Tuesday, August 27, 2013

Excess weight: The military's new battle

Potential military recruits fresh from a life of minimal strenuous physical activity are commonly shellshocked by military fitness regimens. Considering a career in the military means meeting stringent health requirements, including weight prerequisites. Unfit recruits, or an overweight and sedentary youth base from where recruits will come in the future, represent a growing problem of the US armed forces today.

Image source: News.wyotech.edu

 Forbes tackles the worrisome prospects of the current weight and physical fitness of American youth. Backed by two academic reports, the article concludes that the American youth are eating too much but exercising less. They consume about “400 billion calories of junk food every year.” The American military may therefore be hardpressed to ensure the physical fitness of its future armed forces.

  Image source: Mensfitness.com

Ret. General Richard Myers warns in an opinion piece that joined with other disqualifying factors, weight issues will ultimately eliminate the chances of youth between the ages of 17 and 24 for a career in the military.

Unfortunately, bulging waistlines are not only common among the base of recruits. They also plague existing troops. The Pentagon has been behooved to evaluate obesity-related medical problems among soldiers, veterans, and their families.

Image source: Centraltogether.org.uk

Physical fitness is not just a matter of personal concern for soldiers. Servicemen have to understand that their health is crucial to national security.  

Steven Lash, one of the country’s most prominent health visionaries, established Satori World Medical in San Diego to provide Americans safe and efficient medical travel services for various physical conditions, including weight and obesity issues. More information on medical travel is available at this website.

Wednesday, August 21, 2013

New obesity drug replicates benefits of gastric bypass surgery

Mayo Clinic describes how a gastric bypass procedure alters the digestive system to help individuals drop excess weight. The procedure essentially reduces nutrient absorption and/or controls the amount of food patients can eat. It is a drastic weight-loss strategy when dieting and exercise are no longer effective, and it is also an effective and timely intervention when serious health issues arise from obesity.

However, recent developments could dodge gastric bypass surgery altogether. The Telegraph unveiled a drug being developed by a team of scientists from Imperial College London that will mimic the effects of a gastric bypass surgery to help patients lose weight.

The drug, which creates lasting hormones, tricks the brain into thinking that the body has taken in enough food.  Researchers hope it will be a better alternative to gastric bypas surgery.  Although the drug is initially expensive, it is created to be a safe and effective treatment option for patients wanting to lose excess pounds.

Image source: Fullplateliving.org

Professor Steve Bloom, who leads the study, still lauds the effectiveness of gastric bypass surgery. However, from a practical point of view, obesity affects an extremely large proportion of the population and causes death from related diseases. “We can’t expect to conduct surgery on half of Europe, for example,” he says.

“So we asked the question of whether we really need to carry out the surgery at all,” Professor Bloom adds.

If it takes appetite suppressants—no matter how expensive they are—to stop overweight people from eating as much as they do and keep them healthy in the long term, then this newfound drug might just be the thing in the future.  

Image source: Warwick.ac.uk

Many people trust Steven Lash and Satori World Medical of San Diego as a provider of their medical travel needs, including interventions for obesity. Visit the company’s website to find out more about its services.

Tuesday, August 20, 2013

Medical tourists: Enjoying life while attending to their health needs

Among the thousands of travelers who regularly flock to popular destinations for leisure, a growing percentage is also traveling abroad for medical treatment. The growth in the medical travel industry has been fueled by problems in the healthcare systems in developed countries.

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In the US, one of the problems is that high-quality care comes at a punitive price. This is why some who feel burdened by the high costs of care search for good options outside the country.

Meanwhile, medical institutions in developing countries have been significantly improving their facilities and their services. Many have created programs to attract foreign patients to their hospitals – with highlights like highly competent English-speaking staff and hospital rooms with all the modern conveniences preferred by tourists.

Image Source: medicaltravelprovider.com

Medical travel is an enticing option for many patients. Not only do they get the opportunity to get the treatment that will improve quality of life, they also can do it while experiencing the culture of another country.

While many still have doubts about going overseas for medical treatment, it is still a less expensive alternative. With enough research and preparation, traveling patients can find medical professionals they can trust and a country they’d like to visit for medical treatments.

Image Source: whatclinic.com

Steven Lash is the President and CEO of Satori World Medical, a medical travel concierge services provider. For more information about medical treatments overseas, visit www.satoriworld.med.com.

Wednesday, August 14, 2013

Why the medical travel industry needs social media

Image Source: stevenlash.blogspot.com

The medical travel industry is peopled with healthcare practitioners and healthcare management professionals. Their services and expertise are primed for interaction with patients. However, in the medical travel industry, patients are no longer just patients; they turn into consumers who have decisive roles in the kinds of services meted to them.

