Friday, October 30, 2009

Health Care and All Hallows Eve

It's that time of year again when kids look forward to indulging in candy and sweets - and parents begin to fret about the damage all that sugar does to their children's teeth as reported by The Medical News. But the Ontario Dental Association (ODA) says that with a few simple oral health-care tips and practices, kids and parents alike can enjoy Halloween. Remember, tooth decay is not caused by sugar alone. It comes from not brushing or flossing regularly and letting food sit on teeth for long periods of time. During this period of increased sugar consumption, parents can mitigate the potential damaging effects of Halloween candy by incorporating healthy habits into your child's everyday oral health-care routine.

Halloween had its beginnings in an ancient, pre-Christian Celtic festival of the dead, according to Library of Congress Folk Life Center (LOC). The Celtic peoples, who were once found all over Europe, divided the year by four major holidays. According to their calendar, the year began on a day corresponding to November 1st on our present calendar. The date marked the beginning of winter. Since they were pastoral people, it was a time when cattle and sheep had to be moved to closer pastures and all livestock had to be secured for the winter months. Crops were harvested and stored. The date marked both an ending and a beginning in an eternal cycle.

The festival observed at this time was called Samhain (pronounced Sah-ween), according to the LOC. It was the biggest and most significant holiday of the Celtic year. The Celts believed that at the time of Samhain, more so than any other time of the year, the ghosts of the dead were able to mingle with the living, because at Samhain the souls of those who had died during the year traveled into the otherworld. People gathered to sacrifice animals, fruits, and vegetables. They also lit bonfires in honor of the dead, to aid them on their journey, and to keep them away from the living. On that day all manner of beings were abroad: ghosts, fairies, and demons--all part of the dark and dread. Samhain became the Halloween we are familiar with when Christian missionaries attempted to change the religious practices of the Celtic people. In the early centuries of the first millennium A.D., before missionaries such as St. Patrick and St. Columcille converted them to Christianity, the Celts practiced an elaborate religion through their priestly caste, the Druids, who were priests, poets, scientists and scholars all at once. As religious leaders, ritual specialists, and bearers of learning, the Druids were not unlike the very missionaries and monks who were to Christianize their people and brand them evil devil worshippers. As a result of their efforts to wipe out "pagan" holidays, such as Samhain, the Christians succeeded in effecting major transformations in it. In 601 A.D. Pope Gregory the First issued a now famous edict to his missionaries concerning the native beliefs and customs of the peoples he hoped to convert. Rather than try to obliterate native peoples' customs and beliefs, the pope instructed his missionaries to use them: if a group of people worshipped a tree, rather than cut it down, he advised them to consecrate it to Christ and allow its continued worship.

The old beliefs associated with Samhain never died out entirely, according to the LOC. The powerful symbolism of the traveling dead was too strong, and perhaps too basic to the human psyche, to be satisfied with the new, more abstract Catholic feast honoring saints. Recognizing that something that would subsume the original energy of Samhain was necessary, the church tried again to supplant it with a Christian feast day in the 9th century. This time it established November 2nd as All Souls Day--a day when the living prayed for the souls of all the dead. But, once again, the practice of retaining traditional customs while attempting to redefine them had a sustaining effect: the traditional beliefs and customs lived on, in new guises. All Saints Day, otherwise known as All Hallows (hallowed means sanctified or holy), continued the ancient Celtic traditions. The evening prior to the day was the time of the most intense activity, both human and supernatural. People continued to celebrate All Hallows Eve as a time of the wandering dead, but the supernatural beings were now thought to be evil. The folk continued to propitiate those spirits (and their masked impersonators) by setting out gifts of food and drink. Subsequently, All Hallows Eve became Hallow Evening, which became Hallowe'en--an ancient Celtic, pre-Christian New Year's Day in contemporary dress. Many supernatural creatures became associated with All Hallows.

