Valery Brouwer is not much taller than many of her patients. Her offce at Edinger Medical Group is overtaken by children’s murals and plastic toys.

As a pediatrician, Brouwer is committed to caring for kids. So when she learned of a hands-on effort to help impoverished children in her native Dominican Republic, she quickly responded to the call. But she doesn’t use her stethoscope or administer vaccines — she builds wells.

“As a physician, I could immediately tell that almost all of these kids are affected by skin, respiratory, and parasitic diseases caused in great part by the poor quality of their drinking water,” says Brouwer, a physician with Edinger Medical Group next door to Orange Coast Memorial Medical Center.

In May 2007, Brouwer joined the efforts of Change for Children, a grassroots foundation launched by friend and neighbor Sallie Black. Black, 43, of Laguna Hills, was moved to action after learning about the living conditions of batays, impoverished squatter villages built on the sites of former sugar cane plantations in the Dominican Republic.  Here, Haitian and Dominican villagers live in shoddy housing and must walk daily to the river to fetch water contaminated by animals and a local chemical plant.

“You can live without a lot of things, but you can’t live without water,” says Black.

In August 2007, the two women met up in the Dominican Republic where they visited La Lecheria, a batay outside of the capital city of Santo Domingo.

“We knew there was a lot of need. We decided bringing water to the community would make the most long term difference,” says Brouwer, 43, who was raised in San to Domingo.

Not knowing how to build a well in a foreign country, the women found the man who would turn their hopes into reality. Pedro Mora was a mechanical engineer who built wells in villages around the Dominican for the Ministry of Water. He helped cut through the bureaucratic red tape. The Ministry allowed the foundation to borrow equipment to build the wells. And Brouwer and Black purchased recycled pipes and tanks, and hired local workers and paid them in food and lodging.

The results were not one, but two wells — a manual well, and an electric pump with a 5,000-gallon tank to satisfy the needs of more than 2,000 people.

“They got water. They got life,” says Brouwer of the villagers. 

The cost to build a well is $5,000 for a manual well, and $10,000 for an electric pump with generator.  Refecting the foundation’s moniker, Change for Children, the women raise funds by collecting spare change from friends and family, leaving penny jars at their children’s schools, and selling jewelry made by Dominican artisans.

A fundraising event is slated for summer to support their next project, building a well in a small batay near the Haitian-Dominican border.

To donate your spare coins or to get involved in the effort, email changeforchildren@cox.net.

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Thousands of patients with leukemia and other life-threatening diseases depend on the Be The Match Registry^SM to find a bone marrow donor match to save their life. Together with Orange Coast Memorial Medical Center, Edinger Medical Group sponsored a ”Be The Match” Registry Drive. Held in our Fountain Valley office, the event raised bone marrow donor awareness and helped register over 200 people as potential donors.  We are especially proud that over 50 of Edinger’s physicians and staff signed up for the registry. For more information about how to become a donor, please visit www.marrow.org.

What is a formulary?

A formulary is a list of medications that your insurance company will help you pay for. This list is reviewed and changed by the insurance company every few months.

The drugs in a formulary are often listed in 2 or more groups, depending on how much of the cost you are expected to pay. The amount you’re expected to pay is called your co-pay. A typical formulary might include the following groups (also called levels or tiers):

The more dollar signs in the table, the higher the co-pay amount.

What’s the difference between a brand-name drug and a generic drug?

When a drug company develops a new drug, it gives it a brand name. Brand names are the names you usually see in ads on TV and in magazines–names like Claritin and Advil.

For several years after the drug is developed, laws prevent other drug companies from copying it. When other companies start manufacturing and selling the drug, their versions are usually known by a different name–the generic name. This is often the chemical name. For instance, the generic name of Claritin is loratadine and the generic name of Advil is ibuprofen.

Generic drugs are chemically the same as brand-name drugs, and they are often less expensive. That’s why many insurance plans encourage you to use generic drugs.

