Ask a Health Advocate: What's the value of a second opinion?

That's a great question--and one that's been in the news lately, too.

For example, a recent New York Times article touched on the case of Andrew Schorr, showing exactly why second opinions are so important. In 1996, Schorr, a specialist in health communications, had been diagnosed with chronic lymphocytic leukemia, which is incurable. His cancer doctors recommended that he immediately undergo chemotherapy.

But Schorr turned to the internet, scouring forums for more information on his disease and how it can be treated. Other chronic lymphocytic leukemia patients spoke highly of a Dr. Michael J. Keating, and soon Schorr hopped a plane from Seattle to Houston to get advice from Dr. Keating. Dr. Keating didn't recommend aggressive treatment like chemotherapy--instead, he recommended no treatment until and unless Schorr's condition worsened. After 4 years, Schorr's condition did indeed worsen, and Dr. Keating treated him with 6 months of standard chemotherapy for leukemia as well as an experimental medicine called Rituxan. This treatment has kept him alive and well, and had he undergone the immediate chemotherapy that his cancer doctors were calling for, he would not have been eligible for Dr. Keating's treatment--and he also may not have been able to father his third child, a son who is now 14 years old.

Getting a second opinion regarding recommended medical care can be beneficial in so many ways. It can:

* Help you save money--the provider who gives you their second opinion may recommend less costly treatment

* Help you be more comfortable--your "second opinion" provider could suggest treatment options that are less invasive, less aggressive, and with fewer side effects

* Verify that treatment is even necessary--sometimes a provider will instead recommend a period of "watchful waiting" before having you undergo any treatment

* Confirm your original medical diagnosis to verify that it is correct

* Recommend an experimental treatment that your previous provider may not have been aware of

Your health advocate (which can be a friend, family member, other person who's close to you, or a representative from an advocacy service) can help you obtain a second opinion from a reputable medical professional. By handing this task over to a health advocate, you can focus on resting and feeling as well as possible. Let your health advocate:

* Research other medical providers to verify that they are in-network with your insurance and are properly certified

* Find out if your insurance plan requires you to have referrals--if so, an advocate can help secure those references for you

* Call those medical providers to set up appointments for you

* Talk with the medical provider about any pre-visit testing or lab work

* Take you to and from those appointments and keep you company in the waiting room

* Take notes during your appointments

* Help you gather your medical records and information so that you're giving each doctor the most up-to-date information

* Help you clarify your health plan details so you can understand what procedures and tests are covered, and help you estimate any out-of-pocket costs you may incur

* Look over any Explanation of Benefits forms and/or medical bills to ensure that they don't contain any erroneous charges

Clearly a second opinion can be quite valuable, and having a reliable health advocate at your side can help you simplify and streamline the process of getting a second opinion.

Have a question about how health advocacy can benefit you? Send your questions to nhess@healthadvocate.com!

Ask a Health Advocate: I have heart disease. How can advocacy help me?

According to the Centers for Disease Control and Prevention (CDC), there are currently 26.8 million Americans who have been diagnosed with heart disease--that's 12% of Americans. Heart disease includes a variety of conditions related to the heart, such as heart attack, coronary heart disease, congenital heart disease, and congestive heart failure. WebMD notes that heart disease is the leading cause of death for men and women in the United States.

Managing heart disease can mean undergoing major lifestyle changes. There is no quick fix for heart disease--but there's a lot you can do to manage the disease and live healthier to reduce the risk of your heart disease worsening. You don't have to make these changes alone, either. You can enlist an advocate to help you. Your employer may offer an advocacy service as part of your employee benefits package; you might seek out a consumer-based advocacy service such as Health Proponent; or you could simply designate a trusted family member or friend to help you better manage your heart disease. Check out the many ways an advocate can help you in this situation:

* An advocate can connect you to the proper medical personnel. A primary care physician or a cardiologist can help treat your heart disease. A nutritionist could help you design a low-cholesterol, heart-healthy diet. A wellness coach could help you plan an exercise regimen. If mortality-related thoughts brought about by your heart disease are making you stressed or anxious, a mental health specialist can help you better handle these thoughts.

* An advocate can help make sure that medical providers take your insurance, and they can set up appointments for you or help arrange transportation to and from these appointments.

* Let your advocate help reduce your stress by having them handle a number of financial issues for you, such as researching pricing for medical procedures and services as well as negotiating costs of medical treatment with insurance companies and medical providers.

* The advocate can also help you by reducing your insurance-related stress. If your insurance company says they won't pay for a treatment or procedure, ask your advocate to handle the insurance company's denial and file an appeal on your behalf.

* Has a medical provider recommended surgery or prescription medication to treat your condition? Your advocate can handle lining up a second opinion for you so that you have the opinions and advice of two medical professionals and can make an informed decision about the type of treatment you're most comfortable with.

* If you smoke, know that an advocacy program like Health Advocate offers a Tobacco Cessation program as part of their benefits. Quitting smoking will not only save you money, but also has heart-healthy benefits!

* Let your advocate be responsible for reminding you about your yearly checkups and other important health screenings (they can set these appointments up for you, too).

* Some advocacy services offer Nurse Lines that members can take advantage of. Nurse Lines, staffed by registered nurses, often have extended hours and in some cases are available 24/7. Members can call the Nurse Line to talk to the nurses about any strange symptoms they're having and whether or not those symptoms necessitate a trip to the emergency room, urgent care, or other medical facility.

* An advocate can do the research on experimental heart-related treatments and clinical studies that you may qualify for.

* If you suspect that office-related stress could be contributing to your heart disease, check into whether an EAP + Work/Life service is part of your advocacy company's benefits. EAP + Work/Life can give you suggestions on how to maintain a better work/life balance that could result in you being less stressed, which is also a heart-healthy change.

