Archive for the ‘health’ Category

Power Out at Shadyside Hospital Buildings?

UPMC Shadyside
Image via Wikipedia

I just called my doctors office which is located in the building next to Shadyside hospital and was told to call back later because they have no power. I asked if it was just the computers or all power is out. The nurse said all power was down. I don’t know if this has impacted the hospital or not but I hope it gets fixed soon.   What could be causing a power outage in the  Shadyside/Oakland area? (more…)

Dine in the Burgh Without Smoke In Your Face

Ten months ago, I quit smoking. It’s one of the most difficult things I’ve ever done. You wouldn’t think so, because quitting something is all about not doing something, and procrastinators like me find it extraordinarily easy to not do things.

But those Cholinergic receptors that form ligand-gated ion channels in cells’ plasma membranes are powerful little buggers. They make you do funny things, like strangle a hobo with his own pants for a puff of his savory dog-end*.

I didn’t actually do that, but I did develop a strong dislike of the smell of cigarette smoke, a dislike that began as a dislike for the smell specifically while I was eating.

And although the state legislature has passed an inherently anti-freedom, anti-smoking law, it won’t start forcing business owners to stop people from smoking for a few weeks yet, you should still know your options. If you’re like me, and you’d rather eat a meal without people smoking around you, you can do things the old fashioned way and vote with your wallet.

Despite its misleading name, SmokeFree Pennsylvania is not in the business of distributing gratis tobacco products. They’re much more concerned with giving customers the ability to find those restaurants that are capable of making the to-smoke-or-not-to-smoke decision on their own without government influence – and they’ve given you a handy guide to it. I give you a direct link to their restaurant and bar listings, but only so you don’t have to suffer through their pro-ban boostering on the front page, since it’s perfectly possible to be against a behavior and still support another person’s right to do it.

* that’s a British term for a cigarette

Friendly public service announcement

Greetings from the lovely hilltops of Oakland, where I’m spending a month at the VA hospital. Great views, pretty nice patients, excellent coordination of care, and a built-in cardio workout if you climb up from Fifth Ave every morning.

All of that aside, I’m taking a few moments out of the lunch break to give you a dire warning: try not to get sick this month. You see, it’s July, which is the month when thousands of freshly-minted doctors, equipped with MDs and not much else, are dispatched to the nation’s hospitals to begin their internship years. In one more year, that’ll be me, and I won’t know much more medicine than I do now. We can talk a pretty good game, but for the first month, we tend to be nervous, uncertain, and still not quite sure how to get things done around our hospitals.

By mid-August, we’ll have worked out the jitters, reminded ourselves that those expensive initials have to be worth *something*, and gotten back to doing our jobs well, but if your family member is hospitalized in July, you’ll do well to go along with them and make sure nothing sets off any warning bells.

More cheerful topics to follow, hopefully…

We’re Number One?

Photo courtesy of the LOC

So Pittsburgh beat Los Angeles yesterday…

…and no, not in sports.

According to the latest American Lung Association report – “State of the Air 2008” – that determines the nation’s most polluted cities, Pittsburgh has been named the “sootiest in the nation.”

Wow, what an honor.

What is this, the 1970s all over again?

The category Pittsburgh claimed top spot in measures short-term particle pollution, or ‘soot.’ However, Janice Nolan, the assistant vice president of national policy and advocacy for the ALA, said that “it’s not that Pittsburgh has gotten worse; it’s that Los Angeles has gotten better.”

Small comfort, that.

Oh, and she said that “if the trend continues, Pittsburgh will top two lists, and LA will only be leading the nation in ozone.”

I see. So if the Steel City just keeps status quo, then we can’t make fun of LA-ites any more for being smoggy people. Great. Not to mention that everyone else in the country will revert back to the post-70’s assumption that Pittsburgh was a dirty, polluted city.

Guillermo Cole, a spokesman for the Allegheny County Health Department, told the Post-Gazette that Pittsburgh didn’t deserve the ranking as the high soot readings come primarily from emissions from U.S. Steel’s Clairton Coke Works. “The fact of the matter is that the ranking only applies accurately to the Liberty-Clairton area, and Pittsburgh, the rest of the county and the surrounding counties have much better air,” Mr. Cole said. “Liberty-Clairton is a unique situation. We have a large source, the coke works, sitting in a river valley, so it’s a real challenge. There’s no other area of the U.S. like that.”