Virtually all present Halloween traditions can be traced to the ancient Celtic day of the dead, according to the LOC. Halloween is a holiday of many mysterious customs, but each one has a history, or at least a story behind it. The wearing of costumes, for instance, and roaming from door to door demanding treats can be traced to the Celtic period and the first few centuries of the Christian era, when it was thought that the souls of the dead were out and around, along with fairies, witches, and demons. Offerings of food and drink were left out to placate them. As the centuries wore on, people began dressing like these dreadful creatures, performing antics in exchange for food and drink. This practice is called mumming, from which the practice of trick-or-treating evolved. To this day, witches, ghosts, and skeleton figures of the dead are among the favorite disguises. Halloween also retains some features that harken back to the original harvest holiday of Samhain, such as the customs of bobbing for apples and carving vegetables, as well as the fruits, nuts, and spices cider associated with the day. Today Halloween is becoming once again and adult holiday or masquerade, like mardi Gras. Men and women in every disguise imaginable are taking to the streets of big American cities and parading past grinningly carved, candlelit jack o'lanterns, re- enacting customs with a lengthy pedigree. Their masked antics challenge, mock, tease, and appease the dread forces of the night, of the soul, and of the otherworld that becomes our world on this night of reversible possibilities, inverted roles, and transcendency. In so doing, they are reaffirming death and its place as a part of life in an exhilarating celebration of a holy and magic evening.

According to LifeAndTruth.com, Trick or Treat has been thought to have come from a European custom called "souling". Beggars would go from village to village begging for "soul cakes" made out of square pieces of bread with currants. The more soul cakes the beggars would receive, the more prayers they would promise to say on behalf of the dead relatives of the donors. At the time, it was believed that the dead remained in limbo for a time after death, and that prayer, even by strangers could guarantee a soul's passage to heaven. Witches and witchcraft are dominant themes of the holiday. Witches generally believe themselves to be followers of an ancient religion, which goes back far beyond Christianity, and which is properly called 'wicca'. Witches are really just one side of a modern revival of paganism - the following of pre-Christian nature religions, the attempt to return to worshipping ancient Norse, Greek or Celtic gods and goddesses.

Halloween has its merits as a fun time for many; but health care, especially dental care, should be considered along with the holiday itself. Healthy habits allow kids to have fun while providing peace-of-mind for parents. Following these tips at Halloween, and all year round, will help you and your family have good oral health for life.

Eating sweets is fine when done in moderation and for a short period of time, e.g. days, not weeks, according to The Medical News. Keep candy in a sealed container and establish times when your child can have a treat. Give your child sweets just after mealtimes, as the amount of saliva produced at this time will help protect your child's teeth. Have your child brush their teeth twice a day and floss once a day, and again after eating sugary treats. If your child doesn't have access to a toothbrush while away from home, give them sugarless gum to help get their saliva flowing. Hard candy, such as lollipops, and sticky sweets, such as toffee, can be more damaging because they remain in the mouth for a longer time. Limit these treats to once a week or get your child to trade them in by offering them stickers. Alternate some healthy snacks, such as vegetables, fruits, yogurts and cheeses, with Halloween treats.

According to the Center for Disease Control (CDC), the following tips for staying safe and healthy for Halloween should be observed:

S--Swords, knives, and similar costume accessories should be short, soft, and flexible.
A--Avoid trick-or-treating alone. Walk in groups or with a trusted adult.
F--Fasten reflective tape to costumes and bags to help drivers see you.
E--Examine all treats for choking hazards and tampering before eating them. Limit the amount of treats you eat.

H--Hold a flashlight while trick-or-treating to help you see and others see you.
A--Always test make-up in a small area first. Remove it before bedtime to prevent skin and eye irritation.
L--Look both ways before crossing the street. Use established crosswalks wherever possible.
L--Lower your risk for serious eye injury by not wearing decorative contact lenses.
O--Only walk on sidewalks or on the far edge of the road facing traffic to stay safe.
W--Wear well-fitting masks, costumes, and shoes to avoid blocked vision, trips, and falls.
E--Eat only factory-wrapped treats. Avoid eating homemade treats unless you know the cook well.
E--Enter homes only if you're with a trusted adult. Otherwise, stay outside.
N--Never walk near lit candles or luminaries. Be sure to wear flame-resistant costumes.

Until next time. Let me know what you think.

Tuesday, October 27, 2009

Health Care and Muscle Fatigue

Ever get tired after a strenuous workout at home or the gym? Or, ever have your muscles ache after a few hours of working in the yard or some other physical tasks? When human muscle fatigues, athletic performance becomes impaired, according to RoutledgeSport.com. For those individuals suffering muscle or metabolic diseases the effects of muscle fatigue can make everyday tasks difficult. Understanding the scientific processes responsible for skeletal muscle fatigue is therefore central to the study of the physiology of sport, exercise and health. Muscle fatigue occurs when the muscles cannot exert normal force, or when more effort than normal is required to achieve a desired level of force, according to WiseGeek.com. There are a number of causes for muscle fatigue, ranging from exercise-induced fatigue to genetic conditions which lead to muscle weakness. Muscle fatigue is recognized as a physical issue which can be very dangerous for patients.