What are preferred and non-preferred drugs?

Often 2 brand-name drugs are useful for the same problem. Your insurance company may be able to get one less expensively than the other. That drug becomes a preferred drug, and the other becomes non-preferred. That’s usually why you pay more for non-preferred drugs.

Sometimes an insurance company will move a drug from the preferred list to the non-preferred list. If this happens to you, your doctor might be able to prescribe a preferred drug that would cost you less money and work just as well for you.

What about drugs that aren’t in the formulary?

Formularies include a limited number of drugs. Many don’t include drugs that the insurance companies believe aren’t necessary to improve health. These are sometimes called lifestyle drugs. Weight loss and hair growth drugs are examples of lifestyle drugs. Your insurance company won’t help you pay for a drug that isn’t part of its formulary.

How can I make filling a prescription easier?

Here’s what you can do to reduce the chances of having a problem when you try to fill your prescription.

• Bring your medication bottles and a copy of your insurance plan’s formulary to your appointment with your doctor.

If you don’t have a copy, you can call the customer service number listed on your membership card and ask to have one mailed to you. You can also ask the customer service representative whether a specific drug is covered and what the co-pay will be for that drug. If you have access to the Internet, you should be able to find your plan’s formulary on its Web site.

• Fill your prescription at a pharmacy that participates with your insurance plan.

Insurers don’t always use all pharmacies. They make deals with certain pharmacies. If you have your prescription filled at a non-participating pharmacy, you may pay a higher price. Ask the customer service representative what pharmacies participate in your insurance plan.

• Keep track of the number of refills you have left on your prescription.

The number of times you can get the prescription refilled should be printed on the label. While you have refills remaining, you can go directly to the pharmacy to get a new supply of medicine. If you are taking the drug over a long period, you’ll need to call your doctor’s office for a new prescription when you have no refills left. The doctor may want to see how you’re doing before prescribing more of the medication.

• Remember, having the right information can save you time and money. Take the time to find out about your drug coverage.

(Source: http://familydoctor.org)

What is an advance directive?

An advance directive tells your doctor what kind of care you would like to have if you become unable to make medical decisions (if you are in a coma, for example).

A good advance directive describes the kind of treatment you would want depending on how sick you are. For example, the directives would describe what kind of care you want if you have an illness that you are unlikely to recover from, or if you are permanently unconscious. Advance directives usually tell your doctor that you don’t want certain kinds of treatment. However, they can also say that you want a certain treatment no matter how ill you are.

Advance directives can take many forms. Laws about advance directives are different in each state. You should be aware of the laws in your state.

What is a living will?

A living will is one type of advance directive. It is a written, legal document that describes the kind of medical treatments or life-sustaining treatments you would want if you were seriously or terminally ill. A living will doesn’t let you select someone to make decisions for you.

What is a durable power of attorney for health care?

A durable power of attorney (DPA) for health care is another kind of advance directive. A DPA states whom you have chosen to make health care decisions for you. It becomes active any time you are unconscious or unable to make medical decisions. A DPA is generally more useful than a living will. But a DPA may not be a good choice if you don’t have another person you trust to make these decisions for you.

Living wills and DPAs are legal in most states. Even if they aren’t officially recognized by the law in your state, they can still guide your loved ones and doctor if you are unable to make decisions about your medical care.

What is a do not resuscitate order?

A do not resuscitate (DNR) order is another kind of advance directive. A DNR is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. (Unless given other instructions, hospital staff will try to help all patients whose heart has stopped or who have stopped breathing.) You can use an advance directive form or tell your doctor that you don’t want to be resuscitated. In this case, a DNR order is put in your medical chart by your doctor. DNR orders are accepted by doctors and hospitals in all states.

Should I have an advance directive?

By creating an advance directive, you are making your preferences about medical care known before you’re faced with a serious injury or illness. This will spare your loved ones the stress of making decisions about your care while you are sick. Any person 18 years of age or older can prepare an advance directive.