The Liberty-Clairton area does not meet federal air quality standards for soot by far, but neither does the surrounding five-county metropolitan area – though soot levels are lower. Plans are in place, however, to improve the city’s overall air quality, especially for the Coke Works.

U.S. Steel has a $1B upgrade in the works for the site which will put the Liberty-Clairton area into attainment by 2015. The rest of the region should hit attainment by 2010.

Even if the area surrounding the Coke Works was removed from the data, Pittsburgh would still rank in the Top Twenty – 16th, to be exact.

So while the news is indeed hard to swallow, remember this: in traffic and commute, Pittsburgh is the fifth BEST city; L.A. is the ninth WORST. And when it comes right down to it, Pittsburghers get more quality time at home and not lodged on the Parkway inhaling exhaust. (Well, except when the “tunnel monster” is running loose.)

Commute vs. pollution? Yeah, I think Western PA wins that round.

Blast furnaces and iron ore at the Carnegie-Illinois Steel Corporation mills, Etna, Pennsylvania (LOC), courtesy of The Library of Congress

Something To Talk About

The Post yesterday had a story that hopefully lead to some serious studying, talking and thinking about the health care system. It seems that UPMC’ s record in terms of patient outcomes for cardiac surgery is no higher than many other hospitals even though it’s services cost as much as %50 more. Hopefully, this report will spark a deeper search for the facts in what is likely a very complex set of numbers. They likely do take on a number of tougher cases than other hospitals and certainly are carrying the huge cost being a major teaching and research institution.

What is interesting to me is not so much the facts that came out, but the fact that under the current system too few people have an active interest in looking in to it. “The variations are no surprise to insurers, who provided 2005 payment data for the report, produced by the Pennsylvania Health Care Cost Containment Council. And consumers are unlikely to change hospitals based on the pricing information because health plans shoulder the bulk of the cost of their care.”

The free market system is based on the fine constant balancing of producers interested getting paid well for their services and consumers looking to get as much value and quality as they can for their money. It’s called the grim science because this is where the our often unlimited desires ; in this case the most basic desire to live and the limits of reality meet. It seems like the current system is there to keep people from facing these hard choices but that does not mean that they do not have to be made.

You Don’t Have To Be Crazy To Work There, But It Helps

Today, as part of my psychiatry rotation, a lucky few of us were able to go on a field trip to Mayview State Hospital. This is a long-term inpatient mental health facility, what in older days might have been referred to as an insane asylum. In its glory days, it had 3000 patients, and a staff of nurses and doctors who lived on the grounds, sustained by the produce of its own farm. Today, it houses about 250 patients on the “civil” side, plus an indeterminate further number on the “forensic” side (patients who have criminal charges pending or are serving jail sentences, but who need serious mental health treatment). A handful are all-but-permanent residents; the majority will stay for weeks to months until they are finally stable enough to go out into that wonderful world we call “the community”. The doctors, nurses, and support staff live in Upper St. Clair.

building photo

When someone says “state mental hospital”, the things that come to mind are right out of _One Flew Over the Cuckoo’s Nest_: catatonics, raving madmen, experimentation on helpless victims, and therapies bordering on torture. From what I know of the history of mental illness in America, those stereotypes were true… decades ago. Now, they’re an almost polar opposite of the truth. I saw an extremely caring and well-trained staff taking care of patients who (with the possible exception of a few forensics) aren’t violent or “basket cases” — they’ve got delusions and depressions and behavior issues that make them unable to live in “normal” society, and they’re getting a pile of counseling (and some meds) to try to help them function. It reminded me a lot of the Alzheimer’s nursing home where I volunteered when I was much younger.

Why am I telling you all this? Well, for one thing, almost nobody realizes that Mayview is so close that you can actually take a PAT bus right onto the grounds (33D, Bridgeville). The bigger reason is because the state hospitals are important; they are, in many cases, the only thing standing between these patients and homelessness/injury/death. They are also under a lot of pressure to move more and more of their patients back into the community, at a faster and faster pace, and not always with all the necessary services in place. Depending on who you believe, we might already be shoving seriously ill patients out the door and allowing them to exercise their “right” to promptly go off their meds, spiral downwards, and end up in the local ER or shot by the cops. This isn’t a “psychopaths are living next to you, be afraid!” thing — it’s a “people who can’t yet fend for themselves are being thrown to the wolves” problem.

