Wednesday, December 24, 2008

Health Care and Christmas

Over two thousand years ago, God came to earth in the form of a newborn baby. At the time, the world was in chaos, and humanity was desperately struggling for survival. Not much different than today over two millenia distant from a night in the Judean hills in a little backwater town called Bethlehem. This was the most unlikely place for a king to be born. There was no press release, no parade, no announcement in the Jerusalem Times, and no crowd pressing in around the baby and his very young, bewildered parents.

There were, though, a handful of visitors including some smelly shepherds, some animals in the cave were they were staying during the birth, and probably no one else. Joseph and Mary were likely exhausted from the trip they were forced to make back to his ancestral town in obedience to the Roman census that was underway. There was no lodging available as the entire area was full of travelers who were doing the same thing--going back home to be counted. Yet, here he was. Emmanuel--"God with us." He came for the redemption of a world gone mad, and to heal the sick and redeem mankind from eternal separation from a holy God. has information about how many of the facts about Jesus' birth have been distorted over time by countless retellings of the story. The actual time of the year and exact location of his birth are not really known but have been put into our collective conscious thought from traditions handed down over the centuries. Despite human misconceptions, however, the actual facts about Jesus are more marvelous than words can express. He was indeed born of a virgin in the city of Bethlehem exactly as prophecied many years before. Jesus was conceived in Mary, not by man, but by the Holy Spirit of God. As the apostle John reveals, Jesus existed before the Creation of the world (John 1). He is part of the Holy Trinity we know as God (Father, Son and Holy Spirit). The Son of God came in human form for a purpose—to die as a willing sacrifice in payment for the sins of mankind. He did this to provide eternal salvation as a free gift to all who will accept it and follow Him.

The gifts we celebrate at Christmas are a material representation of what happened when God the Father gave His Son to mankind as the ultimate expression of love. Jesus is the Gift of Gifts. Many times, people often confuse a relationship with God with how spiritual they feel. According to, spirituality is the way you find meaning, hope, comfort and inner peace in your life. Many people find spirituality through religion. Some find it through music, art or a connection with nature. Others find it in their values and principles. Spirituality is related to health. And, it seems the body, mind and spirit are connected. The health of any one of these elements seems to affect the health of the others. Some research shows that things such as positive beliefs, comfort and strength gained from religion, meditation and prayer can contribute to healing and a sense of well-being. Most medical practitioners believe that improving your spiritual health may not cure an illness, but it may help you feel better, prevent some health problems and help you cope with illness, stress or death. If you are being treated for an illness, it's important for your doctor to know how your spirituality might be affecting your feelings and thoughts about your medical situation. If you think your spiritual beliefs are affecting your health care decisions or your ability to follow your doctor's recommendations, tell your doctor. If you have spiritual beliefs, worries or concerns that are causing you stress, talk with your doctor. Your doctor would like to help. If your doctor can't help you with these issues, he or she may be able to suggest someone who can.

Believers in Christ will avow that the spiritual life they lead will definitely be affected by their health. No one in their right mind would agree that being sick makes us happy. However, what most people don't realize is that even in the midst of terrible suffering or illness, a peace and joy can be possible when the focus is not on the pain but on Jesus. This is not channeling, counting beads, yoga, or saying countless mantras over and over. It is learning to allow His strength to comfort you both in good and bad times. Dealing with sickness and disease on a personal level can be disastrous on your spiritual life if you try to handle those issues on your own apart from a meaningful relationship with God. There are always questions of why suffering, illness and death happen to Christians, even those who appear to be the most faithful. Your health affects your spiritual life, and your spiritual life affects your health. You are never promised a life free of difficulties or trials, only the fact that you will be comforted in the midst of pain.

According to, there are three primary ways to allow your spiritual life to have positive impact on your health:
1.)Be Forgiving--You must forgive others and forgive yourself. Forgiveness frees you from hate, forces you to examine your motives and demands that you give up the need to be always right. When you hold back forgiveness, you let things eat away in your heart. This cannot only affect your spiritual health, but it can also be detrimental to your physical and emotional well-being.
When you forgive someone who has harmed you or done you wrong, you not only free yourself of the burden, but you actually gain power over the situation. Anger or revenge only escalates the problem within your spirit. But forgiveness does not mean you must continue to deal with the person. Some good expressions to remember are; "Forgive and forget" and "to forgive is divine." Forgiveness is an important step in maintaining your spiritual well-being.

2.) Be Grateful--You should be grateful and thankful for the blessings you receive. Every time you have a negative thought, countered with a thought of gratitude the more you contemplate your blessings, the more you feel the changes in your emotional and spiritual outlook. The worst habit is ingratitude. If you feel gratitude, you will be amazed at the changes in yourself, your health, your relationships, your career—your entire life.

3.) Be at Peace--You need a personal peace that will disconnect you from the disquieting or threatening thoughts. Personal peace is the knowledge that all is well and understanding that God has everything under control. It becomes a reality when we shift our focus from problems we cannot solve to a higher vision of hopefulness.

Physical and spiritual health are inter-connected way beyond our comprehension to understand completely how one affects the other. Those who have taken advantage of the true Gift of the Season know that to be true. Others still searching for the Gift are caught up in the spirit of the season, but do not know the truth of its meaning. They are just trying to make it to the New Year. Giving and receiving gifts are part of Christmas and should never be downplayed as unimportant. However, the focus should be placed more on the Reason for the Season. Without Christ, there is no Christmas. Without God, there is no Gift. Without hope, there is no future. Without eternity, there is no meaning to life. He came to give life, and life more abundantly regardless of your physical health. When you consider your health at this Christmas time, remember The One responsible for sustaining life. Give Him the praise for what He has done. Emmanuel.

Until next time. Let me know what you think.

Friday, December 19, 2008

Health Care and Holiday Shopping

Tis the Season...for mad dashing to the stores, for endless parking lot road games, for multiple stops at Starbucks to stay caffeinated and energized, for hectic holiday shopping til you're dropping. Dr. Vincent Ianelli, pediatrician, says that parents usually have a lot to think about when trying to buy gifts for their kids at the holidays. This year, make sure you also think about your child's safety and think about choosing safe toys and gifts. Additionally, there are multiple health considerations when you are out fighting the crowds for those perfect gifts to give family and friends.

The Consumer Product Safety Commission offers these toy safety shopping tips--
Under 3 Years Old:
Children under 3 tend to put everything in their mouths. Avoid buying toys intended for older children which may have small parts that pose a choking danger. Never let children of any age play with uninflated or broken balloons because of the choking danger. Avoid marbles, balls, and games with balls that have balls with a diameter of 1.75 inches or less. These products also pose a choking hazard to young children. Avoid toys with small magnets, magnetic pieces, or loose magnets, as they can be swallowed. Unfortunately, if two magnets connect together after they are swallowed, they can cause an intestinal blockage or more serious problems. Children at this age pull, prod and twist toys. Look for toys that are well-made with tightly secured eyes, noses and other parts.

Ages 3 Through 5:
Avoid toys that have sharp edges and points. Avoid toys that are constructed with thin, brittle plastic that might easily break into small pieces or leave jagged edges. Look for household art materials including crayons and paint sets, marked with the designation "ASTM D-4236." This means the product has been reviewed by a toxicologist and, if necessary, labeled with cautionary information. You should also avoid toys with magnets at this age.

Ages 6 Through 12:
Teach older children to keep their toys away from their younger brothers and sisters. If buying a toy gun, be sure the barrel or the entire gun is brightly colored so that it's not mistaken for a real gun. For children of all ages: check toys regularly for small parts, breakage and potential hazards, including chipped or peeling pain. Damaged or dangerous toys should be repaired or thrown away. And, watch for toy recalls and quickly remove recalled toys. Also, encourage your kids to not put their toys in their mouth (although it is harder for infants and younger toddlers). If you buy a bicycle, scooter, skates, or other sporting goods, buy a helmet and appropriate pads too, and make sure the child wears them. Teach them to put toys away when they're finished playing so they don't trip over or fall on them. Also keep in mind that the American Academy of Pediatrics: recommends against the home use of trampolines, recommends that children under 16 shouldn't ride on 4 wheel All Terrain Vehicles, advises a ban on the sale of all 3-wheeled ATVs, and advises that children are at big risk of getting hurt from non-powder guns, like BB guns, pellet guns, air rifles, and paintball guns

Hearing Loss and Loud Toys: It is easy to spot some unsafe toys, like those with sharp edges or small parts, but loud toys are an under-recognized hazard to children. Remember that some toys, even those recommended for young children, can produce noise at a level that could damage your child's hearing. These types of toys include cap guns, musical toys, toy phones, horns, sirens, and even squeaky rubber toys, which can produce noise as high as 90 to 120 decibels. According to the American Speech-Language-Hearing Association, when held directly to the ear, as children often do, a noisy toy actually exposes the ear to as much as 120 dB of sound, a damaging dose -- the equivalent of a jet plane taking off. Noise at this level is painful and can result in permanent hearing loss. Although you likely should avoid toys that sound loud, if your child gets any toys that make noise, be sure that he doesn't put them up to his ear, which can cause even more damage to his hearing.

