many reasons. Indigestion, allergies, or some bacterial infection are among the most common causes of abdominal pain. These symptoms can be addressed by taking either prescription or over-the-counter medications. And more importantly, by practicing proper hygiene like washing hands regularly or sanitizing surfaces with disinfecting wipes before use.

However, in some cases, stomach pain signals something more serious, such as a heart attack. Other symptoms to watch out for are nausea and heartburn. Meanwhile, “crampy” abdominal pain that is accompanied by bloating and diarrhea may signal irritable bowel syndrome (IBS).

Chest Discomfort

Chest pain is a major red flag that requires immediate medical attention. It’s a common symptom of a heart attack but it could also be caused by pancreatitis, pneumonia, panic attack, and many more health problems.

If you or someone you know suffers from chest pain along with nausea, shortness of breath, pain or numbness, lightheadedness or dizziness, sudden weakness, flushing or a cold sweat, call 911 immediately.

Skin Problems

You can have a quick assessment of your overall health just by looking at your skin.

Being the largest organ in the human body, the skin can tell a lot of things about our health. For instance, a skin rash that is accompanied by fever, joint pain, or muscle pain could indicate an internal problem or an infection. Yellowing of the skin could suggest liver failure while darkening of the skin, particularly on skin folds, could be a sign of hormonal disease.

Other skin problems that signal a need to check in with your doctor are:

Wrinkles

It’s common for older adults to have these. But deep forehead wrinkles could point to atherosclerosis which is the hardening of arteries – a risk factor for heart disease.

Breakouts

Acne is a common skin problem that can happen even in healthy individuals. But how do you know that it’s more than acne? If you haven’t had acne for a long time and you suddenly experience breakouts, it’s best to consult your doctor. Sometimes, it could indicate Polycystic Ovarian Syndrome (PCOS) or hormonal disorders.

Dryness

Dry and itchy skin could be a sign of a hormonal problem, such as an overactive thyroid. Meanwhile, people with autoimmune disease may suffer from swelling and hardening of the skin.

Weakness in the Arms and Legs

This symptom is due to loss of muscle strength, which can be caused by different health problems. Weakness, which also comes in the form of weariness, tiredness, lack of energy, or fatigue could be a sign of underlying illnesses like congenital myopathies, electrolyte imbalances, malnutrition, malignant tumors, nerve impingement.

Fluctuation in Body Temperature

The normal body temperature is 98.6°F (37°C) ± 1°. It’s common to go past this reading when you have a fever. Also, minor fluctuations are normal and can be attributed to environmental factors. However, excessive fluctuations in body temperature could signal more serious conditions, such as hypothyroidism, adrenal fatigue, septicemia (a type of bacterial infection), and altered insulin activity.

Sleep Issues

Common conditions associated with sleep problems are heart failure, musculoskeletal disorders, kidney disease, and thyroid disease. Insomnia is also a common symptom of mental health disorders like general anxiety, phobias and panic attacks, bipolar disorder, depression, and schizophrenia.

Moreover, certain brain and nerve disorders like dementia and Parkinson’s disease can all cause sleeplessness.

Bathroom Problems

People with type 2 diabetes have bodies that are less efficient at breaking down food into sugar. As a defense mechanism, the body will try to eliminate the sugar by flushing it out into the urine. If you experience more frequent trips to the bathroom (and feel thirsty more often), consider undergoing a blood test to know your average blood glucose level. The sooner diabetes is diagnosed, the easier it is to reverse through proper lifestyle changes.

Chapped Lips

If you can’t live without applying lip balm, it’s your body’s way of telling you that something is wrong. Dry, chapped lips are a common cause of vitamin deficiency. Consult your doctor for some lab tests and switch to a more balanced diet to make sure you’re getting the nutrients your body needs.

Cloudy Mind

Do you feel ‘lost’ lately? Are you unable to solve simple problems or formulate a potent thought? Cognitive and physical health are intertwined. Just as cognitive problems can result in some physical symptoms, physical illness can also affect our cognitive abilities. Obesity, for example, can significantly impact one’s ability to think and reason.

