Tag Archives: healthnetwork foundation

Taking the guesswork out of genetic testing

A genome is the total of an individual’s genetic material. The genome consists of chromosomes made from very long strands of DNA. Each human has 23 pairs of chromosomes. Half are inherited from the mother and half from the father.

Susan Locke

Susan Locke

Chromosomes are organized into many subunits; the subunit is called a gene. There are 30,000 to 50,000 genes in an individual’s genome. The specific combination of genes that an individual has makes up his/her genetic identity known as a genotype.

By 2003, scientists were able to identify every gene in a human’s body. Scientists then began to look at the genes to try to pair them with the medical problems that they cause. There are many diseases that are thought to be caused by alterations (mutations) in DNA. These alterations can occur spontaneously or be inherited.

Some of the diseases with a genetic component include Alzheimer’s disease, breast cancer, ovarian cancer, colon cancer, leukemia, lymphoma, bone marrow disorders and others.

There are seven main reasons that genetic testing is performed: clinical testing to determine current or future disease; pharmacogenomics used to assess therapeutic drug treatment; identity testing (also known as “DNA testing”) used for criminal investigations or forensic studies; parentage testing (paternity testing); tissue typing for transplantation; cytogenetics (chromosome analysis, often performed on pregnant women); and infectious disease testing to determine how much viral material is still in the body after treatment.

Questions arise about the use of home genetic testing, such as “23andme.” The test can tell you if your odds of getting a certain condition are better or worse than the general population. The results you receive from this should be reviewed with your doctor. Data from 23andme can be helpful in its assessment of how a person may metabolize certain drugs.

Your results from a testing service like this should be carefully evaluated. Even if your results indicate that you possess a certain version of a gene, it does not mean that you will develop the disease.

These tests may tell you the chance of developing a certain genetic disorder, but not conclusively that the disease will develop. When a test detects a problem gene, it also cannot predict how severely the person will be affected if he or she develops the disorder.

Many diseases are a result of the interaction between genetics and environment. For example, lifestyle plays an extremely important role in who will develop heart disease. It is important to ask your physician about steps you can take to mitigate risk factors associated with any potential disorders.

There are a few other factors to consider before deciding whether to get genetic testing. There is a psychological component to testing. While having a negative test can be reassuring, a test indicating that you have a gene that predisposes you to an increased risk of a disease could be psychologically traumatizing. On the other hand, it could also lead to positive changes in lifestyle. Legally, it is possible that the results of the genetic testing could be used to determine insurance coverage.

If you do get genetic testing, the most important thing is to work with an expert to understand your test results. Most doctors are not trained to interpret these results. Genetic counselors and/ or a geneticist can help with the interpretation and implications of these complicated tests.

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

Sugar hidden in your meals

The American Heart Association has set guidelines for the recommended daily amount of added sugar in our diets: women: 6 teaspoons = 25 grams (gm) of sugar and men: 9 teaspoons = 36 gm.

Susan Locke

Susan Locke

If we are not careful, we can easily exceed this number on a daily basis. This puts us at risk for obesity, heart disease or diabetes. Let’s take a look at some common meals and their accompanying sugar amounts.

58-Gram Breakfast
1 packet maple brown sugar oatmeal: 13 gm
Drizzle of honey: 11 gm
1 tbsp French vanilla coffee creamer: 5 gm
1 cup vanilla almond milk: 16 gm ¾ cup
Honey Nut Cheerios: 13 gm

Think granola is healthier? A ½ cup of Quaker Oats Granola, has 13 gm of sugar. Who can stop at a ½ cup?

30-Gram Lunch
1 PBJ sandwich: 18 gm
6 oz. plain low fat yogurt: 12 gm

Beware of yogurt with added fruit on the bottom; they can have up to a whopping 19 gm per cup.

24-Gram Lunch
1 bowl Subway tomato basil soup: 8 gm
6-inch Subway sweet onion chicken teriyaki sandwich: 16 gm

Canned soups sometimes contain added sugar as a preservative to extend their shelf life, and you might find up to 15 grams of sugar per 1½ cup in certain varieties.

24-Gram Dinner
2 tbsp. French dressing on salad: 6 gm
1½ cup cheese tortellini pasta: 2 gm
¾ cup tomato sauce: 16 gm

Some salad dressings contain 4 gm of sugar per tablespoon. Light or fat-free varieties will use sugar to make up for the flavor lost by cutting out fat.

