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The INDEPENDENT, January 21, 2010
“Choking game” can kill children
To Your Health!
By Judy Hargis, P.A
PATIENT
ADVOCACY
Facilitating better care
for patients: There was a
time when healthcare
seemed simple. We knew
our family doctor well and
he was familiar with our
health needs. We often
paid cash for our care and sometimes even
bartered for it. Technology, medications, and
treatment options were limited. Many people had
no health insurance, but the costs for our care
were reasonable. Now the world of medicine is
changing at a rapid pace. It is hard to keep up
with the methods of treatment and how health-
care is delivered to the consumer. Navigating the
complexities of the healthcare system can be
overwhelming to even the most knowledgeable
patient. Dealing with a diagnosis of a serious or
life threatening illness or multiple chronic illness-
es can seem impossible. Imagine the challenges
facing a person living with a mental or physical
disability, or an elderly patient trying to under-
stand the implications of multiple medications,
diagnostic tests, medications and treatments.
Then there are the issues around long term care
and end of life decisions. Add to that, navigating
the cost of care and insurance plans; it can feel
insurmountable to patients and their loved ones.
We know that patients who are well informed
and working in partnership with their health care
provider, help to ensure the best treatment out-
comes. Patient advocacy has been an emerging
resource in recent years and has been making a
difference in the lives of many patients and their
families. There now are patient advocacy groups
that help patients and families access resources
and services. There are patient advocates who
can be hired to work one-on-one with patients
and their loved ones. Patient advocacy is a valu-
able, growing profession. The patient advocate
can work with patients
to help them with
medical care issues, insurance, home health,
long term care placements, elder assistance and
end of life decisions. They can act as a liaison
between the patient and their health care
provider and often accompany patients to doc-
tors’ appointments. They can sort out insurance
claims and appeals, research treatment plans
and can frequently help patients access special-
ists.
There are great resources and services avail-
able through the patient advocate organizations
such as the PAF (Patient Advocacy Foundation)
which can be accessed by phone or on-line.
They provide a wealth of information and re-
sources, and have programs available including
the Co-Pay Relief Program (CPR) which pro-
vides direct financial support to insured patients,
including Medicare part-D beneficiaries. They
have counselors available to guide patients
through the enrollment process and a dedicated,
secure website for health care providers to enroll
their patients. PAF is a great starting point for pa-
tients and their families. There are many patient
advocates and patient advocacy groups avail-
able today. PAF can help assess individual situ-
ations and find the right services, dependent on
patient needs. You can find them at
www.PAF.com.
There are many rough waters ahead for
healthcare and the impact on all of us can be un-
settling. Our healthcare system is not going to be
consumer friendly anytime soon. In the mean-
time, patient advocacy groups can be a tremen-
dous resource in assisting patients to access
care which will lead to better health outcomes.
These programs can provide patients with real
support as they deal with the challenges faced
with medical issues in their lives.
I want to thank Audeen Wagner for working on
this column with me over the the last few years.
She has been a teacher, mentor and wonderful
friend. I am happy to share with you that I spoke
with Laura Nichols in the fall and she is interest-
ed in writing a few columns for To Your Health! It
is a wonderful opportunity for her to share some
of her wealth of information and reconnect with
the community. Some students from Pacific
Northwest School of Health Sciences will write,
as well.
As always, I would love to answer questions
and hear feedback from our readers. If there is a
health topic that you would like more information
on, please let us know. You
can reach me at health@the-
independent.net.
503-901-1705
Oregon Public Health offi-
cials want parents and health-
care providers to be aware of a
dangerous and potentially fatal
activity in which many young
teens are engaging.
According to the Oregon
Healthy Teens Survey, con-
ducted every other year by
Oregon Public Health, as many
as 2,600 eighth graders in the
state have participated in the
“choking game,” also some-
times called Pass-Out, Space
Monkey, Flat Liner and Black-
out. The survey also found that
one in three eighth graders had
heard of someone participating
in this activity and that six per-
cent reported participating
themselves.
Oregon is the first state to
systematically assess this be-
havior. “The Oregon Healthy
Teens Survey is a key tool for
monitoring health behaviors
among our youth, and without
public health conducting this
kind of surveillance study, most
people would be unaware of
this threat to the health of our
children,” said Mel Kohn, MD,
MPH, acting director at Oregon
Public Health. Kohn also noted
that injuries are the leading
cause of death for children and
young adults.
The “choking game” is an
activity in which people stran-
gle themselves using a belt, tie,
scarf or similar item, or teens
strangle each other using their
hands, to achieve euphoria. Af-
ter a short time people can
pass out, which can cause in-
jury, long-term disability or
death.
“Many people will be sur-
prised at how widespread this
dangerous behavior is,” says
Kohn, “so parents, healthcare
providers and others who work
with teens should be alert for
signs of participation in stran-
gulation activities, particularly
in young teens.”
Sarah Ramowski at Oregon
Public Health, lead author of a
report on these data published
by the Centers for Disease
Control and Prevention (CDC)
in the Morbidity and Mortality
Weekly Report for the week of
January 11, says that warning
signs that a child may be partic-
ipating in this activity include:
• Unexplained marks on the
neck
• Bloodshot eyes
• Ropes, scarves, belts tied
to bedroom furniture or door-
knobs
• Unexplained presence of
leashes or bungee cords
• Pinpoint bleeding spots un-
der the skin on the face, espe-
cially the eyelids
• Discussion or mention of
this activity
• Disorientation, especially
after spending time alone.
According to the CDC report
there have been 82 deaths oc-
curring in 31 states from this
activity from 1995 to 2007. In
Oregon, an Eagle Point sixth-
grader died in 2006 due to this
activity.
Columbia
County
Mental Health
800-294-5211
-----------------
Suicide
Hotline
1-800-784-2433
or
1-800-273-
TALK(8255)
-----------------
Domestic
Abuse
Hotline
503-397-6161
or
866-397-6161