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BMH’s Keyserling center to relocate, expand

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keyserling

Photo above: Oncology services currently located in the hospital’s Port Royal-based Keyserling Cancer Center facility are scheduled to move to the main Beaufort Memorial campus next year. Photo provided.

In an effort to both consolidate and expand local oncology services, Beaufort Memorial Hospital has announced plans to move the Keyserling Cancer Center to a new, expanded location on the BMH main campus. 

The hospital was considering an expansion and renovation of its existing location at 1680 Ribaut Road; however, construction costs, regulatory concerns and other limiting factors did not support the long-term benefits of an offsite campus.  

“When the cancer center was opened in 2006, it was the realization of a vision to provide services in one location for coordinated care and patient convenience,” said BMH President and CEO Russell Baxley. “Over the years we’ve added services and staff on the main campus because the center could not accommodate them. This is a great opportunity to bring the vision back into focus by consolidating all of our providers and services in one location.” 

The new center will be located on the first floor of the Beaufort Medical Plaza at 989 Ribaut Road. The hospital opened an outpatient infusion center on the same floor of the plaza in 2015, and plans to expand that area to accommodate additional infusion bays. 

The hospital also will work with a development firm to build out space to accommodate a new True Beam linear accelerator to provide radiation therapy treatments, and to house the clinicians who support the service. The new radiation oncology unit will be adjacent to the infusion center. 

“I’m very excited about the upcoming changes for our cancer services,” said BMH board-certified medical oncologist Dr. Mark Newberry, whose practice is currently located in the Beaufort Medical Plaza. “Moving the Keyserling Cancer Center onto the campus of the hospital will allow our patients to eventually have a single location where they can receive all of their cancer care.”

Newberry’s practice, as well as that of board certified medical oncologist Dr. Majd Chahin, will be located on the third floor of the building, with convenient outpatient lab and imaging services on the second and first floors, respectively. 

The Beaufort Memorial Breast Health Center is also located on the first floor, allowing breast nurse navigators and surgeons to consult with patients and physicians and more seamlessly coordinate care. 

“The ability to have the full complement of oncology, breast, imaging, surgical and lab services available under one roof is greater than we ever imagined when we developed the center in 2006,” said Chahin, medical director for Beaufort Memorial Oncology Services, who was instrumental in the development of the Port Royal location. “This also brings us closer to our patients in the hospital and the radiology and pathology experts we consult with daily.” 

Once construction begins the project will take approximately one year to complete. The hospital will maintain ownership of the current cancer center building and will locate other services and providers there when on-campus construction is complete. 

For news and information about Beaufort Memorial, visit www.bmhsc.org. To support expanded cancer services, click “Make a Gift.” 

Locals attend Farm Bureau conference

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Beaufort

From left, Beaufort County residents Laura Hansen, Abigale Hansen, Ann Ackerman, Beverly Brown, Sandra Simmons and Melinda Ackerman were among nearly 80 women from 22 counties across the state who gathered in Greenville Sept. 25-26 for the South Carolina Farm Bureau Federation’s (SCFB) annual Women’s Leadership Conference to participate in workshops that showcased local agriculture, offered personal development, and provided tools to promote agriculture in their counties. Photo provided.

Laser or traditional cataract surgery?

in Contributors/Dr. Mark Siegel, MD FAAO/Health by

By Dr. Mark Siegel

Are you planning to have cataract surgery? If so, you may be offered a choice of two surgical options: traditional manual cataract surgery or laser-assisted cataract surgery.

Traditional cataract surgery is one of the most common surgeries in the world. It is recognized as being safe and effective. 

Laser cataract surgery, which is not covered by insurance plans, costs more than traditional cataract surgery but provides some advantages in terms of precision and accuracy — in the proper situation. 

So how do you decide which type of cataract surgery to have?

Here are some things you should understand about both kinds of cataract surgery. Talk with your ophthalmologist to determine the best type of surgery for you.