In medical travel, patients have more choices and can pick their own medical travel provider with the desire for more value for their money. And they no longer rely on medical travel companies’ websites and brochures, formerly where the markets sought references. Potential medical tourists are now more Internet savvy, reading online articles and reviews written about available medical travel providers. They seek out feedback people who have had the same medical procedures.

Image Source: physiciansweekly.com

This is why medical travel companies need to invest more on their online presence, actively engaging and conversing with potential customers in order to build rapport and create patient advocates. Building a loyal client base is a continuing conversation that can take place in social media.

Social media is fast outpacing traditional methods of marketing and communication, and medical travel companies who take advantage of it may very well lead the industry to a new era.

Image Source: imedicalapps.com

Steven Lash is the founder and CEO of Satori World Medical in San Diego. More information about him and his company can be found at this website.

Friday, August 9, 2013

Why expensive healthcare does not always mean the best

While the nation struggles with various problems in the healthcare system, important medical treatments remain inaccessible for many. The cost of medical products and procedures are higher in the US than in other countries. For people paying for these out of their own pockets, the price is too steep.

Image Source: npr.org

For some, a solution has been to think outside the box and consider getting treatment where it is cheaper – overseas. Medical travel is currently a burgeoning industry, with more patients considering medical institutions overseas as one of their more accessible healthcare options. 

Previously, most patients had reservations about seeking cheaper care options, believing that lower costs are indicative of substandard quality. However, news about the quality of care in medical institutions outside the US has worked to convince many patients to venture out.

Image Source: telegraph.co.uk

It’s difficult to ignore the benefits of medical travel. For many, the alternative is to go on without treatment or wait until either the price drops or their savings grow.

Venturing out of the country for a necessary surgery does have its pitfalls. But with proper preparation and research, patients can easily get the treatment that they need to reclaim their healthy lives.

Image Source: mymedholiday.com/

Steven Lash is the president and CEO of Satori World Medical, a leader in medical travel services. For more information on medical treatments available abroad, visit www.satoriworld.med.com.

Monday, July 29, 2013

REPOST: Nightmares After the I.C.U.

This article on the New York Times wellness blog, reveals that a significant number of patients who have stayed in an intensive care unit in the United States may have symptoms of PTSD for up to two years after their experience. Find out why here:

When Lygia Dunsworth was sedated, intubated and strapped down in the intensive care unit at a Fort Worth hospital, she was racked by paranoid hallucinations:

Outside her window, she saw helicopters evacuating patients from an impending tornado, leaving her behind. Nurses plotted to toss her into rough lake waters. She hallucinated an escape from the I.C.U. — she ducked into a food freezer, only to find herself surrounded by body parts.

Mrs. Dunsworth, who had been gravely ill from abdominal infections and surgeries, eventually recovered physically. But for several years, her stay in intensive care tormented her. She had short-term memory loss and difficulty sleeping. She would not go into the ocean or a lake. She was terrified to fly or even travel alone.

Nor would she talk about it. “Either people think you’re crazy or you scare them,” said Mrs. Dunsworth, 54, a registered nurse in the Dallas-Fort Worth area. In fact, she was having symptoms associated with post-traumatic stress disorder.

Lygia Dunsworth, a registered nurse in Texas, had traumatic hallucinations while in the I.C.U. after abdominal surgery and infection. Afterward she had symptoms associated with PTSD for several years.
Image Source: well.blogs.nytimes.com

Annually, about five million patients stay in an intensive care unit in the United States. Studies show that up to 35 percent may have symptoms of PTSD for as long as two years after that experience, particularly if they had a prolonged stay due to a critical illness with severe infection or respiratory failure. Those persistent symptoms include intrusive thoughts, avoidant behaviors, mood swings, emotional numbness and reckless behavior.

Yet I.C.U.-induced PTSD has been largely unidentified and untreated. When patients leave the I.C.U., said Dr. O. Joseph Bienvenu, a psychiatrist and associate professor at Johns Hopkins University School of Medicine, “Everyone pays attention to whether patients can walk and how weak they are. But it’s the exception for them to be screened for psychiatric symptoms like post-traumatic stress or low mood.”

Now critical care specialists are trying to prevent or shorten the duration of the mood disorders, which can rattle not only I.C.U. patients but their frantic relatives. Sometimes family members, rather than the sedated patient, develop the symptoms of having been traumatized, tormented by memories of a loved one thrashing in restraints, delirious, near death. Other PTSD sufferers — victims of combat, sexual assault or natural disasters — also endure flashbacks, but theirs are grounded in episodes that can often be corroborated. What is unsettling for post-I.C.U. patients is that no one can verify their seemingly real horrors; one patient described a food cart in the I.C.U. selling strips of her flayed flesh.