Living Healthy Chicago offers the following tips for healthy holiday gift giving--
1.) Gym Membership: Treat your loved one to a personal training session at their gym (who doesn't want customized care?), or give them a headstart on their New Year's resolution by buying them a year-long membership at a gym nearby their home or office.
2.) Trendy Exercise Gear: Did you know that what you wear to the gym can affect your workout mood? Wear soft, comfortable gymwear. You likely do not feel as motivated when sporting a ratty t-shirt and old sweatpants. Nike, Lululemon and Champion offer workout apparel that's both fashionable and functional.
3.) Fruit Gift Basket: A bouquet of edible fruit and the large, colorful basket is always a hit with the entire office. Real flowers are replaced with carefully carved cantaloupe, watermelon and pineapple. This is a sweet gesture and provides deliciously sin-free snacking.
4.) Flu Shot: Seems like an odd gift, but some people have avoided getting the Flu shot this year because they don't want to cough up the $20-$25 fee. Your friend or college-aged child will thank you for the gesture when he or she steers clear of the bug invading the office or dorm room.
5.) Facial Steamer & Aromatherapy Perfumes: Winter's unpredictable weather patterns make us all an easy target for colds and coughs in the winter months. Give your friend a facial steamer and bottle of aromatherapy to keep them healthy throughout the cold season. Plants like Eucalyptus and Peppermint help clear sinuses and provide a general state of relaxation.

Finally, keep in mind that colds, viruses, and flu bugs are rampant this time of year. Protect yourself and others when you are shopping, especially if the weather takes a nasty turn for the worse. Try to avoid people who are rampantly coughing, sneezing, or snorting. Stay safe and warm if you need to be out in very cold temperatures, and make sure that your vehicle is mechanically up to speed if you are driving in bad weather or at night. Wash your hands often to keep bacteria at bay; and bundle up the kids if you take them with you, especially if the temperatures dip into the 30's or below. Also, avoid fatigue as much as possible by pacing yourself during the marathon shopping events. Keep a good sense of humor, too. Using common sense will help keep you and your loved ones safe during the Holidays.

Until next time. Let me know what you think.

Wednesday, December 17, 2008

Health Care and Carbon Monoxide Poisoning

This time of year, thousands of Americans suffer from carbon monoxide poisoning. According to eDocAmerica, carbon monoxide is a compound composed of carbon and oxygen and has the chemical formula - CO. It is a highly poisonous gas that when inhaled can result in asphyxiation. Carbon monoxide is formed when carbon-containing substances (gas, oil, kerosene, wood, or charcoal) are burned with insufficient amounts of air. Automobiles, space heaters, ranges, ovens, stoves, furnaces, fireplaces, water heaters, and clothes dryers are all common sources of carbon monoxide production. CO poisoning can occur if appliances are not working or vented properly and dangerous levels of CO build up.

Information from eDocAmerica tells what causes CO poisoning. Red blood cells are responsible for transporting oxygen to the body. Since blood cells pick up CO quicker than they pick up oxygen, if there is a lot of CO in the air, the body may replace oxygen in blood with CO. This blocks oxygen from getting into the body, which can damage tissues and result in death. Carbon monoxide is a clear, colorless gas, so it can be very difficult to detect. At moderate levels, the most common symptoms of CO poisoning are headache, dizziness, weakness, nausea, vomiting, chest pain, and confusion. Higher levels of CO inhalation can result in loss of consciousness and death. Some people have been fooled into thinking that their symptoms were due to a cold or flu, whereas they were really experiencing CO toxicity. Each year, approximately 400 people die from CO poisoning and another 20,000 seek emergency treatment in an Emergency Room. The risk of succumbing to CO poisoning is highest among the elderly, those with chronic respiratory or heart problems, children and people with anemia. If you experience symptoms that you think could be from CO poisoning, get fresh air immediately. Open doors and windows to ventilate the house and turn off all fuel-burning appliances. Go to an Emergency Room as quickly as possible and inform the staff that you suspect CO poisoning. A fairly simple blood test that measures the level of a compound called carboxyhemogloin can be done to help confirm the diagnosis.

The Centers for Disease Control has offered the following suggestions to help prevent CO poisoning:
--Have your fuel-burning appliances (oil and gas furnaces, gas water heaters, gas ranges and ovens, gas dryers, gas or kerosene space heaters, fireplaces, and wood stoves) inspected by a professional at the beginning of every heating season.
--Choose appliances that vent their fumes to the outside and make sure that they've been properly installed.
--Read and follow instruction manuals that accompany fuel-burning devices.
--Don't idle the car in a garage, even if the garage door is open
--Don't use a gas oven to heat your home, even for a short time.
--Don't use a charcoal grill indoors, even in a fireplace.
--Don't sleep in any room with an unvented gas or kerosene space heater
--Don't ignore symptoms, particularly if more than one person is experiencing them.

CO detectors should not be a substitute for proper use and maintenance of your fuel-burning appliances according to eDocAmerica. While many authorities recommend their use, it should be realized that the sensitivity and reliability of these devices varies greatly. Be sure that any CO detector that you buy has received UL certification. Check the batteries every time you check your smoke detector batteries - at least twice a year. If an alarm sounds make sure that it is the CO detector rather than the smoke alarm. If anyone in the home is experiencing symptoms of CO poisoning take them to an Emergency Room right away. If no one is experiencing symptoms, ventilate the house and turn off all fuel-burning appliances. Have a qualified technician inspect the home for potential sources of CO production.

Carbon monoxide (CO) is a gas that has no odor or color according to the National Institutes of Health (NIH). But it is very dangerous. It can cause sudden illness and death. CO is found in combustion fumes, such as those made by cars and trucks, lanterns, stoves, gas ranges and heating systems. CO from these fumes can build up in places that don't have a good flow of fresh air. You can be poisoned by breathing them in. It is often hard to tell if someone has CO poisoning, because the symptoms may be like those of other illnesses. People who are sleeping or intoxicated can die from CO poisoning before they have symptoms. And, according to the Mayo Clinic, carbon monoxide fumes are dangerous for anyone. Some people are more susceptible to the effects of carbon monoxide, including:
--Unborn babies
--Older adults
--People who smoke
--People who have chronic heart disease, anemia or respiratory problems.

The Mayo Clinic also reports that depending on the degree and length of exposure, carbon monoxide poisoning can cause:
--Permanent brain damage
--Damage to your heart, possibly leading to life-threatening cardiac complications years after the poisoning
The goal of treatment is to replace the carbon monoxide in your blood with oxygen. In the hospital, you may breathe pure oxygen through a mask placed over your nose and mouth. This helps oxygen reach your organs and tissues. If you can't breathe on your own, a machine (ventilator) may do the breathing for you. In some cases, hyperbaric oxygen therapy is recommended. With this therapy, you're placed in a full-body pressurized chamber. Inside the chamber, air pressure is more than twice as high as normal atmospheric pressure. This speeds the removal of carbon monoxide from your blood.

The Mayo Clinic also offers some simple precautions that can help prevent carbon monoxide poisoning. Consider these do's and don'ts:
1.) Invest in carbon monoxide detectors. Install a carbon monoxide detector on every floor or level of your home. Install additional detectors outside individual bedrooms. Check the batteries every time you check your smoke detector batteries — at least twice a year. If the alarm sounds, leave the house and call the fire department or local utility company from a nearby phone.
2.) Open the garage door before starting your car. Never run your car in a closed garage. If you have an attached garage, keep the garage door open and the door to the house firmly closed while the car is running. Remove snow or other debris from the tailpipe before using the car.
3.) Use gas appliances as recommended. Never use a gas stove or oven to heat your home. Use portable gas camp stoves only outdoors. Use fuel-burning space heaters only when someone is awake to monitor them and doors or windows are open to provide fresh air. Don't run a generator in an enclosed space, such as the basement or garage.
4.) Keep your gas appliances and fireplace in good repair. Make sure your appliances are properly vented. Clean your fireplace chimney and flue every year. Ask your utility company about yearly checkups for any gas appliances.

Finally, use common sense--a great option when in doubt. Carbon Monoxide poisoning can kill. Check your home for the potential hazards related to it and fix whatever is broken so you or a family member are not a story on the evening news. The fall and winter are prime times for carbon monoxide poisoning to happen because of weather and other seasonal events. Follow your instruction guides and make sure that you do the right thing when exposure to this gas is a possibility at any time.

Until next time. Let me know what you think.

Tuesday, December 16, 2008

Health Care and Sleep Deprivation

Have you ever had a bad night's sleep or have had difficulty falling asleep when it's bedtime? Feeling groggy and tired, even exhausted? Often, having a hard time falling asleep may be caused by interruptions in our schedules, an over abundance of stress-especially during the Holidays, or from some health care problems that cause us to lose sleep. Most adults can survive on a few hours sleep per night, but children and teenagers need more because they are still growing and need that extra time in bed.

