Ethical Exercise

Oh, Covid 19 has created opportunities for ethics discussions... read on..

#MSselfie Q: As I have MS and get severe #COVID19 will I be managed in a critical care unit? Who will decide? What factors will be taken into account? #MSCOVID19 https://t.co/Ho4rPUkFjo pic.twitter.com/UFYbX3eoxd

— Gavin Giovannoni (@GavinGiovannoni) March 30, 2020

Conflict of Interest?

Will @NIHDirector ask @radiology_rsna to retract their highly corrupt #Gadolinium Research Roadmap? Should authors paid by MRI contrast makers be setting the standards to prove/disprove if gadolinium is causing harm?

1/2 BILLION MRIs w contrast to datehttps://t.co/us1B6tdxWC https://t.co/KfkhwT7MKg pic.twitter.com/iQ2hgsCQjE

— Mollie B (@HrsQuiet) January 26, 2020

Healthcare... Reform?

My thoughts follow as I read this blog by a favorite neurologist...

The cost of treating MS https://t.co/6YbCCGvy1L

— Mary Gerdt (@marygerdt) November 26, 2019

My comments:
“I woke up wondering how I could get my next 90 day allotment of Glatopa shots 💉  before the end of the year because I’ve met my $750 deductible for 2019. Glatopa is he generic of Copaxone, both of which seem old school, so yesterday. But at 61 on Medicare and a Supplement, Why should I expect More?
There’s something cruel about making me pay $750 USD in January right after Christmas 🎄
Then I thought about young Serbians, without even Access to DMT’s and I felt Rich, Elite, Privileged. Am I really worth it?
Now,
Maybe we can leave President Trump out of this.
He didn’t devise the ill fated Obama-Care, which put high premiums, deductibles and penalties for not participating.
He didn’t tout “Medicare for all “ like the Democratic Party Candidates.
He didn’t give the Legislature better healthcare insurance than their constituents.
The Legislature did that.
He didn’t propose employers stop using healthcare as a benefit of employment.
In fact, that is why some people work.
I realize I’m rambling in the wee hours but the Healthcare Morass is easy to get stuck in.
A system so complicated and so emotionally charged,
A system we rely on to give us Health and Life.
A system of Incrementalism.
A battle of Legislative Priorities.
Lobbyists from Pharma and Healthcare systems compete to buy the lawmakers drinks 🍷
I sit here typing letters to my legislators and get a generic “Thanks for sharing “ email back.
You may not want to hear my theories about Gadolinium, a rare earth toxic metal used for better MRI pictures.
In fact, no one wants to talk about it.
Isn’t that part of the problem when the USA FDA , Food and Drug Administration can get thousands of patient reports of ill effects of Gadolinium while big Corporations like Bayer, GE, Make bazillions pushing this toxic metal?
The source Of Gadolinium is China, where God only knows how it is mined and refined.
Nobody is listening  as I sing like a canary, “Gad is Bad”.
Meanwhile consider your municipal drinking water supply probably contains Gadolinium,
Source? The  urinary tracts of  MRI Patients.
The Theme of this Healthcare Quagmire is Money and Profits
Disregarding Humans and True Science.
Stay tuned.
Healthcare “reform” is coming.
It’s a bitter pill.”

Healthcare for All?

While UK Citizens struggle with the unintended consequences of a Socialist approach to Medicine,
USA Citizens fight each other, one proclaims “Healthcare For All” “Government Run Healthcare” “Medicare for All”
The Status Quo in USA is Public and Private Insurance.
Some Government controlled:
Medicare benefits of aged and disabled workers,
Medicaid: State run benefits for poor and children with special health needs
Private: Commercial Insurance and HMO plans, Employer sponsored Or Self insured individuals
Private Pay: no insurance. Several reasons: can’t afford, Preexisting conditions make premiums unaffordable,
May be Irresponsible, lazy, sick, depressed, didn’t think they’d get sick
Last the Non Profit Hospitals under Hill Burton Act must provide some free care in order to maintain their Non Profit status.
Some people in USA say we should just let The Government run this.
I feel like our system is working as well as it can at the moment.
Incremental changes to insure a safety net.
Mandate free care provision in non profit healthcare systems.
Just don’t let the Government take care of you.
We can’t afford that.
About a Questionnaire study of the Diagnosis-Treatment-Outcomes comparison,
Might want to do a worldwide study.
Don’t forget Serbia where patients get the Least.

