Medical center plans to offer weight loss surgery
The North Platte Telegraph Weight loss surgery is the newest service offered at Great Plains Regional Medical Center. Dr. Brendon Curtis and Dr. Christopher Seip are the two surgeons who do the procedures.

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Deciphering the Alphabet Soup of Medical Professionals’ Initials

If you’ve ever wondered what the meanings are behind the letters and abbreviations at the end of your healthcare practitioner’s name, you’re not alone. Beyond the commonly known credentials, MD (medical doctor), RN (registered nurse) and PA (physician assistant), there is a litany of titles that signify a medical professional’s specialization, training and professional affiliations. Chances are, as a patient, you know which ailments your doctor or medical professional is capable of treating. However, the medical apparel industry is tasked with understanding medical and technical titles to best serve their clients, who wear lab coats and clinician scrubs in clinical settings, at the hospital, in laboratories and at the office. Lab coats typically bear the names and titles of their owners, who are educated and trained in their chosen profession. When ordering lab coats and scrubs as gifts for graduation, white coat ceremonies or for the holidays and birthdays, it’s important to obtain the recipient’s correct title before it is embroidered on the coat. These abbreviations can sometimes be found on a clinician’s business card but to ensure that you have the right title before ordering, check the list provided below.

A Summary of Common Medical Professional Titles

CDE – Certified Diabetes Educator
CNM – Certified Nurse Midwife
CPT – Certified Phlebotomy Technician
DHM or DHm – Doctor of Homeopathic Medicine
DMD – Doctor of Dental Medicine
DMFT – Doctor of Marriage and Family Therapy
DDS – Doctor of Dental Surgery
DO – Doctor of Osteopathy
DOM – Doctor of Oriental Medicine
DPM – Doctor of Podiatric Medicine
DVM – Doctor of Veterinary Medicine
EMT – Emergency Medical Technician
EENT or ENT – Eye, Ear, Nose and Throat specialist (MD)
EPC – Certified Exercise Physiologist
FAAD – Fellow  American Academy of Dermatology
FAAFP – Fellow American Academy of Family Physicians
FAAO – Fellow American Academy of Optometry
FAAP – Fellow American Academy of Pediatrics
FACE – Fellow American College of Endocrinology
FACP – Fellow American College of Physicians
FACS – Fellow American College of Surgeons
FADA – Fellow  American Dietetic Association
FAGD – Fellow  Academy of General Dentistry
FAPhA – Fellow  American Pharmaceutical Association
FASHP – Fellow American Society of Health-System Pharmacists
FNP – Family Nurse Practitioner
FNP-C – Family Nurse Practitioner, Certified
GP – General Physician
HMD – Homeopathic Medical Doctor
IBCLC- International Board Certified Lactation Consultant
ICCE - Certified Childbirth Educator
ICPE – Certified Postnatal Educator
LAc - Licensed Acupuncturist
LCCE- Lamaze Certified Childbirth Educator
LCSW – Licensed Clinical Social Worker
LM – Licensed Midwife
LMA – Licensed Masters of Social Work, Adv Clinical Practitioner
LN – Licensed Nutritionist
LNC – Licensed Nutritionist Counselor
LNHA- Licensed Nursing Home Administrator
LPN – Licensed Practical Nurse
LVN – Licensed Vocational Nurse

MA – Medical Assistant
MAc – Masters in Acupuncture
MD – Medical Doctor
ME - Medical Examiner
MHSc – Master of Health Science
MNNP – Master of Nursing, Nurse Practitioner
MPH - Master of Public Health
MS – Master of Science Degree
MSN – Master of Nursing
MSW – Master of Social Work
ND – Naturopathic Doctor
NMD - Naturopathic Medical Doctor
NP - Nurse Practitioner
NP-C – Nurse Practitioner, Certified
OB/GYN – Obstetrician who is also a Gynecologist
OCN – Oncology Certified Nurse
OD – Doctor of Optometry; Optometrist
ONC – Orthopaedic (Orthopedic) Nurse, Certified
OPA-C – Orthopaedic (Orthopedic) Physician Assistant, Certified
OT – Occupational Therapist
PA – Physician Assistant
PA-C – Physician Assistant, Certified
PharmD – Pharmacy Doctorate
PhD – Doctorate Degree
PsyD – Doctor of Psychology
PT - Physical Therapist
PTA – Physical Therapist Assistant
RAc – Registered Acupuncturist
RD – Registered Dietitian
RDH – Registered Dental Hygienist
RDN – Registered Dietitian and Nutritionist
RKT – Registered Kinesiotherapist
RN – Registered Nurse
RN-C – Registered Nurse, Certified
RNCS - Registered Nurse Clinical Specialist
RN/NP – Registered Nurse, Nurse Practitioner
RPA-C – Registered Physician Assistant, Certified
RPh – Registered Pharmacist
RRT – Registered Respiratory Therapist

There are some medical apparel manufacturers that offer online ordering of lab coats and medical scrubs. Medelita’s web site offers custom embroidery on women’s scrubs, lab coats and nursing scrubs, for an additional charge.