It's not unusual during the holidays, with all the parties, shopping, travel and preparation according to Health & Wellness Remedy Here are some common culprits, and solutions that should soon have you snoozing soundly:

1.) The Problem: Jet Lag--It’s a disruption of your underlying sleep-wake cycle, your internal body clock. And the more time zones you cross, the longer it takes to adjust back. In other words, when your internal clock is out of step with the one ticking away on the wall, you’re going to be sleepy—and not sleepy—at the wrong times. The Fix: Adjust. Before your trip, gradually adjust sleeping and eating hours to those of your destination. Because dehydration makes it tougher for the body to adapt, be sure to drink plenty of fluids on the plane. Follow the schedule of your new destination right away. Plenty of exposure to bright light will help you reset your circadian rhythms. If it’s still light outside, head outdoors for at least 30 minutes whenever you feel sleepy. And be sure to get some exercise, which raises your endorphin levels and can make you feel better.

2.) The Problem: Stress--All those things you didn’t have time to think about during the day come into consciousness the minute your head hits the pillow. The Fix: Make a list. Before bed, sit in a quiet place with pen and paper. Let your mind wander just as it does in the middle of the night, and then spend 10 or 15 minutes writing down everything you need to do. Once it’s written down, you can let it go. When you’re in bed, imagine going down a staircase or riding down an escalator. The lower you go, the more deeply you’ll relax.

3.) The Problem: Wining & Dining--Though alcohol can sometimes help you relax and fall asleep faster, it suppresses REM sleep—and so you wake up feeling groggy. And if you eat too much, your body’s going to be too busy digesting dinner to focus on sleep. The Fix: Time it right. If you simply must have some wine, make sure you finish your last alcoholic drink and any big meal three hours before you plan to sleep.

4.) The Problem: Being Away From HomeAre you a city person spending time at your cousin’s country cabin (or vice versa)? You might find nodding off a challenge. Each of us has a sleep environment we’ve adapted to, and, for some people, any change—even if it’s quieter—can make it difficult to fall asleep. The Fix: Take Control. If noise bothers you, try a pair of earplugs; if lack of noise does, turn on a fan or tune the radio between stations to create white noise. In a hotel, ask for a room far from busy spots such as elevators, stairways, and vending and ice machines. Stretch out your bedtime routine so it really feels like home.

According to the Centers for Disease Control (CDC), most adults need 7 to 8 hours of sleep per night. People who are well rested feel alert and do not have the urge to nap as reported by the Nebraska Rural Health and Safety Coalition. If this becomes a chronic problem, sleep deprivation can cause difficulties with social relationships because of irritability; as well as some significant medical problems.

Sleep deprivation can have serious effects on your health in the form of physical and mental impairments. Inadequate rest impairs our ability to think, to handle stress, to maintain a healthy immune system and to moderate our emotions. In fact, sleep is so important to our overall health that total sleep deprivation has been proven to be fatal according to the website Without adequate rest, the brain's ability to function quickly deteriorates. The brain works harder to counteract sleep deprivation effects, but operates less effectively: concentration levels drop, and memory becomes impaired. Similarly, the brain's ability to problem solve is greatly impaired. Decision-making abilities are compromised, and the brain falls into rigid thought patterns that make it difficult to generate new problem-solving ideas. And, insufficient rest can also cause people to have hallucinations. Other typical effects of sleep deprivation include:
--Heart disease
--Slower reaction times
--Slurred speech

The older we get, according to, the more likely it is that we will suffer from some kind of sleep disorder. In fact, over 50% of people over 64 years old suffer from some type of sleep disorder. While the hormonal and physical changes that occur as we age will likely affect sleep, especially in menopausal women, the increased presence of other medical conditions and disorders is also a factor that tends to upset the sleep of the elderly. One of the biggest sleeping problems the elderly experience is the inability to get deep, restorative sleep. Although they tend to sleep just as much as they did when they were younger, the elderly don’t get as quality sleep, meaning that they often suffer from fatigue and daytime drowsiness. The main reason for this is because older people don’t get as much REM sleep, the deepest, most restorative sleep phase. Keep reading to learn more about the relationship between sleep and aging.

Dramatic weight changes, especially weight gain, are also common effects of sleep deprivation. Because the amount and quality of the sleep we get affects our hormone levels, namely our levels of leptin and ghrelin, many physiological processes that depend on these hormone levels to function properly, including appetite, are affected by our sleep. While leptin is a hormone that affects our feelings of fullness and satisfaction after a meal, ghrelin is the hormone that stimulates our appetites. When you suffer from sleep deprivation, your body’s levels of leptin fall while ghrelin levels increase. This means that you end up feeling hungrier without really feeling satisfied by what you eat, causing you to eat more and, consequently, gain weight.

Sleep is very critical to your health. In olden days, before the light bulb, people slept longer. All those long days everyone seems to endure these days now add up to a lot less sleep. When you suffer from sleep deprivation, your health suffers. Make the best of your night time slumber.

Until next time. Let me know what you think.

Monday, December 15, 2008

Health Care and Electronic Records

Many people in the US healthcare industry, our government, and the press use the terms electronic medical record (EMR) and electronic health record (EHR) interchangeably, according to HIMSS Analytics. However, these terms describe completely different concepts, both of which are crucial to the success of local, regional, and national goals to improve patient safety, improve the quality and efficiency of patient care, and reduce healthcare delivery costs. EHRs are reliant on EMRs being in place, and EMRs will never reach their full potential without interoperable EHRs in place. It is important to understand the differences, and to reduce confusion in the market. The EMR is the legal record created in hospitals and ambulatory environments that is the sourceof data for the EHR. The EHR represents the ability to easily share medical information among stakeholders and to have a patient s information follow him or her through the various modalities of care engaged by that individual. Stakeholders are composed of patients/consumers, healthcare providers, employers, and/or payers/insurers, including the government.But before we can move to effective EHR environments, provider organizations must implement complete EMR solutions. At this point, few hospitals have EMR solutions that can effectively reduce medical errors or improve the quality and efficiency of patient care.

According to sources on Wikipedia, A major concern is adequate confidentiality of the individual records being managed electronically. The LA Times reports roughly 150 people (from doctors and nurses to technicians and billing clerks) have access to at least part of a patient's records during a hospitalization, and 600,000 payers, providers and other entities that handle providers' billing data have some access. Multiple access points over an open network like the Internet increases possible patient data interception. In the United States, this class of information is referred to as Protected Health Information (PHI) and its management is addressed under the Health Insurance Portability and Accountability Act (HIPAA) as well as many local laws.
Additionally, as reported by Wikipedia, to attain the wide accessibility, efficiency, patient safety and cost savings promised by EMR, older paper medical records ideally should be incorporated into the patient's record. The digital scanning process involved in conversion of these physical records to EMR is an expensive, time-consuming process, which must be done to exacting standards to ensure exact capture of the content. Because many of these records involve extensive handwritten content, some of which may have been generated by different healthcare professionals over the life span of the patient, some of the content is illegible following conversion. The material may exist in any number of formats, sizes, media types and qualities, which further complicates accurate conversion. In addition, the destruction of original healthcare records must be done in a way that ensures that they are completely and confidentially destroyed. Results of scanned records are not always usable; medical surveys found that 22-25% of physicians are much less satisfied with the use of scanned document images than that of regular electronic data.
According to the New York Times, a report by The New England Journal of Medicine found that doctors who use electronic health records say overwhelmingly that such records have helped improve the quality and timeliness of care. Yet fewer than one in five of the nation’s doctors has started using such records. Bringing patient records into the computer age, experts say, is crucial to improving care, reducing errors and containing costs in the American health care system. The slow adoption of the technology is mainly economic. Most doctors in private practice, especially those in small practices, lack the financial incentive to invest in computerized records. The national survey found that electronic records were used in less than 9% of small offices with one to three doctors, where nearly half of the country’s doctors practice medicine. Private and government insurers and hospitals can save money as a result of less paper handling, lower administration expenses and fewer unnecessary lab tests when they are connected to electronic health records in doctors’ offices. Still, it is mainly doctors who bear the burden making the initial investment.
The NY Times reports electronic health records were used by 51% of larger practices, with 50 or more doctors. Indeed, electronic health records are pervasive in the largest integrated medical groups like Kaiser Permanente, the Mayo Clinic, the Cleveland Clinic, University of Pittsburgh Medical Center and others. These integrated groups not only have deep pockets. By combining doctors, clinics, hospitals and often some insurance they can also capture the financial savings from electronic health records. Large medical groups have long been the early adopters, and small practices have struggled. With physicians who use electronic records, the results, also show a strong endorsement of electronic health records by doctors who have them, especially for what the report termed “fully functional” records, which include reminders of care guidelines, based on a patient’s age, gender or medical history. For example, 82% of those using such electronic records said they improved the quality of clinical decisions, 86% said they helped in avoiding medication errors and 85% said they improved the delivery of preventative care. One wave of innovation is coming from big technology companies, like Microsoft and Google, which recently have begun services that offer consumer-controlled personal health records over the Web, which are stored in the companies’ data centers. These consumer-controlled health records are intended to link up and exchange information with electronic patient records in doctors’ offices and hospitals.
According to, electronic medical records offer numerous advantages over paper records which are sometimes illegible and very often not where the patient is when he or she needs treatment. An electronic medical record allows the doctor to instantly see the patient's prior treatment, medication history, and other details critical to care, and errors decrease.
Electronic records also promote preventive care, improving health and lowering costs. For example, the medical staff can be electronically prompted to offer an older individual a pneumonia shot or to remind the patient of the need for colonoscopy. And by preventing pneumonia or by diagnosing cancer at an earlier stage, electronic medical records can substantially reduce health-care costs.
A variety of companies — from private health-care providers and insurance companies to big technology firms such as Microsoft and Google — are developing and launching sites, most of them free, that allow patients to keep personal health records according to USA Today. They can include everything from medical histories to test results, doctors' notes and prescriptions. Patients can input their records themselves or have them added by the few doctors' offices and other medical facilities that keep compatible electronic records online. Because the field is so new, standards and legislation still are under development. And privacy advocates worry about sensitive records falling into the wrong hands. But nearly everyone applauds the idea behind the records: They aim to bring the notoriously slow-to-computerize health records out of the era of manila folders and scribbled notes and into the future of electronic information that can be transported with the click of a button. Most of the sites also are trying to become health leaders by running online health-care malls, where people can do everything from storing their own records to doing medical research online.
According to USA Today, advocates of personal health records say they will result in better-informed patients, the elimination of redundant tests and better-prepared doctors who can get a more complete picture by having their patients' entire medical history in front of them. Errors will be reduced by quickly giving physicians access to crucial information, such as allergies, advocates say. Ultimately, systems could allow emergency room physicians, for instance, to have instant access to incoming patients' records. But others warn there's a big downside to personal health records, especially the chance that private and personal records could be bought and sold by, for instance, pharmaceutical companies. All companies with private personal health records say privacy is of paramount importance and outline strict privacy measures in their terms of service agreements. Privacy advocates worry that companies could legally sell medical records, valuable to drug and insurance companies.
Regardless of the evidence in favor of electronic medical records, fears of privacy breaches or corruption of records are real needs that must be addressed by government, private medical providers, and the medical community. The cost of health care and medical treatment has skyrocketed over the past few years, and some of those cost increases may be alleviated or softened by the use of electronic medical records. However, the cost of implementation and the concerns over who has access must also be addressed before there would be a complete transformation of record keeping in the health care industry.
Until next time. Let me know what you think.