Traditional cataract surgery

With traditional cataract surgery, called phacoemulsification, the eye surgeon creates a small incision in the side of the cornea by hand with a scalpel blade. 

An instrument is inserted through this incision into the area behind the pupil where the eye’s lens sits in a capsule or bag. The surgeon uses a cystatome (bent needle) instrument to create a circular opening in the lens capsule. Then a special pen-shaped probe is inserted through that opening to apply sound waves (ultrasound) to break up the cloudy center of the lens. 

Then the broken-up pieces of lens are suctioned out of the eye. An artificial intraocular lens (IOL) is implanted to replace the cloudy natural lens. 

The side walls of the corneal incision will be filled with a special liquid and self-seal after surgery, so most commonly stitches are not needed.

Laser-assisted cataract surgery

With laser-assisted cataract surgery, a camera/ultrasound imaging device (OCT) is placed over your eye to map its surface and gather information about the lens. 

The device sends detailed information to a computer that programs the laser for the exact location, size and depth of the incisions. 

The surgeon uses the laser to make the corneal incisions, especially astigmatic incisions, and the opening in the lens capsule. 

Energy from the laser is also used to soften the cataract into fragments. Then the ultrasound probe used in traditional cataract surgery is used to gently suction them out of the eye. The IOL is implanted. 

As with traditional cataract surgery, the corneal incision usually does not require stitches.

What’s best for you

Under today’s Medicare guidelines, only certain patients may be offered laser-assisted cataract surgery.

Specifically, your ophthalmologist can offer it if you have astigmatism diagnosed during your cataract consultation and would like to have that refractive error corrected during cataract surgery. 

In this situation, the laser is used to create specific incisions, called limbal relaxing incisions in the cornea to reshape it, treating the astigmatism.

You may also be offered laser cataract surgery if you choose to have a premium lens implanted, such as an astigmatism-correcting toric IOL or a multifocal IOL.

Ophthalmologists who use laser cataract removal technology recognize that it allows them to see and map the lens capsule better and place the opening in the capsule more precisely, allowing for better centering and placement of the IOL.

Can you choose to have laser-assisted cataract surgery if you don’t have either of the conditions above?

Current Medicare guidelines say that a surgeon may not offer and charge for the laser-assisted cataract surgery unless one of the two conditions above is met.

Recovery from surgery

The recovery period for both laser-assisted cataract surgery and traditional cataract surgery is the same. 

Some people can see clearly almost immediately, while others may find their vision clears within about a week or two. 

Studies have shown that laser cataract surgery reduces the amount of ultrasonic energy required to break up the cataract which may reduce post-operative swelling. 

Remember that it takes about three months to fully recover from cataract surgery.

Benefits of surgery

What benefits does laser cataract surgery offer that traditional cataract surgery does not?

Using a laser to do cataract surgery allows the surgeon to make very precise incisions in less time. It can improve accuracy and precision in the surgical steps. And laser-assisted cataract surgery can provide a higher degree of correction for a refractive error, such asastigmatism, than traditional cataract surgery.

However, it is important to be aware that studies have not shown that laser-assisted cataract surgery results in fewer complications or better visual outcomes than traditional cataract surgery. 

With any type of cataract surgery, your outcome depends in large part on the skill and experience of your eye surgeon.

For some people, simply replacing a cloudy lens with a clear implant and wearing glasses for some activities is perfect. For others, achieving the best possible vision without glasses after cataract surgery is the goal. 

Your vision needs and expectations can help you and your ophthalmologist decide the best surgical option for you.

Dr. Mark Siegel is the medical director at Sea Island Ophthalmology at 111 High Tide Drive (off Midtown Drive near Low Country Medical Group). Visit www.seaislandophthalmology.com.

Health briefs for October 12th-18th

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breast cancer

Photo above: Beaufort Memorial kicked off breast cancer awareness month last weekend with Pink Yoga in the Kate Gleason Park. Over 40 people joined the hospital’s Breast Health Center and the LifeFit Wellness Center staffs for the free event. For more on the topic of breast cancer, see page B1. Photo provided.

