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| Know his rights like patient |
| Know his rights like patient |
Writing / agency
Washington Hispanic
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| Many states have an office of defensoría of the people for problems with the care of the long-term health. |
Like patient, we all have certain rights. Some of them are guaranteed by the federal, such laws as the right to receive a copy of his case history and the right to preserve the privacy of the information. Many states have other laws that protect the patients. Also, the health centers usually have a declaration of the rights of his patients.
An important right of the patient is the informed assent. That means that if you must surrender to a treatment, the doctor will give him the necessary information so that it takes a decision.
Many hospitals have persons who advocate the patients who need help, if they go so far as to have some problem. Many states have an office of defensoría of the people for problems with the care of the long-term health. The department of health of his state also can help it. The rights of the patient.
I. Information revelation
The person has right to receive information precise and easy to understand about the health plan, professionals of the health and facilities of attention. If the person speaks another language, it has a physical or mental disability or simply there is something that does not understand, help will be given him so that it could take decisions of attention in health properly informed.
II. Professionals' selection of the health and plans
The person has right to a professionals' selection of the health that they offer to him sufficient access to the attention in appropriate health and of high quality.
III. I access to emergency services
If the person has an intense pain, an injury or a sudden illness that convinces it with that his health is threatened seriously, it has right to receive services of evaluation and stabilization of urgency where and when I needed them, without authorization or previous financial compensation.
IV. Participation in the decisions of the treatment
The person has right to know all the treatment options and take part in all the decisions about his care. The parents, tutors, relatives or other individuals that the person designates can represent it if she cannot take its own decisions.
V. Respect and not discrimination
The person has right to a considered, respectful and not discriminatory attention on the part of his doctors, representatives of the plan of health and other professionals of the health.
VI. Confidentiality of the information of health
The person has right to speak in confidence with the doctors and to which protects the information of medical attention. Also it has right to check and copy its own medical record and request that the doctor corrects it if it is not precise, excellent or finished.
VII. Complaints and appeals
The person has right to a just, rapid and objective review of any complaint that has against his health plan, doctors, hospitals or another attention personnel in health. The previous thing includes complaints about waiting times, hours of functioning, the conduct of the personnel of medical attention and the conditions of the facilities of attention of the health.
Responsibilities of the patients
In addition to underlining the rights of the pacietes for the attention of the health, the protection Commission of the Consumers and Quality of the Industry of the System of Health (Advisory Commission on Consumer Protection and Quality in the Health Care Industry) also establishes the responsibilities that the user has opposite to his own medical attention. The planned responsibilities are the forms at which the user can be employed together with the doctor to achieve the best result as health.
* To take responsibility of maximizing the healthy habits like the exercise, without smoking and consuming a healthy diet.
* To interfere in specific decisions of medical attention.
* To be employed in a collaborating way with the doctors at the development and fulfillment of the agreed plans of treatment.
* To reveal the excellent information and to communicate with clarity the desires and the needs.
* To use the internal process of complaint and appeal of the plan to face the worries that could appear.
* To avoid to spread the illness deliberately.
* To recognize the reality of the risks and the limits of the medicine and the fallibility humanizes of the medical professional.
* To realize the obligation of the doctor to be reasonably efficient and equitable on having given attention to other patients and the community.
* To know about the coverage of his plan of health and the options of this one (when they exist) including all the benefits that cover, limitations and exclusions, the rules of the use of the information and the process to appeal the decisions of coverage.
* To show respect for other patients and the workpeople of the health.
* To do a bona fide effort to expire with the financial obligations.
* To expire with the administrative and operative procedures of the plans of health and of the doctors.
* To report about crimes and frauds to the dependencies or appropriate legal authorities.
| A survey of the program Window of Health of the consulate of this country in DC delivers lights on this population |
| Mexicans of the area do not have medical insurance |
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| Alcira Farrier. Foto:Felipe Lagos/WH. |
For Felipe Lagos
Washington Hispanic
A recent survey done to users of the Window of Health of the Hispanic Institute of Prevention of the Blindness, thought that their 70 % does not possess medical insurance.
The finds, which are gathered from the personalized survey of needs that realizes all the persons who agree to realize preventive examinations in this program, it throws a light to the condition and the perceptions of health of a population who often is left aside by surveys or investigations with a vaster scope.
Alcira Farrier, manager of Programmes Window of Health of the Consulate of Mexico in DC, points out that the survey does not remain there, because immediately afterwards it offers to the true persons measurements to take depending on the result. “This information is born of an individual evaluation of the needs of the persons. Apart from this, it offers them options to do something on this matter. It is not an only one question, but based on the answer options and education are offered. The principal target of the Window of Health is to help these persons to find a medical hearth, a place where they could have a health provider”, says Farrier.