Tomato sauces often contain sugar to cut the acidic taste and to keep jarred sauces fresh for a longer period. You might find up to 12 gm hiding in a ½ cup serving.

25-Gram Dinner
2 tbsp. barbecue sauce/grilled chicken: 16 gm
¼ cup glazed walnuts on salad: 9 gm

Sugar can sneak up on you in bread too, with some varieties containing up to 2 gm of sugar per slice (and that includes some whole wheat breads).

Snacks and Drinks
1 store bought granola bar: 7 gm
½ cup vanilla ice cream: 19 gm
1 blueberry muffin: 38 gm
1 handful dried cranberries: 29 gm
12 oz. serving Coke: 39 gm
1 cup hot cocoa: 24 gm
1 bottle Snapple peach tea: 39 gm
Pumpkin spice latte w/ whole milk: 39 gm

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

Natural sugar vs. added sugar

There are two types of sugars: naturally occurring sugars and added sugars. Naturally occurring sugars are in foods such as fruit (called fructose) and in milk (lactose). Added sugars are those added to food or drinks during preparation or processing.

Susan Locke

Susan Locke

The average American eats more than 60 lbs. of added sugar per year. The major offenders are soft drinks, candy, cake, cookies, pies, ice cream, processed food and many types of store-bought fruit juice. That’s the bad news.

The good news is that sugar does not need to be completely eliminated from your diet. The American Heart Association’s guidelines for added sugars include these recommendations: men: 150 calories per day (37.5 g or 9 teaspoons); women: 100 calories per day (25 g or 6 teaspoons); children: preschool age, 4 teaspoons; age 4-8 years: 3 teaspoons; preteens and teens: 5-8 teaspoons.

You would think that reading a food label to see how many grams of sugar are in the product would be a good way to track how much sugar you’re eating. Here’s the problem: nutrition labels combine both the amount of naturally occurring sugar and added sugar to determine the sugar content. So products that contain milk or unprocessed fruit will have some natural sugars in the measurement. You don’t know how much is natural and how much is added.

In addition to the total grams of sugar listed on the nutrition label, it’s important to read the ingredient label carefully to see if there are added sugars. There are many different names for added sugar in a product, including: corn syrup, corn sweetener, fruit juice concentrates, honey, high-fructose corn syrup, brown sugar, malt sugar, raw sugar, sugar, syrup, and products ending in “ose’ (glucose, dextrose fructose, lactose maltose, sucrose).

Here are some hints to help you decipher the language of sugar content on food labels: sugar free (contains <0.5 g of added sugars), reduced sugar (contains at least 25% fewer sugars per serving when compared to the standard product), no added sugar, without added sugar (no sugars or sugar-containing ingredients have been added).

When you look at the label and see 12 grams of total sugar, how do you determine how many calories in a serving are from sugar? There are four calories per gram of sugar. Multiply the number of grams by four and you will get the number of calories of total sugar per serving. For example: 12 g x 4 = 48 calories. However, you still don’t know exactly how many calories are coming from added sugar. Even so, this can be valuable information when trying to limit the amount of sugar in your diet.

We should care about added sugar in our diet because too much can contribute to obesity, diabetes and heart disease. Many things are toxic when consumed in large amounts, including water. This doesn’t mean we need to stop drinking water or cut out sugar entirely. Moderation is key. Watch for more on sugar in next month’s column.

SUSAN LOCKE is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

Healthnetwork gives Orlando Legate a fighting chance

Joanne Brown and her husband Bill are founders of Legatus’ Orlando Chapter. Over the years, they heard many great stories of families who had been helped by Healthnetwork. They considered themselves an active and healthy couple and fortunately had not had an opportunity to work with Healthnetwork.

hannibal

Katie Hannibal

Last fall, Joanne went for a routine medical test. A few days passed and the physician called, asking her to come back because he suspected cancer. He ordered a second test; this one came back “inconclusive.” The next recommendation was to see a specialist.

“I called a specialist in Orlando and the soonest appointment was six weeks out,” Joanne explained. “When you have the uncertainty of cancer, you want answers quickly so I called Healthnetwork for assistance at Mayo Clinic Florida. I spoke with medical coordinator Laura.”

The Browns have a cottage in Michigan where they stay during the summer. “I wanted the Mayo appointment before we left. I called every day, hoping they would have a cancellation, but I was getting nowhere and time was dwindling. Then I heard from Laura and the liaison at Mayo. I was all set for the Friday before we left.”

