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Trend Health Advocacy

The Doctor in Your Corner

About Dr. Trend

During her 20+ years as a practicing pediatrician, Dr. Carolyn Trend saw just how complex and frustrating the healthcare system can be. More importantly, she learned to help patients and their families understand and navigate this system. When a close family member was diagnosed with a serious illness, Dr. Trend understood on a deeper level the overwhelming stress that accompanies the illness of a loved one. Having recently retired from clinical medicine, Dr. Trend had the medical knowledge, experience, and time to ensure her loved one received the excellent care he deserved, but she realized that most people don't have the advantages of a medical degree and spare time to negotiate the complexities of the healthcare system. 

As an independent health advocate, Dr. Trend draws on her professional and personal experience to help her clients navigate the healthcare system. She can explain complex issues in plain English, help you understand your health conditions and the treatments you are receiving, and enhance communication between you and your medical providers. Offering a range of services to help you and your loved ones navigate the healthcare system, Dr. Trend will be the doctor in your corner. 

Overview of Services

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Communication Liaison

  • Explain diagnoses,  test results, and treatments

  • Bridge communication gaps among providers, patients, and family members

  • Prepare you for upcoming appointments

  • Speak directly to your care providers 

  • Accompany you to medical appointments (as permitted by your providers)

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Care Coordination

  • Schedule medical appointments

  • Arrange second opinions

  • Coordinate and/or attend family meetings

  • Research home healthcare, assisted living, skilled nursing, and hospice facilities

  • Review and organize medication regimens

  • Organize your health information and resources for increased clarity and accessibility

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Healthcare Navigation for Young Adults

  • Provide overview of important healthcare concepts:

    • Accessing healthcare while away from home

    • Health insurance​

    • Medical Records

    • Privacy & informed consent

    • Medication storage & use

  • Develop personalized action plan

  • Provide direct support & advocacy services

Please note that in her role as an independent health advocate, Dr. Trend  does NOT provide medical care or medical advice. Clients are advised to seek the advice of their personal physician(s).

Clients Say

Maureen, NJ

When my dad was hospitalized, it felt like we were playing Whac-a-Mole: every time one symptom or concern was resolved, another popped up. We were dealing with multiple specialists. It was totally overwhelming. But having Dr. Trend in our corner made a huge difference. She knew the right questions to ask, how to resolve conflicting opinions across all those specialists, and how to translate all the medical jargon into language and concepts we could understand. She gave our family peace of mind during a very stressful time and I'm so grateful.

William, NJ

Dr. Trend reviewed my medical records, discussed my questions and concerns before doctors' appointments, and actually attended appointments on speaker phone to make sure my doctor and I understood each other. She helped me find a second opinion and arranged to have my records sent to that doctor. It was a huge help to have Dr. Trend speak directly to the specialist, to answer some of his more technical questions, and to make sure he knew all of the pertinent details of my history. Dr. Trend made sure my wife and I always left our appointments with a clear understanding of my medical issues and treatment plans. 

Contact Me

To contact Dr. Trend directly, or to schedule a free 20-minute introductory phone call, please complete the information below. You can expect a reply within 2-3 business days. 

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Blog

Staying young when you are getting old(er)

We recently celebrated my father’s 85th birthday. Just about everyone who meets my dad makes the same remark: “He is a really GOOD 85.” (My mom also gets frequent, well-deserved props for being an equally impressive eighty-something!). We all know them when we see them, but what makes someone “good” for their age? More importantly, what is their secret? If you’re looking for the “CliffsNotes” version of this blog, the answer is, “Use it or lose it.” For those of you hoping for a more detailed explanation, read on to learn what we can be doing now, in our 40s, 50s, and 60s, to increase the likelihood that we, like my parents, will remain as active and mentally sharp as many people half our age.

 

 

 

 

 

 

 

 

 

 

 

   My dad and his birthday balloons

Stay active:

 

My parents get dressed in real clothes – no hanging around in bathrobes or house coats – and get out of the house every day. They go to church and walk at least 2 miles a day, chat with friends they meet along the way, and take detours to bring in newspapers and garbage cans from “older” neighbors’ driveways. They don’t walk if the roads are icy, a policy that has also contributed to their longevity. Highly competitive games of Rummikub, Wordle, and “7 Little Words” round out their mornings. The remainder of their day involves some combination of reading (at least a couple of books a week for each of them), socializing with friends and family, doing errands, and participating in church and community organizations. If you’re feeling a little exhausted just thinking about all of that, read on to see why routines like this are so important, and how you might incorporate some of these habits into your own life.