Here’s the article that started my thoughts ruminating...

Time is Brain https://t.co/cDHDuJ6od9

— Mary Gerdt (@marygerdt) November 25, 2019

Letters I've sent #healthcare

Hello Senator Leahy,
I write to you about health care and all the urgent reform some think are needed.I am an RN Case Manager with almost 30 years experience working in Vermont between hospital, subacute, nursing home, insurance/HMO, long term care and home based care. That is in spite of low wages initially and tough conditions.I was laid off in 1996 because I was under 40 and the legislature protected the elder workers.
I have recently lost over 40 thousand dollars in my retirement/savings, was denied disability insurance 3 days after my MS diagnosis and lost a bundle-over 200 thousand on legal expenses and payout after a 5 year bloody family land court fight.
But I never wrote you before that I recall.Maybe I was just stunned by circumstances.But I write you now, not angrily, but passionately, that you must not pass legislation that promises to fix the health care system in a thousand pages.
My healthcare is pretty good now so please stop saying how broken it is. I agree with Medicaid waivers because I work for Vermont's Choices for Care. And yet I disagree with the generous financial loopholes where large assets are hidden and passed to others while I visit other starving or homeless Vermonters and pay very high taxes.Managed care is not something to be undertaken lightly. I worked for Kaiser and believed in our concepts but still it soured my stomach to turn down a circumcision because the child wasn't the right age.I have cared for Canadians who had to wait or spend their dollars in the US to get our level of care.And please support tort reform. Not only for health care. But also in cases like ours, where we lost so much.Finally, I must remain in my present health care support system. Do not change one thing. Add a catastrophic+preventive system for the poor. Vermont has an ideal system. I fear we will not be able to afford it much longer.Aren't you better off really studying what is working, who is happy, and who needs what? Then make incremental changes. Do not doubt we have the best health care system in the world. This means more to me than money or time. That is why I write today, not out of anger. My anger is gone since diagnosed with MS. I do not have the time for anger. Mary Gerdt RN 

---

Our 4th generation farm was threatened by a near tax lien sale. I am a woman landowner and was not notified. I have no recourse but to sue the town of Monkton. You helped save our bats/neighbors on Raven Ridge. How about reforming tax lien sales. We cannot afford to sue the town. Legal aid laughed at me because I have a savings account. I need the savings as my disability insurance because I have MS and was denied disability insurance.The town fathers think they only had to tell my husband, whose father just died. The town fathers used our old attorney against us who denied a conflict of interest. We were only 9 months late paying property taxes.Can you help or will you ignore? My blog: http://traveloguefortheuniverse.blogspot.com

Letter to radio station wdev  Nurses not represented on GMC Board Regarding health care reform, as a Registered Nurse in the State of Vermont for 30 years this year, I am disappointed none of "The 5" represent the viewpoint of a number of caregivers: nurses, support care workers, direct support people, ICU&ER nurses, nurses all over.  This is critical. Restructuring the financial charts first is not a good approach. The beginning assumptions that the system is irreparably flawed is, itself, a flawed assumption. First, to me the strengths of the current system must be identified, then identify the weaknesses. Then work incrementally, not immediately. Then assess the incremental changes.I hope my opinions are considered by those who read this. You may need a nurse to save your life. Nurses need their valuable opinions heard and considered. I believe the best way is with widespread surveys of every Vermonter and every direct care worker. What works? What does not? Why? How to make it better. Thanks for posting info about the 5. - Mary E. Gerdt

Link to Article: Healthcare Trends to Watch

Link to Article: Healthcare Trends to Watch

Travelogue for the Universe: Silence is not a sign 2011

#2


Travelogue for the Universe: Silence is not a sign: Silence is not a sign of agreement instead, it can be a sign of shock dismay depression giving up a time to huddle up regroup rec...

