Helping those with PTSD

Helping those with PTSD

Recently, I met a pastor who was a combat marine in 1965 during the Vietnam War who today occasionally suffers from Post Traumatic Stress Disorder (PTSD). Counseling helped a great deal, but the 4th of July fireworks sometimes take him back to the jungle and gun fire of Vietnam. His wife has learned to grab his hand and remind him that he’s safe and with the family in America which helps decrease his stress. How many combat soldiers among us need that comfort and support as well? Further, are there any non-combat people who also suffer from PTSD?

Post Traumatic Stress Disorder (PTSD)?
Post Traumatic Stress (PTSD) is a mental health condition caused from experiencing an extremely terrifying event, being part of trauma or witnessing it. Symptoms may include flashbacks, nightmares, severe anxiety, intrusive, repetitive and uncomfortable thoughts regarding the event. While we often think of it only in combat soldiers it may occur within adults and children of any age.

Adult Symptoms of PTSD
There are a variety of symptoms an individual may experience after a traumatic event.

 Intrusive Memories: Repeated thoughts of the traumatic event may occur as if it was happening now. Sleep may be disturbed with horrific nightmares. Certain events such as fireworks may remind them of the event and trigger a strong uncomfortable physical reaction such as increased heart rate, pulse, respirations and blood pressure. It’s as if the person is reliving it repeatedly.  

Avoidance: Some people desperately try to avoid thinking about the event. The individual may avoid people, places and activities that are a reminder which leads to social isolation.

Negative Changes in Thinking and Mood: Some suppress the memory of the event, but it comes out in negative thoughts about the world and others. Harmful emotions such as fear, blame, guilt, anger or shame may persist. Poor self-esteem may follow. Emotions are numbed with a detachment from family and friends. Individuals may avoid activities once enjoyed.

Physical and Emotional Changes: While some emotions are numbed, others may be hyper aroused. The individual may be easily frightened, irritable, aggressive or always looking out for danger. Self-destructive behaviors such as alcohol, drug abuse or aggressive driving may occur.

Children’s Symptoms
For children >6 years old he or she may reenact the traumatic event through play or experience unusual frightening dreams.

Suicidal Thoughts
If you or someone you now express suicidal thoughts get help immediately! Reach out to someone you trust, a spiritual leader or healthcare provider.

In the US call or text 988 (24 hour a day Suicide & Crisis Lifeline)

US Veterans can call 988 and then press 1 or text 838255 (Veterans Crisis Line)

If the individual thinks they may hurt themself or someone else call 911!

When to Seek Treatment
If the PTSD symptoms persist after a month from the traumatic event or interfere with a normal life, it’s a good idea to seek a healthcare provider or mental health professional.

Psychological Treatments
The American Psychological Association (APA)’s Clinical Guideline recommends various areas of focus.

Cognitive Behavioral Therapy (CBT): The guideline recommends this approach as the first line of treatment. The individual learns to focus their thoughts, feelings and triggers of the PTSD reactions. New ways of coping are developed and harmful memories regarding the traumatic event are lessened. Avoidance behaviors are explored and reduced with slow prolonged exposures. Baby steps reduce fear.

Eye Movement and Reprocessing (EMDR) This therapy is a second line approach. Disturbing memories can become stored inappropriately or greatly repressed. EMDR directs the individual to briefly focus on their painful memory while moving both eyes in certain directions. In essence it restores the painful memory with a more positive one.

The Cleveland Clinic describes it best:
EMDR therapy is a relatively new — but very effective — method of helping people with traumatic memories. When you undergo EMDR, you access memories of a trauma event in very specific ways. Combined with eye movements and guided instructions, accessing those memories helps you reprocess what you remember from the negative event. That reprocessing helps “repair” the mental injury from that memory. Remembering what happened to you will no longer feel like reliving it, and the related feelings will be much more manageable.