BMH offering life-saving lung cancer screening

Beaufort Memorial radiologist Dr. Eric Billig reviews low dose computed tomography (LDCT) scans. LDCT scans of the chest provide more detailed images than X-rays and are better at finding abnormal areas in the lungs. Photo provided.
Beaufort Memorial radiologist Dr. Eric Billig reviews low dose computed tomography (LDCT) scans. LDCT scans of the chest provide more detailed images than X-rays and are better at finding abnormal areas in the lungs. Photo provided.

Beaufort Memorial Hospital is now offering a new lung cancer screening clinically proven to reduce the risk of dying from the disease.

Low dose computed tomography (LDCT) is the only diagnostic medical test endorsed by both the U.S. Preventive Services Task Force and the American College of Radiology. It is recommended for current and former heavy smokers between 55 and 77 years of age. 

“Approximately 85 percent of lung cancer deaths are attributed to smoking,” said Matthew Hurtt, Beaufort Memorial’s advanced imaging manager and LDCT program coordinator. “Early detection is especially important with lung cancer because by the time you have symptoms of the disease, the cancer has usually metastasized and is much more difficult to treat.”

The five-year survival rate for lung cancer that has spread to other organs is only 4 percent. When the disease is localized, the survival rate increases to 55 percent. But only 16 percent of lung cancer cases are diagnosed at an early stage, according to the American Lung Association.  

LDCT scans of the chest provide more detailed images of the chest than X-rays and are better at finding abnormal areas in the lungs.  

A national clinical trial of people at high risk of lung cancer found that those receiving annual LDCT screens reduced their risk of death from lung cancer by 20 percent compared to smokers who were screened using an X-ray. 

“CT scans allow doctors to visualize subtle abnormalities that may not be apparent on regular X-rays,” said board-certified Beaufort Memorial radiologist Dr. Phillip Blalock. “Over the years, the technology has improved to minimize the radiation exposure and still produce a good image.”

The test is quick, painless and exposes patients to a minimal amount of radiation. Medicare, Medicaid and most insurance companies cover LDCT once a year with a physician referral. 

The annual screening is recommended for adults who currently smoke or have quit within the past 15 years and have a smoking history of at least 30 “pack years,” meaning those who smoked a pack a day for 30 years or any combination of packs and years totaling 30. 

One of the first hospitals in the area to offer the lung cancer screening program, Beaufort Memorial recently received the designation of Screening Center of Excellence by the Lung Cancer Alliance for providing safe, high-quality low dose lung CT.

Lung cancer is the leading cancer killer in both men and women in the U.S., claiming some 156,000 lives each year – more than breast, prostate and colon cancer combined. Half of patients with lung cancer die within one year of being diagnosed. 

For more information on LDCT lung cancer screening, call 843-522-LUNG (5864).

Seeing dentist regularly part of good oral health

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By Dr. Stephen Durham

Many dental patients don’t think twice about the recommendation to come in twice a year for an exam and cleaning. Others wonder if they really need bi-annual exams. 

The answer is yes, according to the American Dental Association (ADA). 

A professional cleaning rids the mouth of bacteria and plaque that can accumulate quickly. The exam portion allows dentists to see potential problems, such as tooth decay and oral cancer. 

The ADA recommends an appointment every three months for those considered high-risk to develop a long-term dental health problem.

Preventive care

Even the best dental patients need help from the professionals to maintain healthy gums and teeth. That is because dental hygienists use tools people just don’t keep at home. This equipment cleans around the entire tooth while removing plaque and tartar at the same time. A hygienist also polishes your teeth after cleaning them. 

You could brush and floss many times each day and still not be able to clean your teeth the way a dental hygienist can. That is the main reason for the bi-annual appointment recommendation.

An examination by a dentist is the other part of a six-month check-up. If your dentist discovers any problems, you can schedule a follow-up appointment right away without waiting another half-year for a dentist to examine you. 

Both the dentist and the hygienist give you helpful tips on caring for your oral health at home that you probably wouldn’t have known otherwise. People often don’t know they have a dental problem until it’s quite advanced. 