According to the Sports Medicine topic on About.com, everyone who exercises realizes that you can’t exercise at a high intensity for long before your muscles tire. You may also know that how long you go depends upon how hard you go. So what causes fatigue and why does it occur faster when you exercise harder? The reason has to do with several factor including the availability of energy to fuel muscle contractions and the mechanism of calcium in muscle cell action.

First, let's consider the energy pathways the body uses for exercise at different intensities, according to About.com. During intense exercise, such as sprinting or lifting heavy weights, muscles rely on anaerobic metabolism, which can only produce a certain amount of energy at a time, unlike the aerobic metabolism system, which can produce energy over hours. Muscles use something called ATP (adenosine triphosphate) as an energy source. ATP is created in essentially two ways. One is by aerobic metabolism using oxygen carried in the bloodstream. This is a sure and steady way to create virtually unlimited sources of energy; however, it has a limit on how fast it can work. The cardiovascular system is limited in its ability to quickly deliver blood and oxygen to the working muscles. Because of this, during high intensity exercise, ATP is also provided by anaerobic metabolism that don't require an ongoing supply of oxygen. Anaerobic pathways can provide ATP immediately, but they also have limited stores that need to be refilled after they are used up. Training can make a difference in how long and fast both of the metabolic pathways work. Trained athletes have a greater ability to quickly deliver oxygen to the working muscles which increases the ability to use aerobic metabolism at a higher exercise intensity. Trained athletes also develop a greater efficiency in both energy deliver, and skill. Finally training may improve the way the body creates and uses the anaerobic systems so you can access ATP more readily.

A recent study by Columbia University Medical Center found that muscle fatigue experienced by athletes after long and intense exercise may be caused by a problem with calcium flow inside muscle cells. fatigue occurs due to tiny leaks of calcium inside the muscles. One of the functions of calcium is to help control muscle contractions. This research found that after extended high-intensity exercise, small channels in the muscle cells begin to leak calcium, which leads to weakened muscle contractions. This leaked calcium also stimulates an enzyme that attacks muscle fibers and also leads to fatigue, noted by Proceedings of the National Academy of Sciences.

In the case of exercise-induced fatigue, according to WiseGeek.com, muscle fatigue is believed to occur when the body temporarily exhausts its supply of energy. Some studies have also implicated disruptions in the flow of calcium through the muscles. Exercise-induced fatigue is usually not treated as a serious medical problem, because it will resolve after rest, and people can train their bodies to get more endurance so that they will not fatigue as quickly. Muscle fatigue is also directly related to the type of exercise someone engages in, and athletes often vary their routines and the intensity of their workouts for this very reason. When physical exertion is not the obvious cause of muscle fatigue, or when minimal exertion results in severe fatigue, it can become a cause for concern. Weakening muscles are an issue not only because they contribute to a decline in quality of life, but because muscle weakness can eventually lead to heart problems and breathing problems, and some chronic conditions like Lou Gehrig's Disease, also known as ALS, actually cause death via muscle weakness, as the patient becomes slowly paralyzed and stops breathing. Processes in several areas of the body can contribute to muscle fatigue, including issues with muscles and nerve cells at the site of an area of fatigue, along with problems with the central and peripheral nervous system. When a patient presents with chronic muscle fatigue, a doctor may use a number of tests, including stress tests, to uncover the cause of the muscle fatigue and to learn more about it. The doctor may also look for related symptoms like joint pain, tremors, and so forth. A number of genetic and acquired conditions can lead to muscle fatigue. The treatments for these conditions vary, depending on the patient and the disease. These treatments can vary from the use of medications to manage or eliminate the condition causing the muscle weakness, to physical therapy which is designed to strengthen and condition the patient's muscles so that he or she will be more functional.

