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Know Where to Buy Your Meds

As a nurse, I often encounter patients who pay high insurance deductibles for medications or have limited insurance that does not cover all medication costs. What many people do not realize is that drug prices vary from pharmacy to pharmacy.

• For example, a 30 day supply of a popular generic high blood pressure med costs $4.00 at Wal-Mart. The exact same generic med costs $30.00 at Walgreens. However, Walgreens is sometimes cheaper for other meds. 

There's a great free app called GoodRx that compares prices of pharmacies in your area. I'd like to note that I don't work for GoodRx or get paid to endorse them. It's simply an easy-to-use app many hospitals and hospital professionals utilize to help patients with their medication costs. Also, GoodRx includes listings for pet meds! 




How does it work? Type in the name of the med and zip code. GoodRx then provides a list of pharmacies along with associated costs.

The app is completely free and is available for download in the Apple iTunes App store and Google Play Android store. Please see the GoodRx website for additional information. Also, please share with anyone who needs help with medication costs for himself or their pet!

The 5 Basic Healthy Habits?

There’s a lot of interest in new ways to boost health, but when it comes down to it, there are really only a few habits that are tried and true–and together can cut disease risk dramatically. These are not smoking, exercising regularly, keeping a healthy body weight, drinking in moderation and sleeping adequately, which is a relatively new recommendation.

A new study from the CDC finds that only a small percentage–just about 6%–of people in the U.S. are engaging in all five healthy behaviors. Given these strangely low numbers, the question may not be so much what makes people healthy, but rather how to get people to actually go about it. And as anyone who’s struggled with behavior changes knows, it’s often much easier said than done.
Here’s the gist of the study: The CDC researchers looked at data from 400,000 people over the age of 21 in all 50 states. The five major health behaviors considered were defined as: not currently smoking; getting regular physical activity; not drinking alcohol, or only drinking in moderation (two drinks per day for men and up to one drink per day for women); maintaining a normal body weight; and getting enough sleep at night (defined as seven or more hours). The results show the percentages of people who engaged in none to all of the behaviors:

• 6.3% of the respondents engaged in all five healthy behaviors
• 24.3% engaged in four of the behaviors
• 35.4% engaged in three of the behaviors
• 24.3% engaged in two of the behaviors
• 8.4% engaged in one of the behaviors
• 1.4% engaged in none of the behaviors

In general, women, older adults, college graduates and Asian-Americans were most likely to engage in the five healthy habits. And not surprisingly, people on the west coast and in the Rocky Mountain states were more likely to engage in four or five habits, while those in the South and the states along the Ohio River were least likely to engage in them.

“A particularly intriguing finding from the study was the geographic differences in the engagement in four or more of the behaviors,” says Wayne Giles, senior author on the study. “The study found that persons in the Pacific and Rocky Mountain states were substantially more likely to engage in these behaviors than persons in the Southern states and Ohio region. Thus, where people live is an important determinant of whether they engage in these behaviors. We need to provide people with choices so that those who want to engage in these five healthy behaviors have the resources and support to do so.”
Given all we know about the habits that contribute to health these days, it seems strange that relatively so few people are engaging in all five of the big ones, particularly in certain regions. It would seem by now that most people know what to do and not to do–maybe that’s not the case overall. Or maybe making fundamental lifestyle changes just isn’t easy enough to do on one’s own, and larger, more collective efforts are required.
The authors point out some strategies that might actually help people change their behaviors, and they’re mainly larger-scale shifts in thinking. For instance, helping people get more sleep is not only a matter of ads on buses, but it’s also a matter of integrating the research into practice in a larger way. For instance, promoting seven hours of sleep as a basic tenet of health might start with beginning school later in the morning for teens, and shifting workday hours for employees. For promoting exercise, it might be making outdoor spaces more activity-friendly and increasing the time devoted to physical activity in schools, rather than cutting it back, as is being done in many areas these days. Changing the makeup of school lunches and teaching kids what good nutrition really means would go a long way, not for kids themselves, but maybe even their families, too.

There are definitely more free and low-cost resources out there than there once were to help us make changes, but we still have a long way to go. It’s easy to talk about getting healthier, but harder to do it all by ourselves. So maybe innovative, outside-the-box strategies on a larger scale would go further in helping us make the changes we need to make–and not just for us, but for the aim of passing better habits on to our kids as well.

Mobile Devices and Personal Health Care Data

Apple's CEO Tim Cook cites users storing personal health information on their iPhones as one of the many reasons for not complying with the FBI's request to unlock iPhones in recent news. Regardless if you agree or disagree with Apple, it has caused many patients to question how secure is their health information stored on personal and mobile devices used by medical personnel.