Kimberly Green
http://www.articlesbase.com/health-articles/what-do-all-the-titles-mean-715878.html

Most Muslims do not fast because of medical benefits but because it has been ordained to them in the Quran. The medical benefits of fasting are as a result of fasting. Fasting in general has been used in medicine for medical reasons including weight management, for rest of the digestive tract and for lowering lipids. There are many adverse effects of total fasting as well as so-called crash diets. Islamic fasting is different from such diet plans because in Ramadan fasting, there is no malnutrition or inadequate calorie intake. The caloric intake of Muslims during Ramadan is at or slightly below the national requirement guidelines. In addition, the fasting in Ramadan is voluntarily taken and is not a prescribed imposition from the physician.

Ramadan is a month of self-regulation and self-training, with the hope that this training will last beyond the end of Ramadan. If the lessons learned during Ramadan, whether in terms of dietary intake or righteousness, are carried on after Ramadan, it is beneficial for one’s entire life. Moreover, the type of food taken during Ramadan does not have any selective criteria of crash diets such as those which are protein only or fruit only type diets. Everything that is permissible is taken in moderate quantities.

The only difference between Ramadan and total fasting is the timing of the food; during Ramadan, we basically miss lunch and take an early breakfast and do not eat until dusk. Abstinence from water during this period is not bad at all and in fact, it causes concentration of all fluids within the body, producing slight dehydration. The body has its own water conservation mechanism; in fact, it has been shown that slight dehydration and water conservation, at least in plant life, improve their longevity.

The physiological effect of fasting includes lower of blood sugar, lowering of cholesterol and lowering of the systolic blood pressure. In fact, Ramadan fasting would be an ideal recommendation for treatment of mild to moderate, stable, non-insulin diabetes, obesity and essential hypertension. In 1994 the first International Congress on “Health and Ramadan”, held in Casablanca, entered 50 research papers from all over the world, from Muslim and non-Muslim researchers who have done extensive studies on the medical ethics of fasting. While improvement in many medical conditions was noted; however, in no way did fasting worsen any patients’ health or baseline medical condition. On the other hand, patients who are suffering from severe diseases, whether diabetes or coronary artery disease, kidney stones, etc., are exempt from fasting and should not try to fast.

There are psychological effects of fasting as well. There is a peace and tranquility for those who fast during the month of Ramadan. Personal hostility is at a minimum, and the crime rate decreases. Muslims take advice from the Prophet who said, “If one slanders you or aggresses against you, say I am fasting.’” This psychological improvement could be related to better stabilization of blood glucose during fasting as hypoglycemia after eating, aggravates behavior changes.

There is a beneficial effect of extra prayer at night. This not only helps with better utilization of food but also helps in output. There are 10 extra calories output for each rikat of the prayer. Again, we do not do prayers for exercise, but a mild movement of the joints with extra calorie utilization is a better form of exercise. Similarly, recitation of the Quran not only produces a tranquility of heart and mind, but improves the memory. Therefore, I encourage my Muslim patients to fast in the month of Ramadan, but they must do it under medical supervision. Healthy adult Muslims should not fear becoming weak by fasting, but instead it should improve their health and stamina.

New research indicates that people with serious mental illness — which include schizophrenia, bipolar disorder, and major clinical depression — die, on average, 25 years earlier than the general population. Sixty percent of premature deaths in persons with schizophrenia are due to medical conditions such as cardiovascular, pulmonary and infectious disease.

Unfortunately, people with serious mental illness also suffer from a high prevalence of modifiable risk factors, in particular obesity and tobacco use. Compounding this problem, people with serious mental illness have poorer access to established monitoring and treatment guidelines for physical health conditions.

Our nation?s healthcare system tends to be fragmented, with increased reliance on specialists who address very focused aspects of the health/illness continuum.

