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Life Extension Magazine September 2012
As We See It

A Deadly Waiting Game

By William Faloon

Reaction Of The Mother's Physician Son

A Deadly Waiting Game

One irony of this tragedy is that this woman's son is an academic surgeon and founder of a training program dedicated to improving the availability and quality of emergency surgical care. Since he practiced in a different city, he was unable to persuade the staff of his mother's hospital to expedite her care. As her son noted, "Many Americans cling to the notion that the shortcomings that afflict our health care system affect only the poor. They are mistaken."1

The hospital cardiologist who postponed this woman's care never returned to face her family. One of the only doctors who acknowledged this needless loss was an intensive care unit intern, who offered his condolences in the hallway the following day.

An Exposé Of A Broken System

This woman's physician son was determined to not let this tragedy be covered up.

His article published by the New England Journal of Medicine revealed that these kinds of needless deaths happen every day in US hospitals. He noted that the factors contributing to emergency room over-crowding and its consequences have been documented by the Institute of Medicine, the Government Accountability Office, the Robert Wood Johnson Foundation, and the Center for Studying Health System Change.10-12

Her son went on to state that "boarding" admitted patients in emergency exam rooms and corridors for extended periods has become commonplace and is being accepted as the norm. Her son noted that a crowded emergency department is a threat to individual patients and to public health. One reason this occurs is that financial profits trump patient safety. The General Accounting Office has stated that hospital administrators tolerate emergency room boarding rather than postpone or cancel profitable elective admissions.12

Her son elaborated further in stating that crowded emergency rooms are only part of the problem: "Inefficient hospital operations are another." While disease and injury occur around the clock, many hospitals operate the majority of critical services five days a week. Many specialists are opting out of on-call duties and not making themselves available after-hours.13 Her son revealed studies showing increases in in-hospital mortality from serious conditions that occur because of gaps in after-hours and weekend coverage at hospitals.14

An Exposé Of A Broken System

As far as solutions, her son stated that in other countries, hospitals first take care of emergency room patients and inpatients with serious problems, and only then allow elective procedures if beds are available. Her son stated that a solution to emergency room boarding (which is what his mother suffered through her first night) would be to provide financial reimbursement that reprioritizes health care resources for patients with urgent conditions. Her son also expressed concern that health care law changes may make tragedies like his mother's more common, as millions more Americans use overwhelmed emergency rooms for primary care.

The name of the editorial written by this woman's physician son is "The Waits That Matter." The following quote by this physician says a lot about the inadequacies of today's sick-care system: "Those of us who have dedicated our careers to health care must confront the fact that our inability (or, more likely, unwillingness) to reduce the waits and delays that bedevil emergency care is harming and even killing our patients." 1 We at Life Extension® commend the physician son of this unfortunate woman who spoke out against conventional medicine's deadly waiting game.

With hospital care costing thousands of dollars a day it is absurd that any patient would be mistreated this way. Medicare's hospital trust fund is facing insolvency as inefficient hospital policies drive up costs, while patient care deteriorates.

Medicare and Medicaid will pay for nearly any hospital procedure regardless of value, but then attempt to restrain costs through price controls. This and other forms of bureaucratic mismanagement result in horrific delays and needless patient suffering and death. Reminiscent of the old Soviet Union, senseless regulations are bankrupting this nation's medical system while quality devolves despite high costs.

Staying OUT of Hospital Emergency Rooms

Staying OUT of Hospital Emergency Rooms

There's a lot we can do to reduce our odds of being victimized in an emergency room hospital setting.

Other than accidents, two major reasons people are rushed to emergency rooms are heart disorders and stroke. Yet these conditions are the most preventable diseases in America.

The problem is the majority of Americans wait until symptoms manifest before seeking proper medical care. That means they face long delays in an emergency room setting and less-than-optimal treatment when their underlying condition acutely manifests.

The first step everyone must take is to ensure they maintain ideal 24-hour blood pressure control. Refer to the box below to learn where your blood pressure needs to be to optimally reduce disease risk.

Newer Anti-Coagulant Drugs Available

Selecting the proper anticoagulant therapy in cases of atrial fibrillation is a delicate matter dependent on a multitude of individual factors. Traditionally, drugs like warfarin or Coumadin® are used to manage clot risk. However, there are new oral anticoagulant treatments available as alternatives to warfarin, with safety and efficacy benefits versus warfarin.

