Health Maintenance

Mamas On Bedrest: Got a Medical Question? Tap into HealthTap for Answers

June 3rd, 2013

Mamas,

When you have medical questions, where do you go for answers? Do you ask your OB? Do you ask a friend? Relatives? How do you handle those pressing medical questions that plague you late at night?

Nagging questions can be burdensome, and often times a simple answer can put your mind to rest. But who do you call when it’s 2 am and your mind is running amok with all sorts of scenarios and “what ifs”?  Which websites should you view? How should you search? And how reputable is the information that you find?

HealthTap LogoMamas, I’d like to introduce you to HealthTap. HealthTap is a health information website with over 40,000 physicians in 3000 cities in all 50 states and 128 specialties. You can post a question and several physicians will  answer, or, you can search the archives for answers to similar questions.  According to Forbes and The New York Times, this immediate access to health information is the wave of the future.

I had the opportunity to hear the founder and CEO, Ron Gutman, speak at Austin’s South by Southwest a couple of years ago when HealthTap was in its development phase. It’s really an interesting concept. For patients, there is an incredible amount of information available right at your fingertips, anytime, day or night. For physicians, there is  a wide reaching platform from which to share expertise nationwide and with consumers otherwise out of reach. HealthTap has the potential to catapult a physician onto the worldwide stage; a physician shares his/her expertise, a syndication or publication sees them and boom-overnight fame, success, the potential to be the next “Dr. Oz. It truly is the interactive wave of the future.

However, there are limitations. While you can ask “personal” questions, most of the physicians cannot offer specific medical advice as they are unable to see you and learn the specific nuances of your situation. So much of the information you’ll receive is general in nature. But at 2 am to be able to calm feelings of anxiety, its a good thing! Also, the information provided is strictly medical in nature. I don’t believe that you are going to get a lot of holistic advice. These are board certified physicians and as is customary, the psycho-social aspects of medicine are left to the consumer.

HealthTap-Smartphone-Member-AppOn May 30, 2013, HealthTap rolled out its app, AppRx. AppRx is an app that recommends the most helpful health apps-per the physicians in the network. While this is a useful service if you are looking for very specific medical information, i.e. what are the best websites/apps for tracking blood sugars, it may not be the best place to look for information on best places to give birth. I don’t know that you are going to get a lot of pro home birth information or information on how to choose a doula. So the app and the website have their limitations. The app is available for both smartphones and tablets.

Like all new technology, there are good things and not so good things. I think that HealthTap is a useful website for people to use to learn more about their health and medical conditions. AppRx is a good tool to use to start a search for medical information. However, I also believe that there is more to health and healing than medical procedures and interventions, and while you will get great medical information, you won’t likely get the information you’ll actually need to really “live” with your condition day by day. I think that consumers should investigate HealthTap and the AppRx and use them as the information tools they are intended to be. Additionally, I think consumers need to be savvy and examine all aspects of their health care conditions and integrate necessary health and wellness practices along with medical treatment for a comprehensive approach to their situation.

On this week’s Wednesday Video, I’ll download and go through the AppRx.

 

Mamas on Bedrest: Did any of you undergo “preconception” counseling before becoming pregnant?

March 18th, 2013

Good Morning Mamas!!

Question: Did any of you undergo “preconception” counseling before becoming pregnant? 

I ask this question because a couple of days ago, I was trolling twitter and inserted myself into the #acogchat. The topic of discussion was preconception evaluations. When I entered the discussion, I’m thinking a good 20-30 minutes into the chat, the group was discussing how more women need to be aware of their health histories and essentially should have all their “medical ducks in a row” prior to becoming pregnant to avoid complications. Well you all know me. The statements were making my neck hairs stand on end because they seemed to be saying that when pregnancy complications arise, it’s because of something mamas haven’t addressed prior to getting pregnant, a sort of negligence. In my experience with Mamas on Bedrest that simply isn’t true. For many mamas, there is no rhyme or reason that they have the complications they have. And on that note, I jumped into the conversation.