 

It is hard to overstate the physical, mental, and psychological benefits of exercise. Regular exercise – even walking at a moderate pace – is associated with improved cognitive function and decreased risks of dementia, heart disease, and several types of cancer. People who engage in regular physical activity are not only less likely to fall, but they are less likely to be seriously injured if they do fall. While current recommendations endorse 150 minutes of moderate activity per week (about 22 minutes per day), some recent data suggest that just 11 minutes of moderate physical activity per day may provide significant health benefits.

In addition to engaging in aerobic activity, mix up your routine with attention to balance, flexibility, and strength-training—those become even more important (particularly in terms of fall prevention) as we age. Although it’s generally safe for most individuals, exercise involves some risk if performed incorrectly or to excess. Before initiating or significantly changing your exercise routine, consult your physician or other healthcare provider to discuss adopting an exercise regimen that is appropriate for you.

 

If you are interested in learning more about all aspects of exercise, visit https://www.cdc.gov/physicalactivity/.

 

     My mom (74 here) & niece, Alyssa, post-ziplining

  

Stay engaged:

 

Many people find it more difficult to remain mentally and socially engaged when they stop working, but higher levels of mental and social activity are associated with a decreased incidence of dementia. Strong social connections are associated with a longer lifespan and decreased rates of depression, anxiety, and cardiovascular disease.

 

Taking up a new hobby (e.g., learning to play an instrument or speak a new language), reading, playing word games, or doing crossword puzzles are common strategies for staying mentally active, but find any activities you find interesting and enjoyable, and do them! Make an effort to see existing friends, and consider volunteering or joining a club, or a religious or community-minded organization to meet new friends.

 

Think positively:

 

My father was hospitalized for nearly a week last year and despite multiple complications and significant pain, he didn’t wallow in his misfortune or even complain. When I told my dad I was amazed by his attitude, he shrugged and said, “I have to go through this no matter what. I can either complain and make myself and everyone around me miserable, or I can be positive, and make this better for all of us.”

Before he could be discharged from the hospital, my father needed to walk up 2 steps. I watched him walk up 2 steps, look at his physical therapist, and ask, “Can I do 2 more?” And then he did 2 more. 💪🏻

 

Many of us (myself included) have probably rolled our eyes at the corny bumper stickers and billboards extolling the virtues of positive thinking. Even Ted Lasso was disparaged for his unwavering optimism. (If you haven’t watched Ted Lasso, it is well worth the $6.99/month cost of AppleTV). I’m sorry to break it to all of you cynics out there, but there is some evidence to suggest that optimism and positive thinking are associated with increased lifespan and decreased rates of depression, cardiovascular disease, and death from infection, cancer, and respiratory disease.

 

If optimism isn’t your default mode, there is hope for you. (See what I did there?). Positive thinking is a skill that can be learned and practiced. Something as simple as putting in writing, every day, 3 good things that happened during the day, or 3 things for which you are grateful, can begin to shift your outlook. If coming up with 3 things sounds overwhelming, start with one and work your way up; it gets easier with practice.

 

Stop smoking:

 

(My parents quit smoking in the early 1960s, and that’s the last thing I’ll write about them today.)

 

Most people associate smoking with lung cancer, but the negative health impacts of smoking reach beyond our lungs. Some of the less well-known complications of smoking include an increased risk of cardiovascular disease (like heart attacks and strokes), and at least a dozen types of cancer. People who smoke are more likely to develop osteoporosis (decreased bone density) and to sustain hip fractures, which are a source of significant morbidity and mortality in older adults.

Smoking cessation is extremely difficult for many people, but there are several effective treatments for those who want to stop smoking. Please contact your physician or other medical provider to discuss which options may be the most appropriate for you, or dial 1-800-QUIT-NOW to access a network of state quit lines that offer counseling, free medication, and referrals to local programs.