For the professional or amateur athlete, there's no thrill like reaching the finish line. And, according to StreetDirectory.com, there's nothing more frustrating than not reaching the finish because of the debilitating effects of muscle fatigue. It's long been understood that dehydration and carbohydrate depletion are the main causes of exercise-induced fatigue. Athletes know they can prolong their activity by loading up on carbohydrates and drinking plenty of fluids. However, recent studies also reveal there are additional key factors that contribute to fatigue during prolonged exercise:

1.) Dehydration: During exercise, the body loses water through sweating and evaporation. Sweat is the way your body keeps from overheating as sweat glands release perspiration that evaporates, cooling the skin and the blood underneath. The cooled blood then flows back to cool the body's core. Even mild dehydration can impair athletic performance. To restore the body's fluids that are lost during exercise, athletes should consume beverages that contain agents such as glucose and sodium, two ingredients found in most sports or energy drinks. These agents help maintain blood volume and aid in the absorption of water into the body.

2.) Overheating: During exercise, an athlete's body temperature, typically about 98.6 degrees, can increase to temps up to 104 degrees or more, especially during intense exercise. While a certain percentage of blood is used to regulate body temperature, large quantities of blood are still required to meet the energy and metabolic needs of working muscles. These demands can overtax the circulatory system, resulting in inadequate removal of body heat and a rise in an athlete's body temperature. Research has proven that athletes involved in endurance sports can experience risks of overheating. Studies indicated that athletes who drank fluids during a two-hour run lowered their body temps by two degrees compared to those who did not rehydrate.

3.) Depletion of Muscle Fuels: During intense short-term exercise, fatigue can result from depletion of glycogen. Glucose is the predominant fuel source for muscles in the first 10 seconds to three minutes of intense exercise. During long-term exercise, the aerobic pathway kicks in for energy production. In addition to glucose, fatty acids and amino acids are burned as fuel for aerobic metabolism, providing a wider range of energy resources. However, glycogen depletion contributes to muscle fatigue even during long-term exercise. During studies, when athletes exercised to near exhaustion at 80 percent of their maximum capacity, the glycogen content of their muscles dropped to near zero in about 90 minutes. Through carbohydrate loading, endurance was increased and glycogen storage capacity was enhanced. These results suggest glycogen is a crucial fuel for energy production. To preserve glycogen, some athletes adopt the method of training the muscles to become more efficient in using fat as a fuel source by completing several extended training sessions, each lasting more than two hours. This method stimulates the enzymes responsible for the conversion of fat into energy, which enables athletes to burn a higher percentage of fat and conserve glycogen for more strenuous efforts.

4.) Low Blood Glucose: In addition to providing energy for muscles, glucose is also a source of energy for the brain and nervous system. In fact, 50 to 60 percent of the glucose supplied by the liver is used strictly for brain and nervous system function. During longer exercise sessions, glycogen stores run low. This reliance on muscle glycogen is balanced by an increased reliance on blood glucose for fuel. After two to three hours of exercise, the majority of carbohydrate energy appears to be derived from glucose, which is transported from circulating blood into exercising muscles. This causes blood glucose to decline to relatively low levels. Fatigue occurs because there is not enough blood glucose available to compensate for the depleted muscle glycogen. The use of sports drinks, carbohydrate gels and sports bars help athletes keep good blood glucose levels elevated to maintain central nervous system function and provides carbohydrates to working muscles. Studies show that athletes are capable of absorbing up to 80 grams of carbohydrates per hour during exercise, delaying fatigue by as much as 30 to 60 minutes.

According to eHow.com, when people work out and feel a sensation that thier muscles are tired, aching, or exhausted, or get to the point that they are working out so hard that they feel as though they can not move thier muscles for another minute, they're experiencing muscle fatigue which limits the performance of the muscles and gives the muscles a sensation of exhaustion. Muscle fatigue can be delayed through diet, hydration, recovery and supplements. Drinking beverages that contain electrolytes and carbohydrates such as Gatorade and Powerade, help the body replace those that are lost during exercise. Caffeine can also help delay muscle fatigue because it causes free-fatty acids to release into the bloodstream, which helps the body burn fat and generate energy. Staying hydrated is essential, and a person who drinks 10 to 12 glasses of water every day can delay muscle fatigue substantially. Maintaining a healthy diet and including an adequate amount of carbohydrates, fat and protein in a diet is extremely helpful in warding off muscle fatigue, according to Realsolutionsmag.com. Athletes should make 40 to 60 percent of their diets carbs and about 30 to 35 percent of thier diets should be protein, since these help the body produce energy according to Realsolutions.com. When the body has adequate amounts of these, it helps it sustain energy and hence delay muscle fatigue.