Pharmaceutical Treatments
Anti-depressants The Selective Serotonin Reuptake Inhibitors (SSRIs): sertraline (Zoloft), paroxetine (Paxil) have been approved by the FDA for the treatment of PTSD. These drugs increase serotonin and dopamine (feel good) chemicals in the brain. Other medications may help. It’s important to speak with the healthcare provider regarding benefits verses potential side effects.

Ketamine Infusion Along with therapy, Ketamine Intravenous IV infusions were approved by the FDA to treat PTSD in the 1970’s. It’s an anesthetic that reduces pain and improves mood thus reducing the negative symptoms from PTSD. Therapy is more successful. An IV infusion is administered every 2 to 4 weeks.

Experimental Psychedelic Hallucinogenic Treatments
These emerging treatments also known as psychedelic augmentation are being used to enhance therapy by altering the perception and mood of how the brain perceives negative memories. Preliminary evidence has been promising but these substances are dangerous and must be used under the care of a physician. Currently they are illegal in the US except in a few research studies.

While these are both still Schedule I substances—drugs with high abuse potential and no currently accepted medical use—ongoing research efforts have found support for using these compounds in conjunction with therapy to treat various mental health conditions, including PTSD. The Veterans Health Administration’s (VHA) Office of Research Development (ORD) is funding research on psychedelic compounds in Veterans.

Methylenedioxymethamphetamine MDMA (Ecstasy/Molly) This drug works by targeting memory storing and reducing areas of the brain. Fear is reduced while social engagement, openness, positivity, empathy, and compassion are enhanced. It also increases serotonin, dopamine and oxytocin (feel-good) chemicals in the brain. While much is still unknown a positive interaction occurs between the medicine, the psychotherapy, the participant and the therapist.

Psilocybin (Magic Mushrooms) While much remains unknown as well, these mushrooms seem to work on various neurotransmitter chemicals in the brain similar to serotonin. Participants under the care of a physician report a wide range of unusual experiences for 4 to 6 hours depending on the dose. They describe multiple senses occurring at once such as tasting color, loss of self, mystical experiences, bliss, connectedness to others and a diminished fear response.

Along with therapy it induces emotional breakthroughs with greater positive changes in personality, behavior and well-being. Research is ongoing into the efficacy of Psilocybin-Assisted Therapy (P-AT), but more evidence-based research is definitely needed.

How Can Families Help?
Learn more through the National Center for PTSD (https://www.ptsd.va.gov/). Offer to go with your loved one to appointments with healthcare providers. Listen as much as you can to their stories and frustrations. Go for a walk or bike ride with them to reduce stress. Encourage socialization with other family members and friends.

Tips to Deal with Anger
Set a Time Out: Determine a signal when anger and frustrations get heated to take a time out until cooler heads prevail. Agree to share where you’ll go and what you’ll do during the time out. Also determine how long the time out should last.

After the Time-Out: Take turns talking about the problem. Listen without interrupting. Use I think or I feel instead of youstatements. Be open to the other person’s point of view. Focus on things you both think will work and agree on solutions. These are great strategies for all of us but especially for someone with PTSD who struggles with an appropriate anger response.

On A Personal Note:
It’s hard to imagine what our hero soldiers went through during combat in war. One of my Great, Great, Grandfathers lost an arm during the Civil War while the other Civil War grandfather never spoke of it. We didn’t even know he served until recently. He lived in Pennsylvania at the time and probably enlisted or was drafted from there. General – President Grant was a distant relative.

We pondered what happened that kept him so quiet. He was also the relative who traveled by covered wagon from Chicago to western Kansas during the great western migration. Why did he never speak of his war experience? I think PTSD may have played a role.

Personally, I’m praying for peace in the Middle East and with Ukraine and Russia. The last thing we need is another war where our soldiers are called upon to experience horrific combat with injuries and or death.

PTSD occurs in other people who didn’t serve in a war. One can only wonder what horror those victims endured. If you or someone you love suffer from any kind of trauma…please reach out for more information and get help. Ask you pastor or spiritual leader for a Christian counselor who specializes in PTSD or trauma recovery. There is much that can be done.

