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If Paula Anderson had more time and energy to devote to something other than practicing medicine, she'd work to get insurance coverage for a particular group of her patients: adults with cystic fibrosis.
That combination — adults and cystic fibrosis — used to be an oxymoron. Today, however, more children with the debilitating lung disease are surviving into adulthood. But because they have CF, they may have trouble getting health insurance.
“It's heartbreaking to see someone not do better because they can't afford their meds,” said Anderson, a pulmonologist with the University of Arkansas for Medical Sciences.
CF patients today live to a median age of 38 — which means half are younger and half are older. Anderson has a patient in her 60s. In the early 1990s, doctors at Children's Hospital who treat CF asked UAMS to begin a clinic for their patients who survived into adulthood. Anderson and another physician at UAMS (one that left soon after making the commitment, she notes wryly) agreed. Today, she has 80 CF patients; the severity of their disease varies widely. It's a disease that affects multiple organs — liver, pancreas, the reproductive tract. Anderson's weapons in the fight against the disease include inhalers that work to clear the mucus in the lungs, antibiotic inhalers, special enzymes to overcome nutrient deficiencies.
Anderson, who's been on the UAMS faculty since 1989, teaches and sees patients with all kinds of lung disease. Hers is a specialty that requires the ability to deal with death. Talking to families about end-of-life decisions “is a big part of what we do”; dealing with the families of the dying is something that medical schools should spend more time teaching their students, she said.
The greater availability of palliative care services today and hospice have lent more dignity and control to dying than in years past. But families need to make their end-of-life desires known “before it becomes a big issue,” she said.
“Sometimes, there's a very clear directive from patients” about whether they want to be ventilated or allowed to die, “and that's wonderful,” Anderson said. “And that would be the minority.” Doctors and other health professionals “are guilty of not bringing the issue up early enough” as well, she added.
How could she free up some time to work on CF issues? If people would quit smoking.
Like all pulmonologists, Anderson is passionate about the need to get people to put down the smokes. Smoking is the single cause of COPD, the heart-lung disease that kills 1,200 Arkansans every year; the disease would disappear if people quit smoking. “Smoking cessation is more important than all the drugs in the world,” Anderson said.
The Little Rock native is a graduate of Hendrix College and UAMS and did a fellowship in respiratory biology at the Harvard School of Public Health in Boston and pulmonary and critical care medicine at UAMS. She is a member of the board of directors of the American College of Chest Physicians' Chest Foundation and was a member of the national Cystic Fibrosis Foundation Center Committee.
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