Friday, December 12, 2008

Health Care and Cancer Threat

According to, Cancer is projected to become the leading cause of death worldwide in 2010. That is a staggering piece of information and one that deserves our full attention. It means that despite the progress we have made here in the United States and other developed countries in decreasing the burden from cancer, the rest of the world is far behind and is suffering the consequences. In the last 30 years of the 20th century, the global burden of cancer more than doubled. That trend is projected to continue, and by 2030 there could be 27 million newly diagnosed cases of cancer, 17 million deaths each year and 75 million people alive with cancer within five years of diagnosis.

The report goes on to say that One quarter of cancers in developing countries are attributable to infectious diseases, some of which are preventable with currently available vaccines. More importantly, although 12 percent of cancers in developing countries today are related to tobacco, that number is expected to increase significantly as cigarettes spread their scourge around the world. There are many countries that are still in the relatively early stages of their own tobacco pandemics, and have yet to be affected to the degree seen in the United States. The future impact of tobacco on the health of those countries is absolutely frightening. Another sad tale is that many developing countries are adopting Western lifestyles at a quickening pace. Americans are exporting our diets, our habits and our fast-food outlets throughout the world. Along with that comes overweight and obesity, and with that an increase in the risk of cancer deaths in both men and women. Couple these factors with an increase in global population and aging of that population, and you have a formula guaranteed to increase the numbers of people diagnosed and dying from cancer.

Obesity has long been associated with an increased risk and severity of breast cancer in postmenopausal women according to the Journal of the National Cancer Institute. New research now shows that this risk is not the result of differences in the use or accuracy of mammography screening but instead may actually be the result of biologic differences in tumor development. Approximately 200,000 women are diagnosed with breast cancer every year in the United States alone. The majority of breast cancers are diagnosed among postmenopausal women. Previous research has indicated that postmenopausal women who are overweight or obese are at an increased risk of developing breast cancer. Furthermore, being overweight or obese has been associated with larger tumor size and more advanced disease at diagnosis. Researchers have been uncertain about the reasons for the association between obesity and increased breast cancer risk, especially because obese women are more likely to be diagnosed with advanced disease. Obese women are more likely than normal weight women to have fatty breast tissue, which increases the visibility of tumors on mammography. However, obese women also have larger breasts and it can be difficult to get accurate images of the entire breast, which could result in missed cancers.

Additionally, the Nemours Foundation reports that although breast cancer in teens is extremely rare, it's a good idea for girls to learn how to perform a breast self-examination (BSE) so they can get used to how their bodies feel normally. After learning what is normal for them, teens can then recognize changes in their breasts. Doctors recommend doing a monthly BSE at the same time each month (like a few days after a girl's period ends, when breasts are less tender). Some kinds of lumps that teenage girls may feel are normal, but a doctor should check out any lump to be sure. If your daughter notices any changes or has any questions, she should talk to her doctor.

According to Punch on the Web, a recent statement by Pfizer, a leading pharmaceutical company, that “no fewer than 100,000 new cases of breast cancer occur in the country every year” calls for serious concern and an urgent action to arrest the ugly trend. The pharmaceutical giant also says the nation has 25 cases per 100, 000 women. This development, it says, has ranked breast cancer as the commonest form of cancer among women. Pfizer further estimates that more than 400, 000 women die annually from the disease. Without a doubt, ignorance is one of the causes of this life-threatening disease. Evidence abounds that breast cancer is treatable if discovered early and that survivors can lead normal lives. Oncology experts agree that early detection is the best way to treat breast cancer. Three steps recommended for early detection of breast cancer are regular mammogram (a screening tool that uses X-ray to provide an image of the breast), clinical breast examination and breast self-examination. They advise women to familiarise themselves with their breasts and report unusual changes to their physicians.

Changes to look out for, according to Pfizer, include a lump or thickening which is different from the rest of the breast tissue; continuous pain in one part of the breast or armpit; one breast becoming larger or lower; when a nipple becomes inverted or changes shape or position; swelling under the armpit or around the collarbone; a rash on or around the nipple and discharge from one or both nipples. both men and women are capable of being affected by the disease but men are generally at low risk for developing breast cancer.

Also, recent studies have found the standard screening test for prostate cancer may not be accurate for obese men, leaving them more vulnerable to the disease, and surgery is less likely to be effective for them as reported by HealthDay online. Obese men are more likely to be diagnosed with an aggressive form of the disease. The reason: The blood test that looks for elevated levels of the protein prostate-specific antigen (PSA), indicating a heightened cancer risk, doesn't seem as reliable for obese men; and the assumption is that these men have more blood volume, so PSA gets diluted. By the time obese men get to elevated levels, the cancer is more advanced. Prostate cancer is suspected when the PSA reading is 4 or higher. The current recommendation is for men aged 50 and older to be offered an annual PSA test, with explanations of its possible risks and benefits. A federal preventive medicine committee this week said that PSA screening should not be done for men aged 75 and older because the risks outweigh the benefits.

Additionally, according to, eating meat grilled well done or burned has been linked to two types of cancer, colon and pancreatic. The longer meat cooks at high temperatures, the greater the buildup of cancer-causing compounds called heterocyclic amines (HCAs). This increased risk of cancer is not confined to grilled foods but is associated with pan-fried meats at high temperatures also. Grilled vegetables, even well-done, do not appear to pose the same risk as overcooked meat. You can also reduce your risk by precooking meats in the oven or microwave, and then finishing them on the grill for just a few minutes. So, go easy on the red meat.

Also, supplements are known for the power to help cure many diseases. According to MedScape, neither vitamin E nor vitamin C reduces the risk for prostate cancer or total cancer, according to the results of a large, long-term, randomized trial of male physicians reported in the December 9 Early Release issue of the Journal of the American Medical Association. Neither vitamin E nor vitamin C supplementation was significantly associated with colorectal, lung, or other site-specific cancers. Overall findings were not affected by adjustment for adherence and exclusion of the first 4 or 6 years of follow-up. Adjustment for various cancer risk factors did not show any significant change of the effect of vitamin E on prostate cancer risk or either agent on total cancer risk. The data provided no support for the use of these supplements for the prevention of cancer in middle-aged and older men. However, it is reassuring that there was not a clear signal of harm for either agent according to the study.

Cancer changes the health care outlook for anyone who receives that diagnosis. It also affects family members, co-workers, employers, and friends. Make sure that you get regular screenings and report any irregularities in self-examinations to your doctor. Early detection saves lives.

Until next time. Let me know what you think.

Tuesday, December 9, 2008

Health Care and Holiday Fire Safety

Every year during the Holiday Season, thousands of Americans suffer harm as a result of a lack in observing fire safety. During the winter months, as the temperature drops fires in the home become a possible safety hazard. This holiday season, make sure your home is safe from fires by following these tips from Underwriters Laboratories (UL), a nonprofit organization that tests products for safety.
- Extinguish a candle when two inches of wax remain (half an inch if the candle is in a container). This prevents heat damage to the surface and stops glass containers from breaking.
- Ensure that outdoor lights, decorations and extension cords are rated for outside use. Lights intended for indoor-only use bear green UL marks on the product or on the packaging. Light strings intended for indoor and outdoor use bear red UL marks.
- Don't use staples or nails to hang light strings. Instead, purchase plastic hooks or clips designed for hanging light strings.
- Don't overload extension cords by plugging in too many decorations.- If the greenery on your live tree isn't fresh, the tree is a greater fire risk. When you put a live tree in the base holder, remember to keep it filled with water at all times.