Thank you to our soldiers who bought our freedom. May you get the love, healing and patience that you need.

Be strong and courageous. Do not be frightened, and do not be dismayed, for the Lord your God is with you wherever you go (Joshua 1:9).

Reference:

“Post-traumatic Stress Disorder (PTSD),” Mayo Clinic. August 16, 2024. https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

“PTSD Treatments APA’s Clinical Practice Guideline Recommends Three Interventions for Treating Posttraumatic Stress Disorder and Suggests Another Four,” April 2025. https://www.apa.org/ptsd-guideline/treatments.

“EMDR,” The Cleveland Clinic, (March 29, 2022). https://my.clevelandclinic.org/health/treatments/22641-emdr-therapy

“Medications for PTSD, American Psychological Association APA (April 2025). https://www.apa.org/ptsd-guideline/treatments/medications

Wadmin, “How Ketamine Infusion Therapy Is helping patients Struggling with PTSD symptoms” Mindful Health Solutions, (February 6, 2023). https://mindfulhealthsolutions.com/how-ketamine-infusion-therapy-is-helping-patients-with-ptsd-symptoms/

  1. Morland & J. Wooley, “Psychedelic-Assisted Therapy for PTSD,” PTSD National Center for PTSD, Veterans Administration, (June 25, 2025). https://www.ptsd.va.gov/professional/treat/txessentials/psychedelics_assisted_therapy.asp

“Helping a Family Member Who Has PTSD” VA PTSD: National Center for PTSD (March 26, 2025). https://www.ptsd.va.gov/family/how_family_member.asp

PTSD: National Center for PTSD, VA, (May 9, 2025). https://www.ptsd.va.gov

I’m a Christian nurse who helps people navigate the murky waters of healthcare

Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

You may visit my website for additional information: jenniejohnsonrn.com

All rights reserved 2025, Jennie E. Johnson, RN-BC, PhD

Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.

Humble – An Inspirational Story

Humble – An Inspirational Story

This story was sent to me via a friend. I thought it was so good that I wanted to share it with all of you. I hope your summer was blessed with wonderful memories.

Enjoy!

 When Henry Ford asked for the cheapest hotel in town… people were stunned.
He had just landed in England — already a billionaire, already one of the most recognized names in the world. But instead of luxury, he walked up to the airport information desk and asked, simply:

“Where’s the cheapest place to stay?” The clerk hesitated. Worn coat. Modest bag. Calm voice. Then he realized who was standing in front of him.

Henry Ford. The man whose name was in every newspaper. The face behind an empire.“Sir… aren’t you Mr. Ford?” he asked, still processing.

Ford nodded. “Yes, I am.”

 Still puzzled, the clerk continued: “I know your son always stays in the best hotels, wears the finest suits. But you—you’re asking for the cheapest room, in an old coat that looks older than you…Why?”

 Ford smiled. Just enough to say everything without saying too much. “Because I don’t need more than a place to sleep. Wherever I stay — I’m still Henry Ford And this coat? It belonged to my father. It keeps me warm. That’s enough.”

 He paused. Then added, quietly: “My son is still learning. He still worries what others think. But I’ve learned to stop paying for approval. I didn’t become wealthy by spending — I became wealthy by understanding what matters, and what doesn’t.”

 A quiet lesson wrapped in humility: True wealth isn’t in what you show — it’s in what you know. You are not your coat, your hotel, or your bank account. You are who you are, wherever you go.

On A Personal Note:
I read this story to my family and most especially my grandchildren after a day of wrangling young children. A silence fell across the room as they loved the story but more importantly learned the lesson.

 Blessed are the meek, for they shall inherit the earth (Matthew 5:5).

Refences:
David Attenborough, “Henry Ford’s Humble Approach to Wealth and Success as Summarized by AI,” Facebook (May 8, 2015). https://www.facebook.com/groups/davidattenboroughfanss/permalink/4128920884045721/

 Be strong and courageous. Do not be frightened, and do not be dismayed, for the Lord your God is with you wherever you go (Joshua 1:9).

