Friday, December 7, 2012

Dr. Larry Greenbaum - "Kiss My..." The Worst Kind of Doctor **UPDATED**

My friends...I have been mulling this post over for several days while being very aggressive in focusing my anger.

On November 30, 2012, Dr. Larry Greenbaum blogged about reprehensible behavior and illegal actions...things he came across as bragging.  His post can be found HERE.

He begins his post with "If your practice is like mine, you probably don’t bill for "consult level 5" very often. That is the most expensive level of care on our office superbill, and I usually reserve it for patients with huge volumes of records, patients who take an inordinate amount of time, or patients who annoy me in some other extraordinary fashion."  I am sorry, but I find this portion of his statement vile, and unlucky for him...potentially illegal, an ethical violation and dickish.

You might ask why I say illegal.  Well, insurance fraud is a criminal act...and if he is found guilty of having done this to patients who were on Medicaid/Medicare, then it could also be a federal crime at that.  Best case scenario in my mind, good ole Larry goes to federal jail, loses his license to practice medicine, and lots of patients and former patients sue his ass off for fraudulent billing to them.  A girl can dream...these wishful thoughts are just my vent ramblings...//sigh...back to reality.

Greenbaum's post goes even further over the line of just that one statement, he talks disparagingly of a 75 year old patient.  While technically he did not violate HIPPA since he did not tell us the patient's name, he provided explicit personal details that would allow the patient and/or anyone close to the patient to figure out who it is.  But what truly angers me the most is this sentence "I charged him level 5 for taking so much of my time, for bad-mouthing his previous doctors, and for incessant whining."  I'm sorry but just because someone expressed displeasure with a previous doctor does not mean he is not speaking the truth about the service given by that same said doctor...which Larry even admitted that "He had a deformity of his big toe due to a claw toe surgical repair that had gone awry." 
So, maybe he didn't "bad mouth" his doctor but Larry was too full of himself to even retract that disparaging assessment.  AND excuse me...INCESSANT WHINING?!?!  WTF? case you didn't use your "brain"...when someone comes into a doctor's office, especially one for rheumatology, they are most likely in PAIN you nebbish, little man.  Where is your compassion, especially for someone who is 75 years of age?  You are the reason there are issues with our healthcare system...that it is broken and why it is so expensive to get care.  You are also a poor excuse for a doctor and human being.

I have reported Larry to the Medical Licensing Board of Indiana, The Indiana Attorney General's Office, the Johnson County Sheriff's office and to I-Team 8's tip line.  I am debating printing out his blog and camping at his office to hand out the blog for his current patients to read how little he thinks of some of them.

You might ask why I am so up in arms over this jerk.  Well, in November 2008, my employer changed my health insurance carrier and I lost the fantastic doctor I had, Dr. Steven Neucks.  Larry was in the new network and he was close to my home.  I only saw him a couple few times.  You know how thin those walls are  in most doctor's offices.  I could hear him talking "down to" and "at" his other patients.  For me, when he became angry when I told him that I didn't want to try methotrexate again because I had already failed it previously and it caused issues with my liver.  When he told me to shut up because he had a headache and that I didn't know what I was talking about...I lost it.  Everyone has bad days.  If he felt so poorly, he should have had someone else cover his appointments or had us reschedule.  But to treat someone like crap because he felt bad, I do my damnedest to not do that when I am flaring.  I ripped into him and told him not to speak to me in that manner because he was there to provide a service to me because I was PAYING HIM, as was my insurance.  I never went back.  I was lucky that my family doctor agreed to treat me until I could get back to my previous doctor.

Now...the site who allows him to blog, in response to all of the outrage directed at Larry's post...instead of reacting in a positive manner to the outrage by denouncing his views and comments, Rheumatology News chose to disable the comment feature on the blog post. for me, that pisses me off because they are trying to hide the outrage his blog caused.

OUTRAGE...that is what is happening with in the autoimmune community.

My friend, Kelly Young, The RA Warrior, responded intelligently to his blog post HERE.

Michael Weiss of Profession Patient Perspective responded HERE.

The Afternoon Nap Society blog responded HERE.

Dr. Pat Salber form the The Doctor Weighs in, responded HERE.  Another doctor commented on her post and it does provide some insight into burn out.

The Rheumatoid Rebel responded HERE.

My sure to avoid this doctor at all costs.  Love you!!

Saturday, November 10, 2012

Vitamin D -- Why It's Important for Us

Vitamin D is one of those vitamins that so many tend to overlook getting in their diet. Why? Most vitamin D is a natural by-product of our skin's exposure to sunlight. It is also readily found in fatty fish -- salmon, herring and mackerel. It is supplemented in most cows milk we purchase at the grocery...or we can take it as a supplement.

In a study from 2010, found that vitamin D is crucial for activating our immune system's "killer cells" referred to as T cells, which if vitamin D is absent or too low in our blood, will remain dormant and oblivious to threats from infections. Vitamin D deficiency is well-known for being a risk factor for rickets (the softening and weakening of bones). There is also mounting evidence that a vitamin D deficiency may increase our susceptibility to autoimmune diseases like multiple sclerosis (MS), rheumatoid arthritis (RA), system lupus erythematosis (SLE), type-1 diabetes, certain types of cancers and dementia.