Preventive care check-ups catch issues earlier when they’re more treatable.

What to expect 

Every patient has their teeth cleaned and receives an exam when he or she visits the dentist. Some patients need X-rays as well. This helps dentists see issues that might not be visible, such as decay between teeth. 

The preventive dental exam is also a front-line defense against oral cancer because dentists check for signs of it at each appointment. Patient education typically occurs at each visit also. 

As a general rule, the more time a patient gives to taking care of their teeth at home means much less time in the hygienist’s chair during your dental visits.

A recipient of the 2012 Mastership Award from the Academy of General Dentistry (AGD), Dr. Stephen Durham is a graduate of Clemson University and the Medical University of South Carolina College of Dental Medicine. He is a past recipient of the LVI Fellowship Award for Neuromuscular and Cosmetic Dentistry. Durham practices at Durham Dental at Town Center in Beaufort. For more information, visit his website at www.DrStephenDurham.com or call 843-379-5400.

BMH recognized for infection prevention

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9/15/16 The 36th annual SCMA/SCHA TAP conference "Opening Doors" held at the Westin Resort Hilton Head including presentation of the Zero Harm awards to area hospitals. Photos by Renée Ittner-McManus/RIM Photography

Beaufort Memorial Hospital (BMH) has racked up another three Certified Zero Harm Awards from the South Carolina Hospital Association (SCHA), along with special recognition for holding state records in preventing two major classes of hospital-acquired infections, according to a release. 

The 197-bed nonprofit hospital reported no central-line-associated bloodstream infections in the Intensive Care Unit and surgical site infections during colon surgery for 45 consecutive months. It was the only area healthcare facility to earn state records in two categories.

“Beaufort Memorial has worked diligently to improve patient safety in every area of care, including hospital-acquired infections,” BMH President and CEO Russell Baxley said. “Preventing bloodstream and post-surgical infections for such an extended period of time is a testament to the commitment our staff has shown in protecting our patients.”

The hospital also received a Certified Zero Harm Award for having no surgical site infections during abdominal hysterectomy surgery for 12 months.

The South Carolina Hospital Association has been giving out Zero Harm Awards since 2013 to acknowledge hospitals that are on the forefront of preventing medical errors, which by some estimates is the third leading cause of death in the United States. This is the second year Beaufort Memorial has won three of the awards. 

To earn a Certified Zero Harm Award, hospitals must experience no preventable hospital-acquired infections of a specific nature over an extended period of time. All hospital data used for the awards is independently verified by the South Carolina Department of Health and Environmental Control.

As part of a collaboration with The Duke Endowment and The Joint Commission Center for Transforming Health, SCHA and South Carolina hospitals have taken part in a statewide effort to reduce harm by implementing robust practices shown to improve patient safety and quality of care. 

“Celebrating milestones, such as zero infections within a given time frame, is a crucial part of our hospitals’ collective journey to highly reliable healthcare,” said South Carolina Hospital Association Vice President for Quality and Safety Lorri Gibbons. “Zero patient harm is possible only if physicians, clinical and support staff members work together.”

Health briefs for October 5th-11th

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Pink Yoga in the Park to raise awareness

Calling all Pink Warriors! Beaufort Memorial will kick off Breast Cancer Awareness Month at 9 a.m. Saturday, Oct. 7, with Pink Yoga in the Park at Kate Gleason Park, behind the hospital.

Wear pink and join the staff from the hospital’s LifeFit Wellness Center and Breast Health Center as they honor those who have been diagnosed, survived or supported someone with breast cancer. 

Yoga mats will be provided on a first-come basis, but participants should bring their own if possible. 

If weather is inclement, the class will move inside to the LifeFit Wellness Center at 990 Ribaut Road.

The event is free, but registration is requested at bmhpinkyogainthepark.eventbrite.com. Visit BeaufortMemorial.org or call 843-522-5635 for more information.