I’m a Christian nurse who helps people navigate the murky waters of healthcare
References:

Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

You may visit my website for additional information: jenniejohnsonrn.com

All rights reserved 2025, Jennie E. Johnson, RN-BC, PhD

Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.

Fasting Diets

Fasting Diets

In the past 60 years obesity rates in the US have tripled from 13% in the 1960’s to 43% today. Nearly 70% of Americans are either overweight or obese. Struggling with excess weight is a daunting reality for far too many Americans. Fasting diets have arisen as a possible solution. The question remains: are they helpful in the long run or harmful?

Intermittent Fasting
Alternating episodes of eating and fasting describe the pattern of intermittent fasting (IF). The Leangains Protocol also known as the 16/8 Method is the one most used. Participants fast for 16 hours and eat for 8. Two meals a day are recommended while bingeing is discouraged. Breakfast is the meal most often skipped.

The Eat-Stop-Eat Method involves a 24 hour fast twice a week. While the 5:2 Diet reduces calories to <500 to 600 on 2 days a week.

3 Day Water Fast
Perhaps the most challenging is the 3 Day Water Fast where primarily only water is consumed. In the first 24 hours the glycogen or sugar stored in the liver and muscles is burned for energy. After 24 hours fat is broken down for energy producing ketones as a byproduct. The ketones in the blood create an acidotic state that over time may change gut bacteria, reduce bone health, damage kidneys and lead to increased risk for cancer and other diseases. Keto Flu symptoms include headaches, brain fog and fatigue.

Benefits of Fasting
A review study was done between 2000 and 2019 examining 27 small studies. Most of the study groups had <50 participants and lasted only between 2 and 26 weeks. Validity is required for much larger numbers and a longer length of time. However, it did indicate that there may be a benefit for some intermittent fasting but much more research is needed to better understand the benefits and harms. Some promising benefits include:

Autophagy may occur after prolonged fasting that begins to repair and renew cells. It may play a role in cancer prevention.

Reduced risk factors for heart disease by lowering blood pressure and improving abnormal cholesterol numbers.

Improved insulin effectiveness and glycemic or glucose metabolism.

Enhanced leptin an appetite suppressant which helps one feel full.

Weight loss

Dangers of Fasting
Obviously the longer the fast, the greater the risk of adverse consequences. The 3 Day Water Fast is the most dangerous for a variety of reasons but everyone should use caution and speak with a healthcare provider before engaging in any fasting eating pattern. The harms may include:

–Dangerous Hypoglycemia (low blood sugar): Severe calorie restrictions play havoc with diabetic medications and MUST NOT be attempted without a healthcare provider’s supervision!

Electrolyte Imbalances: Too much water flushes sodium out with the excess water recommended during the fast. Hyponatremia (low sodium) is a dangerous deadly condition that may result.

Gout Eruption: Anyone with a history of gout should also speak with a healthcare provider as severe dehydration and calorie restriction enhances uric acid formation.

Orthostatic Hypotension: Low blood pressure may occur when standing suddenly.

Nutritional Deficits: Lack of a variety of food depletes key vitamins and minerals needed to enhance immunity and body functions.

Muscle Loss: In general, the greater the muscle size, the higher the metabolism. Longer term fasting results in muscle loss.

Dehydration:  Food provides 20% to 30% of daily water hydration and is depleted when fasting.

Psychological Complications: Exacerbation of eating disorders, discouragement and despair when the weight returns.

Refeeding Syndrome
This problem occurs if too much food is consumed following fasting, especially after a 3 Day water fast. During the fast key nutrients have been depleted and the body adjusted to the starvation state. Adding too much food too fast may induce severe electrolyte abnormalities that alter the function of the heart, lungs, brain and kidneys. It induces a myriad of serious potentially lethal complications. Again, working with a healthcare provider is the safest approach to prevent this potentially lethal complication.

 

What Does Work?
I’ve counseled many people on proper weight management that is maintained over time. The following recommendations have been the most helpful for continued success.

