Stanford Study: Double Mastectomies Don’t Increase Breast Cancer Survival Rate

(Getty Images)

About one-third of women under 40 diagnosed with breast cancer in California choose double mastectomy. (Getty Images)

By Nancy Shute, NPR

More women are choosing to have bilateral mastectomies when they are diagnosed with early-stage breast cancer, even though there’s little evidence that removing both breasts improves their survival compared with more conservative treatments.

Doctors worry that women choose double mastectomy out of the mistaken belief that it eliminates their future risk of cancer.
The biggest study yet on the question has found no survival benefit with bilateral mastectomy compared to breast-conserving surgery with radiation.

The study, published Tuesday in JAMA, the Journal of the American Medical Association, looked at the records of all women in California who were diagnosed with early-stage breast cancer from 1998 to 2011 — 189,734 women, all told. Continue reading

How Will Your Hospital Fare in the Next Earthquake?

Two buildings at the Veterans Hospital in San Fernando collapsed during the 1971 Sylmar quake. (Photo: USGS)

Two buildings at the Veterans Hospital in San Fernando collapsed during the 1971 Sylmar quake. (Photo: USGS)

One thing about an earthquake: it focuses the mind.

In the wake of last Sunday morning’s Napa Quake, I became focused on hospital safety.

Queen of the Valley Hospital in Napa sustained only minor damage from the earthquake — falling items and leaks. A statement released 13 hours after the earthquake said that “(n)one of these issues have prevented the hospital from triaging and treating patients. Queen of the Valley remains operational and continues to be able to accept and treat patients.” 

Legislation passed 20 years ago, in the wake of the Northridge earthquake, seeks to make Queen of the Valley’s performance the norm for hospitals statewide after a major earthquake. That 1994 legislation was itself an update to the 1973 Seismic Safety Act, which in turn was written in the wake of the Sylmar earthquake when several hospitals collapsed. Continue reading

California Prisons Adopt Plan to Restrict Segregation for Mentally Ill Inmates

A psychiatric segregation cell at Sacramento Prison. (Julie Small/KQED)

A psychiatric segregation cell at Sacramento Prison. (Julie Small/KQED)

By Julie Small

In response to a court order, California prison officials proposed a new approach Friday to how they treat mentally ill inmates who break rules or commit new crimes. The judge who ordered the change immediately approved the plan.

Right now, if a mentally ill inmate refuses to follow orders or attacks another inmate or guards, the prison sends him to a segregation unit. In segregation, prisoners spend more time confined to their cells and must submit to routine strip searches for weapons and drugs. Advocates for inmates have long insisted the conditions only worsen mental illness. Earlier this year, U.S. District Judge Lawrence Karlton unequivocally backed them up.

In an April ruling, the judge wrote, “placement of seriously mentally ill inmates in California’s segregation housing unit can and does cause serious psychological harm” by worsening symptoms, inducing psychosis and increasing suicidal urges. Continue reading

People Found Ineligible for Obamacare Coverage Must Repay Subsidies

A report from Berkeley's Greenlining Institute called on Covered California to make its enrollment website available in more languages than English and Spanish.

The rule primarily affects immigrants. Many people have not provided sufficient documentation to prove lawful presence or citizenship in California.

By Julie Appleby, Kaiser Health News

Consumers getting government subsidies for health insurance who are later found ineligible for those payments will owe the government, but not necessarily the full amount, according to the Treasury Department.

100,000 Californians must provide proof of legal residency or lose eligibility for subsidies.

The clarified rule could affect some of the 300,000 people enrolled in a health plan through healthcare.gov. They face a Sept. 5 deadline to submit additional documents to confirm their citizenship or immigration status, and also apply broadly to anyone ultimately deemed ineligible for subsidies.

California runs its own exchange and is on a different timeline. Covered California will send notices starting next week to 100,000 people affected. They have until September 30 to respond.  Continue reading

Options Outlined in Doctors Medical Center Court Hearing

(s_falkow: Flickr)

(s_falkow: Flickr)

(Bay City News) A federal judge in San Francisco today heard arguments Wednesday for — and against — court intervention that would force financially embattled Doctors Medical Center in San Pablo to restore recently cut emergency services.

The U.S. District Court hearing came amid an ongoing fight to keep the hospital open. Officials have reduced services and shed more than 80 staff members there after multiple failed attempts to cover the hospital’s $18 million deficit.

Earlier this month, the hospital stopped accepting emergency ambulances, closed its heart attack intervention unit and reduced its number of inpatient beds to 50. Emergency ambulances that would normally go to DMC are now re-routed to other area hospitals.