Fragmentation is most notable in the separation between the treatment for mental and physical illnesses. This separation is an artifact of how services have been funded historically, with the preponderance of funding for mental illness treatment coming from states and directed toward state psychiatric facilities that were often — literally and figuratively — far away from the mainstream of medical delivery.
What Can Be Done to Address this Tragedy?

There are solutions to this epidemic of premature death and morbidity among persons with mental illness. Policy makers can provide the policies, resources, and leadership to close this gap. We will have accomplished this goal when we can say that:

- Adequate funding is available to allow every provider of public mental health services to assess the physical health status as well as mental status of clients served in the public mental health system.

- States are learning from and following the examples of states such as Missouri and Louisiana, which are implementing primary care medical home initiatives with explicit mechanisms and financing integrated treatment between the mental health and primary care providers for coordination of services.

- State legislatures can create the policy infrastructure through statute or regulation to ensure that there is a strong working partnership between community mental health and community health provider organizations. These policies can define roles for these organizations, establish referral protocols, or allow for the cross-placement and reimbursement of clinical staff.

Disease Management: Another Promising Approach

Usual medical care often fails to meet the needs of chronically ill patients, even in managed, integrated delivery systems. The medical literature suggests strategies to improve outcomes in these patients. Effective interventions tend to fall into one of five areas: the use of evidence-based, planned care; reorganization of practice systems and provider roles; improved patient self-management support; increased access to expertise; and greater availability of clinical information. The challenge is to organize these components into an integrated system of chronic illness care. One approach to meeting these goals is through the creation of disease management programs.

Disease management (DM) is an approach to care coordination for individuals with chronic or persistent medical conditions for two important reasons: improved quality of care and decreased cost. Quality is improved because treatment is coordinated across the spectrum of care for individuals with these conditions using evidence-based practice guidelines and education on illness self-management. States have also been able to reduce costs through this approach.
The Centers for Medicaid and Medicare Services (CMS) issued a letter to state Medicaid directors encouraging the adoption of DM. Currently, DM is now widely used in states for asthma, diabetes, hypertension and other persistent medical conditions, and increasingly for enrollees with serious mental illnesses.

Washington State Example

On June 28, CMS approved a state plan amendment (SPA) for Washington State that uses the Benchmark Plan option to offer regular Medicaid State plan services plus disease management (DM) services to adult Medicaid recipients with complex medical needs. The benchmark State plan option provides States with the opportunity to offer an alternative benefit package to beneficiaries without regard to comparability of services, a traditional Medicaid requirement.
Medicaid recipients statewide will be identified by a contractor based on claims history, referred by a provider, or may be self-referred. Eligible recipients include those who are diagnosed with certain chronic medical conditions, including: diabetes, heart failure, coronary artery disease, cerebrovascular disease, renal failure, and chronic pain associated with musculoskeletal conditions and other chronic illnesses, including co-morbid depression and/or anxiety.

In addition to the traditional State Medicaid plan services, individuals enrolled in the DM program will receive assistance in locating a primary care provider (“Medical Home”) and additional benefits tailored to specific health needs, including:

- Condition-specific education;

- Access to a nurse call line;

- Regularly scheduled telephonic health care management and support; and

- Care coordination, including feedback to the primary care physician.

Linda Rosenberg
http://www.articlesbase.com/mental-health-articles/an-avoidable-tragedy-the-relationship-of-premature-death-and-serious-mental-illness-696271.html

I know the cost of pump & supplies so that’s not what I am looking for.
Do not need current protocol in feline diabetes management, looking for information beyond that.

I am looking for research papers, or medical guidelines if such a thing exists.

I understand in theory it may be possible to use an insulin pump on a pet, (cost prohibits most people/pets). I want to know if anyone has done it or is researching it.

Thanks.
thanks for the yahoo group suggestion, I will look into it.
What I am looking for is research data above and beyond the current, cutting edge vet medical data.

You can probably find a good answer by joining the Yahoo group for feline diabetes. There are lots of members and as with other "specialized" cat groups on Yahoo there are always one or two members who are very up-to-date on the medical research.

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The American College of Physicians has released an updated clinical practice guideline for the diagnosis and treatment of chronic obstructive pulmonary disease (COPD). COPD is a collection of slowly progressing lung diseases more commonly found in smokers. Over 5% of adults in the US have COPD and it is the fourth primary cause of death and twelfth leading cause of illness. A patient suffering from the disease will typically have a chronic cough, wheezing, and some patients also have a shortness of breath and and activity limitation.

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