Travelogue for the Universe: "When you go for end of life Counseling,

With Obamacare in flux,
An administrative tug of war,
War of tugs,
The Healthcare Morass.
Swirling whirling Dervishes,
Tumbleweeds of Confusion,
Blame Insurance
And patients
Sick, old, young,
Genetically unlucky,
Pain of living easier
Than the paperwork from Hell.
So yesterday,
In a fit of clarity,
I posted old articles I had done
Starting
Circa 2009
To present.
Will put up one at a time.
Hope you enjoy .
Meg




Travelogue for the Universe: "When you go for end of life Counseling,: Leave your walker or assistive device in the car," I heard on the Radio the other morning. So continues the debate. Here is my viewp...

Alternative Therapies...

The Pain,

Contemplated,

Begs for an alternative,

To #Pharma

Hey, Pharma isn't all bad,

It has got me out of a lot of jams and presently keeps

me moving forward.

Pharma Plus Dedicated Doctors

Create winning medications, combinations,

Always trying to minimize side effects, I hope.

If you think it's easy or profitable for Doctors to write prescriptions, then you don't know 90% of Doctors.

It's just more paperwork.

Patients often seek out a solution to their ailment (or they wouldn't pay the copay to visit).

Don't figure all pharma is responsible for all the bad in healthcare.

At the same time, do accept there may be alternative therapies, ointments, poultices, tinctures, elixirs, topicals, ingested, teas, and on and on.

As the Vermont legislative year began, the politicians were hot and cold on the alternative ancient healing herb, Cannabis.

Sounds like the cold ones have never been on

 "The Rack" of MS Pain.

Sounds like they aren't going to ask me what I think.

So, here goes a little statement into the blogosphere (it was also sent to the ms society-no response...I asked my bc case manager and she said medical director doesn't believe in it...there are at least 50 different sets of laws and standards, diagnoses eligible, licenses, blah, blah) :

I don't understand your position on Cannabis. There is plenty of research.

 Please help medical users gain legalization in all states. Decision between Doctor and patient. Often as a last resort. The pain is excruciating, spasms debilitating, depression heavy. Please help. Natural products, effective, as old as civilization itself.

Healthcare Reform....Fact or fiction?

Raise your hand,

If you recognize this as a US doctor's examination room.

FYI,

None of the items in this photo

Will make you healthy.

How you feel about this room

Is directly related to

Your past experiences

With such a room.

Some of your most serious lifetime conversations happen here.

Only with the addition of people,

Will this room potentially take on powers,

Healing, diagnostics, therapeutic encounters,

Hard conversations,

Avoidance, denial, anger, acceptance,

Planning,

Education,

All can happen here.

Or not.

The concept of healthcare reform

Is inconceivable.

The variables,

The formulae,

Protocols,

Costs, belief systems, cultures,

Too much to analyze,

Make sense of,

Predict outcomes.

(Seems most of what I saw was billing codes...not reform!)

I believe the system of healthcare in the U.S.

Cannot be reformed by taking pictures of doctor's offices,

With the caption,

Healthcare Reform.

Like this photo,

Meaningless without the people,

The patient, their people,

The doctor, nurse, the healthcare providers.

Healthcare reform

Should not be penned by politicians,

Healthcare lobbyists,

Or CPA's.

(Sorry, missed a few words first go around)

The people who should have the biggest input...

The people who would be in this room:

Patient, family, and doctors, nurses.

Cavuto: Mr. President, we at Fox News are not the problem

***Warning to liberal readers and friends,
I <3 nbsp="" p="" you...="">> I respect your right to your opinion.
Please respect mine.