Joanne met with a physician at Mayo Clinic Florida. He did more testing and mentioned surgery could be a possible next step. While she was waiting, he came in and said they didn’t find cancer, and there would be no need for surgery. However, they wanted another test in six months.

Bill and Joanne Brown are founders of Legatus’ Orlando Chapter

Bill and Joanne Brown are founders of Legatus’ Orlando Chapter

Joanne’s next test came back positive for a very early stage cancer. Multiple biopsies were taken and only one came back positive. She was scheduled for surgery at Mayo to remove the cancer cells. After the surgery, she didn’t hear from the surgeon immediately, so she thought she was home free. A month later, she received a call. The surgeon presented her case before Mayo’s cancer board to get a consensus about diagnosis and treatment options. One of the biopsies indicated that it had penetrated the organ wall, meaning it was Stage II. Typically, this was treated with surgery. Joanne was given the option to have the surgery or continue with tests every three months. She felt confident in the physician’s care and opted to wait and do the tests.

“I can’t say enough about how great Healthnetwork has been,” Joanne said. “To have someone step in like Laura did and take the stress out of getting to the best care was such a relief. My Legatus chapter needs to know just how Healthnetwork can help when you call them. This is such an advantage for all of us.

“Laura was so kind, attentive and understanding. Because of my experience and because I have family members with health concerns, Bill and I chose to become Healthnetwork GOLD supporters. I am so grateful for the extraordinary care and support and the quick response; it felt good to support Healthnetwork and the important work they do for all of us. And if the time comes to help them, I know Healthnetwork will step in and get them to the best medical care.”

KATIE HANNIBAL is Healthnetwork Foundation’s marketing director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

Evaluating your health

Without good health, not much else matters. A complete physical exam is an excellent way to identify undetected illness, to pinpoint risk factors and to discuss lifestyle changes.

healthnetHow often should you be evaluated? A rule of thumb is three physicals in your 30s, four physicals in your 40s, five in your 50s, six in your 60s, etc. However, this frequency may depend upon your risk factors for different diseases. This article will explain several options for you.

Complete Physical Exam (CPE). These exams are most often done by your primary care physician (PCP). Most PCPs allot 60-90 minutes for a CPE. They schedule routine blood tests prior to your visit so your doctor can review the results and focus on abnormalities during the CPE. A chest X-ray and EKG are usually part of a CPE. Physicals should be tailored to your particular needs.

Executive Physical (Health Exam). Many of our partner hospitals offer executive physicals, which are designed to take 7-8 hours and get most, if not all, of your tests and procedures on the same day. This is very appealing to busy executives. Although the comprehensive exam is theoretically tailored to you, most patients get the standard evaluation which includes extensive laboratory testing, a cardiac health evaluation, visual exam, auditory exam, pulmonary evaluation, and weight, fitness and stress evaluations.

In addition to the standard evaluation, other options you may add on at an additional cost include genetic testing, whole body CT scan, dermatology consultation, etc. At the end of the day, your physician will review available test results with you and provide an overview of your health. In most cases, you will receive a written comprehensive report 2-3 weeks after the executive physical. The report will include recommendations for addressing problems and developing strategies for healthy living.

The main advantage is you can spend one day at the hospital and have all or most of your evaluation completed at one location. There are a few disadvantages to consider. Executive physicals entail comprehensive testing. While comprehensive testing may uncover some asymptomatic illness, it may lead to false positive results and unnecessary additional testing. Moreover, the physician who works with you during your physical will not be the same one to follow up with you if an issue is detected.

Destination Executive Health Programs. A destination executive health program (for example, Canyon Ranch in Tucson, Ariz.) includes a physical exam and comprehensive testing, but also places an emphasis on lifestyle changes with a more holistic approach. An advantage of a destination health program is that since you are in the unhurried atmosphere of a resort, it’s possible to focus on implementing lifestyle changes. It’s a more relaxing experience. The program can last four to seven days, with a condensed option lasting two days. Disadvantages include the longer time commitment, the expense and determining who will follow up on findings that are identified during the course of the evaluation.

The cost of these programs varies. The most cost effective is the CPE with your PCP, as most of the testing is covered by insurance. At an executive physical, some but not all testing will be covered by insurance. Destination programs are not covered by insurance.