The National Fire Protection Association (NFPA) reports that there is an estimated annual average of 210 home structure fires that begin with Christmas trees. The NFPA analysis also shows that although the number of Christmas tree fires is low, these fires represent a higher level of hazard. On average, 1 of every 9 Christmas tree fires resulted in a fatality compared to an average of one death per 75 non-confined home structure fires overall. Further, 49% of Christmas tree fires spread beyond the room of origin. The fires that spread beyond the room of origin caused 94% of the associated fatalities. The percentage of trees involved in structure fires represent an extremely small portion of the total number of natural Christmas trees sold, which is estimated at 30 million trees, in the United States each year. The moisture content of each tree can play a dominant role in determining the fire hazard each tree represents. Properly maintaining a cut Christmas tree is important to retaining a high moisture content in the needles of the tree to limit accidental ignition and prevent rapid flame spread. A tree which has dry needles can readily ignite with a flaming source and generate heat release rates that are capable of causing flashover in residential scale rooms.

The US Fire Administration (USFA) reports that each year fires occurring during the holiday season claim the lives of over 400 people, injure 1,650 more, and cause over $990 million in damage. According to the United States Fire Administration (USFA), there are simple life-saving steps you can take to ensure a safe and happy holiday. By following some of the outlined precautionary tips, individuals can greatly reduce their chances of becoming a holiday fire casualty:
1.) Preventing Christmas Tree Fires
--Christmas Tree Fire Hazards - Movie segments demonstrating how fast a live Christmas tree can become fully engulfed in flames. Special fire safety precautions need to be taken when keeping a live tree in the house. A burning tree can rapidly fill a room with fire and deadly gases.
--Selecting a Tree for the Holiday - Needles on fresh trees should be green and hard to pull back from the branches, and the needle should not break if the tree has been freshly cut. The trunk should be sticky to the touch. Old trees can be identified by bouncing the tree trunk on the ground. If many needles fall off, the tree has been cut too long, has probably dried out, and is a fire hazard.
--Caring for Your Tree -Do not place your tree close to a heat source, including a fireplace or heat vent. The heat will dry out the tree, causing it to be more easily ignited by heat, flame or sparks. Be careful not to drop or flick cigarette ashes near a tree. Do not put your live tree up too early or leave it up for longer than two weeks. Keep the tree stand filled with water at all times.
--Disposing of Your Tree - Never put tree branches or needles in a fireplace or woodburning stove. When the tree becomes dry, discard it promptly. The best way to dispose of your tree is by taking it to a recycling center or having it hauled away by a community pick-up service.
Holiday Lights
2.) Maintain Your Holiday Lights
--Light Inspection - Inspect holiday lights each year for frayed wires, bare spots, gaps in the insulation, broken or cracked sockets, and excessive kinking or wear before putting them up. Use only lighting listed by an approved testing laboratory.
--Do Not Overload Electrical Outlets - Do not link more than three light strands, unless the directions indicate it is safe. Connect strings of lights to an extension cord before plugging the cord into the outlet. Make sure to periodically check the wires - they should not be warm to the touch.
--Do Not Leave Holiday Lights on Unattended
3.) Holiday Decorations
--Use Only Nonflammable Decorations - All decorations should be nonflammable or flame-retardant and placed away from heat vents.
--Never Put Wrapping Paper in a Fireplace - It can result in a very large fire, throwing off dangerous sparks and embers and may result in a chimney fire.
--Artificial Christmas Trees - If you are using a metallic or artificial tree, make sure it is flame retardant.
4.) Candle Care
-- Avoid Using Lit Candles - If you do use them, make sure they are in stable holders and place them where they cannot be easily knocked down. Never leave the house with candles burning.
-- Never Put Lit Candles on a Tree - Do not go near a Christmas tree with an open flame - candles, lighters or matches.

Finally, according to the USFA, as in every season, have working smoke alarms installed on every level of your home, test them monthly and keep them clean and equipped with fresh batteries at all times. Know when and how to call for help. And remember to practice your home escape plan. There is nothing more cozy or relaxing than curling up in front of a roaring fire next to a majestic Christmas tree all a-twinkle with lights and ornaments according to The lights illuminate every tiny branch and the room becomes a veritable Christmas wonderland. It is easy to get caught up in the Christmas season with its hustle and bustle of shopping, cooking, and celebrating, but holiday fire safety is definitely one thing to keep close in mind during the most jovial time of the year.

Until next time. Let me know what you think.

Friday, December 5, 2008

Health Care and the National Health Czar

The majority of Americans in the post-election era of 2008 who are still in the honeymoon phase of the president-elect relationship are practically giddy over the new administration and its desire to "change" our political landscape. In an attempt to satisfy the Democratic masses yearning for universal health care, Mr. Obama will likely name a health care czar to overseeing the dismantling of the free market health system for a single payor type arrangement--essentially allowing the US government to determine what doctors you will see and whether or not you are eligible to receive medical care.

Sound harsh? Government mandated health care is definitely on the agenda for the new administration. How it shakes out will be worth serious consideration by not only the medical community including doctors, hospitals, specialty clinics, labs and all other health care providers, but also both Democrats and Republicans at the federal level of government and all Americans who have a stake in the decision.

Whether you agree with the government making such decisions for its citizens or not (and such rationing is routine in European government-controlled health care systems), the decision about government rationing of granny's health care should occur out in public, not hidden away from the public in this legislation. According to, the Democratic Congress and President Obama have disgraced themselves in their desire to ram through major changes to health care. As the American people discover how vicious and ruthless their new "nanny" health care system would be in rationing care, they will punish those who caused and enabled this.

President Obama says this person will keep a close eye on the healthcare industry according to NBC News. He will be monitoring treatments to make sure doctors are doing what the federal government defines as appropriate and cost effective. The system that the Czar will head, will consist of a health care network that will be able to electronically transmit patient records in an effort to reduce medical errors. The plan will also enforce national guidelines for doctors, nurses, and other medical personnel. Hospitals and doctors that don't follow the new system will face penalties.

One of the potential models that has been floated is to create a board, similar to the Federal Reserve, that will oversee national health care according to Investor's Business Daily (IBD). The entity would be like the United Kingdom's National Institute for Health and Clinical Evaluation, or NICE, which is "the single entity responsible for providing guidance on the use of new and existing drugs, treatments, and procedures." NICE doesn't simply tap the expertise of professional bodies but also weighs "economic evidence — how well the medicine or treatment works in relation to how much it costs." would compare drugs and treatments, then use the federal government's enormous buying power (Medicare, Medicaid, VA) and influence (published reports and public statements) to push the rest of us along. "In choosing what it will cover and how much it will pay, the US version could steer providers to the services that are the most clinically valuable and cost effective, and dissuade them from wasting time and money on those that are neither." They even suggest that the board would recommend to the NIH and NIMH what to fund.

There are problems with this model according to IBD. For one, it goes beyond the role of the Fed, which effectively sets just one price. It also goes well beyond the role of any equivalent health body across the Western world. For the most part, NICE looks at the funding of new drugs and devices — generating incredible controversy and criticism. A health superboard is so bold as to be impractical. Can a government body really measure the "value" of every health service performed in the United States? Can it judge what's good care, right down to the level of the clinician and his prescription pad? There's some precedence for this: Medicare, which has an endlessly complex pricing system, attempts to attach a dollar figure to 9,000-plus services — winning bipartisan criticism, since it badly overpays certain services (cardiac surgeries, for example) and underpays others (like ER care). Medicare also has spectacular inconsistency, paying twice as much for a Florida man as his Minneapolis cousin, with no difference in health outcomes — a testament to the limitations of central pricing.

According to IBD, that's not an attack on the fundamental ideas of weighing in on issues of quality and appropriateness and empowering people to make better choices for their health care. Americans need not look to Britain for inspiration; in most of the economy, the market works, giving us information. Because of archaic pricing and regulatory hurdles, a government hand would be needed to improve health care transparency. The US can find good ideas in the work already done by the Bush White House. Also, the American system can push further: releasing more Medicare and Medicaid data and standardizing electronic medical records. The former will shed light on billions of dollars of health spending; the latter will allow us to better study health outcomes. Together, these steps, not bureaucrats, will help Americans make better decisions.

A health care czar may sound like a good idea in theory, but in practice the work could be done with a new HHS Secretary that had valuable, seasoned, respectable experience in the health care industry and a staff that had a mandate to push for better quality of care, more effective record keeping, and hands off government control of medical providers.

Until next time. Let me know what you think.