Mental health care in America receives nothing near the attention it deserves, when compared to what we do for more “physical” illnesses. Mayview is just one more place where this is happening. It’s an invisible problem, but it’s one worth knowing about, because it’s killing innocents every day.

(On a lighter note, if you’d like to see more photos, start here.

You Don’t Buy Coffee, You Rent It

I frequently find myself at the Beehive. I like the energy, I like the vibes, and most of all I like the fact that I can smoke my lungs black while watching the most interesting foot traffic in Pittsburgh.

The men’s room is a veritable museum of graffiti, as you can see in Jeremy Salapek’s photograph. There is also one toilet and one urinal. That makes two places for men to do their business, and one sink in which to wash our hands.

Twice now, as I was doing the standing-up thing, other men have opened the door, exclaimed in embarrassment, and excused themselves for disturbing me.

My question is this: how does a heterosexual man with no salacious intentions whatsoever indicate to another man with no salacious intentions that there are, indeed, two places to pee, and that his embarrassment is unwarranted.

Everything I’ve been able to come up with sounds like a come-on.

“Hey, no problem man, there’s room for two in here!”
“No, don’t be embarrassed, there’s plenty of room.”
“You don’t have to wait, dude, come on in.”
“Hey, there’s a stall in here, too.”

Any suggestions?

There is such thing as a free helmet


Kids and bikes go together like peanut butter and jelly. But what makes the sandwich work? The bread. And what makes kids and bikes safe? Helmets.

You’re right, that metaphor is a bit awkward.

Anyway, Children’s Hospital of Pittsbugh is giving away free bike helmets to kids — up to age 20! — next Wednesday, May 9, at the Family Care Connection office at 5235 Butler Street in Lawrenceville. Staff will even make sure that the helmets fit properly.

Might as well get one, right? Then ride off to make a peanut butter and jelly sandwich.

photo by Phil Aaronson via Flickr

Arguing with James about tobacco

My MetBlog colleague Mr. Foreman had an entry about the smoking ban earlier today. As a good little libertarian, I understand where he’s coming from, but I have to argue the other side. He’s half right — there’s no reason to do this for the customers. Speaking as a customer of many Pittsburgh watering holes, I know which establishments will and will not blow lots of cigarette smoke in my face, and I take my money mostly to the latter. The part that, in my marginally-qualified medical opinion, he’s wrong about is the employees.

See, the problem is that “Prospective employees can choose not to work at such locations,” is a false statement. I’ve spent the past three months treating the uninsured, underinsured, and medically underserved of Allegheny County, and I’m going to spend the next year-and-some-change doing the same. I see a lot of patients who smoke. Some, we’re able to help quit. When we’re not able to, one of the biggest factors is that they’re constantly around people who smoke. The fact is that there’s more job-seekers than there are jobs in our fair city, particularly for that segment of society that doesn’t have a lot in the way of higher education. These folks don’t have a choice of jobs — they have a choice between the job that exposes them to tobacco smoke all day, or no job at all.

People should be free to choose what they put in their own bodies and who they associate with, but there’s no reason to force them to choose between poisoning their long-term health and being able to eat tomorrow.

First Fido, Now Us

catfood.jpgMore than a month ago news broke that some foods were making pets sick; the recall began March 16. So if you were thinking that the suspect petfood — which, it appears, contains the toxic chemical melamine, used in making plastics — might have been cleared from shelves by now, well, you’d probably be right.

Trouble is, that icky melamine may be laying in wait for us humans. Yesterday the FDA announced that pigs destined to be pork chops and bacon had eaten suspect food. More pig farms and a chicken farm are being checked out. Yikes.

Maybe it’s time to go vegetarian for a while.

Or not. The suspect wheat gluten (and now possibly corn gluten, rice protein concentrate and more) is found in “foods often eaten by vegetarians,” according to Dr. David Acheson, chief medical officer of the FDA’s Center for Food Safety and Applied Nutrition — including bread, pasta, cereal, protein shakes and energy bars. And, while this doesn’t apply to me, I certainly don’t want to leave it out: baby food.

So what does that mean? If, like me, you’d rather your melamine be in your plates than on them, seems like it might be a good time to start up that salad and fresh veggies diet again.

photo by welovethedark via flickr

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