Managing your heart disease is a lifelong commitment. It could require years of treatment and a medical team that includes many different medical professionals. This could result in piles of paperwork and bills to sort through, many phone calls to your medical team or insurance company, translating explanations of benefits or doctor-ese, resolving billing errors or insurance claim denials, and having overnight stays in the hospital. All of these things can be intimidating and stressful. You don't have to endure it alone. Recruit a health advocate to do the leg work for you so that you can focus on being as healthy as possible.

Curious about how a health advocate can help you? Email your questions to nhess@healthadvocate.com.

You’re Not Alone: Tips on Caring for an Elderly Loved One

Caring for an elderly loved one often requires an abundance of time and energy. Being a caregiver can include tasks such as administering medications, transporting someone to doctor appointments, and trying to make sense of medical coverage and bills. For the caregiver, trying to meet these needs could lead to taking extra days off of work or even quitting a job.

If you are a caregiver for an elderly loved one, Health Advocate provides the following tips that can help you avoid handling caregiving duties alone.

If you are a Health Advocate member…

• We can help. Our Personal Health Advocates can help you with caregiving needs, including:
• Locating alternative care facilities
• Obtaining coverage for medical supplies
• Providing information on local adult day care programs
• Coordinating coverage for home care services with insurance provider or Medicare
• Locating private duty nursing and home health aides
• Finding physicians who make house calls

Health Advocate members and non-members alike can benefit from these tips:

• Get the family together. If possible, hold a family meeting to discuss the needs of your aging loved one. A social worker or other facilitator can help with difficult issues, such as placement in an assisted living center or a skilled nursing facility.
• Discuss advance directives. Living wills detail medical care preferences. A power of attorney for healthcare document allows your loved one to designate another person to make financial or medical decisions, should they themselves become unable to do so.
• Investigate eldercare products. Work with a case manager and/or insurance company to locate emergency call buttons, stair chair lifts, electric scooters and other helpful items.
• Expect "live-in" adjustments. Be prepared for readjustments in mealtimes and sleep schedules, and to experience a "role reversal" in your relationship, placing you in a parenting type of role.
• Find support for yourself. Local organizations may offer adult day care, emergency respite and support groups. Health Advocate’s "Helping You Help a Loved One" brochure lists some resources you can turn to for support.

As you are caring for your loved one, don’t underestimate the ability of others to help alleviate some of the day-to-day challenges associated with caregiving. Remember, if you have Health Advocate as a service, we can help address your eldercare questions and needs—give us a call today!

What is diabetes, and how can it be prevented and/or managed?

November is American Diabetes Month, a time when the American Diabetes Association focuses on communicating the seriousness of the disease and the importance of diabetes prevention and management. Let's take a look at what diabetes is, what kind of impact it's having on Americans, and what steps you can take to prevent and/or manage the disease.

What is diabetes?

• The American Diabetes Association defines diabetes as "a group of diseases characterized by high blood glucose levels that result from defects in the body's ability to produce and/or use insulin."
• The American Diabetes Association lists many things as possible symptoms of diabetes, including frequent urination, unusual thirst, blurred vision, and more.  But some diabetics have no symptoms.  Also, it's important to note that many other ailments have some of the same symptoms as diabetes.  If you suspect you may have diabetes, talk to your doctor, who can evaluate your symptoms and determine if you should be tested for diabetes and/or any other conditions.

Who has diabetes?

• Currently, 25.8 million adults and children in the United States have diabetes--that's 8.3% of the population.
• In 2010, there were 1.9 million new cases of diabetes diagnosed in people age 20 and over.
• The American Diabetes Association estimates that the total national cost of diagnosed cases of diabetes in the United States is $174 billion.
• Since 2 out of 3 people with diabetes die from stroke or heart attack, diabetes is the leading cause of blindness in adults, and also the leading cause of kidney failure, it is crucial that non-diabetics engage in proper preventative measures and that diabetics effectively manage their disease.  The American Diabetes Association believes that another 57 million Americans are at risk--and that, if current trends continue, one out of every three children will face a future with diabetes.

How can a diabetic person manage the disease--and how can a non-diabetic prevent diabetes?

• Don't use tobacco products.  If you already smoke or use other tobacco products, check into whether your workplace has a tobacco cessation program you can participate in.
• Reach and maintain a healthy weight.
• Be physically active--don't be sedentary.  Talk to your doctor about what kind of exercise is safe for you to do.
• If you have diabetes, look into getting a flu shot and a pneumonia shot (diabetics are more likely to die from pneumonia or influenza than non-diabetics), but first confirm with your doctor that it's OK for you to do so.  Also, talk to your doctor about how to maintain your blood glucose, blood pressure, and cholesterol.
• Diabetic or not, you should make sure that you have a primary care physician.  If you don't have one, consider reaching out to an advocacy service that can help you find a doctor that is in-network with your insurance plan and is local to you.  You may have access to an advocacy service like Health Advocate as part of your benefits plan; if you don't, Health Proponent is an advocacy service that individuals can use.

How can you get involved in efforts to stop diabetes?

• Take the American Diabetes Month pledge on Facebook to raise your hand to help stop diabetes.
• Attend an American Diabetes Month event (click here to find events local to you).
• Visit your YMCA.  The CDC and YMCA have partnered up to fight diabetes--as part of the National Diabetes Prevention Program, they're offering classes that encourage healthy lifestyle choices like physical activity and moderate weight loss.  there are currently classes being offered at 178 YMCA locations nationwide.
• Get more information about diabetes by calling 1-800-DIABETES or by visiting StopDiabetes.com.