The Mediterranean Diet: This eating plan remains the most effective and best tasting strategy for people across the world.

Set Up your Environment for Success: Remove those foods that lead to binge eating. If it’s not good for you it’s not good for your children either. Brian Wansink’s book Mindless Eating describes those unconscious mistakes that sabotage the best of intentions.

Don’t Drink your Calories: Sweetened coffee, alcoholic beverages and sodas are killers.

Increase Protein in your Diet: Protein throughout the day helps stabilize blood sugar levels and reduce cravings.

Reduce your Portion Sizes.

Eat a Variety of Fruits and Vegetables.

Increase your Muscle Mass: Bigger muscles increase metabolism while at rest as you burn extra calories.

Go for a walk, get a good night’s sleep and destress your life.

On A Personal Note:
I’ve maintained a healthy weight all my life. I enjoy the food I love in smaller portions, have added more protein to my diet, and working on increasing my physical activity. This past fall I had a knee replacement. Due to an allergy to the adhesive in the dressing I had to be on Benadryl for a week. It completely reduced my appetite and broke a lifelong sugar craving.

It was all I could do to get the Ensure down that I needed to heal.

However, 9 months later I’ve maintained the 20-pound weight loss. I don’t crave sugar as I did before. I may have a sweet, but it just doesn’t taste the same. Consider a sugar break for 2 weeks. You’ll be shocked how it will also help end your sugar addiction.

Personally, I use a modified 16/8 fast. I eat a very small portion of either a small amount of yogurt, a handful of nuts or a piece of peanut butter toast for breakfast. The protein lingers filling me up until lunch. If’ I’m hungry I eat a palm size of peanuts. Honestly, I’m shocked how it works.

Maintaining a healthy weight is a challenge in a world filled with wonderful food and enormous portion sizes. But you can do it! Try a few of these tips and if you do decide to try a fast, please check with your doctor.

May God bless you as you try some new strategies to maintain a healthier weight over time.

 So, whether you eat or drink, or whatever you do, do all to the glory of God (1 Corinthians 10:31).

I’m a Christian nurse who helps people navigate the murky waters of healthcare
References:

USA Facts Team, “USA Obesity Rates Tripled Over the last 60 Years,” USA Facts (March 21, 2023). https://usafacts.org/articles/obesity-rate-nearly-triples-united-states-over-last-50-years/

  1. Gunners, “Intermittent Fasting 101-The Ultimate Beginner’s Guide, Healthline, Nutrition (May 3, 2024). https://www.healthline.com/nutrition/intermittent-fasting-guide

  1. Mitri, “Fasting for 3 Days: Is It a Game -Changer for your Metabolism or a Risk not Worth Taking?” Welltech/Well Hub (January 1, 2025). https://welltech.com/content/fasting-for-3-days/

  1. Streit, “7 Keto Risks to Keep in Mind,” Healthline (March 25, 2025). https://www.healthline.com/nutrition/dangers-of-keto-diet#5-May-cause-dangerously-low-blood-sugar

Welton et al., “Intermittent Fasting and Weight Loss, Systematic Review” Canada Family Physician (February 2020). https://pmc.ncbi.nlm.nih.gov/articles/PMC7021351/

  1. Raman, “Water Fasting: Benefits and Dangers,” Healthline (October 10, 2022).

https://www.healthline.com/nutrition/water-fasting

“Refeeding Syndrome,” The Cleveland Clinic (June 6, 2022). https://my.clevelandclinic.org/health/diseases/23228-refeeding-syndrome

  1. Wansink, Mindless Eating: Why We Eat More than We Think (December 28, 2010). https://www.amazon.com/Mindless-Eating-More-Than-Think/dp/034552688

I’m a Christian nurse who helps people navigate the murky waters of healthcare.

Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

You may visit my website for additional information: jenniejohnsonrn.com

All rights reserved 2025, Jennie E. Johnson, RN-BC, PhD

Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.