A group of doctors, nurses and community advocates filed a lawsuit in federal court on Aug. 12 against Contra Costa County, each member of the Board of Supervisors and West Contra Costa County Healthcare District and district board chairman Eric Zell. Continue reading

Sleep Apps, Myths and More: Strategies for a Good Night’s Rest

(Flood G./Flickr)

(Flood G./Flickr)

By Kathy Shield

If you go to Apple’s App Store and search “sleep,” you’ll net over 2,000 results. Many of these apps play soothing white noise for a set period of time to help you fall asleep; others are simply alarm clocks. But many track your sleep, providing you with data about your nightly sleep quality, your average sleep time and more.

I must admit, I use Sleep Cycle to track my sleep, and my mom uses FitBit. So when sleep experts answered questions on KQED’s Forum Wednesday, I was more than happy to listen in.

Stanford’s famous sleep scientist, Professor William Dement, joined the panel and described one discovery of his original research that apparently led to the technology to track sleep: “During rapid eye movement (REM) sleep, the body is completely paralyzed except the eyes and the diaphragm.” Continue reading

Earthquake Safety: Stand In A Doorway?

Police officers in Napa prop up a fallen door in front of a damaged building following Sunday's earthquake there. (Justin Sullivan/Getty Images)

Police officers in Napa prop up a fallen door in front of a damaged building following Sunday’s earthquake there. (Justin Sullivan/Getty Images)

I don’t like earthquakes, yet I live in quake country. It’s a paradox.

To mitigate my worry, I err on the side of preparedness. But this post is not to lecture you about creating an earthquake kit (although it’s not hard to do). It’s to let you know what to do the moment the shaking starts.

And it’s to tell you what not to do.

Folks, when the shaking starts, do not head to the nearest doorway. I cannot stress this enough: Do not stand in a doorway. Continue reading

High-Priced Drug Sovaldi Coming to California Prisoners with Hepatitis C

Chino State Prison. (Kevork Djansezian/Getty Images)

Chino State Prison. (Kevork Djansezian/Getty Images)

By George Lauer, California Healthline

It’s the drug that can cure most people with hepatitis C in 12 weeks — but comes at a high cost: $1,000 a pill. Now, California Correctional Health Care Services, which oversees clinical care and drug prescriptions for 125,000 inmates at 34 prisons across the state, began using Sovaldi last month.

Made by Gilead Sciences of Foster City, Sovaldi has become part of the “community standard” for medical professionals treating patients with hepatitis C, according to prison officials. A full course of treatment runs about $84,000.

Hepatitis C, a viral infection that can lead to liver failure, cancer or other health problems, is often associated with intravenous drug use. Many of the estimated 3.2 million Americans living with hepatitis C in the U.S. are poor, imprisoned, elderly or all of the above, giving public systems a disproportionate share of hepatitis C patients. Continue reading

For Some, Medi-Cal Might Mean Ultimately Losing Their Homes

Anne-Louise Vernon in front of her home in Campbell. (Photo: Pauline Bartolone)

Anne-Louise Vernon in front of her home in Campbell. She recently enrolled in Medi-Cal then found out the state could use proceeds from her home to recover costs of her health care. (Photo: Pauline Bartolone)

By Pauline Bartolone, Kaiser Health News

Anne-Louise Vernon had been looking forward to signing up for health insurance under Covered California. She was hoping to save hundreds of dollars a month. But when she called to enroll, she was told her income wasn’t high enough to purchase a subsidized plan.

“It never even occurred to me I might be on Medi-Cal,” she said, in reference to the state’s version of Medicaid, “and I didn’t know anything about it.”

She says she asked whether there were any strings attached.

“And the woman said very cheerfully, “Oh no, no, it’s all free. There’s nothing you have to worry about, this is your lucky day.’” she recounts.

Vernon signed up for Medi-Cal on the phone from her home in Campbell. But months later, she learned online about a state law that allows California to take assets of people who die if they received health care through Medi-Cal after the age of 55. Continue reading

IUD Costs Vary by $600 in Bay Area; What Did You Pay?

Intrauterine devices are one of the most effective forms of birth control, but are relatively underutilized, at least in the United States. (Spike Mafford/Getty Images)

Intrauterine devices are one of the most effective forms of birth control. (Spike Mafford/Getty Images)

If you’re one of the 62 million American women of childbearing age, we have a question for you: How much do you pay for birth control? Did you know you might be able to save perhaps hundreds of dollars on your contraceptive method, just by asking?

Let’s back up. We’ve reached the halfway point in our PriceCheck project. We’re shining a light on notoriously opaque and highly variable health care costs. We’re asking you, the members of our community, to share what you’ve paid for common procedures including mammograms and back MRIs. We found that both screening mammograms and back MRIs could vary in price ten-fold.

Now we’re moving on to a new health care service: IUDs. We’re asking you to share what you paid for your IUD.

The two most widely-used IUDs are Mirena (a hormonally-based IUD) and ParaGard (a non-hormonal product). Both are more than 99 percent effective in preventing pregnancy. Our PriceCheck partner, ClearHealthCosts.com, has surveyed health care providers and lists cash prices for these IUDs in our PriceCheck database. Continue reading