People who are sersiouly or terminally ill are more likely to have an advance directive. For example, someone with terminal cancer might write that she does not want to be put on a respirator if she stops breathing. This action can reduce her suffering, increase her peace of mind and increase her control over her death. However, even if you are in good health, you might want to consider writing an advance directive. An accident or serious illness can happen suddenly, and if you already have a signed advance directive, your wishes are more likely to be followed.

How can I write an advance directive?

You can write an advance directive in several ways:

• Use a form provided by your doctor. (Click to download)
• Write your wishes down by yourself.
• Call your health department or state department on aging to get a form.
• Call a lawyer.
• Use a computer software package for legal documents.

Advance directives and living wills do not have to be complicated legal documents. They can be short, simple statements about what you want done or not done if you can’t speak for yourself. Remember, anything you write by yourself or with a computer software package should follow your state laws. You may also want to have what you have written reviewed by your doctor or a lawyer to make sure your directives are understood exactly as you intended. When you are satisfied with your directives, the orders should be notarized if possible, and copies should be given to your family and your doctor.

Can I change my advance directive?

You may change or cancel your advance directive at any time, as long as you are considered of sound mind to do so. Being of sound mind means that you are still able to think rationally and communicate your wishes in a clear manner. Again, your changes must be made, signed and notarized according to the laws in your state. Make sure that your doctor and any family members who knew about your directives are also aware that you have changed them.

If you do not have time to put your changes in writing, you can make them known while you are in the hospital. Tell your doctor and any family or friends present exactly what you want to happen. Usually, wishes that are made in person will be followed in place of the ones made earlier in writing. Be sure your instructions are clearly understood by everyone you have told.

(Source: http://familydoctor.org)

Government agencies, purchasers of group health care, physicians and other health care providers are working together to make the U.S. health care system safer.

How can I help protect myself against medical errors?

The single most important way you can help to prevent errors is to be an active member of your health care team. That means taking part in every decision about your health care. Research shows that patients who are more involved with their care tend to get better results.

Keep your health care team informed.

• Make sure that all of your doctors know about everything you are taking. This includes prescription and over-the-counter medicines, and dietary supplements such as vitamins and herbs. At least once a year, bring all of your medicines and supplements with you to your doctor.
• Make sure your doctor knows about any allergies and adverse reactions you have had to medicines. This can help you avoid getting a medicine that can harm you.
• Make sure that all health professionals involved in your care have important health information about you. Do not assume that everyone knows everything they need to.

Ask for information about your medicines in terms you can understand.

• Ask for this information both when your medicines are prescribed and when you receive them. See the box below for a list of questions you should ask about your prescription.
• Ask for written information about the side effects your medicine could cause. If you know what might happen, you will be better prepared if it does or, if something unexpected happens instead. That way, you can report the problem right away and get help before it gets worse.
• When your doctor writes you a prescription, make sure you can read it. If you can’t read your doctor’s handwriting, your pharmacist might not be able to either.

Questions to ask about your medicines

• What is the medicine for?
• How am I supposed to take it, and for how long?
• What side effects are likely? What do I do if they occur?
• Is this medicine safe to take with other medicines (both prescription and over-the-counter) or dietary supplements I am taking?
• What food, drink or activities should I avoid while taking this medicine?

Talk to your pharmacist.

• When you pick up your medicine from the pharmacy, ask whether it is the medicine that your doctor prescribed. A study by the Massachusetts College of Pharmacy and Allied Health Sciences found that 88 percent of medicine errors involved the wrong drug or the wrong dose.
• If you have any questions about the directions on your medicine labels, ask. Medicine labels can be hard to understand. For example, ask if “four doses daily” means taking a dose every 6 hours around the clock or just during regular waking hours.
• Ask your pharmacist for the best device to measure your liquid medicine. Also, ask questions if you’re not sure how to use it. Research shows that many people do not understand the right way to measure liquid medicines. For example, many use household teaspoons, which often do not hold a true teaspoon of liquid.