Prescriptions – How the System Works

Prescriptions – How the System Works

Recently, President Trump made news with an Executive Order designed to decrease the cost of prescriptions for Americans. He told a story that articulates the problem best:

A friend of mine who’s a businessman, very, very, very top guy, most of you would have heard of him. Highly neurotic, brilliant businessman, seriously overweight … and he takes the … fat shot drug. He called me up and he said, ‘President… I’m in London and I just paid for this fat drug I take…I just paid $88 and in New York I pay $1,300.’

Unfortunately, this problem is all too common for most Americans who take medications that have not been released in a generic form. President Trump’s first paragraph of the Executive Order describes the problem:

 The United States has less than five percent of the world’s population and yet funds around three quarters of global pharmaceutical profits. This egregious imbalance is orchestrated through a purposeful scheme in which drug manufacturers deeply discount their products to access foreign markets and subsidize that decrease through enormously high prices in the United States.

For as long as I remember the argument for the disparity of the cost of what Americans pay for non-generic medications compared to the rest of the world is that we need to fund research and development. There is no doubt that American drug companies’ revolutionary drugs have developed incredible solutions to many health problems. However, the question remains why must Americans shoulder most of the costs?

The Current System
It takes years to develop a new drug and then test it for efficacy and safety. Drug studies are very expensive involving thousands of people. The FDA then evaluates the results to determine if the new drug should be approved for use. The system only works if the FDA evaluators are independent of the pharmaceutical companies. For years there has been a revolving door of evaluators serving in the FDA then accepting positions at pharmaceutical companies. Questions have arisen regarding the objectivity of these affiliated members.

Generic Drugs
After 20 years or so the new drug’s recipe becomes available to other manufactures and generic drugs are born. They are significantly cheaper than the trade name or newer patent protected drug. Most healthcare providers utilize generic drugs whenever they can to reduce costs for their patients. Currently many are made in other countries. There is a move to bring that manufacturing back to the United States.

Pharmacy Benefit Managers: The Middlemen
Compounding the problem are the large pharmacy benefit managers or also known as middlemen who go-between the drug company and the pharmacy. The Federal Trade Commission issued an interim report in 2024: The report details how prescription drug middlemen profit at the expense of patients by inflating drug costs and squeezing main street pharmacies. It’s a complicated system that President Trump is looking into with the recent Executive Order.  

What You Can Do if Your Medications Cost to Much

 Insurance
If you’re on Medicare during the annual enrollment period, you can change your drug plan to one that is more affordable. Rates tend to increase annually so it’s a good idea to examine your plan and change it to a cheaper one that covers your costs better. A Medicare/Secondary advisor can evaluate your plan.

Coupons
Good RX, and others provide coupons that you present to your pharmacist to get a better price on an expensive medication. They usually require a cash payment to use the coupon. As an example, go to goodrx.com and enter your medication. A list of local pharmacies will be displayed and their cost for that drug. Just because you have most of your medications at one pharmacy doesn’t mean you have to remain with that pharmacy when using a cash payment and a coupon. You may pick up the expensive one at one place and use your insurance for the others at a different place.

Hardship Cases
For some people the cheaper generics just simply don’t work and a newer more expensive trade name still under patent is needed but you can’t afford it. You can contact the drug manufacture directly to inquire if you qualify for a major reduction in cost based on your financial situation.

On A Personal Note:
My husband had a slight detached retina a few years ago. It required several repairs, and very expensive eye drops to heal it. With a little bit of homework, we worked with the doctor, pharmacy and insurance company to find solutions and drops that worked but were more affordable.

I’m on an estrogen derivative that is very expensive. I used Good RX for a few years but the price was still very expensive. Surprisingly, I found it much cheaper on the Amazon Pharmacy. It’s easy to use. Amazon provides a form for the healthcare provider to email the prescription. The medication is sent out in the mail.