In this same study, the researchers mapped out the specific locations where vitamin D affects our DNA through a process called vitamin D receptor (VDR) which binds to very specific locations in the human genome -- more than 200 genes have been identified which show a direct influence by the VDR. Keeping all of this in mind, the researchers looked at the regions associated with diseases on the gene map to see where there were elevated levels of VDR binding. They found that there was significant binding in regions linked to several common autoimmune diseases -- type 1 diabetes, Crohn's disease, MS, and in regions associated with leukemia and colorectal cancer.

In a 2007 research study, vitamin D was studied in its role as a part of the endocrine system. Vitamin D is an important component in the interaction between the kidney, bone, parathyroid hormone, and the intestine, which maintains extracellular calcium level and helping maintain skeletal integrity. Vitamin D levels are also associated with hypertension, muscular function, immunity, and ability to encounter infection, autoimmune disease, and cancer.

The active form of vitamin D produces and maintains self immunologic tolerance and inhibits induction of disease in autoimmune encephalomyelitis, thyroiditis, type-1 diabetes mellitus, inflammatory bowel disease (IBD, Crohn's), systemic lupus erythematosus, and collagen-induced arthritis and Lyme arthritis.

There is still much we need to learn to truly know the full role vitamin D plays in our health.  But we can do something to help ourselves.  For overall good health, it's essential we meet vitamin D requirements. If our doctor tests our blood vitamin D level and finds a deficiency.  

There are things that we can do.  You ask how? Where can you find this bone-building, immune-boosting vitamin? Here are some simple ways to get the recommended daily intake of vitamin D:
  • Feed on fish. Specifically, canned pink salmon, mackerel, and sardines offer the highest amounts of vitamin D.
  • Choose fortified beverages. Both soy and cow’s milk are available fortified with vitamin D. Some brands of orange juice also come with an added dose of D.
  • Eat egg yolks. Though they're sometimes a concern because of cholesterol, egg yolks are a good source of vitamin D.
  • Start your day with cereal. Dry cereals and instant oatmeal that have been fortified with vitamin D are a great way to start your day.
  • Keep it simple with a supplement. Vitamin D supplements can make it easy to get all you need each day — just take one pill. If you have absorption issues, your doctor may try a prescription pill that is a once a week dosage. 
  • Sunlight. Exposure to the sun also helps your body to produce vitamin D. Relaxing in the sun for a brief period of time (just 5 to 10 minutes) a few days per week without sunscreen can help your body create enough vitamin D to ward off a deficiency. Just remember to guard against the potential damage of the sun — keep your exposure limited to reap the vitamin D benefits without harming your skin. For many of us we take medications that make us more prone to burning. With sunblock and following the brief times listed, we should be able to do this minimal risk to ourselves.

I cannot stress enough to you my friends.  Be your own best health advocate.  Knowledge is power and together with your doctor, you can be in the best health of your life despite having lupus or RA or whatever autoimmune disease you may be facing.

Monday, November 5, 2012

Welcome back to me...

I haven't written in such a long time.  Not sure where the days went.  My last vlog/blog post was April 2011.  So much has happened since then.  Where to begin??  Well I guess I should start there...the beginning.

I was in the middle of the worst lupus flare of my life...I was dying.  I was blessed enough to have my doctors send me to be seen by the wonderful doctors at the Mayo Clinic in Rochester, MN.  They confirmed many diagnoses for me as well as diagnosed some new things.  They worked out an incredible treatment plan that has essentially put me in a near remission state of being.  I lost my the job I loved and went over a year looking for a new one...and now working part-time in another department on campus is such a perfect fit for me.  They treat me with such respect and appreciation.  I am valued by my boss who recruited me for the new position.  It will be going full-time sometime after the first of the year..which helps my body adjust to the rigors of longer hours without being a huge tax on my body.

Yes, I still manage my energy because pacing myself is so important.  I rest when my body says rest.  But I can do so much more than I could when I was flaring.  I never gave up hope...the belief that I was in control of me and no matter how much my lupus was attacking me that it never had me.

I am now focusing on educating others on lupus and autoimmune issues.  So many people do not realize that people like us exist and that we are not freaks...neither are our diseases contagious.

First off...autoimmune diseases does not mean we have AIDS.  AIDS stands for acquired immunodeficiency syndrome.  Having an autoimmune disease is where our bodies immune systems become activated to attack our own cells.  There are many theories and hypotheses as to why this happens.  The simplest way to explain is that certain factors have to come into play for someone to develop an autoimmune disease.  There are genetic/hereditary components for the vast majority, some viral infections can be part of the process...but  once it begins, it is very extremely difficult to "turn off" or put into "remission".

What illnesses/diseases are autoimmune?  It's a VERY long list.  I will name some common AIs.

Juvenile Diabetes
Rheumatoid Arthritis
Multiple Sclerosis*
System Lupus Erythematosis*
Myasthenia Gravis
Psoriatic Arthritis* 
Crohn's Disease
Ankylosing Spondylitis
Sjögren's Syndrome*
Hashimoto's Thyroiditis*
Raynaud's Phenomenom*

(and many of the above have juvenile forms as well so those are also included in this)

I's rather daunting to look at all those intimidating and frightening names of things.  See all of the ones with "*" beside them.  Those are the ones I have...and that isn't even all of them.  //sigh.

Back to better news.  I am feeling better and enjoying how my life is progressing.  I still have more changes I need to do.  Working on figuring out how to get more stamina and being more overall fit are top on the list.

I bid you all adieu.  I will chat you later. *mwah*