Neil and I share a very expensive disease, MS, which although that is not the focus of this video,
our individual pathways led our passions about healthcare. Our passions have roots in a disease that causes unpredictable, scary symptoms, and costs lots of money for treatment, diagnosis and the rest.
Facing a chronic debilitating disease,
people realize they have one thing that is more important than anything else,
Health.
Then those same people get angry, confused and frustrated, despondent, concerned, shut down even.
Why apply with no money? No immediate need?
Overwhelmed?
Yeah, it is overwhleming.
Inflation, fuel, taxes, meds, now messing with our healthcare.
I warned in earlier posts in section Health Care Morass regarding the cost of mandates, the people who do not have to submit to the mandated insurance.
Thanks Neil for speaking up when so many of us cannot speak this outloud.
 

Health Care reform of the Third Kind

This is filed under my Health care file: Health Care Morass.
That is not to say it is bad. This is actually a Sensible Good article!!
My thanks to openplacement.com for sending this......
It really is in the spirit of helping solve all these
issues we have without more money, rules, codes or lingo...
Hey, what if we just tell the Patient...
(who can be you or I even if I work in health care
 Will remind you I am a victim, we all are when we are a Patient on the other side...

Check it out...........
 

Patients, the Forgotten Health Care Team Members | #OpenCommunity Blog: openplacement.com/community/blog… via @openplacement
— Mary Gerdt (@marygerdt) June 10, 2013

Ideal Medical Care

http://www.idealmedicalcare.org/

Dr. Pam Wible has crafted a wonderful collection of info
and ideas about creating the ideal medical system.

This one starts with a great deal of thought, community involvement
and respect for individual, choice and buy in to the plan.

Definitely check out her you tube spots and you may start
to think about, what is your Ideal Medical Care?
and how do we get there?

Silence is not a sign

Silence
is not a sign of agreement

instead, it can be a sign of

shock
dismay
depression
giving up
a time to huddle up
regroup
reconnoiter

See posting on Sprachlos,
Speechless,
don't know what to say,
too much snow, winter, fatigue from impending and past taxes,
how will we keep our precious farm
our jobs
our health,
our sanity.

But if I am silent about health care single payer
It is not because I think it is a wonderful panacea as sold.

It is because as with other miraculous easy fixes,
Single payer will prove another weight around our necks.
It looks like a done deal anyway.

Is that an affirmation?

See my posts on health care morass.

I wrote my legislators like Peter Welch about my opinions about health care,
single payer, government control over health care.
He sent me a cute myths page.

Like I do not know one thing about health care, or illness, or what it is like to be a middle class white american working woman
with ms
While I work to help people access long term care services
for the past 30 years.

As if he can say he knows more than I do.
Guess I will be silent for now.
Can you hear that?

Healthcare What? passes

ok, so the good guys to half the populace of the u.s. won.
drink your champagne.
when you get gout, don't head out to the e.r.
things are still no better today.

so the good guys won and are the only smart ones
will they pull the plug on the dumb ones
can anybody tell me how the hell
they are going to fix the system
with a few thousand pages of bureaucracy
when that's what got us into this mess
to begin with.

when you remember the wins,
shun the losers
be proud.

the price tag appears
you wait in line
and you will ask out loud,

"How do I get to the beginning of the line"
The bureaucrat says, " there".
You say, "its too long."
"Reform", he will declare.

Do Crows have ESP?

Do Crows have ESP?


The sense that something will

Or might

Happen?



Do cats have ESP?

Do they know what I will do,

Before I do it,

Or sense something I cannot sense

on the human plane? Or can I, but I forgot or don't know how?



Does ego negate the senses we were given?

Is that the snake in the garden?

Do even tiny black flies sense my intention and

Land on my head the minute both my hands are busy?



Is ESP truly a special skill or one we just forgot because

We don't need to guess about the weather,

The weatherman says,

We don't need to know which herb to take that won't kill us,

The doctor says,

We don't need to worry our pretty heads about the healthcare morass,

The politicians say.



What is my sense about this?

My ESP is not all that reliable

By history,

a fact I cannot deny, in spite of my sometimes wish

We could predict the future,
When I really stop to think hard about things that I might have known in advance,
I have to conclude
Without too long a pondering
What a disappointment that might have been to know the future
Before it happens.
 
But...
Do Crows have ESP?
 