Finally, Americans have been expected to carry the heavy burden of all the nations around the world on many issues. It’s time that they step up and share these costs as well. The bottom line for this is to pray for our representatives to come up with commonsense Judea Christian governance to solve the problems of today. May they do so…

Let the wise hear and increase in learning, and the one who understands obtain guidance (Proverbs 1:5).

References:

Kinsey Crowley, “Trump Mentions ‘Fat Shot Drug’ in Executive Order Announcement. Will Ozempic Get Cheaper?” USA Today (May 13, 2025). https://www.usatoday.com/story/news/2025/05/13/trump-fat-shot-drug-ozempic-prices-wegovy/83595110007/ .

“Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients,” The White House, (May 12, 2025). https://www.whitehouse.gov/presidential-actions/2025/05/delivering-most-favored-nation-prescription-drug-pricing-to-american-patients/

Sydney Lupkin, “A Look at How the Revolving Door Spins from FDA to Industry,” NPR Shots Health News (September 28, 2016). https://www.npr.org/sections/health-shots/2016/09/28/495694559/a-look-at-how-the-revolving-door-spins-from-fda-to-industry

Ananya Mandal MD, “Drug Patents & Generic Pharmaceutical Drugs, News medical Life Sciences (September 24, 2016). https://www.news-medical.net/health/Drug-Patents-and-Generics.aspx

“FTC Releases Interim Staff Report on Prescription Drug Middlemen,” Federal Trade Commission (July 9, 2024). https://www.ftc.gov/news-events/news/press-releases/2024/07/ftc-releases-interim-staff-report-prescription-drug-middlemen

GoodRX.com. https://www.goodrx.com    

“How It Works” Amazon Pharmacy. https://pharmacy.amazon.com/?nodl=0&ref_=nav_cs_pharmacy

I’m a Christian nurse who helps people navigate the murky waters of healthcare.

Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

You may visit my website for additional information: jenniejohnsonrn.com

All rights reserved 2025, Jennie E. Johnson, RN-BC, PhD

Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.

Levels of Healthcare: Homecare to ICU

Levels of Healthcare: Homecare to ICU

Many people appear truly confused about the various levels of healthcare available to people when they get sick. This blog will help end some of that confusion.

Diagnosis

Providers
There are several options for diagnosing medical problems. The best approach is to have a long-term relationship with a healthcare provider, whether it be a physician, a nurse practitioner or a physician’s assistant. Doctors are the most experienced having gone to medical school for 3 years then several more years of residency within their area of expertise.

Nurses spend 4 years in nursing school and then another 3 years learning how to diagnose and treat common problems. Physician assistants graduate from college from a variety of backgrounds and then spend 2 to 3 years of medical training.

Facilities
Clinics are also another option for care. You may or may not see a different healthcare provider for each visit and are generally more economical.

 Urgent Care centers are satellite emergency rooms that can handle most common, easy to treat problems and are generally cheaper. Hospital Emergency (ER) rooms provide more comprehensive and challenging care. Some ER’s are trauma centers with staff available for very serious acute conditions.

 For rare and unusual medical problems, it’s wise to seek care in a specialty center generally found within larger urban areas. They have physicians who’ve spent a vast number of years dealing with unique, uncommon health concerns.

Treatment
Day Surgery
Many day surgery centers are popping up throughout the US. They typically handle relatively healthy people who need a surgical procedure and is not expected to have serious complications. The operation and discharge usually occur on the same day. It’s much more economical in many cases than a major hospital operating center. However, a hospital is the best place for a major operation needing additional backup or someone who may have serious complications or possible delayed recovery.

Recovery Room 
Whether in a Day Center or Hospital patients will need to recover from the anesthesia while being monitored following surgery. Once awake and stable they’re moved to a holding area in the Day Surgery facility or a surgical floor in the hospital.

 Acute Care
Regular Floor\
When you think of being hospitalized most have visited someone on what’s known as the regular floor. Stable patients who still need registered nurse monitoring and care are admitted until ready for discharge home. The patient may stay overnight or for a few days depending on their procedure and health status.

