National Heart Month
By Robert J. Gay, MD, Clinical Pathology Consultants, Member of SCAIP

Cardiovascular, or heart disease, is the number one killer of Americans, causing approximately one out of every 2.9 deaths in the United States. A pathologist is a specialized physician who helps your physician with your diagnosis and treatment by supervising laboratory tests and by studying body fluids and tissues.  This assists with your diagnosis and even though they play a significant role in the diagnosis of heart disease, very few people know how their pathologist is involved.

There are various types of heart disease, including coronary artery disease, high blood pressure, angina,  cardiomyopathy and congestive heart failure, making it very important to have regular examinations and screenings. To detect heart disease, especially cardiomyopathy, occasionally a heart biopsy is used. This is performed by using a small catheter with a grasping device on the end to obtain a small piece of the heart muscle tissue. Any time a heart biopsy is performed, a pathologist carefully examines the tissue and determines whether you have a heart condition.  While we are fortunate that Cancer of the heart is rare, other heart conditions are still a serious threat.
   A pathologist is not only important to the laboratory, but also helps the emergency room. Congestive heart failure is when the heart can’t pump enough blood to the body’s other organs. When the heart is under stress, its ventricles secrete brain natriuetic peptide (BNP). Patients arriving at the emergency room with shortness of breath that might be caused by congestive heart failure often get a blood test for BNP while those arriving with chest pain often get Troponin, CRP and CK-MB—blood tests that are used to diagnose a heart attack.
   Believe it or not, your pathologist also plays a role in the prevention of heart disease!  Regular screenings for cholesterol, HDL, LDL and triglycerides, can get you started on medications and lifestyle changes that will prevent serious problems later in life.  Your pathologist is responsible for overseeing these laboratory tests that help make your diagnosis.
   The more risk factors you have, the higher your chances are of developing heart disease. Unfortunately, many risk factors of heart disease are uncontrollable. These include age, gender, ethnicity and heredity.  However, there still many heart disease risk factors that can be controlled such as:
  •    Smoking- Smokers are two to four times at greater risk of developing heart disease.
  •    Poor diet- A diet high in fat has been linked with heart disease.
  •    Lack of exercise- Obesity, overweight and physical inactivity are risk factors for heart disease, even if the individual has no other risk factor.
  •    High Blood Pressure – Over time the damage caused by high blood pressure will lead to heart disease.
  •    High Cholesterol – Healthy adults aged 20 years or older should have a cholesterol test once every five years.
    By controlling as many risk factors as possible through lifestyle changes such as quitting smoking, exercising and eating right you can drastically reduce your risk of heart disease. February is American Heart Month, which is sponsored by the American Heart Association.  In observation of this month, contact your physician to schedule a checkup to determine what lifestyle changes you should make and which preventative screenings you should receive.
   Remember, it is your right to choose your pathologist as carefully as you would choose  your physician. For accurate and timely results, make sure a member of the South Carolina Association of Independent Pathologists reads your next test.
   The South Carolina Association of Independent Pathologists (SCAIP) is a membership-based, non-profit organization that works locally and maintains no affiliations with national laboratories. Members currently include Clinical Pathology Consultants, PA in Conway, Diagnostic Pathology in Myrtle Beach and Palmetto Pathology, PA in Loris and North Myrtle Beach. Visit their website at www.independentpathologists.com.

The healthcare crisis in the United States affects most Americans regardless of age but the senior population including the “Baby Boomers” face the greatest Threat to their quality of life. Many Americans are suffering from the adverse affects of inadequate health insurance coverage for themselves or their loved ones.

   Patient Advocate Foundation (PAF) helps patients who are facing insurance issues, job retention issues and debt crisis issues as a result of their diagnosis of a chronic, life threatening or debilitating disease. Patient Advocate Foundation is a national 501 (c) 3 non-profit organization dedicated to “Insuring Equal Access to Healthcare for all Americans One Patient at a Time”.

   The National Patient Advocate Foundation (NPAF) a companion non-profit organization is dedicated to the mission of creating avenues of patient access to insurance coverage, evolving therapies, therapeutic agents and devices through legislative and policy reform. Both organizations receive generous support from major corporations, associations, universities and private donors.

   PAF’s professional case managers, doctors and healthcare attorneys will personally mediate on the patient’s behalf with their insurance company, their employer and their creditors to help resolve the problems that may be preventing the patient from focusing on getting well while preserving their financial stability.

PAF call counselors provide direct personal services to patients at no cost which include:

Jim who was 48 at the time believed that his insurance would cover the cost of his medical treatment. Faced with the added burden of an unexpected financial crisis Jim became despondent and did not want to go on with his treatment.

I provided Jim with a link to Patient Advocate Foundation. (www.patientadvocate.org.) Out of sheer desperation, my friend filled out an online form for assistance. The next day PAF contacted Jim.