Thursday, December 4, 2008

Health Care and Hand Washing

As Americans prepare for another Winter Season, consideration of personal hygiene becomes even more important. Cold and flu season is almost synonymous with this time of year. Staying healthy during the winter months is more difficult due to the weather and the fact that there is more interaction among people during these months. This week is National Hand Washing Awareness Week. According to the Centers for Disease Control, "the most important thing you can do to keep from getting sick is to wash you hands." Judicious hand washing can prevent not only common diseases like colds, but also more serious diseases like hepatitis A, meningitis, and infectious diarrhea. By frequently washing your hands, you wash away germs that you have picked up from other people, or from contaminated surfaces, or from animals and animal waste. The simple act of consistently performing this basic task properly will make a big difference in your own household as well as in work, school and public settings.

According to the CDC, tips for hand washing are vital. Here is why hand washing is important:
--Children have weaker immune systems than adults and can become sick quicker.
--1 in 3 E.coli outbreaks is caused by poor hand washing by food preparers.
--Germs that cause disease live in meat, vegetables, and more.
--Germs are spread from unclean hands to food, usually when the food handler doesn’t wash after going to the bathroom. Germs are then passed on to those who eat the food. Germs spread from uncooked foods like hamburger to the hands, then from the hands to other foods like salads. The germs can remain in the salads and eventually affect those who eat the food.
--Putting cooked meat back into its original container re-contaminates the cooked food.
--Avoid cutting vegetables on the same board used to cut meat contaminates the vegetables.

Here are 6 Main Rules of Hand Washing as noted by the CDC:
--Always wash your hands after using the bathroom, changing diapers, cleaning up after your pets, or handling money.
--Wash your hands when they’re dirty.
--Always wash your hands before eating.
--Don’t cough or sneeze into your hands.
--Refrain from putting your fingers in your eyes, nose, or mouth.
--Avoid touching people and surfaces with unclean hands.

Here is the correct way of washing hands according to the CDC:
--Wet hands with warm water (not hot) and use soap.
--Rub your hands together, making sure to scrub all areas.
--Rub for a minimum of 15 seconds or sing “Happy Birthday.”
--Rince thoroughly, then dry hands on a clean towel.
--Turn the faucet off with the towel, not hands, to keep away from re-contamination.

The CDC also provides some interesting statistics:
--2/3 of adults in the US wash hands after using the bathroom.
--1 in 4 adults don’t wash hands after changing diapers.
--Less than 1/2 of Americans wash hands after cleaning up after pets.
--1 in 3 wash hands after sneezing/coughing.
--Less than 1 in 5 wash hands after touching money.
--1 in 3 E.coli occurrences is caused from not washing hands before handling food.

According to, by following the 4 Principles of Hand Awareness you will be in virtual isolation regardless of the people around you. Direct contamination (inoculation) of your mucus membranes(eyes, nose or mouth) is how infectious disease enters your body. It is not wafting through the ventilation system in the building. Let's work together to minimize the fear factor of infectious disease pandemics or seasonal illness. Only you are responsible for giving yourself the flu or flu-like illness! The four principles of hand awareness endorsed by the American Medical Association are: (1)Wash your hands when they are dirty of before eating (2) Don't cough into your hands (3) Don't sneeze into your hands (4) Don't put your fingers into your eyes, nose or mouth. National Handwashing Awareness Week is the first full week of December each year since 1999. Thank you for lending a Hand to Protect your family and community!

According to the Pennsylvania Department of Health, everyone should wash his or her hands before eating, after going to the bathroom, during food preparation, after handling animals, upon arriving home, after changing diapers, when leaving the hospital or doctor's office and any other time hands may have become dirty or been in contact with germs. They report that according to the Centers for Disease Control and Prevention, 36,000 people die from the flu or flu-like illness each year, 5,000 people die from food borne illness each year, and between 78,000 and 90,000 patients die each year from hospital acquired infections, many of which could have been prevented with proper hand washing.

The Oklahoma Department of Health reports that hand sanitizing occurs when hands are visibly clean but can be de-contaminated by using an alcohol-based hand product such as a gel or foam. Check the label to be sure the product contains between 60 and 95 percent alcohol. Alcohol-based hand products only work on hands that appear to be clean because they cannot remove debris. Use enough of the product to thoroughly moisten your hands, and then rub the product in until your hands are dry. Hand sanitizers are fast and convenient. Most respiratory illnesses such as colds and influenza (flu), gastrointestinal illnesses such as diarrhea, and skin infections such as MRSA (Methicillin-resistant Staphylococcus aureus) are spread by unclean hands. Germs multiply quickly on your skin and hands, so cleaning your hands well and often is important.

Maintaining good health is very important, especially with children, seniors and those with poor immune systems. Those who work in the food industry and the medical community especially are aware of the importance of hand washing. The old adage "Cleanliness is next to Godliness" is still true when it comes to staying healthy.

Until next time. Let me know what you think.

Tuesday, November 25, 2008

Health Care and Thanksgiving 2008

On November 27th, in just 2 days, Americans will celebrate a holiday that is classic for our nation only; and since the early 1600's, this day is observed as a time honored tradition to give thanks for the blessings we enjoy as a country of immigrants. As reported from, in 1621, the Plymouth colonists and Wampanoag Indians shared an autumn harvest feast which is acknowledged today as one of the first Thanksgiving celebrations in the colonies. This harvest meal has become a symbol of cooperation and interaction between English colonists and Native Americans. Although this feast is considered by many to the very first Thanksgiving celebration, it was actually in keeping with a long tradition of celebrating the harvest and giving thanks for a successful bounty of crops. Native American groups throughout the Americas, including the Pueblo, Cherokee, Creek and many others organized harvest festivals, ceremonial dances, and other celebrations of thanks for centuries before the arrival of Europeans in North America.

Also according to, historians have also recorded other ceremonies of thanks among European settlers in North America, including British colonists in Berkeley Plantation, Virginia. At this site near the Charles River in December of 1619, a group of British settlers led by Captain John Woodlief knelt in prayer and pledged "Thanksgiving" to God for their healthy arrival after a long voyage across the Atlantic. This event has been acknowledged by some scholars and writers as the official first Thanksgiving among European settlers on record. Whether at Plymouth, Berkeley Plantation, or throughout the Americas, celebrations of thanks have held great meaning and importance over time. The legacy of thanks, and particularly of the feast, have survived the centuries as people throughout the United States gather family, friends, and enormous amounts of food for their yearly Thanksgiving meal.

According to, the most detailed description of the "First Thanksgiving" comes from Edward Winslow from A Journal of the Pilgrims at Plymouth, in 1621: "Our harvest being gotten in, our governor sent four men on fowling, that so we might after a special manner rejoice together after we had gathered the fruit of our labors. They four in one day killed as much fowl as, with a little help beside, served the company almost a week. At which time, among other recreations, we exercised our arms, many of the Indians coming amongst us, and among the rest their greatest king Massasoit, with some ninety men, whom for three days we entertained and feasted, and they went out and killed five deer, which they brought to the plantation and bestowed upon our governor, and upon the captain, and others. And although it be not always so plentiful as it was at this time with us, yet by the goodness of God, we are so far from want that we often wish you partakers of our plenty."

Historians are no exactly sure what was eaten at the first Thanksgiving back in 1621 according to, but they are certain that the Pilgrims and the Indians didn't sit down at a table and consume cranberry sauce, mashed potatoes, or pumpkin pie. Many of the culinary delights that are placed on our Thanksgiving tables are very similar to those foods that were around during the Pilgrims time, but the dishes that were actually served were not similar to modern dishes. For example, cranberries were available back in 1621, but sugar had not yet come to the New World. So, it is hard to believe that cranberries were part of the first Thanksgiving menu. However, the Thanksgiving holiday is chock full of symbolism which provides the perfect occasion for sharing an American tale about determination, freedom, survival, and celebration. Telling the story of Thanksgiving is a great way to teach kids American history and the idea of giving thanks. American history may be a boring subject as far as kids are concerned, but recounting the story of Thanksgiving by using some of the food that the Pilgrims ate for their Thanksgiving could make children view American history in a more positive and creative way.

So, what might have been served on that 17th century menu? According to the folks at, wild turkey might have been on the menu but it would have been served with venison, which is deer meat. In addition, fishes such eel, sea bass, and cod might have made an appearance for the first Thanksgiving. However, potatoes, yams, and sweet potatoes wouldn't have made it on the menu because they had not yet been introduced in New England. In addition, there was a large variety of corn including red, yellow, white, and blue corn. As far as dessert was concerned, at the first Thanksgiving there were no pumpkin pies topped with whipped cream or apple pie a la mode. However there were a wide variety of nuts and fruits such as walnuts, acorns, dried cherries, plums, blueberries, and strawberries. Regardless of the early dishes of food, today's Thanksgiving is creating a tradition all of its own because the turkey is still the culinary symbol of Thanksgiving. In fact, 91% of Americans eat turkey on Thanksgiving; and of the 300 million turkeys raised each year, 45 million turkeys are eaten on Thanksgiving. It doesn't matter whether the first Thanksgiving dinner had roasted turkey or baked eel. What matters is that Thanksgiving has an important place on our calendars and in American culture. The Pilgrims celebrated a fine harvest after a cold winter, and we also celebrate what we have accomplished over the past year. Thanksgiving is another holiday that celebrates faith, family, friends, and food.