Lions Club collecting eyeglasses, contacts

The Beaufort Lions Club will hold its first annual prescription vision products collections drive from Sunday, Oct. 8, to Saturday, Oct. 14.

Collection boxes will be placed in eye doctors’ offices throughout Beaufort and Port Royal during that week. 

People are asked to donate unused, unopened contact lens, or no longer needed prescription eyeglasses and sunglasses. 

Collected items are sent to South Carolina Charitable Foundation and Services in Columbia, sterilized and sorted and then distributed to various world health agencies such as Doctors Without Borders.

Collection boxes are located at Beaufort Eye Clinic at 1664 Ribault Road; AMVETS on Ribault Road; TCL (library and admissions); Beaufort Memorial Hospital lobby; Sea Island Ophthalmology at 111 High Tide Drive; Rubin Vision Center at 330 Robert Smalls Parkway; Naval Hospital; and the Beaufort Branch Library at 311 Scott St.

Red Cross urges donors of all blood types to help

The American Red Cross urges eligible donors of all races and ethnicities to give blood to help ensure a diverse blood supply for patients in need.

Some blood types are unique to certain racial and ethnic groups, so a diverse blood supply is important to meeting the medical needs of an increasingly diverse patient population. 

A blood drive will be held at 6 p.m. Thursday, Oct. 5, at Carteret Street United Methodist Church at 408 Carteret St. in Beaufort.

Download the American Red Cross Blood Donor App, visit redcrossblood.org or call 1-800-RED CROSS (1-800-733-2767) to make an appointment or for more information. 

Don’t know what to do? The answer is blowin’ in the wind

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By Katherine Tandy Brown

The Lowcountry’s recent encounter with the edges of what arrived in Beaufort as watery Tropical Storm Irma brought back to mind the importance of getting as ready as possible for come-what-may.

And then waiting to see whether or not to leave. 

Unless, of course, you want nothing to do with wind and water, you’re not fond of those interstate parking lots, and/or you’re looking forward to a “stay-cation” with Aunt Ethel in the Upstate. 

But if you’d really rather hunker down in your own comfy home, it’s the waiting, and if you remain, the long hours of the storm’s duration, that are the truly difficult parts. It’s the frustration of “not knowing.” 

Enter those wise Buddhists, who have a saying for uncertain times. “The ‘don’t-know mind’ is a powerful place to be.” I’ll explain.

As a 12-year resident of this lovely land, I experienced my first evacuation last October when Matthew blew in. 

At the first whisper of “this one might really hit us,” I sifted through the contents of my hurricane preparedness file, pulling out evacuation route maps, government information resources, instructions on readying my home, necessary vital documents and a roll call of emergency supplies: water, a can opener and nonperishable food such as soup, granola or pork rinds, depending on your preference; flashlights and batteries, a generator for those so inclined, medications and prescriptions, pet supplies, etc. 

I’d made a list of possible evac destinations, depending upon the storm’s predicted course, and chose Charlotte, a free place for me to stay. A neighbor headed in the same direction and I hopped in the car and skedaddled. 

Not until we were cruising through downtown Yemassee – too late to turn back – did I remember the family photos. At that moment I learned that what gets left behind during a storm evacuation must be kissed a teary goodbye, with a hope for the best. 

Self-employed, I packed a number of clients’ editing projects, books to read and of course, my work-in-progress first novel. I’d like to say I returned home five days later having lightened my work load. But the truth is that I could not concentrate on anything but The Weather Channel. 

I fixated on its multicolored maps of Matthew’s meandering path and Jim Cantore hanging onto a palm tree, his foul weather gear flapping in hurricane-force winds. 

Whenever I wasn’t glued to a television screen, i.e. during time spent with beloved family members I see far too infrequently, my attention returned to the Lowcountry, friends who had chosen to stick it out, and my house, where those photos remained. 

While seeming to engage in conversation, I became aware that I was completely distracted, counting the minutes until I could check with Jim again. 

I’ve now heard this phenomenon called “hurricane brain” and realize it to be a commonality among those leaving lives behind to flee a natural disaster. It’s the constant wondering and waiting. The not knowing.