SUSAN LOCKE, MD is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

Conversation starters on mental health

There is no “one size fits all” solution when it comes to mental health. Healthnetwork Foundation addresses each family’s needs and questions with utmost confidentiality and compassion. The Centers for Disease Control and Prevention (CDC) estimates as much as 25% of the American population has some form of mental illness.

While many of us are open with our friends about our physical health, talking about mental health isn’t as easy. There is fear of embarrassment, being judged or stigmatized, and it may be difficult to find words to describe how they’re feeling. About 20% of teens meet the diagnostic criteria for a mental health disorder. Like adults, these teens are often afraid to talk about it. Some attempt suicide as a means of escaping mental illness symptoms. The most important thing parents or grandparents can do is encourage them to talk to you about the problem. Here are a few tips to help begin a productive discussion.

Open the line of communication with: “I’m worried about you.” “You don’t seem like yourself lately. What’s going on?” Ask them to let you help: “Can we talk about how we can make this better?” “Would you like me to help you make an appointment so you can talk with someone?” Above all, listen to their answers.

Emphasize that talking with you is a safe environment to discuss any issues respectfully and without judgment. Together, determine what steps need to be taken to get help. Here are some sample action plans:

Depression. Determine if they have suicidal thoughts or plan to hurt themselves. If so, take them to the nearest emergency room. If they express homicidal ideation, take them immediately to ER. Legally, the person being threatened must be warned about the threat. If they are suicidal or homicidal and refuse to go to the ER, call 911. If they’re depressed, but not suicidal, get them to a physician ASAP. Primary care physicians can be a great first step if they’re unable to see a psychiatrist right away. Make sure that they’re not alone. If they live alone, have someone stay with him/her.

Manic. Familiarize yourself with the symptoms of mania (unusually high energy and mood accompanied by at least three of the following symptoms): Needing less sleep in order to feel rested, talking rapidly or excessively, distractibility, tendency to show poor judgment, inflated self-esteem or grandiosity, reckless behaviors. If you determine that they are manic, seek medical help ASAP. They may need hospitalization.

Substance abuse. Determine if the individual is willing to seek help. If yes, have a professional determine what level of care is appropriate. Their primary care physician or a psychiatrist can help determine the next steps. Healthnetwork may also be able to assist with referrals. If they’re unwilling, consider staging an “intervention” under professional guidance where close friends and family confront the individual.

Forbes recently reported that the effects of mental illness in the U.S. cost nearly $210.5 billion a year in lost productivity and direct costs, with an estimated 19 million Americans afflicted with clinical depression. Mental diseases are real, diagnosable and often treatable. The first step to recovery is often asking, “How can I help you?” Fortunately, Legatus members have Healthnetwork as a partner to help find the right resources.

SUSAN LOCKE, MD is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

Back pain and the realities of surgical recovery

Statistics show that 80% of us will have at least one episode of low back pain during our lifetime. This is especially important when you consider these factors will increase your risk: obesity, smoking, age, female, physically strenuous work, sedentary work, stress, job dissatisfaction, anxiety or depression.

healthnetThere are four main regions of the back: Neck: seven cervical vertebrae (C1-C7), Upper back: 12 thoracic vertebrae (T1- T12), Lower back: five lumbar vertebrae (L1-L5), and Base of spine: sacrum, coccyx (S1- S4). Low back pain is most commonly found in the L4, L5 and S1 areas. However, most people (>85%) have “nonspecific low back pain,” which means there isn’t a specific disease or abnormality in the spine clearly causing the pain.

Causes of low back pain include: degenerative disc disease (wear and tear causing breakdown of spinal discs or loss of fluid in the discs), facet joint arthropathy (arthritis in joints connecting the vertebrae to one another), spondylolisthesis (one of the vertebrae of lower spine slips forward), herniated disc (outer covering of disc is torn, soft inner tissue extrudes), lumbar spinal stenosis (open space inside the vertebrae is narrowed), and spinal compression fractures.

Symptoms include: radiculopathy (nerve root becomes irritated, causing radiating pain, numbness, etc.), sciatica (one of the five branches of the sciatic nerve becomes irritated), neurogenic claudication (pain runs down the back to buttocks, thighs and lower legs, often on both sides and may cause weakness and limping).

Diagnosis: Imaging studies including X-rays, MRI, CT scan. It’s interesting to note that a patient may have an abnormality on imaging and actually experience no symptoms.