Better Homes and Gardens offers some tips on making sure your turkey doesn't make you sick for the Thanksgiving holiday:
--Also check for the "sell by" date on the label of a fresh turkey. This date is the last day the turkey should be sold by the retailer.
--The unopened turkey should maintain its quality and be safe to use for one or two days after the "sell by" date.
--If you buy a frozen turkey, look for packaging that is clean, undamaged, and frost-free.
--Keep it in the fridge. Never marinate or defrost poultry on the counter. Always keep poultry in the refrigerator until you are ready to cook it.
--Keep it clean. Always wash your hands, work surfaces, the sink, and utensils in hot, soapy water after handling raw poultry, to prevent spreading bacteria to other foods.
--Cut right. When cutting raw poultry, use a plastic cutting board; it's easier to clean and disinfect than a wooden one.
--Don't wash the bird. Washing raw poultry is not necessary, and the splashing water may contaminate surrounding objects. In general, the less you handle poultry, the safer it remains.
--Avoid cross contamination. Never use the same plate or utensils for uncooked and cooked poultry unless you have thoroughly washed them first. This rule applies to basting brushes as well. If you are going to baste the bird, wash the brush each time.
--Don't stuff it early. If you're planning to stuff the bird, do so immediately before cooking.
--Never allow the stuffing to touch raw poultry unless you are going to cook both right away.
--Heat any marinade or basting sauce that has been in contact with the raw poultry if it is to be served with the cooked poultry. Juices from the uncooked poultry may contain bacteria. Or, before you start basting, set some of the sauce aside to serve with the poultry.
--Serve poultry immediately after cooking it. Don't let it stand at room temperature longer than two hours, or bacteria will multiply rapidly -- especially in warm weather. Refrigerate leftovers as soon as possible.
--Reheat wisely. Heat leftover gravy to a rolling boil in a covered saucepan, stirring occasionally, for food-safety assurance.

And now, from Better Homes and Gardens, for the perfect Thanksgiving holiday treat--Traditional Pumpkin Pie. Ingredients:
1 recipe Pastry for Single-Crust Pie (see below)
1 15-ounce can pumpkin
2/3 cup sugar
1 teaspoon ground cinnamon
1/2 teaspoon ground ginger
1/2 teaspoon ground nutmeg
3 slightly beaten eggs
1 5-ounce can (2/3 cup) evaporated milk
1/2 cup milk

1. Prepare and roll out Pastry for Single-Crust Pie. Line a 9-inch pie plate with the pastry. Trim to 1/2 inch beyond edge of pie plate. Fold under extra pastry; crimp edge as desired.
2. For filling, in a mixing bowl combine pumpkin, sugar, cinnamon, ginger, and nutmeg. Add eggs. Beat lightly with a rotary beater or fork just until combined. Gradually stir in evaporated milk and milk; mix well.
3. Place the pastry-lined pie plate on the oven rack. Carefully pour filling into pastry shell.
4. To prevent overbrowning, cover edge of the pie with foil. Bake in a 375 degree F oven for 25 minutes. Remove foil. Bake about 25 minutes more or until a knife inserted near the center comes out clean. Cool on a wire rack. Refrigerate within 2 hours; cover for longer storage. Makes 8 servings.

Pastry for Single-Crust Pie: Stir together 1-1/4 cups all-purpose flour and 1/4 teaspoon salt. Using a pastry blender cut in 1/3 cup shortening until pieces are pea-size. Using 4 to 5 tablespoons cold water, sprinkle 1 tablespoon of the water over part of the mixture; gently toss with a fork. Push moistened dough to side of the bowl. Repeat moistening dough, using 1 tablespoon of the water at a time, until all the dough is moistened. Form dough into a ball. On a lightly floured surface, use your hands to slightly flatten dough. Roll dough from center to edge into a circle about 12 inches in diameter.

Make-Ahead Tip: Prepare, bake, and cool pie as above. Cover and refrigerate for up to 8 hours.
Test Kitchen Tip: You can use 1-1/2 teaspoons pumpkin pie spice for the spices in this pie.
Nutrition Facts: Calories 286, Total Fat (g) 13, Saturated Fat (g) 4, Cholesterol (mg) 86, Sodium (mg) 120, Carbohydrate (g) 38, Fiber (g) 2, Protein (g) 7, Vitamin A (DV%) 130, Vitamin C (DV%) 9, Calcium (DV%) 7, Iron (DV%) 13. Percent Daily Values are based on a 2,000 calorie diet.

Thanksgiving is a time to be with family and friends, to honor our nation, freedoms, and heritage, and to give thanks for all the blessings provided by God. Take time during the holiday to stop and actually give thanks for everything you have. Thanksgiving means more than a big meal with lots of food and people around the table. It's more than all day football on TV or going to the mall for the beginning of the Christmas Season. The real meaning of Thanksgiving reaches deep into our soul and spirit and represents all that is good. Make this Thanksgiving a great one to remember.

Until next time. Let me know what you think.

Monday, November 17, 2008

Health Care and Open Enrollment

Now is the time of year that many companies are going through the time honored employer tradition called "Open Enrollment." Businesses are offering their workers health insurance options that may or may not be what the employees want but must choose to participate in before year end if they want to be insured and whether to include any dependents. According to, from October to November every year, millions of Americans must select health insurance and other benefits at work. Each year the choices get more complex and the financial consequences get bigger. For 2009, nearly half of companies plan to push more health-care costs onto employees, often in less than transparent ways as reported by Mercer. There will be higher premiums, of course - on average, 8% higher, according to Hewitt. Also, they report you should expect increased deductibles (what you shell out before benefits kick in), co-pays (flat fees at the doctor or pharmacy) and co-insurance (your percentage of the bill in other cases).

Most likely, according to CNNMoney, your options will fall into four categories: There's the familiar health maintenance organization (HMO), which typically requires you to use approved doctors and hospitals. Then there are the preferred-provider organization (PPO) and point-of-service (POS) plans, which give you the option to see an out-of-network doctor for a higher price. And this year your employer may join the increasing number of firms offering a high-deductible plan tied to a tax-free health savings account (HSA), a low-premium option that provides limited benefits until you spend a certain amount out of pocket.

All the more reason to consider every option according to CNNMoney. Use this strategy to pick a plan that gives you value for your health-care dollar - without putting your finances at risk. Here are the steps to follow when considering a plan during open enrollment:

Step 1: Separate the apples from the oranges.
Start by deciding if the high-deductible plan with an HSA is right for you. This may be the first time you've seen such a plan. At first glance, it will stick out the most with its comparatively low premiums - for 2008, employees paid an average of $2,330 for family coverage vs. $3,340 to $3,730 for the other plan types, reports the Kaiser Family Foundation. In exchange for this price break, families in these plans typically face deductibles from $2,300 to $10,000. (The average in 2008 was $3,910, compared with $1,340 in a PPO, according to Kaiser.) Many of the plans cover preventive care at 100%. But for everything else, you pay in full until you hit the deductible, after which the plan usually functions like any other. To cover out-of-pocket costs, you can save pretax dollars - up to $5,950 in 2009, plus a $1,000 catch-up for those 55 or older - in the HSA. Your employer may also contribute. The money rolls over year to year and can be taken out for any purpose at age 65, though it's taxable if not used on medical costs. (Note: Not all high-deductible plans qualify for an HSA. Your plan paperwork should say if yours does.) Intrigued? Understand this: Signing up for this type of plan is essentially making a bet that you'll stay healthy. You'll probably save money over traditional plans while you're well, but you'll likely spend a lot more if you get sick. (Figure that you could owe the whole deductible in one pop if you're hospitalized.) So if you have young kids, a costly chronic condition or a family history of a debilitating disease, you're likely better off with the other plan types. Usually high deductible plans make the most sense for those who are young and healthy, but they can also offer financial benefit for wealthy empty-nesters who want to take advantage of the tax savings and can handle a financial surprise. In fact, anyone who is interested in this plan type should make sure they can afford the deductible -if you get sick before your HSA reaches that amount, you'll have to come up with the cash. Eliminate this option if you don't have the funds.

Step 2: Narrow the oranges.
Skipping the high-deductible plan? To make sense of your leftover options, which are more similar in the way they operate, start with two questions: Are your doctors in-network? And would you ever want to go out of network? First, unless you're willing to switch providers, search the insurers' Web sites or simply call your doctors and hospitals to find out if they accept the plans you're considering. With an HMO, you'll typically have to use doctors on the list; with a PPO or POS, using out-of-network doctors will cost you significantly more. Either way, you may want to jettison any plans that your favorite docs don't participate in. As to the second question, if you'd rather not be restricted from seeing, say, the top oncologist in your state if he's not on your plan, you may want a more flexible PPO or POS. Also, note that HMO and POS plans generally require referrals to see specialists. If that bothers you, you may want to go PPO.

