Life Line Screening - Worth the Money?

A patient brought in a flyer for Life Line Screening where for $129 an individual can have their carotid (neck) and peripheral (leg) arteries screened for blockage, abdominal aorta for aneurysm (swelling), and osteoporosis. The advertisement claims that "we can help you avoid a stroke" and their logo notes Life Line Screening - The Power of Prevention.

The question is whether having this Life Line Screening test is worth your money?

Short answer? No.

Although the flyer correctly indicates that 80 percent of stokes can be prevented, the National Stroke Assocation does not recommend ultrasound as a screening test. Preventing stroke includes quitting smoking, knowing your blood pressure and cholesterol numbers, drinking alcohol in moderation (if already doing so), regularly exercising, and ingesting a low sodium diet. Their is no mention of an ultrasound test. Why?

Because there is NO evidence that this type of ultrasound testing saves lives in individuals who are healthy and have no symptoms except for the following situations.

The United States Preventive Services Task Force (USPSTF) latest guidelines recommend only screening men between age 65 to 75 years old who have ever smoked to be screened for an aortic aneurysm. If you are in this group, ask your doctor for an ultrasound.

For women, osteoporosis screening should begin at age 65 years old and have a bone density test done. Among the "different bone measurement tests performed at various anatomical sites, bone density measured at the femoral neck by dual-energy x-ray absorptiometry (DXA) is the best predictor of hip fracture." It is unclear how accurate or how good ultrasound of the heel or wrist is compared to the bone density test. If you feel you have other risk factors, like family history, use of steroids for a long period of time, then check with your doctor to see if screening should be done sooner. Otherwise at age 65, all women should be evaluated not with an ultrasound but a bone density test.

USPSTF recommends against screening for peripheral artery / vascular disease (PAD) as well as carotid ultrasound.

Worried about either condition? Ask your doctor. For peripheral vascular disease, particularly when significant, individuals commonly have leg pain when walking. The blockage in the arteries decreases blood flow to the leg muscles when active causing pain. When the person stops walking, the pain resolves. A doctor can determine whether you have PAD by seeing if you have good foot pulses simply by placing fingers on the pedal pulses. If your pulses are normal, then you don't have significant PAD. If the doctor is concerned about your symptoms, he will order an ultrasound which will be covered by insurance.

There is a reason why Life Line Screening in small print writes that they do "not participate in the Medicare program and the cost of [their] screening services is not covered or reimbursable by Medicare" as well as they do "not file insurance claims and the cost of [their] screening services is your responsibility."

There is NO scientific evidence these tests can make a difference except in the specific situations listed above. Since insurance companies and Medicare only want to cover what is proven, Life Line Screening wants you to pay for an essentially unnecessary test.

Better use for your money? Check your blood pressure and your cholesterol. Quit smoking. Cut down alcohol use if you already drink. Maintain a low sodium diet. To prevent osteoporosis, women should take 1200 to 1500 mg of calcium per day as well as 800 to 1000 IU of vitamin D daily.

For $129? Get a really nice pair of walking shoes. Get a pedal exerciser for under your desk. Keep your muscles moving and maintain a healthy weight.

Oh, please don't spend too much money on multivitamins because they aren't worth the money either.

Want more helpful tips? Worry about whether you are getting the best medical care? Does your doctor seemed rushed? Not answering your questions? I have a solution for you!

Multivitamins Not Worth the Money - Except...

Interesting, yet hardly surprising story that in most cases multivitamins are NOT worth the money.

The source is from an article from the Annals of Internal Medicine specifically:

• the 161,808 postmenopausal women enrolled in the Women's Health Initiative Study that took multivitamins there was no protective effect from common forms of cancer, heart attacks, or strokes.
• during the eight years of observation, the numbers of deaths were the same between women who took and did not take vitamins.

There were situations, however, which are still every important vitamins are taken. These are:
* Folic acid supplements in women who are pregnant or plan to become pregnant can help to prevent serious neural-tube defects that affect the baby's brain and spine.
* Supplements that contain more vitamin D and calcium than is present in regular multivitamin pills can help older men, and especially women, avoid osteoporosis and bone fractures.
* Supplements of vitamins C and E, beta-carotene, zinc, and copper may slow the progression of vision loss in people with early macular degeneration.

Check with your doctor to see if multivitamins are necessary or a waste of your money and time.

Book Review - How to Save on Prescription Drugs

Fairly good. Mostly accurate.

Dr. Edward Jardini, a family physician focuses on one aspect of healthcare costs, specifically prescription drugs. His 20 cost-saving methods break down into the following groups.

(1) eliminate nonessential prescriptions – stop medications no longer needed because the problem resolved, medications no longer worked, medications never worked, medications were never needed.

(2) think beyond the prescription bottle – treat whatever ails you with lifestyle changes (lose weight, exercise, eat healthier, quit smoking), nondrug treatments, prevent disease naturally.