   Now here is where it really gets good. Some of you may remember a TV show named “The Equalizer” it was about a retired secret agent who offered his services to total strangers by running a classified ad in the daily paper offering to help people who were in mortal danger. Well that was a fictional TV show about crime and violence. PAF is very real and it too helps people who are in mortal danger. (Without the violence.)

   Getting back to Jim, PAF filed two appeals with the insurance company and shortly thereafter, the $30,000. was reduced to a $20.00 office visit. PAF was the “Equalizer” for my friend.

You can call PAF toll free at 1-800-532-5274. This may be the most important telephone number you may ever need.

   While I am offering important phone numbers, you may want to make a note of this one too. 1-866-512-3861. This number will connect you to the Patient Advocate Foundation

   Co-Pay Relief Program also known as The Patient Assistance Program (PAP). This much needed service assists patients diagnosed with Breast Cancer—Lung Cancer—Prostate Cancer—Macular degeneration.and provides financial help. The Office of Inspector General (OIG) has approved an additional 23 diagnosis for assistance as the funds become available.

   Assistance may also be available to patients who are experiencing secondary issues as a result of cancer treatment. The website is www.copays.org.

   PAP provides co-payment financial assistance to insured Americans who qualify. Enrolled patients receive direct co-payment financial assistance to help them with the medication co-payments required by their insurance companies. Serious illness can be a financial catastrophe even for patients with private health insurance or Medicare.

   A recent study conducted by the Harvard Medical School indicated that

PAF encourages patients diagnosed with covered illnesses to apply for assistance if they are having difficulties paying for their treatment co-pays. Dedicated call counselors will give personalized assistance to patients, helping them complete the application process.

Physicians play an important role in helping patients enroll in the program. “A physician cannot treat their patients in a vacuum. As care providers, we have to recognize that in order to deliver quality care, we must factor in outside hurdles that insured patients face, including the substantial co-pays for treatment costs”,

says Dennis Gastineau MD., Director, Human Cell Therapy Laboratory, Division of Transfusion Medicine and Hematology, Mayo Clinic and Chair of the Patient Advocate Foundation’s Scientific Board.

Patient Advocate Foundation case managers work with patients to discover local, state and federal programs that provide assistance for their individual needs. The Foundation seeks to empower patients to take control of their own health care issues. PAF has developed six self help publications to assist in this goal.

We often associate chronic conditions with seniors but many chronic illnesses like cancer and heart disease strike younger people as well. The impact of chronic illness on families can have a devastating effect on the financial stability of several generations simultaneously. The uninsured population in America exceeds 45 million people. Add the underinsured including many people who are unaware of the inadequacies of their health insurance plans and the number can more than double.

   A new social dilemma is tearing at the fabric of many American families. It is referred to as the "Sandwich Generation" inherent with caring for children, parents, and grandparents. A serious illness that strikes any of the generations can require large sums of money to supplement the lack of adequate health insurance. The Patient Advocate Foundation may be the family’s best hope to preserve their wealth.

The PAF has developed a series of (three fold) informational brochures in response to

frequently asked questions (FAQ’s) by patients. The brochures are available free of charge and include:

Fortunately there are local care giving services that you can turn to.

"Caregivers of South Carolina" is a family owned service that will save you money. They have been offering care giving services in the home, and private services in hospitals and nursing homes for nearly ten years. They respond to referrals from doctors and hospitals on a daily basis. Call them at 347-6440 and compare their rates to corporate franchises in the area.

The NCI Cancer Advocates E-News is a newsletter that comes out every other week with news tailored to the cancer advocacy community. Get information on clinical trials and new treatment updates. Federal agency fact sheets updates and related websites.

To subscribe send an email to listserv@od.nci.nih.gov with the following command in the message body: subscribe cancer-advocates

Conversations in Care® The power of open communication between patients, doctors, family members, friends, and health care support personnel is explored in depth on this interactive website. Read the completed portion of a manual on patient communications that will grow chapter by chapter. Each chapter is authored by a leading expert in the field of communications. A multimedia library of dramatic audio and video productions that are moving and informative is available. This site is a must for CSA’s and anyone interested in understanding the sensitivities inherent in dealing with serious illness.

www.conversationsincare.com

Provides information on free or low cost temporary lodging to families or patients who are undergoing treatment away from home.

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Pecan Pie Bars

Abbie Hall

I’ve made these bars for my family for years, and now everyone at work wants me to bring them for covered dish dinners!

3 cups all-purpose flour

1/2 cup white sugar

1 cup butter

1/2 teaspoon salt

4 eggs

1 1/2 cups light corn syrup

1 1/2 cups white sugar

3 tablespoons margarine, melted

1 1/2 teaspoons vanilla extract

2 1/2 c

ups chopped pecans

1.       Preheat oven to 350 degrees F.  Grease the sides and bottom of one 15x10 inch pan.

2.       In a large bowl combine the flour, 1/2 cup sugar, margarine or butter and salt until the mixture resemble coarse crumbs. Press firmly into the prepared pan.