Step 3: Zero in on key costs
If you still have multiple plans on your list, compare their main terms. Premiums on HMO, PPO and POS plans can be similar, but the plans' less-transparent costs vary widely. If your company hasn't done so for you, chart out the costs. Turn an 8½-by-11-inch page on its side and write plan names along the top and the following terms down the left. Fill in details for each, making sure to note, where appropriate, how costs differ in and out of network; include what counts toward deductibles and maximums. Don't forget to consider the following:
--Co-pays and co-insurance
--Prescription coverage (Confirm that the plan covers your current meds.)
--Out-of-pocket maximums

Step 4: Pick your final answer.
If the choice isn't obvious after comparing plans, calculate your costs on each using a guesstimate of last year's health-care usage. Then see how much it would run if you needed a lot more care. (Your employer or the plan sponsors may offer online calculators to make this math easier.) The main thing to consider in making the final pick: You want a plan that you'll be able to afford, whether you're healthy or unhealthy. Whatever you do, don't miss the sign-up deadline. More companies are defaulting workers into high-deductible plans instead of their past year's choice. Meaning: Unless you're hale and hearty, indecision could be costly.

So if you have more than one health care plan to choose from, review your options, don't just blindly renew according to Make sure you're in a plan that is right for you both in terms of coverage and cost. And take advantage of Flexible Spending Accounts. More workers need to take advantage of these really great accounts. These accounts allow you to use pretax dollars to pay for healthcare costs not covered by your insurance. This includes your deductible and co-payments, but also can include things like eye glasses, over the counter medications, stop-smoking programs and so on. The one catch here is that this is a use-it-or-lose-it proposition: you need to use the money in roughly a one year period or you lose it. So, be conservative, but don't skip this option altogether. Also, max out your Dependent Care Account and Transit Accounts. These are different types of flexible spending accounts. One lets you use up to $5,000 in pretax dollars to pay for the daycare costs of a child that's under age 13, or an elderly parent who lives with you who also needs daycare. The other type of account lets you use pretax dollars to pay for commuting and parking costs. If you're offered these types of accounts and you have these types of expenses, it's a no-brainer. Something else to consider is the Roth 401(k). Employers have been slow to embrace this new twist on the traditional 401(k) plan. But thanks to some tax code changes we're finally starting to see them rolled out. Like a Roth IRA, these accounts are funded with after-tax dollars, but withdrawals taken during retirement are completely tax free and that's a big gift from the government. These are a great option for younger workers. And no matter what, try to increase your 401(k) contribution for 2009. And finally look for other fringe benefits. Gym discounts, discounts on cell phone providers and discounts for buying a hybrid car. Many employees, especially big ones, offer all kinds of employee perks. Find out what's available. Taking advantage of these options is like getting a little raise and with no added work.

According to, the open enrollment period happens on an annual basis. It’s easiest to coordinate with your providers to make sure that open enrollment for each coverage plan falls at the same time of the year, rather than have different open enrollment times for every plan. Most plan providers won’t let you or your employers make a change unless there’s a qualifying event. The main qualifying event is defined by the IRS as an event that:
--Divorce or legal separation;
--Death of spouse or dependent.

Usually open enrollment covers insurance plans such as health, dental, vision, life, accidental death & dismemberment, short term disability and long term disability according to It also covers any additional voluntary or supplementary plans your company may offer. Employees can choose:
--To start coverage if they don’t have any;
--Change from one plan to another, if that option is available; or
--Drop coverage completely, if that’s an option

Employees need the option to choose from one of those plans, or to choose none at all. That’s what open enrollment is all about. Do your homework early and find out what option works best for you. Make sure that your employer has provided all the information you need to make a wise choice for your employer sponsored health care plan. Knowledge is power. Be informed. Choose wisely.

Until next time. Let me know what you think.

Friday, November 14, 2008

Health Care and Strokes

Stroke is the third leading cause of death in America and the No. 1 cause of adult disability according to the National Stroke Association. A stroke occurs when a blood clot blocks an artery (a blood vessel that carries blood from the heart to the body) or a blood vessel (a tube through which the blood moves through the body) breaks, interrupting blood flow to an area of the brain. When either of these things happen, brain cells begin to die and brain damage occurs. When brain cells die during a stroke, abilities controlled by that area of the brain are lost.

These abilities include speech, movement and memory according to the National Stroke Association. How a stroke patient is affected depends on where the stroke occurs in the brain and how much the brain is damaged. For example, someone who has a small stroke may experience only minor problems such as weakness of an arm or leg. People who have larger strokes may be paralyzed on one side or lose their ability to speak. Some people recover completely from strokes, but more than 2/3 of survivors will have some type of disability.

Also called a brian attack according to the National Institute of Neurological Disorders and Stroke (NIH), a stroke is a medical emergency. Strokes happen when blood flow to your brain stops. Within minutes, brain cells begin to die. There are two kinds of stroke. The more common kind, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain. "Mini-strokes" or transient ischemic attacks (TIAs), occur when the blood supply to the brain is briefly interrupted. Symptoms of stroke are:
--Sudden numbness or weakness of the face, arm or leg (especially on one side of the body).
--Sudden confusion, trouble speaking or understanding speech.
--Sudden trouble seeing in one or both eyes.
--Sudden trouble walking, dizziness, loss of balance or coordination.
--Sudden severe headache with no known cause.

If you have any of these symptoms, you must get to a hospital quickly to begin treatment according to the NIH. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot or by stopping the bleeding. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Drug therapy with blood thinners is the most common treatment for stroke. Each year in the United States, there are more than 700,000 strokes. Stroke is the third leading cause of death in the country. And stroke causes more serious long-term disabilities than any other disease. Nearly three-quarters of all strokes occur in people over the age of 65 and the risk of having a stroke more than doubles each decade after the age of 55. For African Americans, stroke is more common and more deadly - even in young and middle-aged adults - than for any ethnic or other racial group in the United States.

According to the American Heart Association (AHA), Ischemic Stroke is the most common type. It accounts for about 87% of all strokes. It occurs when a blood clot (thrombus) forms and blocks blood flow in an artery bringing blood to part of the brain. Blood clots usually form in arteries damaged by fatty buildups, called atherosclerosis. When the blood clot forms within an artery of the brain, it's called a thrombotic stroke. These often occur at night or first thing in the morning. Another distinguishing feature is that very often they're preceded by a TIA or "warning stroke." TIAs have the same symptoms of stroke but only last a few minutes; stroke symptoms last much longer. If someones experiences a TIA, they should urgent medical care immediately.

A wandering clot (an embolus) or some other particle that forms away from the brain, usually in the heart, may also cause an ischemic stroke according to the AHA. This is called cerebral embolism. The clot is carried by the bloodstream until it lodges in an artery leading to or in the brain, blocking the flow of blood. The most common cause of these emboli is blood clots that form during atrial fibrillation (AF). AF is a disorder found in about 2.2 million Americans. It's responsible for 15–20 percent of all strokes. In AF, the heart's two small upper chambers (the atria) quiver like a bowl of jello instead of beating strongly and effectively. Some blood isn't pumped completely out of them when the heart beats, so it pools and clots can form. When a blood clot enters the circulation and lodges in a narrowed artery of the brain, a stroke occurs. This is called a cardioembolic stroke, or a stroke that occurs because of a heart problem.

According to the American Heart Association, a subarachnoid hemorrhage occurs when a blood vessel on the brain's surface ruptures and bleeds into the space between the brain and the skull (but not into the brain itself). A cerebral hemorrhage occurs when a defective artery in the brain bursts, flooding the surrounding tissue with blood. Hemorrhage (or bleeding) from an artery in the brain can be caused by a head injury or a burst aneurysm. Aneurysms are blood-filled pouches that balloon out from weak spots in the artery wall. They're often caused or made worse by high blood pressure. Aneurysms aren't always dangerous, but if one bursts in the brain, they cause a hemorrhagic stroke. When a cerebral or subarachnoid hemorrhage occurs, the loss of a constant blood supply means some brain cells no longer can work. Accumulated blood from the burst artery also may put pressure on surrounding brain tissue and interfere with how the brain works. Severe or mild symptoms can result, depending on the amount of pressure. The amount of bleeding determines the severity of cerebral hemorrhages. In many cases, people with cerebral hemorrhages die of increased pressure on their brains. But those who live tend to recover much more than people who've had strokes caused by a clot. That's because when a blood vessel is blocked, part of the brain dies — and the brain doesn't regenerate itself; in other words, brain cells can't be replaced. But when a blood vessel in the brain bursts, pressure from the blood compresses part of the brain. If the person survives, gradually the pressure goes away. Then the brain may regain some of its former function.

According to, typically, a clot forms in a small blood vessel within the brain that has been previously narrowed due to a variety of risk factors including:
--High blood pressure (hypertension)
--High cholesterol

According to the Mayo Clinic, stroke is a medical emergency, and prompt treatment of a stroke is crucial. Early treatment can minimize damage to your brain and potential stroke complications. The good news is that strokes can be treated, and many fewer Americans now die of strokes than was the case 20 or 30 years ago. Improvement in the control of major risk factors for stroke — high blood pressure, smoking and high cholesterol — is likely responsible for the decline.

The NIH reports that because stroke injures the brain, you may not realize that you are having a stroke. The people around you might not know it either. Your family, friends, or neighbors may think you are confused. You may not be able to call 911 on your own. That's why everyone should know the signs of stroke - and know how to act fast. Don't wait for the symptoms to improve or worsen. If you believe you are having a stroke - or someone you know is having a stroke - call 911 immediately. Making the decision to call for medical help can make the difference in avoiding a lifelong disability.

Until next time. Let me know what you think.