Tax tip
Need a last-minute money saver? Contribute to a 2014 IRA before April 15 and reduce your taxable income. The max deduction for those under age 50 is $5,500 ($6,500 for those 50 and older). Taxpayers also can give to the IRA of a young relative or to a person just starting out. Not only might this help the payer, but the lower-income "workers" of all ages can save more, be taxed less and gain a larger health care subsidy if they're not insured through either the taxpayer's medical plan or one at work.
Q: It's time to schedule my first colonoscopy, and I'm apprehensive about an outpatient procedure. Any advice?
-- Freda Frightened
A: Dear Ms. Frightened: Preparation is key here. (And I don't mean the kind of prep your gastroenterologist prescribes.)
While a huge number of outpatient procedures take place in office surgical suites and go off without a hitch, problems can and do occur. Here is some advice from Bottom Line Health that should help make outpatient procedures safer.
1 Check your "physical status classification." This is a numerical scale from the American Society of Anesthesiologists that assesses a patient's surgical risks. Those with physical status (PS) scores of four or five need to be admitted to the hospital for procedures as their risk for complications is higher. For example, someone with poorly controlled diabetes shouldn't have outpatient knee replacement surgery because of various diabetic factors that can result in life-threatening issues.
2 Don't Yellow Page the doc. Not all surgeons have the same credentials or experience. First, ensure that your surgeon is board-certified in his or her field. Secondly, check how many successful procedures the person has performed. Statistics show that the more one has done, the fewer complications arise. The surgeon quoted in Bottom Line, D.C.'s David Sherer, says he wouldn't dream of, for instance, having LASIK eye surgery unless the surgeon's cases numbered in the hundreds or thousands. Get recommendations on a surgeon, just as you would for more commonplace services.
3 Open your mouth. Tell your doctor about the prescription drugs you're taking as well as any supplements. Even something as ordinary as an aspirin can interact with drugs given during and following surgery.When combined with aspirin, garlic supplements increase risk of excessive bleeding. Natural remedies, such as vitamin E and echinacea also raise risks, so be sure to ask if they should be discontinued.
4 Get the paddles. Unfortunately, too many outpatient surgical centers don't have the necessary supplies on hand in case of a life-threatening emergency. For starters, be absolutely positive the center has a crash cart available. Also ask if they have the drug dantrolene on hand to reverse malignant hyperthermia, a rare but deadly complication from anesthesia. And definitely make sure succinylcholine -- a fast-acting paralytic agent that helps to quickly intubate patients who can't breathe -- is nearby. (Had this drug been available when Joan Rivers underwent her procedure, she might have lived.)
5 Nausea is unacceptable. Estimates show that 30 percent of all post-op patients experience nausea. While many anesthesiologists administer something to prevent the vomiting, remind him ahead of time not to forget your dose.
6 Why hurt? The most common (and certainly one of the most serious) post-op trouble is probably pain. It impairs immunity, slows healing time and increases blood clot risks because it prevents patients from moving normally. Emphasize to your surgeon just how terrified of pain you are and ask what he plans to do to alleviate it post-surgery. Remember, too, because of so much bad press that narcotics get these days, medical folks aren't so likely to prescribe strong pain killers for an extended time. Dr. Sherer reveals a recently approved non-narcotic drug, bupivacaine. An extended release injection that lasts for 72 hours, the FDA says the shot relieves pain just as well as narcotics.
7 Move around afterwards. Blood clots, edema, muscle weakness, and other medical problems can arise if such efforts are too negligible. Even if you can't immediately walk, try to stretch, move your arms and legs, roll to your side and so forth. Not only does movement increase blood flow, it also improves recovery time and helps to prevent post-surgical pneumonia.
I like to think I know just enough about plenty of topics to stay out of trouble; however, I must admit the research for Ms. Frightened opened my (preventive) eyes even more. Thanks to both Bottom Line Health and to this reader.
Contact Ellen Phillips at consumerwatch@timesfreepress.com