Treatment: Remaining active helps to relieve muscle spasms and prevents loss of muscle strength. Also helpful: heat, pain meds, exercise to increase back flexibility and strengthen core muscles, physical therapy, chiropractic manipulation, acupuncture, massage, trigger point injections into the soft tissues of back or epidural injections, traction, ultrasound, electrical nerve stimulation, low level laser therapy.

Surgery is only recommended if more conservative treatments fail. Options include spinal fusion (fusing two or more vertebral bodies together), lumbar disc replacement (may help preserve normal range of motion), discectomy (removes part of/entire disc to relieve pressure on the nerve roots), open discectomy (standard surgical incision), micro discectomy (smaller incision to remove of disc fragment).

Spinal fusion recovery. Pain should decrease gradually. Usually the worst is over by four weeks. However, some patients have pain for three to six months after surgery. Avoid bending, twisting or lifting anything over 10-15 lbs. If a back brace is recommended, wear it for six weeks to three months after surgery. Driving may be allowed after four to six weeks. Outpatient physical therapy may be started at six weeks.

At three to six months’ post-surgery, exercise is the central component of the recovery process. Focus should be on strengthening your back and core muscles for support. Complete recovery may take up to eight months. Bone continues to evolve for 12-18 months.

SUSAN LOCKE, MD is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

Back in business: John Hunt values Healthnetwork’s assistance

John Hunt has always valued Legatus’ relationship with Healthnetwork Foundation, but when his severe back pain incapacitated him late last year, Legatus’ executive director realized that value firsthand.

Pat Ridolfi, Healthnetwork

Pat Ridolfi

On Christmas Eve, Hunt experienced a severe attack of back pain which traveled from his lower back and radiated down his right leg. He spent two hours on the floor, unable to move until his son found him and helped him into a chair.

Doctors subsequently diagnosed him with retrolisthesis of L1 and 2. Hunt had been going to a chiropractor on a maintenance basis for manipulation for a number of years, but he knew this episode was different. He realized his situation would require more than manipulation because simple movements like standing too long or bending over to pick something up proved to be too difficult.

Hunt called Healthnetwork and was immediately referred to the Rehabilitation Institute of Chicago (RIC), the No. 1-ranked rehabilitation hospital in the U.S. Even better, Hunt and his wife Kathie were in Chicago at the time, so travel was not an issue.

Pat, a Healthnetwork medical coordinator, secured Hunt’s first appointment the next day. When he arrived, Hunt was greeted at the elevator by Matthew Ginsberg, global patient services business process manager, who went through the necessary paperwork so he could get started.

Hunt saw Dr. Alexander Sheng, who was able to identify the crux of the problem. He ordered the appropriate scans of Hunt’s back and diagnosed the problem immediately. Hunt was then introduced to Davalyn Partain, who began his physical therapy program that day.

John Hunt, Legatus’ executive director, and his wife Kathie are founding members of Legatus’ Chicago Chapter

John Hunt, Legatus’ executive director, and his wife Kathie are founding members of Legatus’ Chicago Chapter

Over the next two weeks Hunt had a series of follow-up visits to RIC and received exercise assignments between visits. His short-term goal, to fulfill his responsibilities at the Annual Legatus Summit by Jan. 28, was accomplished.

“My experience with Healthnetwork reaffirmed my belief that Legatus’ affiliation with this organization is a valuable Legatus member benefit that should be called upon whenever a family health crisis arises,” Hunt said.

Hunt said that what impressed him the most was the manner in which he was received at RIC and how diligently and professionally they helped him achieve his short- and long-term goals. Hunt said his rehabilitation continues to go well, and he is grateful for Healthnetwork’s assistance.

PAT RIDOLFI is a medical coordinator at Healthnetwork Foundation.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

Here’s how to find a clinical trial

If you or someone you know has a disease that’s not responding to traditional treatment protocols, you may want to consider taking part in a clinical trial.

Susan Locke

The first step is to ask your physician if he or she is aware of any clinical trials where you would meet the qualifications for the study. Be aware that clinical trials have very specific inclusion and exclusion criteria: the stage of your disease, age, previous treatments, medical illnesses, etc. It’s also important to understand the phases of clinical trials.

Phase 1: Researchers test a new drug or treatment in a small group (10-20) of subjects for the first time to evaluate its safety and safe dosage — and to identify side effects.