— What other important information appears in the survey?
“, On having asked them if they have an illness, 80 % says that not. Nevertheless, 77 % says that he needs a medical examination. 75 % attention of the eyes and 48 % says that it needs a sight from the dentist. Of the whole of polled patients, who are 1.822 during the first trimester of 2009. Only 27 % has done an examination to himself in the last year. This means that we are speaking about the people that they have surely not even illnesses, that examinations neither have been done nor have gone to the doctor any more than one year ago, but if they believe that they need an examination. The problem is that they do not have where to go”.
— How many of these persons gained access to a medical hearth?
“ I do not know it, but 46 % received a reference to a public clinic of health. Namely 860 persons had the need to be present at a welfare center. A reference one gave them to all of them, but it is necessary to make to notice that we do not have the mechanisms to state if it is that these persons did his appointments. The following step is to do a pursuit to state if the persons could have gone and if not, to see what are the barriers that they avoid that they do it or that enrolen in community clinics”.
— What is the most excellent thing that presents this survey?
“ First, what it is necessary to rescue is that these are statistical first hand of a population to whom many studies are not done. For me they have a big value because this is a submerged population. That's why, to obtain this information facilitates to us to see what so well they work the Window of Health. From this point of view, considering the resources and the targets, we can see that this project is successful because they are the relatively young people that in a big percentage they do not have surely and that although they do not have medical conditions, can be because they have not gone to the doctor. But also it can be that there are conditions that have not been detected, like the diabetes, that they have major influence in the Mexican population”.
— Also it can be that they have certain conducts of risk that in the future cause them problems of health.
“ Correct, especially thinking that their three per cent have never had an examination in his life. This makes to see that the window is very useful to assure that they register in a clinical hearth”.
| Actuality |
| A good nutrition can save cancer patients |
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| When the patients receive the cancer diagnosis, the fourth part loses the appetite, and most of the treatments can have side effects that worsen the problem. |
Agencies
Washington Hispanic
The serious undernourishment and the loss of weight influence at least one of the five deaths for cancer in the United States, but the feeding is generally slightly secondary for the patients until it turns into a real problem.
Fortunately changes begin to be seen, from the chefs gourmet that begin being employed at the hospitals up to the dietitians of the American Society of the Cancer who have a telephone line.
With the cancer "it is necessary to give many other nutrients in every morsel", said the certified chef Jack Shoop. The specialist was employed usually at restaurants, but now it is in charge of the kitchen in the American Centers of Treatment of the Cancer in Philadelphia.
To do that the meal is tasty is a big problem. When the patients receive the cancer diagnosis, the fourth part loses the appetite, and most of the treatments can have side effects that worsen the problem.
Other common discomforts are the nausea, vomiting and diarrhea, but some types of cancer also inhibit the nutrients absorption. In addition to the alterations in the taste, make them ill they can suffer also mouth injuries, the dryness, difficulties to swallow and constipation.
Almost half of all the patients of cancer go so far as to endure a syndrome called caquexia, which is characterized by the loss of a big quantity of weight and undernourishment, for what not only there lose fat but essential muscles.
The body of a healthy person adapts itself when it does not receive enough calories and slows down the metabolism to preserve the nutrients. But the body of a patient of cancer does not manage to do this adjustment of the metabolism and even can go so far as to accelerate it.
The National Institute of Cancer thinks that the caquexia is the prime mover of the death of at least 20 % of the patients of cancer, although the advanced cancer might go so far as to end with his lives.
The American Society of the Cancer recommends to the patients to ask for the consultancy of a just dietitian when the cancer diagnosis should appear. Although this is a common practice in the centers specializing in cancer, where the dietitians are a part of the base personnel, it is not anything normal in other parts as it is showed by the studies, which show to only one third of the patients with attention in the nutritive diet.
" The patients who have a good nutrition have less demurrages and more fellings in hospitals and can tolerate better the treatment", in addition to that they have a better quality of life, said Colleen Doyle, chief of nutrition in the society that it offers consultancy in an available telephone line in the United States.
The patients usually look for information in Internet in the middle of the desperation but they cannot discern which advices are valid.
For example, the myth exists in Internet on which the sugar does that the cells of the tumors grow. But this is not true, according to Maureen Huhmann, the director of the group of oncological nutrition of the Association of Nutriólogos Estadounidenses. In fact the malteadas with proteinic additives and the batters of fruits can save the lives of some patients.
