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By Barbara Bronson Gray
HealthDay Reporter
WEDNESDAY, March 20 (HealthDay News) -- Here's a cautionary tale about the value of moderation.
A case study reported in the March 21 issue of the New England Journal of Medicine shows how habitually drinking an extreme form of highly concentrated tea over almost 20 years created a hard-to-diagnose case of severe bone damage in a 47-year-old woman.
Worried that she had cancer, the patient told her primary care doctor in Lansing, Mich., that she was concerned about bone pain she had been having in her lower back, arms, legs and hips for five years. She also had had all her teeth extracted due to brittleness.
Her X-rays showed her bones were unusually dense, but there was no sign of disease. The fluoride level in her blood was also high. She was referred to Dr. Sudhaker Rao, section head of bone and mineral metabolism and director of the bone and mineral research laboratory at Henry Ford Health System in Detroit, for a bone biopsy.
The patient's intake of brewed tea was astronomically high, said Rao, who learned that the patient had been regularly drinking a pitcher a day of tea made from about 100 to 150 tea bags, which gave her more than 20 milligrams (mg) of fluoride. She had a fluoride concentration in her blood of 0.43 milligrams per liter, while the normal concentration is less than 0.10 mg per liter, Rao reported.
Fluoride is used to prevent tooth decay and is usually prescribed for children and adults whose homes have water that does not naturally have fluoride in it, according to the U.S. National Library of Medicine.
It turns out that Rao, the author of the case study, came from an area in India where fluoride levels in the water were naturally extremely high, sometimes causing a condition called skeletal fluorosis. He has also recently consulted on a few cases involving high fluoride in the blood, he pointed out.
"Most of us can excrete fluoride extremely well, but if you drink too much, it can be a problem," he said. Brewed tea has one of the highest fluoride contents of all the beverages in the United States, according to Rao. He immediately wondered if the fluoride in the concentrated tea concoction the woman was regularly drinking could be the cause of her bone troubles, he said. "There have been about three to four cases reported in the U.S. associated with ingesting tea, especially large amounts of it," he noted.
When Rao tried to perform the biopsy, the woman's bone was so hard he said his instrument could not penetrate the bone. "It was like steel," he said. "Her bone density was very high, seven times denser than normal."
My 13.5 yr old daughter is having some issues. Her family doctor is starting the referral process for depression, cutting and borderline aneroxia. Last aug she weighed 106 at 5 feet. She is now 89pds. She still has not had her first period either. I know enough of the warning signs and we have been trying to help her ourselves over the past 6 months but we are struggling with so many family dynamics. She is very secretive about the friends at her new school so we are limiting her outside independant contact with them. She spends far too much time alone and on social media sites that she says make her feel better. She says that she doesnt visit any pro sites butshe last cut herself on monday. I dont want to be a food warden but she expresses guilt when she eats and she doesnt feel thin enough. We are worried that her self harm thoughts will excelate further and we want to try to avoid going directlyto the emerg dep for an immediate psych eval. Im hoping some of you here can give me some advice in how to keep her on an even keel until the referral comes thru.
Edited May 30 2013 15:01 by coach_k
By Dennis Thompson
HealthDay ReporterWEDNESDAY, May 29 (HealthDay News) -- An Affordable Care Act provision has shielded thousands of young U.S. adults and their families from millions of dollars in treatment costs for serious medical emergencies, a new study shows.
Starting in September 2010, federal health care reform has required private health plans to cover young adults up to age 25 under their parents' insurance.
More than 22,000 cases of emergency hospital treatment in 2011 involving young adults aged 19 to 25 received coverage under private plans due to the expansion, the study found. The coverage protected patients and parents from an estimated $147 million in hospital charges.
The study was published in the May 30 issue of the New England Journal of Medicine.
"Without this provision, they'd be facing hospital bills," said study author Andrew Mulcahy, a health policy researcher at RAND Health, a nonprofit research organization. "Their family might be on the hook for it. If they can't pay, as a last resort, the hospital might have to eat the cost and write it off. Ultimately, in some states, the taxpayers are on the hook because the state chips in and tries to compensate hospitals for care that is uncompensated."
The study also noted that the provision increased health insurance rates about 3 percent among the young adults who sought emergency treatment.
Recent reports have estimated that this particular provision of the Affordable Care Act has led to the coverage of an additional 3.1 million young adults nationally.
In the study, researchers examined details about emergency medical care provided to adults aged 19 to 31 at 392 hospitals from 2008 through 2011.
The study focused on injuries so severe that the young adults would have to receive emergency treatment regardless of insurance coverage, including broken bones and head injuries.
"We were very careful in looking at the most serious conditions -- conditions so serious you have to go to the ER for treatment," Mulcahy said. "This study is about real-world impact and a very direct test of whether the provision is improving financial protection."
Those sorts of injuries accounted for about 6 percent of emergency department visits by young adults, the researchers concluded.
The research team then compared the coverage of those aged 19 to 25 to patients aged 26 to 31, who were unaffected by the new health care law. That way, they could rule out other trends that might have affected the subjects' insurance coverage.
"We found that the provision resulted in increased financial protection for young adults and the hospitals who provided care for these patients," Mulcahy concluded. "We're careful to say it didn't result in additional visits. It's a shift. The provision didn't lead to more people going to the ER. They would have gone without this provision, but they would have been uninsured."