 Telemetry Unit
This unit is needed when someone has a heart issue or irregular rhythm problem, and needs monitored while recovering. They are generally otherwise stable patients.

Step-Down Unit
Patients discharged from a critical care unit are often sent to the Step-Down unit where there are fewer patients for each registered nurse. These patients are generally monitored for heart irregularities and respiratory complications. They require greater care than the telemetry floor nurses could provide.

 Critical Care (ICU/CCU)
Registered nurses in critical care units generally have 1 or 2 patients who may be very unstable. Some surgical patients following complicated operations may be sent to ICU for monitoring for dangerous complications in the immediate post-op period.

Chronic Care
Long In-house Hospital Care
Some hospitals have a unit for patients with longer term care needs but are not stable enough to be discharged to another center. They work much like a rehabilitation center but with more closely monitoring and nursing care.

 Rehabilitation Care Centers
These centers provide a few weeks or months of nursing care while someone recovers from a medical problem.

Assisted Living Care
Another name for a nursing home is often assisted living. A registered nurse or a technician is available for medication dispensary and nursing support. The patient isn’t able to care for themself at home. All meals are provided, and staff can help with bathing, etc. Some individuals don’t require heavier medical care but need the assistance with meals and medication support.

Independent Living Care
These facilities offer meals while the individual lives in more of an apartment environment. Medication support can be arranged. Rides for activities and social events are available since most people are unable to drive.

In-Home Healthcare Options
Most people would rather remain in their home for as long as possible. Visiting or home healthcare nurses make home visits to assess patients, change dressings, draw blood or even give IV medications. Most insurance covers their time for a while. Physical therapists also make home visits to provide physical therapy. Private companies may supply nursing aide staff for basic care, housekeeping and simple errands.

Palliative Care
Most people are unaware of the palliative care program provided through hospice. When one is suffering from chronic pain nearing the end-of-life palliative nurses can be extremely helpful. They evaluate all medications and work with a doctor to prescribe overall care that improves the quality of life.

My frail mother suffered from anxiety attacks and explosive diarrhea related to her dementia a year before she died. Sometimes she refused to take any medications to help unless a family member was present. The palliative nurse ordered a cream to reduce her anxiety and a Kefir drink for the diarrhea which greatly improved her life.

Hospice
For someone in the last chapter of their life, the hospice team provides excellent care to ease the suffering. The nurses are also highly trained to assist families in the grieving process as well.

On A Personal Note:
The healthcare system in the United States is certainly complicated but there are a few things you can do to simplify your situation. First, the biggest mistake people make is not getting a second opinion when solutions to a problem aren’t getting resolved. Healthcare providers are human. The really good ones that I know are not threatened by another opinion. They welcome it! They want answers to your problem as well.

Secondly, keep escalating the healthcare providers until you get resolution. Reach out to the larger medical centers where they are experienced at dealing with what I call the weird and the rare.

My mother-in-law had miserable abdominal hives for 6 months. None of the specialists within her city could find a cause despite innumerable tests. It was definitely a weird and rare phenomenon. We took her to the Mayo Clinic in Rochester, Minnesota. In one day, she saw a dermatologist for the rash, a hematologist for the dangerously high platelets and a neurologist for her dementia. The high platelets were causing the rash. A new medication reduced them, and the rash disappeared. Her brain scan showed extensive damage and the cause of her frequent accidents. He gave her the news about no further driving.

Finally, while we all want to have our surgery the closest to home as possible, sometimes that makes life more complicated. Smaller hospitals and day surgery centers are staffed for common procedures and problems. But if you are one of those weird and rare situations you may be better off doing more homework and getting your procedure done at a major medical center where they have more experienced staff to care for your strange problem.

May God bless you with wisdom on finding excellent providers to care for you and yours…

If anyone of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him (James 1:5)

    I’m a Christian nurse who helps people navigate the murky waters of healthcare.

    Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

    You may visit my website for additional information: jenniejohnsonrn.com

    All rights reserved 2025, Jennie E. Johnson, RN-BC, PhD

    Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.