Listen up:

 

Most older adults experience some degree of hearing loss, which is associated with social isolation, depression, and more disturbingly, cognitive decline and dementia. The good news is that there are many options for addressing hearing loss; a variety of hearing aids are available both with a prescription and, recently, over the counter. Some types of hearing loss can be treated with a surgical procedure (i.e., cochlear implant). Because even mild hearing loss may be associated with negative health consequences, it is important to be evaluated for these symptoms.

 

Excessive noise exposure is one of the most common causes of hearing loss. Take advantage of phone settings or mobile apps that limit maximum allowed volume. Use hearing protection (e.g., earplugs, noise-canceling headphones) when you are in a noisy environment. These are very easy, low-cost ways to minimize hearing loss and its associated complications.

 

For more information on hearing loss, visit https://hopkinsmedicine.org/heatlh/wellness-and-prevention/the-hidden-risks-of-hearing-loss/.

Anticipate future challenges:

 

As you get older, begin to limit or outsource the activities and chores that are potentially dangerous (e.g., climbing ladders; carrying heavy or bulky objects on the stairs). Assess your home for conditions that increase your risk of tripping or falling. (Click here for specific tips: https://www.trendhealthadvocacy.com/post/your-loved-one-is-getting-older-now-what).

 

If you haven’t already done so, please identify health proxies, create an advanced directive, and discuss your wishes with your loved ones. If you have adult children, have these discussions when you are all present (even if via conference call or video) to ensure that everyone hears and understands the same information. A candid discussion while you are healthy and capable may prevent major disagreements and even estrangements down the road.

 

Final thoughts:

 

Although good, clean living does not guarantee health or longevity, staying active, making informed lifestyle choices, and anticipating potential challenges remain our best strategies for maintaining a rich, enjoyable experience well into old age, whatever your definition of “old” may be.

This blog is for informational purposes only. In her role as an independent health advocate, Dr. Trend does not provide medical care or medical advice. Clients are advised to seek the advice of their personal physician(s).

 

Your Loved One is Getting Older... Now What?

All of us, if we are fortunate, will eventually grow old. Along with a great deal of wisdom and a lifetime of happy memories, old age presents a unique set of challenges. If you are trying to support a loved one who is aging – or if you identify as a senior, yourself – here are some of the issues that affect older adults:

Falls:

Many older individuals are at increased risk of falling for a variety of reasons: decreased strength; poor balance; difficulty seeing or hearing; decreased cognitive ability; underlying medical conditions and/or the medications used to treat them. If your loved one allows, speak with their medical provider about potential side effects of medications (e.g., dizziness, fatigue) that may increase their risk of falling, and confirm that these medications are still necessary and appropriate for your loved one’s medical conditions.

Evaluate (or hire a professional to evaluate) your loved one’s environment for common fall hazards such as area rugs, poor lighting, and uneven or slippery flooring or stairs.

  • The bathroom can be a particularly dangerous place for older individuals; consider installing a shower chair, shower bars, and an elevated toilet seat with grip bars.

  • If your loved one is frequently alone, they might consider using a medical alert system. Several smart watches are also equipped with fall detection technology, and these may be a better option for individuals who are resistant to the idea of using a traditional, free-standing medical alert system.

  • Consider giving an extra house key to a trusted neighbor or storing a spare key in a lockbox (similar to those used by realtors). The combination to the lockbox may be kept on file with emergency services and/or a medical alert system provider. This will make it easier to access your loved one's home in the event of an emergency.

 

Social isolation and loneliness:

Many older adults continue working or volunteering regularly, well into their 80s and 90s. Many working and retired individuals enjoy very active social lives, take up new hobbies, or return to the hobbies they were too busy to pursue when they were juggling family and career responsibilities.

 

Some older adults, however, face increasing social isolation and loneliness. When my sister worked as a bank teller during college, she recognized that she was the only social connection some of her elderly customers enjoyed during a given day or week. Much to the dismay of her productivity-focused employers, she took the time to get to know these older customers and engage with them on a personal level.

 

While I was writing this blog, the Surgeon General, Dr. Vivek Murthy, declared that the “impacts of social isolation and loneliness are a critical public health concern.” At the age of 18, long before Dr. Murthy’s declaration, my sister may not have realized the public health implications of her kindness, but she did understand how important these even brief interactions were to her customers (which to this day makes me immensely proud of her!).

