I read Jonathan Papernick's account of solving his mystery illness with disbelief.    Here was a man who was already  diagnosed with Celiac Disease and living gluten-free.   Common sense would indicate such a patient would be susceptible to other ailments of a dietary, or auto-immune, origin.     In addition, a diet void of gluten, must consist of something else, and perhaps the 'something else'  has accumulated quite a quantity over the years.   But this was not investigated until after much suffering, time and expense.   Papernick states that a "simple blood test" revealed a yeast allergy/infestation in his intestines.   A mold specialist later confirmed his NYC apartment was a virtual incubator.  Certainly gives new meaning to the phrase: An apartment to die for!

After releasing our mobile service, we were inundated with requests to list mold and yeast in our drop down menu of common allergies.   We started with the 'Big 8" but after emails fraught with despair,  one woman wrote she had her lung removed due to a mold, we developed our custom diet box, so our subscribers could enter their own allergy terms.     Papernick's story is a convincing testament to 'heal thyself".    With the doctor's fee slashed to an average of $30 per patient, chances are, he/she won't remember anything in your chart unless you remind, prod, pester him/her at each visit, and likely why a condition like Papernick's went untreated for so long.   In conclusion:  be a pest, you'll live longer.

http://well.blogs.nytimes.com/2010/07/20/for-a-celiac-sufferer-a-new-mystery-illness/

Much effort and publicity has been made in the electronic reporting process of health data for medical professionals and facilities.    This affords improved access to patient data should lead to improved care.    Lesser known, was a study conducted last year on consumer views on healthIT , where focus groups from each region of the country participated in a survey.    They viewed health IT as a domain, and tool, that benefits health  professionals, and did not see themselves as a participant/partner.     Unfortunately, little has been done to educate the public on the benefits, or  tools available, in advocating for their health.   Perhaps this is why consumer creation/adoption of a Personal Health Record, PHR, is so dismal, or is it the consumer tools themselves?

This past week I  registered a health profile with 4 separate on-line tools/websites.  A couple I could not possibly complete by myself and would need my physician, and all but one had many notes I had to fill out, so that quailty of that data would vary upon the level of education, health related and otherwise, of the person doing the data entry.   While this is just my informal review, it mirrors the focus groups' perception that healthIT in was not for 'them'.    Futher,  that  the process [decisions] "had begun[made] without them", and they were "powerless" to exert " influence".    They suggested a consumer advocate/representative was needed before being 'steam rolled' by health and government officials that don't always put the consumer's interests first.    The groups' largest concern was that their privacy was at risk from unauthorized sharing of information or hackers.

The completion and results of this survey were public a year ago yet, puzzling then, that no meaningful follow-up action has occurred from it.   If the HHS is serious about consumer participation,  it needs to address these concerns, and standardize not just the reporting of information at the healthcare professional end but the consumer end as well,  to ensure the  process of  PHR creation is simple, user-friendly and fosters adoption, and they need to do it NOW.  

http://healthit.ahrq.gov/portal/server.pt/gateway/PTARGS_0_9442_909189_0_0_18/09-0081-EF.pdf

With incidence of food allergies on the rise, chances are you have, or care for/about or know someone who must manage them.   At ScanAvert we hear daily from someone who is seeking assistance in this daunting task, particularly  a fear that caregivers won't  be as dilligent about what their child consumes.    ScanAvert is a vital tool in this area but  allergy awareness  is the  key to adherance.   So here's  worthy event in my neck of the woods worth sharing:

http://www.meetup.com/WestFAST/calendar/14019666/#posted.

We all benefit when we share our experiences so come join, visit and learn.   This event is being held  July 27,  in Tarrytown, NY but there are other chapters throughout the country-find yours.

Like many football fans, I viewed the death of  Chris Henry at 26  as a tragic but almost a predictable end, given the details of his life as they emerged last December.   Today it was reported that his autopsy results revealed that he suffered from chronic traumatic encephalopathy.   This has raised concerns since CTE,  often associated with boxers or much older players, is usually the result of head trauma occuring over a period of  time.   It is also possible that Henry had suffered violent confrontations from early in his life and not just what was noted on the field, but that was not what I found noteworthy about this article.

Instead, I focused on the following statement: "Its effects are mainly neurobehavioral.  These symptoms include poor decision-making, behavioral problems, failure at personal and business relationships, use of drugs and alcohol, depression and suicide."

The gray area of what is a symptom and what is behavior is a slippery slope.  If I have a cold my symptom is a sneeze, or runny nose.   Over dosing on Benadryl however, is NOT a symptom, it is an act.  Likewise, "use of drugs and alcohol" are NOT symptoms but also an act, and as they are often illegal, a crime as well.   By including them as symptoms, it infers that such actions are beyond our control and provides a crutch for anyone with a habit.   It is one thing to hear Gamblers, morbidly Obese, Alcoholics cite such reason for their state of poor health, or  their drunk driving accidents, but when the medical community engages in such banter, alleviating us from the responsibility from our actions, it is cause for concern.    Americans, more than any other population on this earth, exercise  free will.  Let's not pretend we don't when the outcome is tragic, or doesn't make for good copy.

http://www.cnn.com/2010/HEALTH/07/02/brain.damage.henry/index.html?hpt=T2

According to an  article in today's NY Times, NYC is 'healthier' than the nation.  That may not seem shocking to people that associate NYC with Manhattan, but  NYC also includes all the outer lying boroughs.  That's quite an accomplishment when just north of 125th street is the largest population, per density, of obesity and diabetes.    So, while I fully note the stamina it requires to mount the subway stairs, speed-walk across major intersections, there must be other explanations than those cited by the author, 'less gun ownership' and 'less car accidents' from residents that rely on mass transit.  The first thing that comes to my mind is that proximity to hospitals means lower mortality statistics in cities, as opposed to the distance to rural health facitilites, so it is likely that several cities are 'healthier' than the national average.

NYC is a melting pot, with more products sold for increasing immigrant populations.  Often that means more fresh produce and, in a stagnant economy, beans and rice become a staple in every home, even those that can trace their ancestors back to the Mayflower.   In my suburb, I can count on one hand the grocers that stock plantains, but near my office, they can be found at every bodega, or street cart vendor, all evidence of healthy dietary offerings.  Before we celebrate, however, we should not disregard the impact of age.

For the elderly in a rent controlled apartment, failed health likely means a move to the retirement facility, often out of the city or state.   Her landlord, unencumbered by Rent Control, will charge whatever the market will bear for her prime Gramercy park apartment, to someone younger [read: healthier]  as it  will not be affordable for many on a fixed income.  In addition, shrinking corporate tax revenue has increased the taxes levied on residents,  making it unaffordable  for retirees.

The critical factor in the depression in the housing market, is that it has an inverse affect on the rental market, which comprises most of NYC residences.    Contrary to prices in home sales,  the rental market climbs as home seekers no longer qualify for mortgages with higher down payment and asset requirements.     It is the younger median age of NYC dwellers that likely accounts for the 'health' statistic reported.   From my perspective, seemingly "better health" at the expense of unaffordable housing, for young and old,  is not something to cheer about.