Before you start your exercise regimen, or plan to spend several hours doing strenuous labor, make sure you follow proper safety precautions for your health to prevent significant muscle fatigue. Follow proper diet guidelines, and keep well hydrated. Short term fixes may help delay muscle fatigue, but usually the long term effects can cause physical damage if not corrected. Everyone at some point suffers from a certain degree of muscle fatigue. Taking care of yourself when you experience it is the best way to maintain a healthy lifestyle.

Until next time. Let me know what you think.

Friday, October 23, 2009

Health Care and Medical Cost Savings

When you are focusing on ways to save money in your household budget, one top shelf expense is your costs for health care. If you have insurance, you are concerned about the premiums and the net cost increase from year to year. If you need medical procedures or medications prescribed by your family doctor, and one or more of those items are not covered by insurance, you are concerned about how much the cost will be and whether you have the money to pay for those medical expenses. If you have no insurance, or are "underinsured", you can be really freaked out when you are totally exposed without any way to pay for even nominal medical bills, such as a brand name drug with no generic option, or even a simple visit to the physician or medical practitioner. How will you pay for an accident that requires a trip to the emergency room or having to be admitted into the hospital? What about paying for physical therapy, trips to the chiropractor, or being away from work with a short term disability? Lots of questions.

Trying to keep costs down is a huge consideration for any individual or family that may be dealing with either an isolated health care incident or ongoing medical issues. Sourcing ways to cut costs can become a full time job in many households. According to the National Center for Policy Analysis (NCPA), and senior fellow Dr. Devon Herrick, people often assume they have little control over how much they spend on health care. After all, sickness cannot be scheduled; doctors prescribe treatments and employers provide health coverage to more than 60 percent of Americans. However, there are many overlooked ways to trim your health costs and still get the care you need.
1.) Cut your prescription costs: Asking questions, research and making some phone calls can make a significant dent in your drug bill. There can be options for treating some medical conditions with more than one specific drug. Always ask your doctor about therapeutic substitutes and/or generics. Of course, large name pharmacies now offer $4 monthly and $10 quarterly costs for many drugs. Mind your co-pay rate; these low prices are sometimes less than your drug plan's co-pay, so make sure you pay the lesser rate. You can compare prices among local pharmacies and reputable Websites by calling or Googling your prescribed dose. For example, Rxaminer.com or pillbot.com have free pharmaceutical cost comparisons. If a brand name drug is best for your particular condition, ask your doctor about free samples. It's unusual for free samples to be available for generic drugs. The samples are promotional tools for newer, more expensive drugs. Also, check the drug manufacturer's website for each of your prescribed drugs. Many manufacturers now post discount offers, coupons, rebates and cost assistance programs. Don't be afraid to ask your doctor or pharmacist about over-the-counter options. There may be drugs or even diagnostic tests that can help manage some temporary and chronic illnesses, and cost a lot less than prescriptions. In fact, nearly one-thousand current OTC drugs were once available only by prescription. These include allergy remedies, pain relievers and heartburn medications.
2.) Pay less for a consultation: Retail clinics (such as MinuteClinic or RediClinic) or telemedicine services that offer phone and online consultations (such as TelaDoc, or CallMD) can cost significantly less than traditional office visits. A visit to a walk-in clinic can result in a bill that is less than half of what you'd see from a doctor's office visit and a fraction of emergency room treatment. Some telemedicine firms charge per consultation. Small, free standing clinics like CareNow also offer costs and wait times that are usually well below those in an emergency room. And, don't pass up the opportunity to visit health fairs -- where most services, such as disease screenings, blood tests and risk assessments are often free.
3.) Shop for diagnostic procedures and lab work: Ask about cash rates and discounts. Call different labs in your area and check prices for both cash and your insurance plan's negotiated rate. Paying upfront and/or filing insurance forms yourself may save significant costs. If you are getting any kind of procedure, make sure -- in advance -- that all providers are in-network, including the anesthesiologist. If uninsured, negotiate in advance of receiving care; check the Internet for discount card programs (Careington--www.careington.com) that lower costs at hospitals, pharmacies, labs and retail clinics. Also, compare prices at different labs and diagnostic centers. Screenings and tests can be priced up to 80 percent less than the cost for the same services in hospitals or clinics.
4.) Medical Tourism: This term originally meant traveling to another country for treatment, but that's changed. If you are in need of costly surgery, there are increasing numbers of reputable clinics, hospitals and surgery centers in the U.S. willing to compete for business by offering services as a steep cash discount. Search the Internet for competitive facilities that cater to cash-paying patients willing to travel to a neighboring town or state to save money. If your deductible is high or you're uninsured, consider traveling to another country where the cost of performing surgery can be a fraction of the cost of same procedure in the U.S. Experts identify India, Singapore and Thailand as the best values, but countries such as Mexico, Panama and Costa Rica have partner relationships with a variety of American hospitals, and provide high quality health care for as much as one-half to two-thirds less the cost of the same procedures in the U.S.
5.) Compare your insurance options: Check your insurance plan; the end of December marks the end of open enrollment at many companies. For those insured through an employer, review your health plan choices. A Health Savings Account (HSA) might save you money over a PPO or HMO, especially with employer contributions. I have saved more than $12,000 during the past five years by taking advantage of my HSA. If on a non-group plan, shop around and consider raising your deductible to reduce your monthly premium and still maintain major medical and catastrophic coverage.
6.) Become an empowered patient: Do your homework and search reputable websites for information that can help you ask more informed questions and possibly prevent an unnecessary office visit. There are growing numbers of educational websites dedicated to information on specific medical conditions. Many are university-, hospital- or association-based. You can learn to help manage chronic conditions, such as asthma, allergies or diabetes. Participating in the daily treatment of your illness can help minimize costly and dangerous complications. If patients learn to ask more questions, do their homework and take an active role in taking better care of themselves, the payoff can result in both medical and financial benefits for the coming year.

