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4A Daily News – Monday, October 17, 2011 Vitality & health Medicare enrollment on earlier schedule this year (MCT) — Medicare enrollment began Saturday — earlier than past years — and will run until Dec. 7. The federal taxpayer-funded insurance program that provides medical care to those 65 and older (or dis- abled) still has four parts — A through D. The "2012 Medicare & You" handbook, produced by the U.S. Department of Health and Human Services and its Centers for Medicare and Medicaid, or CMS, was to be mailed to the homes of people in Medicare. It is online at: medicare.gov/publications/pubs/pdf/10050.pdf. Medicare part A covers inpatient care in hospitals, skilled nursing facilities, hospice, and some home health care. Part B covers doctors' services, outpatient care and other home health services. Part C, otherwise known as Medicare Advantage Plans, are offered by private insurance companies approved by Medicare. Such plans include Part A and B coverage. For a price, those plans usually offer extra coverage such as vision, hearing or dental. Most of those plans include Part D, which is the prescription drug plan. Private plans must follow Medicare rules, but they can set other policies on out-of-pocket costs or refer- rals, for example. Information on plans is on the Medicare website, www.medicare.gov/find-a-plan, or by calling 1-800- MEDICARE and 1-800-633-4227. (MCT) — Joe and Tere- sa Graedon give lots of health care advice in their syndicated column, "The People's Pharmacy," and on their National Public Radio show by the same name. He's a pharmacologist, and she's a medical anthro- pologist. The Durham, N.C., res- idents have written more than 14 books on topics from herbal remedies to deadly drug interactions. They should know how to get the best medical care. But in 1996, Joe's 92- year-old mother, Helen, died as the result of errors made at Duke Hospital. Joe Graedon thought he had been a good advocate. He stayed by his mother's bedside and repeatedly told her caregivers that she couldn't tolerate morphine and other narcotics. But in the end, he said, "You have to trust the doctor." He felt guilty about not being able to protect her. But soon that guilt turned to action. He and his wife recon- structed the steps leading to Helen Graedon's death, and that story opens their new book, "Top Screwups Doctors Make and How to Avoid Them." "A series of medical errors led to the horrific conclusion of a wonderful life," they write. "We could have sued Duke Hospital for the series of mistakes that were made ... (Instead) we began a long campaign to try to reduce medical errors and improve patient safety." The couple served on patient-safety committees at Duke and believe it is "a much safer place" today. "Serious mistakes are made at every hospital in America on a daily basis," the Graedons write. Nutrition Quiz: Doritos (MCT) — Sad news on the snack-food front: Arch West, the inventor of Dori- tos, died recently. He was 97, and news reports said his family planned to place crunched chips among his remains. Our tribute? A quiz about the (ahem) nutritional content of Dori- tos. 1. How many more calories per (50g) bag are Nacho Cheese Doritos than regular Doritos? a) 10 b) 30 c) 50 2. Which of these Dori- to options has the lowest fat content? a) Cool Ranch b) Regular c) Nacho Cheese 3. The most notorious caloric time bomb in the Dorito family is the First Degree Burn Blazin' Jalapeno bag. How many calories are there per ounce (11 chips)? a) 205 b) 287 c) 320 4. How many mil- ligrams of sodium are pumped into a bag of Jalapeno chips? a) 410 mg b) 510 mg c) 610 mg 5. Paying tribute to West, comedian Stephen Colbert wrote which of the following eulogies on Twit- ter? a) His memory will live on, like the preservatives in Doritos. b) There will be a moment of silence at the Super Bowl. c) Ashes to ashes, cheese dust to cheese dust ANSWERS: 1: c gu-(Nacho: 250 calories; re lar 200); 2: a (Cool Ranch: 7 grams; original: 11g; Nacho: 13g); 3: c; 4: b; 5: c. Northern Valley Indian Health, Inc. WE HAVE MOVED! We proudly announce the opening of our DENTAL CLINIC at a new location 2500 Main Street Red Bluff (530) 529-2567 Call for an appointment today! Proudly serving all communities. We Accept Medi-Cal, Delta Dental, and most major dental insurances. "... The death toll from health care screw-ups adds up to at least 500,000 Americans annually. That is the equivalent of more than three jumbo jets crashing every day of the year. "Because these individ- uals are dying at home, in hospitals, or in nursing homes, no one is counting the bodies ... The medical profession seems largely immune to the conse- quences of its errors." T he story of Helen Graedon's death doesn't take up many pages in the book. But it serves as an example of the mistakes that happen every day. In December 1996, she was recovering from a suc- cessful angioplasty and stent placement to open a blocked artery. When Joe Graedon left the hospital at 9 p.m., his mother was looking forward to going home the next day. Then at 2 a.m., she called in a panic. "Joe, I've been poi- soned. Come quick." When he arrived, she was thrashing wildly, her fitness How to avoid deadly medical mistakes MCT photo The People's Pharmacy hosts Joe and Terry Graedon are seen at WUNC-FM studios in Durham, North Carolina, Oct. 6.The Durham couple have a new book, "Top Screwups Doctors Make and How