(3) avoid overpriced me-too drugs – don’t asked for advertised drugs, don’t take free drug samples (it’s how drug companies get you hooked on their most expensive drugs), insist on generic drugs, insist on cheaper drugs in the same medication class, for a particular medical problem (i.e. allergies), get the medication class that is cheapest (antihistamines like benadryl are cheaper than nasal prescription steroids).

(4) be smart – split tablets, be prescribed the right dosage or amount (some medications cost the same for the 20 mg and 40 mg so if you take two 20 mg pills per day, it would be cheaper to tae a 40 mg pill), ask to see if another dosage exists, don’t treat one medication’s side effects with another, shop around, get it for free (take free samples that you absolutely need and enough for the short period of time you need it or if you’ll get insurance to cover the cost), and finally,

(5) use pill programs – programs from drug companies that give discounts (PPA Rx 1-888-4PPA-NOW or www.pparx.org), through the federal government like the VA, TRICARE, or state through Medicaid / Medi-Cal, and possibly Medicare Part D).

Overall the advice is good and we should always ask the doctor for generic medications that are effective for the problem at hand and not get fooled by slick advertising. An excellent free website listing drugs that are the best value for the conditions they treat is by Consumer Reports and found at www.crbestbuydrugs.org. I was surprised he didn’t include this important unbiased source. He also didn’t talk about how Wal-mart and other retailers offer $4 prescription medication and for 90 days, it would cost $10. Another cost saver.

At times, the advice given was misleading or overly optimistic. On page 3, he notes that the generic cholesterol medication lovastatin 10 mg tablet is 58% cheaper than the brand name Lipitor 10 mg pill which is true. What he failed to mention is that the generic drug is only ¼ as potent which means you’d need four times as many pills to get the same cholesterol lowering effect! For the area on think beyond the prescription bottle, yes lifestyle changes would be great, but for the vast majority of people they’ve tried dieting, exercising, and they ultimately need medications to address their medical condition. Telling us what we should do but despite our best intentions are unable to do so really isn’t a cost-saving method per se. Dr. Jardini focuses on one aspect of healthcare costs, specifically prescription drugs. His 20 cost-saving methods break down into the following groups.

(1) eliminate nonessential prescriptions - stop medications no longer needed because the problem resolved, medications no longer worked, medications never worked, medications were never needed.

(2) think beyond the prescription bottle - treat whatever ails you with lifestyle changes (lose weight, exercise, eat healthier, quit smoking), nondrug treatments, prevent disease naturally.

(3) avoid overpriced me-too drugs - don't asked for advertised drugs, don't take free drug samples (it's how drug companies get you hooked on their most expensive drugs), insist on generic drugs, insist on cheaper drugs in the same medication class, for a particular medical problem (i.e. allergies) get the medication class that is cheapest (antihistamines like benadryl are cheaper than nasal prescription steroids).

(4) be smart - split tablets, be prescribed the right dosage or amount (some medications cost the same for the 20 mg and 40 mg so if you take two 20 mg pills per day, it would be cheaper to take a 40 mg pill), ask to see if another dosage exists, don't treat one medication's side effects with another, shop around, get it for free (take free samples that you absolutely need and enough for the short period of time you need it or if you'll get insurance to cover the cost), and finally,

(5) use pill programs - programs from drug companies that give discounts (PPA Rx 1-888-4PPA-NOW or www.pparx.org), through the federal government like the VA, TRICARE, or state through Medicaid / Medi-Cal, and possibly Medicare Part D.

Overall the advice is good and we should always ask the doctor for generic medications that are effective for the problem at hand and not get fooled by slick advertising. An excellent free website listing drugs that are the best value for the conditions they treat is by Consumer Reports and found at www.crbestbuydrugs.org. I was surprised he didn't include this important unbiased source. He also didn't talk about how Wal-mart and other retailers offer $4 prescription medication and for 90 days, it would cost $10. Another cost saver.

At times, the advice given was misleading or overly optimistic. On page 3, he notes that the generic cholesterol medication lovastatin 10 mg tablet is 58% cheaper than the brand name Lipitor 10 mg pill which is true. What he failed to mention is that the generic drug is only ¼ as potent which means you'd need four times as many pills to get the same cholesterol lowering effect! For the area on think beyond the prescription bottle, yes lifestyle changes would be great, but for the vast majority of people they've tried dieting, exercising, and they ultimately need medications to address their medical condition. Telling us what we should do but despite our best intentions are unable to do so really isn't a cost-saving method per se. Also asking doctors about whether the evidence from various research studies on heart disease or osteoporosis means that medications can be stopped may be out of the reach of most patients. Often seeing a doctor is intimidating. Asking a doctor about not only the latest research but also then asking to stop the medication because of it may seem too high of a hurdle for some to do.

Nevertheless, he advocates that readers communicate with their doctors about prescription drugs and not to stop without checking in with their doctor. An excellent companion book which covers how to talk to doctors, offers the truth about herbals, dietary supplements, body scans, and also has a section on prescription drugs that would complement this book well is Stay Healthy, Live Longer, Spend Wisely – Making Intelligent Choices in America’s Healthcare System.