Wednesday Wishes

Life with chronic illness.  You don't ever just get a tooth pulled or an implant implanted.  I saw three dentists yesterday -- oral surgeon, regular dentist, endodontist.  The oral surgeon thought perhaps I had an infection from a neighboring tooth that needed root canal, but the endodontist thinks I don't need root  canal and it's the implant.  My Crohn's expert -- the most fabulous Ellen Scherl at Weill-Cornell -- is really concerned because I take so much azathioprine, a chemotherapy drug that suppresses the immune system.  She wanted me to hop in my car and go to NY to see the top infectious disease doctor at NY Presbyterian.  By 5:30 pm, I was a dishrag, exhausted, fried, in pain.  And so I finally said: STOP.  If I'm supposed to fight off an infection, I need to get some rest and hope that my body does its job.  Today, the swelling is much better and the only really bad pain is from the incision from where the butcher oral surgeon sliced the gum open on Monday.  So I am hoping against hope that, if I can manage a couple of quieter days, maybe leaving work at a reasonable hour -- we had a board meeting last night and I left here at 9 pm -- with the antibiotics and everything, maybe this will heal itself.  And so it goes.  Because nobody with a chronic illness just gets a toothache.  It's always more complicated.

I think I'll distract myself with a little news.

Under health reform, the Department of Health and Human Services has the power to evaluate proposed health insurance rate increases of more than 10% and declare them to be unreasonable, but not to stop the increases from taking effect.  Apparently, insurers aren't at all concerned about HHS's declaration that rates are unreasonable.  However, the truth is that fewer insurers are seeking increases of more than 10%.  So they may not be afraid of the bad publicity, but they are changing their behavior -- so I say it's working! 

A new study says that states should limit the number of plans that offer insurance on the Exchanges.   This is one of the big decisions that states will have to make.  Should they allow any insurer to offer as many plans as they want, or should they study the plans for their value to consumers and limit the number of plans offered for sale?  The Utah model -- which has not been successful -- allowed any plan to be listed on their exchange; the Massachusetts model -- which has been successful -- evaluates plans and chooses the best options for consumers.  The Massachusetts experience showed the benefit of offering a carefully vetted limited number of plans.  Consumers seem to like this model better. 

HHS has awarded innovation awards that recognize the need for innovation in health care service delivery.  The truth is that we don't know what's going to work to control costs while promoting quality of care.  We need lots of these pilot programs and demonstration projects so we can test ideas and see what works.  Federal financial support is essential to that.  And that is part of health reform.

The FDA will announce today a plan to cut radiation exposure of children from imaging.  Apparently, the rate of kids getting CT scans has soared, and the machines don't include settings for kids.  The FDA proposes 4 settings for kids up to age 12. 

There's some good research on probiotics -- they may well help avoid digestive diseases.  For me, the hardest part is figuring out which probiotic(s) to take.  They're all different bacteria, so some people say you need 2 or 3 probiotics to really cover the bacterial map.  I take Align every day, and when I'm on antibiotics, I add Florastor.  I never know if it's really doing any good, but according to this new research, it may well be.  So I think I'll keep taking them.

A drug that's on the market for treating HIV has been shown to prevent it!  What a miracle that would be.  The FDA meets today to discuss whether to approve the drug for prevention.  Very exciting.

And that's it for this rainy Wednesday morning.  Have a great day!  Jennifer