Let me begin by saying that the moderators and participants of the chat were very gracious and receptive to me and my views. I didn’t exactly “tip toe” my way into the chat, I went in full throttle in defense of mamas! But as the chat progressed, we all reached a really good consensus about preconception health care and health care in general. With a candid discussion about the limitations of our current health care climate as well as cultural and societal opinions, we all left the chat with the following “agreement” regarding preconception evaluations/examinations/counseling:

A Preconception Exam/Evaluation is really preventive maintenance. As the chat progressed, we all realized that if health care providers ask, AT EACH AND EVERY VISIT, about a person’s medical history; if any new complications have arisen, if the patient has any new concerns, is there any change in family history…Then we are doing preconception counseling-the way that it should be done. A woman’s health (or anyone’s health) should always be optimized at any doctor/patient interaction. When we providers don’t ask these questions and update a patient’s record each and ever visit, we drop the ball not the patient.

Preconception Exams/Evaluations must be done for men as well as women! Conception takes 2 PEOPLE!! We focus so much on women (as the carriers) but we cannot forget the fact that the sperm quality will also affect whether or not conception takes place and has just as significant an impact on the health of the baby as the quality of the egg and mama’s health. Just as it’s important for mamas not to smoke or drink if they are trying to get pregnant, fathers who smoke, drink or have other health issues won’t impart healthy genes to their offspring and may also be impeding the conception process.

Preconception Exams/Evaluations must begin in pediatrics. This is one area in which there was some controversy. We all know that teen pregnancy is an issue in the United States. Yet, there is no consensus on when/how to teach sex education in schools. What we as a group came up with is that if we teach children to always take exemplary care of their bodies; stressing the importance of not smoking, not drinking alcohol in excess, avoiding recreational drugs, maintaining a healthy weight for height, getting regular exercise, avoiding risky sexual behavior, etc…We are teaching not only good health habits, but imparting good preconception habits.  By focusing on good health, we can reduce the stress many parents feel regarding “sex education” and not step on toes. For example, talking to a teenager about how condoms work and how they prevent the spread of disease is a different conversation than, “You should use condoms at every sexual encounter. ” We impart the medical information and allow parents to speak to the moral implications as they see fit. (And while we know that many parents won’t speak with their children about sex, it is still the parents’ right to impart their moral code on children, not ours-no matter how much we feel it is needed. We can suggest to parents that they discuss certain issues with their children, but in the end, as it was brought up by a parent on the chat, it’s the parent’s obligation, responsibility and right to educate their children (or not) about sex.)

Do discuss medical costs. I brought this to the attention of the group that many insurance companies don’t cover maternity care and require a separate rider on policies. So many woman have been caught by this. Who wouldn’t? It’s natural to assume that if you have insurance, it will cover you if you become pregnant. This just isn’t the case! So as clinicians, we must ask our patients at each and every visit if their insurance has changed, and to give them a simple “heads up” that many treatments and procedures aren’t covered and they should review their insurance policies annually (and most especially if they are planning to become pregnant).

Make Sure Pre-Existing Conditions are Well Controlled Prior to Conception. Again, this was a topic that got us wound up for a minute. But as we discussed it, we all realized, that if health care providers are truly monitoring their patients’ medical conditions, say diabetes, then the goal should always be tight control. At each office visit the importance of blood sugar control should be discussed and emphasized-whether the patient is trying to become pregnant or not. So again, it’s not a question of preparing the patient for pregnancy, it’s about making sure the patient is in optimum health always.

 

I really am glad that I “crashed the chat”. I had the opportunity to speak on behalf of Mamas on Bedrest and to contribute to a really great discussion on patient care. The one area we were not able to address is the notion that all of this can be done in 8-12 minutes. But I am confident that given the passion and dedication to this group of health care professionals, even that “obstacle” will soon be eliminated.

Mamas on Bedrest: The Votes are in-The Affordable Care Act Stands!

November 9th, 2012

With the Re-election of President Barack Obama, The Affordable Care Act (aka Obamacare) is pretty much solidified as part of American Culture. Here, Bedrest Coach Darline Turner reviews just what the Affordable Care Act provides for women, Mamas on Bedrest in particular.