“I.C.U. patients have vivid memories of events that objectively didn’t occur,” Dr. Bienvenu said. “They recall being raped and tortured as opposed to what really happened,” such as painful procedures like the insertion of catheters and IV lines.

The I.C.U. setting itself can feel sinister to patients, as if lifted from “The Twilight Zone.” The eerie, sleep-indifferent lights. The cacophony of machines and alarms.

Certain treatments in the I.C.U. may be grim, but they are essential. Intubation, for example: Patients who need help breathing must have a plastic tube placed down their windpipes for mechanical ventilation. The feeling of near-suffocation and the inability to speak can be nightmarish. Such invasive procedures may raise the odds that a patient develops PTSD.

A longer I.C.U. stay also increases the risk of post-traumatic symptoms. But some patients arrive more vulnerable to PTSD. Women may be more at risk than men, as are patients with a history of depression or other emotional difficulties. Because patients are often rushed to the I.C.U. unexpectedly, doctors cannot take a psychological history.

Age may be a factor. Elderly patients generally recover more slowly, but younger patients may be more likely to develop symptoms of PTSD. Experts suspect that young patients, further from natural mortality, are even more shaken by the possibility of unanticipated death.

Moreover, the violent events that land patients in the I.C.U., like gunshots and car crashes, tend to happen to younger people, noted Dr. Babar Ali Khan, an assistant professor at the Indiana University School of Medicine. Those events also exacerbate the onset of PTSD, he said.

But researchers have begun to identify the I.C.U. treatment that has led to the most harrowing flashbacks: sedation.

Sedation — to manage pain and compel patients to lie still and not fight the ventilator — is crucial in the I.C.U. But many sedatives contribute to the patient’s delirium and intense hallucinations, which can return, unbidden, for years.

A British doctor, Sarah Wake, was a 25-year-old intern when in 2011 she was intubated and sedated in the I.C.U. following a severe reaction to an asthma medication. She described her hallucinations in the British journal BMJ in May: “Blood seeping through holes and cracks in my skin, forming a puddle of red around me.”

She wrote that the fragmented delusional memories made it difficult for her to understand what had happened. “This prevented my psychological recovery and led to the development of post-traumatic stress disorder.”

For months she could not work in a hospital. Even now, after therapy, she is practicing medicine again and yet, she wrote, “I still cannot bear a shower curtain to be drawn as it reminds me of closed hospital curtains and hidden death.”

Dr. Wake was given benzodiazepines, a class of sedatives that includes Valium and Ativan, as well as opioids for pain. Researchers now believe that benzodiazepines may intensify the hallucinations that are so disturbing to I.C.U. patients.

The philosophy about I.C.U. sedation has gone through pendulum swings. In the 1970s, patients on ventilators were allowed to remain awake. But doctors turned to benzodiazepines to calm anxious patients and prevent them from fighting the tubes. If a patient was heavily sedated, thought doctors, the resulting amnesia about the ordeal would be worthwhile.

But in the last decade, researchers have realized that the benzodiazepines did not just give patients amnesia: the delirium and hallucinations they may also trigger in critically ill patients may set the stage for PTSD. Opioids can also cause delirium. Dose and duration are also relevant.

In January, the Society of Critical Care Medicine, concerned about the weakened physical, cognitive and psychological condition of many post-I.C.U. patients, released new sedation guidelines.

They urged I.C.U. doctors to treat pain first and only then to weigh using benzodiazepines for anxiety. Although evidence is not definitive, lighter sedation seems tied to better cognitive and physical rehabilitative recovery, as well as fewer and less shattering hallucinations. I.C.U. staff were encouraged to keep assessing patients for pain, alertness and delirium.

Dr. Dale M. Needham, an associate professor in pulmonary and critical care medicine at Johns Hopkins, noted that even when the sedation has stopped, a patient’s delirium may continue.

Many patients return home mentally shaken, with physical and cognitive weaknesses. Dr. Needham said they haven’t “fully recovered within six months or a year.” Therefore, he added, the I.C.U. stay can place a lingering burden on both the patient and the family.

I.C.U. nurses have taken the lead in efforts to alleviate the trauma of stays and to shorten the duration of the subsequent mood disorders, for both families as well as patients. In Britain, Germany and some Scandinavian countries, nurses in many critical care units keep a diary of the care they provide to a patient, with contributions from the family, which they give to the patient upon discharge. The diaries function as a realistic counterpoint to patients’ hallucinations or amnesia.