In the hospital

• If you have a choice, choose a hospital at which many patients have the procedure or surgery you need. Research shows that patients tend to have better results when they are treated in hospitals that have a great deal of experience with their condition.
• If you are in a hospital, consider asking all health care workers who have direct contact with you whether they have washed their hands. Handwashing is an important way to prevent the spread of infections in hospitals.
• When you are being discharged from the hospital, ask your doctor to explain the treatment plan you will use at home. This includes learning about your medicines and finding out when you can get back to your regular activities. Research shows that at discharge time, doctors think their patients understand more than they really do about what they should or should not do when they return home.

Before surgery

• If you are having surgery, make sure that you, your doctor and your surgeon all agree and are clear on exactly what will be done. Doing surgery at the wrong site (for example, operating on the left knee instead of the right) is rare. But even once is too often. The good news is that wrong-site surgery is 100 percent preventable. The American Academy of Orthopaedic Surgeons urges surgeons to sign their initials directly on the site to be operated on before the surgery.

Take responsibility for your health care.

• Speak up if you have questions or concerns. You have a right to question anyone who is involved with your care.
• Make sure that someone, such as your personal doctor, is in charge of your care. This is especially important if you have many health problems or are in a hospital.
• Ask a family member or friend to be there with you and to be your advocate (someone who can help get things done and speak up for you if you can’t). Even if you think you don’t need help now, you might need it later.

Learn more about your condition and the tests and treatments recommended by your doctor.

• Know that “more” is not always better. It is a good idea to find out why a test or treatment is needed and how it can help you. You could be better off without it.
• If you have a test, don’t assume that no news is good news. Ask about the results.
• Ask your doctor and nurse and use other reliable sources to get more information about your condition and treatments.

(Source: http://familydoctor.org)

Dr. Nguyen graduated with honors from the University of California, Berkeley where she majored in Molecular and Cell Biology. She received her Doctorate of Medicine from the University of California, San Diego. Dr. Nguyen completed her pediatric residency at UCLA. Dr. Nguyen can perform pediatric gynecological exams. She speak Vietnamese and “Medical” Spanish and is Board Certified.

Board Certification
Pediatrics

Hospital Affiliations
Orange Coast Memorial Medical Center
Hoag Memorial Hospital Presbyterian
Fountain Valley Regional Hospital

Education
Bachelor of Science, University of California, Berkeley
Medical Degree, University of California, San Diego

Residency
UCLA Medical Center

Board Certification
Pediatrics

Hospital Affiliations
Orange Coast Memorial Medical Center
Hoag Memorial Hospital Presbyterian
Fountain Valley Regional Hospital

Education
Bachelor of Science, University of Illinois
Medical Degree, University of Illinois College of Medicine

Residency
University of Illinois College of Medicine

Appointments/ Memberships
Fellow, American Academy of Pediatrics
District Chair of California Chapter, American Academy of Pediatrics
Board of Trustees at Fountain Valley Regional Hospital

Board Certification
Pediatrics

Hospital Affiliations
Orange Coast Memorial Medical Center
Hoag Memorial Hospital Presbyterian
Fountain Valley Regional Hospital

Education
Bachelor of Science, Summa Cum Laude, Harvard University
Medical Degree, Dartmouth University/Brown University Program in Medicine

Residency
UCLA Medical Center

Board Certification
Pediatrics

Hospital Affiliations
Orange Coast Memorial Medical Center
Hoag Memorial Hospital Presbyterian
Fountain Valley Regional Hospital

Education
Bachelor of Science, University of Illinois
Medical Degree, University of Illinois College of Medicine

Residency
University of Illinois

Appointments/Memberships
Past President, American Academy of Pediatrics, Orange County Chapter
Clinical Professor, Department of Pediatrics, UC Irvine
Chair, Pediatric Research in Office Settings (PROS), Education and Breast Feeding
Journal Editor, American Academy of Pediatrics