Most hospitals are now using mobile devices such as iPads and tablets to collect data while conducting patient health assessments. Instead of lugging around cumbersome paper charts or laptops while making rounds, physicians are now using a variety of mobile devices to access a patient's latest lab work and test results. They can also quickly chart their assessment at bedside while it's fresh instead of waiting later in the day.  It's quick, easy and simple. But how secure is it? Here's some pointers to keep in mind when storing your health information.

1. If an app is to be used by average people (as opposed to medical personnel or staff), then it likely does not need to be HIPAA-compliant.  For example, if you download an app from iTunes to help you track your medication, this information is usually NOT secure. Never store your personal health information in an app unless it says it's HIPAA-compliant in the app's description. Many apps use third parties to store data and/or they sell information collected. So again, any app that you download for personal use in order to keep track of your private health information is usually NOT safe unless it specifically says it's HIPAA-compliant. 
2. Not all apps used by medical personnel need to be compliant. For example, applications that let doctors or other professionals look up disease information do not need to be HIPAA-compliant. However, if the app allows the doctor to record disease information about a specific patient, it must be compliant. Therefore, the iPads and tablets in hospitals are safe. 

If you feel your privacy has been breached either by an app or medical facility, click on the following link for additional information and to file a complaint. Health Information Privacy

The Influence of the Internet on Patients' Expectations

Patients are now able to access a huge amount of information about their health and health conditions via the internet. Advances in information technology have radically transformed both decision-making and treatment processes. The rise in popularity of the internet has, however, been accompanied by claims that it sometimes harms patients and the doctor–patient relationship. In particular, it has been criticized for turning patients away from conventional treatments, misleading patients as to the efficacy of alternative therapies, unnecessarily increasing consultation times, and creating conflict between the doctor and patient in medical consultations.


Medical specialists differ in their views of, and responses to, internet-informed patients. Some describe significant improvements in decision-making processes, increased patient autonomy, satisfaction with decision making, shared responsibility and increased concordance. Others, however, feel negative toward internet-informed patients and report conflict dynamics within medical consultations. Clearly there is something of a split between those specialists prepared to move toward a more open and consultative approach to decision-making processes and the doctor–patient relationship, and those who seek to preserve a more paternalistic dynamic within medical consultations. The latter approach merely alienates many patients and results in lower levels of satisfaction with care. This is unfortunate given that, when utilized effectively, the internet can provide a useful addition to existing patient information and support services.

Most patients desire (and will appreciate) guidance from their specialist regarding how best to use the internet, and will readily accept reasonable explanations as to the inappropriateness of information they have retrieved. It is important that doctors acknowledge the efforts of their patients and encourage their 'activeness' in treatment processes, as well as ensuring they are not misled as to the efficacy of treatments. Dismissing patients' online information retrieval, regardless of how inappropriate the material they bring along, will only service to alienate them and potentially result in them utilizing inappropriate information.

Exercise Really Does Help with Depression - Here's Why

There are many possible causes of depression. Some have biological explanations (or, at least, speculations) — genetic vulnerability, medications, chemicals in the brain. Others are personal and psychological: Stressful life events such as illness, divorce, a death, unemployment. (Personally, I would add, there’s also the philosophical despair that follows exposure to inequality, injustice, violence, suffering, and misogyny.) It’s much easier for biomedicine to study the biological causes rather than the psychological (or philosophical) ones.

Physical exercise is often recommended as a way to alleviate depression and to alter our mood. Biomedicine would like to know if exercise really does change the chemicals in our brain. A recent article in NEJM reports on a study that suggests it does: Muscling In on Depression.
The explanation is rather technical but here’s my summary in a nutshell. Tryptophan, an essential amino acid in the human diet, is found in foods containing protein (it’s also in chocolate). When we experience stress, organs such as the liver produce enzymes that cause tryptophan to produce. In order to metabolize tryptophane, our bodies produce kynurenine. Sometimes quite large amounts are produced, and that's not good. Kynurenine is associated with depression, cognitive deficits of schizophrenia, Alzheimer’s, and tics. Exercise produces an enzyme that converts kynurenine to kynurenic acid, which is much better than having kynurenine floating around, wreaking havoc and causing depression.

Admirable, no doubt, but do I detect here the possibility that the pharmaceutical industry may soon be at work on a pill it can market as an alternative to exercise? Possibly. But in the meantime, exercise! It really does help with depression both physically and psychologically.

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