Phase 2: The drug is given to a larger group (100-300) to see if it’s effective and to further evaluate its safety.

Phase 3: The drug is given to an even large group (1,000-3,000) to confirm its effectiveness, monitor side effects and compare it to commonly used treatment.

Phase 4: Studies are done after the drug or treatment has been marketed to gather further information about the effect in various populations and side effects of long-term use. After a drug is approved by the FDA and made available to the public, researchers track its safety, seeking more information about a drug or treatment’s risks, benefits and optimal use.

The most comprehensive site to find clinical trials for all medical conditions is clinicaltrials.gov. Search for studies under “advanced search.” The “search terms” have to be filled out to get results. But the key is to try to get the most relevant studies for your condition.

Here are a few hints for the specific sections to make your search more specific. Recruitment: choose “open studies.” Study Results: choose “all.” Study type: choose “interventional studies.” Skip “Targeted Search” unless you’re only looking for a specific intervention. Locations: if location is an issue, you can specify. The most important section in “Additional Criteria” is to specify the phase of the study. I recommend limiting your choice to Phase 3 or 4.

healthnetHit “search” and you’ll be see all the trials that meet the criteria you specified. However, you need to look at each study individually. It’s important to understand what treatments are being given and also to look at the inclusion and exclusion criteria.

Confer with your physician if you find a likely match. He will need to be involved with your application for the trial. Clinical trial investigators will want to get specific medical information and history from your physician.

For clinical trials specific to a cancer treatment, another excellent source is on the American Cancer Society website: cancer.org. This site lists National Cancer Institute-supported trials.

Healthnetwork can help with your search, but understand that we’re limited by not knowing all the medical details of your specific condition and previous treatments. The list we generate may include many studies for which you do not qualify.

If you would like more information about Healthnetwork Foundation and how we can advocate for you, please call or email us today.

SUSAN LOCKE,MD, is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.

How to choose a physical therapy practice

Choosing a facility for you or a loved one to recuperate can be a difficult thing to do —especially when you are mired in the medical issues. To help in this instance, the experts at Hospital for Special Surgery created some tips to guide you in your decision-making.

Susan Locke

· Call the facility and ask questions to make sure there are physical therapists with expertise in treating your particular problem.

· Ask who will be treating you and how much experience the therapist has. Once you begin physical therapy, make sure you’re receiving care from a licensed physical therapist or a licensed physical therapy assistant.

· Choose a location that is convenient to where you live or work. Try to set up a time to take a tour of the facility before beginning therapy. A reputable practice should have no problem arranging a quick visit.

· Note if the facility is clean and well maintained. Are therapists washing their hands between patients? Consider what the atmosphere is like. Are therapists and therapy assistants actively working with patients, or are people standing around waiting to be treated?

· Are people working there wearing a name badge with their job title? They are required to do so in many states, including New York.

healthnet· Inquire about the cancellation policy. Some facilities charge a fee for canceling an appointment.

· Consider how quickly you can get an appointment. If you need to wait more than a week or two, you may be better off finding a facility where you can start sooner, especially if you’ve had recent surgery.

· If health insurance is an important consideration for you, make sure the practice accepts your insurance. Also, if you require special equipment, such as a pool, make sure it’s available at the facility.

· If you feel the physical therapist is not spending enough time with you, appears distracted, or is bouncing back and forth between you and other patients, you may want to find someone who offers more personalized care and attention. The experts say that if you ever feel uncomfortable or if an exercise or treatment is painful, you should speak up.

· You should also receive instruction on exercises to do at home. The therapist may provide handouts, a link to a video demonstrating the correct movements, or another form of instruction to ensure you are doing the exercise correctly.

Your physician and social worker should be able to provide you with a few options for a rehabilitation center. If possible, Healthnetwork will try to assist with referrals for rehabilitation centers; however, we have limited options. Please call our office for more information.

SUSAN LOCKE,MD, is Healthnetwork Foundation’s medical director.

HEALTHNETWORK is a Legatus membership benefit, a healthcare “concierge service” that provides members and their families access to some of the most respected hospitals in the world. One Call Starts It All: (866) 968-2467 or (440) 893-0830. Email: help@healthnetworkfoundation.org

HEALTHNETWORK FOUNDATION is a non-profit whose mission is to improve medicine for all by connecting CEOs with leading hospitals and their doctors to provide the best access to world-class care and increase philanthropic funding for medical research.