" It is not good that the people begin to lose weight because he stops eating things when it must not do it", said Huhmann.
There are persons who have excess weight when cancer diagnoses them and feel good of losing weight until they discover that not only they are remaining lean, but also without muscles.
| To his health |
| How to recognize a heart attack? |
For the doctor Elmer Huerta
The director Preventorium del Cáncer
Washington Hospital Center
I remember very well the first heart attacks to that I attended in my medical career. It was in the Public welfare of Lima of the avenue Grau, place that I moderated my beginner nerves and learned much of what it is the practice of medicine of urgencies.
One of the showiest signs of a cardiac infarction is the paleness of the patient; a waxen paleness, almost always accompanied by an abundant cold sudoración. But the clinical image that more I have had left is the calm anxiety, the calmed desperation and the angustiante worry that there shows the patient, who anticipates that in every respiration him the life goes away and knows that it is traveling how in a juggler's, afraid wire of move not to worsen very much the things.
So pronounced (and harmful) is this anxiety that one of the first treatments in the emergency is to administer generous morphine doses to sedate and obnubilar the conscience of the patient. What it spends is that the anxiety liberates enormous adrenaline quantities, a hormone that accelerates the heart and makes it work more, slightly logically counter-productively when the heart is having an attack for lack of blood.
Speaking about blood absence, this is precisely what happens in an attack or cardiac infarction; the heart remains without blood and it is the intensity of this isquemia (palabrita skill that it means precisely lacking in blood), which is going to determine the gravity of the heart attack.
Let's remember that the heart is a bomb that expels fresh blood across the enormous artery aorta to feed to the whole body. The heart is a bomb so efficient that it works day and night, pumping blood 70 to 80 times per minute, making to circulate in a minute, the whole blood of an adult (5 liters and a half).
But as well as the heart has the responsibility of pumping fresh blood to feed to the body, has also that to feed itself. For that it uses of a few small arteries called coronary arteries, which distribute fresh blood to the proper heart.
There it is where the problem takes root with the cardiac infarction, these coronary arteries are stopped up by the called cholesterol badges, by what the heart is remaining without blood for itself. This blood decrease produces one of the first symptoms of the heart attack, the sensation of heaviness and discomfort in the breast, almost always during a physical effort, which is when the heart needs more blood for itself. This is what in medicine is called an angina pectoris.
Sometimes, these cholesterol badges break, producing to him a paradoxical one bled inside the proper coronary artery. That one bled forms a clot that stops up the artery, which can be so massive that it causes instantaneous death for cardiac unemployment.
It is known that of every 100 heart attacks, approximately 20 % is these massive attacks that have no time for anything, the death is fulminating. Approximately 30 % is the called “heart attacks of soap opera” in which there is breast pain, sudoración, paleness, anxiety and sometimes morning sickness and vomiting; in this type of attack there is time to go to the hospital. The rest, or 50 % is treacherous and silent, they last hours or days and make a mistake with indigestions, pains of jaw, and weariness without apparent reason.
These are some of the symptoms that can precede a heart attack:
• Pain in the breast or sensation that “an elephant sits down on the breast”, is missing of air in rest, extreme fatigue, pain that is radiated to the left arm, in the neck or in the jaw. Also pain appears in the mouth of the stomach or sensation of indigestion, morning sickness or vomiting, sudoración fry, sickness or sensation of faint, sometimes lost of conscience.
It is incredible but as well as men and women are so different in many things, they are also very different as for the frequency, age of appearance and type of symptoms of a heart attack.
The males can begin having attacks at the age of 40, while in the women, these are rare before 40 years, in them the infarctions begin appearing after 50 years. After 60 years, the number of infarctions is equal in men and women.
Another important fact is that the women have symptoms very different from that of the men, being the principal one that they have great less frequency of pain of breast.
Before end, because I am sure that some readership began feeling already dolorcitos in the breast as they were reading this note, I believe that it is very useful to remember that the majority of heart attacks in men happens after the 40 and in women after 50 years. In such a way that if reading you have between 20 and 30, it is very probable that this dolorcito in the breast is not a heart attack, but anyhow it must see his doctor because one of the consequences of the recent obesity indexes in our society is the heart attacks appearance in young people.
We must remember that these illnesses are prevenibles and that the eight most important risk factors to develop them are a sedentary life, feeding abundant and very rich in fats, excess weight and obesity, to smoke cigarets, not treated blood pressure, not controlled diabetes, high cholesterol and not controlled stress
Those persons who have a major number of these factors of risk, have logically more probabilities of suffering a brain haemorrhage or a heart attack.
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