A letter to Congress

I wrote this letter tonight to congressional delegates from Vermont.
I anticipate flak from some direction but I have ripened to an age where I could give a damn.

"Please vote no on this bill. I favor an approach that involves all clients and health care workers, not lawyers and actuaries. Do not force me to pay in a new direction. I have MS and am happy with my current system. Don't mess up a good thing. Focus on what's broke and stop playing with my healthcare with making deals for votes.Stop pretending you can save medicare dollars. People do and always will get sick and that costs money. Don't be labelled as the congress who spent all my grandchildren's money."


don't hate me because I am a nurse with 30 years experience from bedside nursing to the inner financial ugliness of the sick body business. let's not delude ourselves into thinking politicians have the ability to reform a system as complex as the nebulae the Hubble spies on. greetings from NW Monkton.
Mary Gerdt, health care consumer, coordinator and advocate of more common sense and less politics

Socialized Medicines

Socialized Medicines...
I guess that is what the Eye doctor was referring to...
My eye doctor who couldn't diagnose my ms but could treat the optic neuritis thus maximally preserving my eyesight. He was informative as ever telling me
all about the latest while he was teaching a med student.
He said that in England, avonex is not covered for ms. Now I am stunned. They do cover "statins"...hey that's cholestrol lowering meds, right?
He keeps talking away and I can't get over avonex not being covered by an entire Government...?
That they think if you have more exacerabations and faster disease progression that that somehow saves money?
Oh the questions that raises.
Also the ignorance of bureaucratic controlling arms that presume to know the cause...do they think it is high cholestrol??
Maybe they figure since it is a shot they can call it icky or awful or inconvenient or too expensive.
Not that studies show it is effective to prevent disease progression.
11/27/09***after posting this, Lisa Emrich, brassandivory.blogspot.com is MS and RA info specialist corrected as you will see in the comments. Look to the groups she lists as advocates for sensible treatment in England. Thanks Lisa!!

My vision is 99 percent better after having had a run of iv steroids 4 years ago. I wondered if I lived in England, would my vision still have that blurry blotch?

Would I be taking a statin and when would I begin to fall?

Have a great black friday.
re gifting is recycling with a rebate of the money you didn't spend.
mary

MS and the Moons

MS and the Moons

I look at the Hubble/astronomy link every day (below). I really liked seeing the Martian moon (above), imagining the streaks were roads but my realistic side saw they really looked liked long scorch marks.

The big crater in a crater. Insult to injury.

So many little nicks, direct hits by rocks and rubble, some even disturbing its orbit, setting it off course.

One of those asteroids or other space rubble may even have knocked the theoretical atmosphere off this cute little moon.

Or was it always a cold looking irregular shaped rock?





What does MS have to do with Martian moons?



When I saw my MRI for the first time, I almost passed out. My neck lesion lit up light a Christmas tree bulb, leading to what had been more than a decade long search for the truth.

But my brain really scared me. Like swiss cheese, I saw. Disbelief looked at the Doctor who was numb to seeing this. These lesions had been there all the time but never explained. I had always heard my tests were normal.



I thought about that as I saw the moon with all its scars.

The moon reminds me of the vision of those pockmarks on my brain that don’t seem to affect anything but does the damage still remain?



Have I lost my atmosphere that can burn down the rocks coming at me?

Do I ever feel out there?

Oh Mary, come back to Earth.



p.s. they found water on our moon. Watch the moon real estate futures market now…

The Answer

The Answer.

Did I get your attention?
Are you looking for the next line?
Is the media fooling the part of your brain that is dying to cut to "the end", "fine", all done, mission accomplished?
Do you keep spinning around on this planet feeling still and wondering why nothing and everything seems to be changing?
Do you wake up in a panic sometimes feeling you have no idea where you or anyone or anything is going?
Do I mourn the whole system where 2 people this week told me they can't afford their cardiac medication? And I know the system these politician prostitutes is creating would not even be useful as cat litter. They are politicians. They did not ask me, the health care provider and consumer what people need. People need people, not a new system.
Don't throw politics in with caring for humans.
But what is the answer?
I don't know, only questions.

Mary