Enter the above don’t-know mind concept, which is, in fact, a Zen koan, i.e., a puzzling, often paradoxical statement used in Zen Buddhism as a means of gaining spiritual awakening. 

One explanation of the don’t-know mind, simply put, is not knowing the answers to some of life’s big questions, accepting the fact that you do not know, and choosing not to worry about the outcome. 

“I don’t know” questions beliefs, such as “a hurricane often destroys everything in its path. My house, my friends and my business are all in its path, so I’m likely to lose everything.” 

The thing is, you don’t know that for sure. No one does. Your apprehension will ease if you choose to focus on a positive belief, such as “I don’t know what the outcome will be of” an impending hurricane – or that of a job-related interview, a delicate surgery, a long-awaited court case, a month in rehab, or an anxiety-producing adoption request. Adding an upbeat mental spin inserts powerful positive energy into a situation.

Another koan follows that of the don’t know mind: “Be like a reed blowing in the wind.” In other words, accept whatever is happening, and above all, stay present and be flexible.

My “get ready” list now includes those photos, securely saved on a flash drive.

Early detection key to treating cataracts in kids

in Contributors/Dr. Mark Siegel, MD FAAO/Health by

By Dr. Mark Siegel

Many people think cataracts only happen to older people, but children can get cataracts too. Both pediatric cataracts and cataracts from aging are a clouding in the lens of the eye that can cause blurry vision or blindness.

In adults, cataracts occur after the eyes and vision are developed and stable. Most adults can have good vision again after the cataracts are removed. Because children’s eyes are still developing until they’re 8 or 10 years old, untreated cataracts can have serious long-term effects on their vision. But early detection and prompt treatment can prevent permanent vision loss in children with cataracts.

Types, causes vary

Pediatric cataracts can be congenital (present at birth) or acquired (develop after birth).

They can occur in one eye (unilateral) or both eyes (bi-lateral). Bi-lateral cataracts can be asymmetric (one cataract is more severe than the other).

Cataracts may appear in different parts of the lens and range in size from tiny dots to dense clouds.

They can be caused by genetic predisposition, metabolic disorders such as diabetes or trauma to the eye that damages the lens. Sometimes they occur spontaneously.

A traumatic cataract in a child's eye. The injury also damaged the iris.
A traumatic cataract in a child’s eye. The injury also damaged the iris.

Early detection

An eye’s lens must be clear to focus the images it sees onto the retina, which then transmits the images to the brain. A cataract can prevent light from reaching the retina or cause light rays to scatter as they pass through the cloudiness. This distorts the retinal image.

For children, whose eyes and brain are still learning to see, distortion can lead to amblyopia (lazy eye). Without proper treatment, pediatric cataracts can cause abnormal connections between the brain and the eye. Once made, these connections are irreversible.

Most pediatric cataracts are detected when the child is examined at birth, before they even leave the hospital. Many more are detected by pediatricians at well-baby exams and some are noticed by parents. They are often noticed as a missing or irregular red reflex test on pediatric screening exams.

Acquired cataracts are most often diagnosed at vision screenings by the pediatrician or after an eye injury.

Pediatric cataract in a child born with aniridia (missing iris).
Pediatric cataract in a child born with aniridia (missing iris).

Long-term strategy

Treatment for pediatric cataracts can vary depending on the type and severity. But the vast majority of children need surgery to remove the cataracts. 

Unlike adults with full-sized eyes, children require specialized surgical instrumentation and techniques. When performed by an experienced pediatric cataract surgeon, cataract removal is generally safe. The most common risks include glaucoma, retinal detachment, infection and the need for more surgeries.

For most children, surgery is just the first step to rehabilitate the eyes. Ongoing treatment must repair eye-brain connections. This involves teaching the eyes how to focus properly.

After surgery, children often need some combination of contact lenses, intraocular lenses implanted in the eye or glasses. If amblyopia has developed, the child may need patching. This treatment involves covering the stronger eye to stimulate vision in the weaker eye.