Judy E. Davidson, research nurse liaison for themedical center at the University of California, San Diego,and a former critical care nurse, teaches nurses to work with relatives of I.C.U. patients to reduce post-trauma symptoms of their own.

“The antecedent to PTSD is fear, horror and helplessness,” Dr. Davidson said. “If you give relatives things to do — applying lip balm and hand lotion to the patient, keeping their joints limber — it keeps their minds active and decreases the fear response and helplessness.”

The details of what happens in the I.C.U. often stay in the I.C.U.: primary care physicians rarely learn about their patients’ difficult journeys there, and so often do not evaluate them for problems that may have arisen. In the interim, a handful of hospitals in the United States are focusing on the challenges faced by post-I.C.U. patients, including PTSD.

Once a week for the last two years, Dr. Khan, a pulmonologist, has been seeing patients at the Critical Care Recovery Center at Wishard Memorial Hospital in Indianapolis. His team treats post-I.C.U. patients who have spent at least two days on a mechanical ventilator or suffered acute brain dysfunction during that period. About half, he said, develop PTSD.

Vanderbilt University Medical Center has been running a post-I.C.U. clinic on Friday afternoons since last fall. Typically, the treatment team includes a critical care nurse-practitioner, a psychologist, a pharmacist, a pulmonologist and a nurse who functions in a social worker capacity. They evaluate patients for physical, cognitive, social and psychological impairments.

But whether patients or family members develop PTSD symptoms or the full disorder, persuading them to seek treatment poses unique challenges.

About three years ago a woman, then 35, had a hysterectomy at a Tennessee community hospital but developed a severe infection. She awoke in the I.C.U., intubated, with delusions that she had been raped and that her family had abandoned her.

Since being discharged, she has had nightmares. She is afraid of crowds, frightened of contagion. She has retreated from activities at church and her children’s school. She has become claustrophobic, in reaction to having been restrained in the I.C.U., said James C. Jackson, a psychologist and assistant professor in the division of critical care medicine at Vanderbilt University School of Medicine, who worked with the patient in a study.

Though she knows she needs help, she is too anxious to go back to the community hospital, which she associates with so much anguish. Such avoidant behavior, Dr. Jackson noted, is among the most debilitating of PTSD symptoms. Even now, seeking medical care anywhere is extremely difficult for her. “This phenomenon is not uncommon,” he said. “But it makes it hard for individuals who need help to take the necessary steps to get it.”

Satori World Medical is a medical travel company that offers all-inclusive medical travel concierge services that broaden the horizons for patients who are seeking a different healthcare experience. Find out more about medical travel at www.satoriworldmedical.com.

Saturday, July 27, 2013

Thailand: Improving medical travel and avoiding complacency

Image Source: novasans.com

Thailand has been successful in attracting tourists from all over the world. BBC confirmed this in its 2012 report citing 2010 travel figures: more than 89% of medical travelers went to Thailand, India, and Singapore that year, with Bangkok and Singapore being the main destinations.

The International Medical Travel Journal also presented figures lending evidence to Thailand’s power as a tourist attraction, particularly among Russians and Eastern Europeans. The number of Russians travelling to the Southeast Asian emerging economy had increased by 24% to 1.31 million in 2012.

This growth is not surprising, since Thailand has earned a reputation for gracious and attentive medical service, and most importantly, affordable medical care. However, the medical travel industry is apprehensive that low prices and a steady increase in demand could be unprofitable in the long run. Complacency is at the root of this worry, as voiced by the Tourism Authority of Thailand. Thailand’s dominance in medical tourism may take the focus away from quality operational standards and fall into a volatile reliance on numbers to fuel profit.

Image Source: thailandmedtourism.com

The tourism body then stated its intention to counter this dangerous tendency by taking on new advances in technology for cosmetic, fertility, anti-aging, and cell treatments targeting markets from Australia, Asia, Russia, and the USA.

Steven Lash, CEO of Satori World Medical, a San Diego-based medical travel company released a statement assuring medical tourists of the quality of medical services in Bangkok:

“The hospitals in Bangkok are some of the highest quality in the world, meeting or exceeding US standards.”

He added that all of the patients he and his team have sent to Bangkok have nothing but positive feedback on procedures and medical experience. 

Image Source: traveldailynews.asia

This Facebook page provides more information on Steven Lash’s work in helping Americans get affordable, safe and quality treatment in Thailand and other countries through Satori World Medical.