For example, in a major hard endpoint study of Pradaxa® (dabigatran) versus warfarin (the RE-LY trial), Pradaxa® was superior for anti-coagulant efficacy at 150 mg two times a day with similar major bleeding risk as warfarin treatment (when patients maintained their INR 2.0 to 3.0),15

The INR (international normalization ratio) is a test that evaluates the clotting tendency of blood. A normal INR reading is 0.8-1.2, but in patients predisposed to abnormal vascular blood clotting (such as those with mechanical heart valves or atrial fibrillation), physicians seek to boost INR to 2.0-3.0, which reduces clotting propensity. Increasing INR to this higher level (2.0-3.0) also increases bleeding risk. When Pradaxa® was used at a lower dose of 110 mg two times daily, it showed similar efficacy to warfarin, but with reduced major bleeding risk.

Advantages of Pradaxa® (dabigatran) vs. warfarin:16

  1. Rapid onset of action;
  2. Consistent, predictable anticoagulant effect;
  3. Reduced potential for drug-food (i.e. foods that contain vitamin K) interactions;
  4. No requirement for anticoagulant blood testing;
  5. Results from a major trial (RE-LY study) showed better protection against stroke, with similar risk for bleeding.

Disadvantages of Pradaxa® (dabigatran) vs. warfarin:

  1. No antidote for severe bleeding (in contrast, overdose with warfarin can be reversed with administration of vitamin K1);
  2. Increased risk of stomach upset;
  3. Need for dose adjustment in patients with kidney disease;
  4. Preliminary, pooled safety data from several trials (published in 2012) suggests a possible increase in heart attack risk.25

Critical Importance of Annual Blood Tests

The probability of you winding up in an emergency room has a lot to do with what's circulating in your blood right now. By having your blood tested before symptomatic disease strikes, corrective actions can be taken before one requires hospital care.

Problems that impede Americans from having their blood properly tested are inconvenience, long waits at doctor's offices, physician ignorance about what tests to prescribe, and high costs.

Life Extension eradicated these issues by enabling members to order comprehensive blood tests directly, go to a drawing station in their area usually with no appointment required, and obtain the critical blood tests they need at a fraction of the price charged by commercial laboratories.

The price of the comprehensive Male or Female Blood Test Panel is much lower than commercial labs, thus enabling members to affordably ascertain their disease risk status and initiate preemptive measures before acute illness strikes.

The retail price for the many individual tests included in the Male or Female Blood Test Panels can be astoundingly high, but Life Extension members obtain them for only $269.

The next page describes the many tests that are included in Life Extension's comprehensive Male or Female Blood Test Panels. When you order them, we send your requisition out immediately, but you can usually walk in for your blood draw at a time that is convenient to you.

For longer life,

William Faloon

Doctors Ignore Dangerously High Blood Pressure

High blood pressure is a silent epidemic that was the primary or contributing killer of over 347,000 Americans in 2008.17 Since increased blood pressure is a major risk factor for heart disease, stroke, congestive heart failure, and kidney disease, it acts as an accomplice in millions of additional deaths each year.18

Mainstream medicine has fallen fatally short of relieving high blood pressure. Of those taking blood pressure medications, control rates are abysmally low.19,20 A major problem is that mainstream medicine accepts blood pressure levels that are too high. This means that the majority of those diagnosed with hypertension spend most of their day with blood pressure levels dangerously elevated.

The medical establishment defines high blood pressure (hypertension) as over 139/89 mmHg. However, in 2006, researchers found that blood pressure levels ranging from 120 to 129 mmHg systolic and 80 to 84 mmHg diastolic were associated with an 81% higher risk of cardiovascular disease compared to levels of less than 120/80 mmHg. Moreover, blood pressure levels of 130-139/85-89 mmHg were associated with a frightening 133% greater risk of cardiovascular disease compared to levels below 120/80.21 Worse yet, studies suggest that conventional physicians are unlikely to treat hypertension until levels exceed 160/90 mmHg, a level that dramatically increases the risk of disease and death.22

Controlling blood pressure means radically reducing disease risk. Studies have estimated that reducing blood pressure by 10/5 mmHg, to 115/75, can reduce the risk of stroke death by 40% and the risk of death due to heart disease or other vascular causes by 30%.23 In individuals 40 to 70 years old, each 20/10 mmHg increment over 115/75 doubles the risk of heart attack, heart failure, stroke, or kidney disease.23,24 Based on this and other data, Life Extension recognizes that for many individuals, a target blood pressure of 115/75 mmHg yields the best preventative benefits.24

To review Life Extension's updated Blood Pressure Management protocol, log on to www.lef.org/hypertension