Chronic health problems usually start with minor symptoms. It’s best to consult your physician for any of your health concerns.

Health Care and Social Media: Importance of Facing Their Challenges

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Social media has greatly influenced many aspects of our society, particularly healthcare. Through social networking sites, blogs, forums, and similar platforms, it has become easier for people to find health information and get the care they need.

But the use of social media in healthcare is not without challenges. Concerns over breaches of patient privacy, the abundance of unreliable health resources, violation of personal–professional boundaries, and many others have surfaced over the past years, which makes both the public and health professionals question the impact of social media on health care.

The Role of Social Media in Health Care

Social media is one of the most popular channels used by healthcare providers (HCPs) to communicate with their patients and promote health. In fact, 99% of hospitals in the U.S. have an active Facebook page. The use of other social networking platforms like Twitter and Instagram in healthcare is also on the rise.

Health education.

Perhaps the biggest benefit of social media in healthcare is information dissemination. It allows health institutions and organizations to share discoveries, research, health tips and recommendations, and relevant news to the people.

Patient care.

Another benefit of social media in healthcare is it helps providers build positive relationships with patients. Gone are the days when people will have to wait in line for hours to have a consultation with their doctors. Today, they can send queries or book an appointment online and get updates from their HCP. This, in turn, strengthens the trust between them and improve the patient experience.

Healthcare promotion.

83% of internet users or 93 million Americans have searched for health-related information online, ranging from mental health, disease management, immunizations, etc. Moreover, 60% of social media users trust the information shared by doctors and other health professionals. Because of this, care providers now utilize social media to promote their services.

Challenges

The online world is an open space. Everyone can upload information without verifying it, view someone else’s data, and in worst cases – steal someone else’s data. Managing social media can also be burdensome for healthcare providers who – as we know it – are some of the busiest professionals there are.

Patient data privacy.

HCPs take extreme caution in sharing information online, afraid that it patient’s privacy. To avoid this, all healthcare providers should adhere to the HIPAA Compliance which is a set of regulatory rules concerning the privacy, security, and integrity of confidential health information.

Social media management.

Healthcare professionals use social media to promote their services and provide better care to their patients. But managing social media is not easy. To reap its benefits, healthcare providers should keep their followers engaged, provide useful information, and respond to the queries of patients. All these take time, strategy, and commitment. For these reasons, many healthcare providers make use of all-in-one marketing platforms like Adrack that can automate social media campaigns, saving them time and resources.

Poor-quality information.

Information on social media circulates easily. While social media is a great channel for promoting health education, a lot of health information shared on various sites lack quality and credibility. Medical information may also be unreferenced or incomplete. It can also be changed by anyone.

Healthcare providers need to remind their patients that not all health information they see on social media is true. They should also guide them to peer-reviewed websites where all information is subject to quality control.

Concerns over professionalism.

A major risk in the use of social media in healthcare is the possibility of posting content that can damage the reputation of providers, students, and the healthcare institution as a whole. Physicians are very concerned that people might lose respect for them if they share inaccurate information or judge them if they share their personal opinion over certain topics. Many healthcare providers also fear that people might perceive them negatively through photos, comments, likes, and other social media activities. Ensuring that they are providing only relevant and appropriate information is the best way to avoid such issues and controversies.

Patient–HCP boundary.

Boundary violations can occur without the physician and the patient even knowing it. A lot of times, it’s the patients who initiate online communication by sending ‘friend requests’ to their physicians. Unknowingly, this violates boundary policies between healthcare professionals and patients. Rather than communicating on social media channels, HCPs should consider setting up a website to be used for sharing posts regarding medical events or services. This way, patients can follow updates in a more professional manner. Also, HCPs should refrain from using investigating the personal behaviors of their patients in making a clinical judgment, such as knowing whether or not they have quit smoking or are observing a healthy diet.

When used responsibly, social media can be a powerful tool to promote health education, build positive HCP-patient relationships, and improve healthcare quality.