3.       Bake at 350 degrees F for 20 minutes.

4.       In a large bowl stir the eggs, corn syrup 1 1/2 cups white sugar, melted margarine and vanilla until blended. Stir in the chopped pecans.

5.       Spread the filling evenly over the hot crust. Bake at 350 degrees for 25 minutes or until set. Let cool before slicing.

Cranberry Ambrosia-Cream Cheese Spread

L Ambrose

This spread has been a favorite at my holiday parties for years.

2 (8-ounce) packages cream cheese, softened

1/4 cup powdered sugar

1 (6-ounce) package sweetened dried cranberries, divided use

1 (15 1/2-ounce) can crushed pineapple, drained well

1 (11-ounce) can mandarin oranges, drained well

1 (3 1/2-ounce) can shredded coconut, divided use

1 cup chopped pecans, toasted

Pecan halves, toasted

Ginger snaps 

Stir together cream cheese and sugar until blended. Add dried cranberries, reserving 1/4 cup cranberries. 

   Drain pineapple and oranges; pat dry between layers of paper towels. Set oranges aside.

   Stir pineapple and coconut into cream cheese mixture, reserving 1/4 cup coconut.

    Stir in chopped pecans. Spoon mixture into a serving bowl. Sprinkle reserved dried cranberries around edges of bowl.

   Arrange orange segments around inside edge of cranberries. Sprinkle reserved 1/4 cup coconut in center, and top with pecan halves. Serve with gingersnaps.

Codfish Potato Salad

Dried, salted codfish

3 lbs potatoes

8 cloves garlic, sliced thin

Fresh Italian flat leaf parsley, chopped

Extra Virgin olive oil, salt, white pepper to taste

    Boil codfish, discard water at least three to four times to remove excess salt, then simmer for about 10 minutes until fish is soft and can be broken up into small pieces.

   Boil potatoes until tender.   Use small red creamers or small Yukon golds, leave skins on, slice or cube when cooked.

   Mix fish, potatoes, oil, salt, pepper together, add parsley and toss gently.   Serve at room temperature or cold.  This actually tastes best after a couple of days when all flavors have a chance to blend.

   History:  Many Italian families celebrate Christmas with a variety of fish fixed different ways.   This was my father’s favorite and Mom only made it to serve on Christmas Eve.  One year, celebrating Mom’s birthday on Christmas Eve at my home, I surprised both parents by serving this dish. I’d never tried it before, but had watched Mom for so many years, it wasn’t difficult to do. I since have made it many times for my husband who really enjoys it, so we might have it for a treat once or twice during the year instead of just at Christmas.

  Here in Columbia, I’ve been fortunate to find the salted cod, packed in wooden boxes (usually a product of Canada) in the freezer section at my local Publix supermarket.

Paulette Kindler

Columbia SC

Eggnog Pie

Jim Morgan

Nutmeg rocks...I forget to use it year-round, and I should, but when I do smell or taste it....it reminds me of the holidays.

1 pkg Jell-O Vanilla Pudding and Pie Filling mix,

6-serving size (not instant) 

1/4 tsp ground nutmeg 

2 C Borden EggNog (dairy fresh, not canned) 

1 1/4 C Milk 

3 T light rum (1tsp rum flavoring); optional; or Kahlua 

2 C whipping cream (1 pint); whipped 

1 9” baked pie crust 

additional ground nutmeg 

In medium saucepan, over medium heat, cook pudding mix using milk and Borden EggNog according to directions on package until thick and bubbly; mix well. Remove from heat. 

   Stir in nutmeg. Stir in rum (optional). Cool or chill thoroughly. Beat until smooth. 

   Fold in whipped cream. Spoon into prepared crust. Garnish with additional nutmeg. 

Chill 4 hours or until set.

Store leftovers covered in refrigerator.

MaryAnne H

Wanted to share this with your readers. My children help me put this mix together to give to neighbors and teachers. They also make delicious cookies

Cookie Mix

1 cup all-purpose flour

1/2 tsp each salt and baking soda

1 cup mini baking M&M’s

13/4 cups old-fashioned oatmeal

1/4 cup each packed dark-brown sugar and granulated sugar

1 cup peanut butter chips

Heat oven to 350°F. Have baking sheet(s) ready. Empty cookie mix into a large bowl, breaking up if clumped. Work in butter with a rubber spatula. Add eggs and vanilla; stir until well blended. Drop heaping measuring tablespoons dough 2 in. apart on ungreased baking sheet(s). Bake 12 minutes or until golden brown. Cool on baking sheet on a wire rack 2 minutes before removing to rack to cool completely.

   Combine flour, salt and baking soda and place in a 5-cup jar with a tight-fitting lid. Top with layers of M&M’s, then oats. Mix sugars; add to jar. Top with peanut butter chips. Cover; give with recipe card.

Write on recipe card:

1 jar Cookie Mix

1 1/2 sticks (3/4 cup) butter, softened

2 large eggs, beaten

1 tsp vanilla extract

Store (mix): Room temperature 1 month