 

Some of the more concerning consequences of isolation and loneliness include:

· Depression

· Anxiety

· Dementia

· Cardiovascular disease

· Premature death

 

Community organizations are typically available to offer social activities, transportation, and companionship for older adults. If you are not sure where to start, your loved one’s medical provider, local house of worship (often even if they are not a member), or a health advocate can guide you.

 

Hearing loss and visual impairment:

Hearing loss is very common as we age and contributes not only to social isolation and depression, but to cognitive decline and dementia. Imagine how frustrating it is when you can’t hear your friends on the phone or follow a conversation in a restaurant. It’s easy to understand why someone experiencing hearing loss might withdraw from their loved ones or their social activities, and in turn experience the consequences of isolation.

 

There are several reasons older adults experience decreased visual acuity including cataracts, glaucoma, macular degeneration, and complications of diabetes. Like hearing impairment, poor vision is associated with social isolation, depression, and cognitive decline, along with an increased risk of falling. Because many of the conditions that lead to vision loss can be treated or controlled, encourage your loved one to have regular screening exams and seek medical evaluation for any concerns.

 

Driving safety:

While many older adults continue to drive safely, increasing age is associated with higher rates of fatal motor vehicle collisions and overall collisions per mile driven. Slower reaction time, decreased visual or hearing acuity, underlying medical conditions, and cognitive decline may contribute to the risk of motor vehicle collisions. Because driving often represents freedom and self-sufficiency, many individuals are reluctant to give up this privilege, even if are no longer able to drive safely; this can be a source of tremendous conflict. If you are concerned about their ability to drive safely, reach out to your loved one’s medical provider to ensure the safety not only of your loved one, but also of those they may encounter on the roads.

 

End of life issues:

Many people feel uncomfortable talking about end-of-life issues, but it is crucial for your aging loved ones (for all of us, in fact) to clarify and document their wishes about the medical care and interventions they want to receive or avoid. Your loved one’s medical provider and/or an attorney can help to guide discussions about advance directives (“living wills”), health proxies, powers-of-attorney, and other important topics. The Institute for Healthcare Improvement provides free written and audio resources at www.theconversationproject.org.

 

Final thoughts:

Get to know (or at least identify) neighbors who can check on your loved one if you are concerned and/or unable to contact them yourself.

If you have concerns about your loved one, reach out to their medical providers. Privacy laws (i.e., HIPAA) prohibit medical providers from disclosing information about their patients; they do NOT prohibit you from sharing your observations and concerns with your loved one’s providers.

 

Keep in mind that your aging loved one has likely spent decades as a productive individual with family and/or career responsibilities and relative independence. Some older adults may be grieving the loss of independence, friends, and many aspects of their identity. While it is natural to want to help, it is important for your loved one to maintain as much independence as they desire and can safely enjoy.

 

 

This blog is for informational purposes only. In her role as an independent health advocate, Dr. Trend does not provide medical care or medical advice. Clients are advised to seek the advice of their personal physician(s).

Making the Most of Your Medical Appointments

Visits to the doctor can be anxiety-provoking, stressful, and sometimes downright unpleasant. The healthcare system can be confusing and overwhelming, doctors are often behind schedule, and patients may be frustrated, uncomfortable, or worried about their health. While some challenges may be unavoidable, there are some things you can do to ensure a more productive, satisfying visit with your physician.

 

Making the Appointment:

Like most things in life, a successful encounter with your physician begins with a strong foundation. When you call to schedule your appointment, clearly state the reason for your visit. Some patients are hesitant to tell the receptionist the “real” reason they want to see the doctor; they may minimize (or exaggerate) their symptoms. Most physicians provide their staff with guidelines for scheduling appointments. A patient with multiple, complicated, or severe symptoms will be allotted more time than one with a straightforward or mild complaint. The nature of your symptoms may dictate when (e.g., immediately, later the same day, or next week) and where (e.g., office, emergency department, or virtually) you will be seen. Communicating effectively with the receptionist increases the likelihood that you will be seen at the appropriate time and place and given the amount of time required to meet your needs.

 

Expert tips:

  • If you can secure the first appointment of the day or the first appointment after lunch, your doctor is more likely to be on time.