Children who receive timely treatment and follow-up have a good prognosis. Successful outcomes may require years of individualized visual rehabilitation.

Dr. Mark Siegel is the medical director at Sea Island Ophthalmology at 111 High Tide Drive (off Midtown Drive near Low Country Medical Group). Visit www.seaislandophthalmology.com.

There are ways to save money on mental health medications

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By Judith Treadway

Over the last several decades, the use of psychiatric medications has greatly increased, and so have the costs. 

The average American takes 12 medications compared to seven medications 20 years ago. 

According to the National Health Center health statistics, more than 16 percent of Americans age 40 to 50 take antidepressants. 

While some generic drugs can be inexpensive, even they can vary drastically in costs in the same community. 

While doing research for this article, I found that Venlafaxine ER 75 mg costs $250 for 60 pills at one drug store and the same generic drug costs $40 at a neighborhood store. Switching to an immediate release formulation costs between $4 and $8. 

There are simple ways to save money on medications, but there are some possible pitfalls of using some methods. 

Formulary 

If you have insurance, look carefully at your plan’s drug formulary. A formulary is a list of the drugs for which your insurance company, Medicare or Medicaid, will pay its part of the cost. 

If your doctor can prescribe you a drug that is on formulary, on a low tier and that does not require prior authorization (a special explanation from the doctor), it will likely save time and money. 

Formulation 

Simpler forms of medication tend to be cheaper than those that are ending in letters like Xl, XR, etc. These usually designate that they are extended-release in some way. 

These medications are not always better than the immediate release, but they are usually more convenient and more expensive. Discuss with your doctor the cheaper immediate release versions, if available. 

Generic medications 

Some patients will say that they have to have the brand name medication, but brand name medication is almost always more expensive. Many drug stores now offer a long list of inexpensive generic drugs. Many cost only $4 for a month’s refill. 

The FDA requires that all generic drugs contain identical amounts of the same active drug ingredients; however, the shape, flavor, inactive ingredients and release may vary. 

Switching to a generic drug may not always be a good idea, for example, for seizure control. 

Many of the so-called big box stores have a $4 generic list for a 30-day supply and many are posted online. Some are also offering a 90-day supply for $10. 

Two pharmacy chains offer free antibiotics and free Metformin for diabetes and Lisinopril for hypertension with prescriptions. One now offers free Amlodipine. 

Websites 

There are websites that may shorten the search for inexpensive generics. These sites are generally run by pharmacist groups. 

You enter the name of the medication you are seeking, the strength, your ZIP code and it compares prices at several local drug stores. Note, though, that these search sites do not cover all medicines or search all pharmacies, so you may still not get the absolute best price. 

It may be best to phone around to compare prices. 

Compassionate programs 

These are programs that are generally need or income-based for people without insurance to help someone who falls into the Medicare doughnut hole. Visit www.needymeds.org or www.ppaRX.org.

Additionally, most large pharmaceutical companies offer assistance for the brand-name medications. Individual websites for the medications also give guidance on how to apply. 

Coupons for medications can sometimes be found at the drug company website. These are usually for brand-name medications and are limited to so many per patient each year. 

Discount savings cards

These can be useful for people without insurance. They are generally free. When the patient uses the card, the discount varies.

Pill splitting 

This is the practice of cutting pills in order to save money. It works best with medication that is scored, i.e., has a line down the middle. 

The AMA and the Americans Pharmacists Association do not endorse the practice but reportedly acknowledged this can save money if done correctly. 

However, there are many medications that should not be split, including those with a hard coating, enteric-coated, time released, birth control or are bitter or crumbly. 

Mail order 

You may be able to order via your health plan and save that way. Make sure there is a safe delivery place that is in the shade. 

Internet medication orders may be fake, fraudulent or unsafe. The FDA has warned that medications ordered from overseas may not be the same as in the USA.

Dr. Judith Treadway is the chief of psychiatric services at Coastal Empire Mental Health in Beaufort.

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