to Avoid Them." muscles in spasm. Nurses had tied her hands and legs to the bed. He learned that she had been given Demerol, a nar- cotic pain reliever, even though he had told the staff hours earlier that she couldn't tolerate narcotics. His warning was writ- ten in her chart, but the chart wasn't at the bedside when another resident administered Demerol, a standard protocol after angioplasty. Hours later, Helen Graedon had recovered enough that doctors thought she could go home around noon. Exhausted but relieved, Joe Graedon went home for a quick shower. Before he returned, he got another call from the hospital. His mother had fallen. She was dead when he got there. The Graedons believe Demerol interacted with another medicine she was taking to produce "sero- tonin syndrome," a condi- tion marked by uncontrol- lable muscle contractions. The death certificate said her death was caused by cardiac arrest due to low blood pressure as a conse- quence of internal bleed- ing. But it didn't say what caused the bleeding. Doctors told the Grae- dons later that patients who've had angioplasty must "lie still" to prevent bleeding at the site where the catheter entered the leg. "The worst thing that can happen ... is for the patient to move around," Joe Graedon said. The muscle spasms "almost certainly brought on the hemorrhaging," the Grae- dons concluded. T he Graedons' sub- sequent work on patient safety impressed Dr. Karen Frush, a pediatrician and chief patient safety officer for Duke University Health System. "They have done a tremendous amount to help us here," she said. Their suggestions have helped change the way Duke operates. For example, Duke had developed an online sys- tem to allow patients to pay bills and make appointments. The Grae- dons asked why patients couldn't also use it to view personal records, such as results of lab tests and X- rays. "Now that we've done that, both physicians and patients realize how good that is," Frush said. The Graedons also helped shape Duke's "rapid response teams" _ groups of health care providers called to the bedside if someone perceives a patient is "starting to go down hill," Frush said. As initially envisioned, the teams were to be called by medical staff. But the Graedons asked if patients and families could also call a "Condition H" (for Help) to get a team. Today, all three Duke hospitals use that system. "It really does take con- stant awareness and com- mitment to provide the safest possible care because systems are com- plex," Frush said. "There are risks all over the place in health care." Dr. Nortin Hadler, a University of North Caroli- na-Chapel Hill rheumatol- ogist and an oft-quoted critic of the U.S. health care system, wrote a blurb for the cover of the Grae- dons' book, but his praise is qualified. "If you're inclined toward doctor-bashing, this book will give you some fodder," he said in an inter- view. "They do know something about drug adverse events and drug- drug interactions ... (But) there's a real problem with assuming that an under- standing of the literature translates perfectly to the bedside. ... There is more nuance to informed med- ical decisions than just the pharmacology of drugs." T he Graedon's book contains more than a dozen lists to help patients and families get the best care. There are lists of com- mon mistakes made in hospitals or by doctors and pharmacists. Lists of tips to prevent medical errors, dangerous drug interactions and diagnos- tic disasters. And lists of suggestions to promote good communication and survive old age. (Above all: "Make sure your doc- tor likes old people.") If medical mistakes were a disease, the Grae- dons write, "there would be a great deal of hand wringing." There would be an organization, such as the American Cancer Society, to raise aware- ness. "Instead, the medical establishment mostly acts as if this problem were invisible. ... No other pro- fession could get away with so many screw-ups and still maintain public confidence." 10 WAYS TO PREVENT MEDICAL ERRORS 1. Expect mistakes and have an advocate with you in the hospital. 2. Check every medi- cine. Make sure the dose is right. 3. Be assertive. "Being nice can get you killed." 4. When in doubt, "say No." Demand an explana- tion. 5. Be vigilant during transitions, from one floor to another, or when shifts change. 6. Alert the nurse or "rapid response team," if something seems wrong. 7. When discharged from the hospital, get detailed instructions and contact information. Know what symptoms might signal a worsening situation or infection. 8. Hospital doctors may never speak to your primary care physician. Take your records and don't assume doctors already know what's in them. 9. Double-check every- thing. Don't assume no news is good news or that test results are always cor- rect. Get copies of lab results in a timely fashion. If something seems wrong, request a repeat. 10. Take a friend or family member to doctor's visits. Nearly every error made in the hospital can also be made in the outpa- tient setting. A second pair of eyes and ears can be very useful in getting instructions and spotting problems. James W. Tysinger, Jr. M.D. Eye Physician & Surgeon Fellow American Academy of Ophtalmology We accept Medical, Medicare & most Insurances Office Hours: Tues-Wed-Thurs 8am-4:30pm Mon & Fri 1pm-5pm For Emergencies, After Hours, Week-ends, Call 530-567-5001 345 Hickory St. Red Bluff Tel: (530) 529-4733 Fax: (530) 529-1114