  • Be nice to the receptionist! Being nice is not only just the right thing to do; staff are much more likely to be accommodating if you treat them well. Everyone wins!

 

Planning/Preparing for your Appointment:

 

Jot down your main concerns before your visit so you don’t forget anything. Remember to bring helpful data to share with your doctor. If you measure your blood pressure or glucose levels at home, bring a copy of the results. If you have a smartwatch that measures your heart rate (especially if there have been any “alarms” for abnormalities), share those numbers. Bring a current list of medications and dosages and the contact information for any other physicians or healthcare providers you see. If you receive all of your care in one healthcare system, your doctor should be able to access your records in the electronic health record. If you see providers outside of that system, bring copies of those records and ask the staff to add them to your chart when you arrive.

 

Expert tips:

  • Check the office website (or ask your new friend, the receptionist!) for forms you can complete prior to your arrival.

  • Take advantage of technology. If you have a camera on your phone, take pictures of your medication bottles to document names and doses. You can also use the camera to document intermittent symptoms like rashes that may not be present at the time of your visit.

 

Arriving at the Appointment:

 

Try to arrive at least 15 minutes before your scheduled appointment. Ideally, if your appointment is at 10:00, you will be in the exam room and ready for the doctor at 10:00. Before seeing the doctor, you may need to complete paperwork, change into a gown, and speak with the medical assistant or nurse. You will likely have your vital signs checked before the doctor sees you, and nothing raises your blood pressure like the stress of running into the office at the last minute!

 

Expert tip:

  • Bring something to occupy you if you do need to wait for your appointment. A good book, crossword puzzles, or some games loaded onto your phone can help pass the time.

 

During the Appointment:

 

Come prepared with an organized “story” to tell your doctor. At the beginning of the visit, tell the doctor, “I have x main concerns,” and then list them, starting with the most important. This overview helps your doctor start to think about what additional information he or she will need to address your concerns.

Expert tip:

  • Don’t wait until the end of the appointment to mention a major issue. Doctors dread hearing, “By the way…” as they are about to leave the exam room, and they may not have the time to assess your problem appropriately.

 

Wrapping it Up:

At the end of the visit, make sure you understand what comes next. If your doctor recommends a treatment, ask in what specific way the treatment should help you and when you should reasonably expect to see a response. Ask, “What are the reasons I should call you?” (e.g., new symptoms develop, failure to respond to treatment in x days) and “When should I make my next appointment?”. Many offices provide a written summary of your visit when you check out after your visit. You are entitled to a copy of the visit note, free of charge. Because many physicians complete their charts at the end of the day, the complete visit note may not be available before you leave the office. Notes should be available on the patient portal. If you do not have access to a patient portal, ask the doctor or a staff member how you can obtain a copy of the visit note. Keep these documents for your records and share them with others who are involved in your care.

 

Expert tips:

  • Write down the names and doses of any medications the doctor is prescribing and compare this to the bottles you get from the pharmacist. While doctors and pharmacists do their best, we are all human and errors sometimes occur.

  • If permitted by your doctor’s office, consider asking a friend or family member to accompany you (in person or by phone/video chat) to your appointment.

  • A professional health advocate is a tremendous resource. They can help you understand and process information, prepare you for, and even accompany you to visits with your physician or other health care providers.

Accessibility Statement

Trend Health Advocacy is committed to providing a website that is accessible to the widest possible audience, regardless of circumstance and ability. We aim to adhere as closely as possible to the Web Content Accessibility Guidelines (WCAG 2.0, Level AA), published by the World Wide Web Consortium (W3C). These guidelines explain how to make Web content more accessible for people with disabilities. Conformance with these guidelines will help make the web more user friendly to everyone. While Trend Health Advocacy strives to adhere to the guidelines and standards for accessibility, it is not always possible to do so in all areas of the website and we are currently working to achieve this. Be aware that due to the dynamic nature of the website, minor issues may occasionally occur as it is updated regularly. We are continually seeking out solutions that will bring all areas of the site up to the same level of overall web accessibility.

If you have any comments and or suggestions relating to improving the accessibility of our site, please don't hesitate to contact Dr. Trend by phone or e-mail. Your feedback will help us make improvements.

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