There are many internet sites that feature how to save money on health care expenses, including Parents.com who list 25 ways to cut costs: http://www.parents.com/parenting/money/family-finances/save-money-on-health-care/, and at eHow.com: http://www.ehow.com/how_2095737_save-money-health-insurance.html . And, according to FiveCentNickel.com, having health insurance helps protect your family from medical problems, and can also help you avoid some huge medical bills. Unfortunately, an estimated 47 million Americans are uninsured. A major contributor to this statistic is the high cost of health insurance premiums. The good news is that there are a few things you can do to reduce your health insurance premiums and associated healthcare expenses.
1.) Increase your health insurance deductible:
This isn’t possible with all plans, but a higher deductible can save you hundreds and monthly premiums. Just be sure that your emergency fund or health savings account (HSA) can cover the deductible.
2.) Go for generic drugs whenever possible:
Some drugs are available in generic form at less than half the cost of the name brand version. On top of this, many major retailers (e.g., Wal-Mart, Costco, Target, and Walgreens) offer $4 prescriptions, and some even offer free antibiotics.
3.) Try health clinics:
This can be a great option for some of your exams, and it can also help save on prescriptions. Check with your local health department to see if there are any such clinics in your area.
4.) Look into private health insurance:
Employers don’t always offer the best deal on health insurance. Shop around online using an online tool to help you compare health insurance companies and see if there a policy that is more affordable for you. You may also qualify for some state run health insurance programs, which can likewise reduce the costs.
So there you have it… Four tips for saving money on health insurance and medical care. While many people are trying to cut costs and save money, that doesn’t have to involve sacrificing the quality of your healthcare.

According to About.com, leading a healthy lifestyle, including stopping smoking, wearing seat belts when you drive, exercising, and maintaining a healthy weight can decrease your healthcare costs. Interestingly it can also help reduce your health insurance premiums. Many employers are providing financial incentives for their employees to stay healthy. By participating in your company’s wellness program, you could not only save money on your share of the premium costs, but you also may improve your heath. Check with your employer’s human resources department to see if your company offers a wellness program with healthy lifestyle incentives. If your company does not offer such a program or if you are self-employed, or unemployed, get out and take a walk and have a salad for lunch instead of fast food!

The DallasMorningNews.com offers some advice to keep health care costs down:
1.) Be honest with the doctor if you can't afford a prescription. The doctor may have free samples or be able to prescribe a less-expensive medicine. Also, ask whether you can save money by buying and splitting a larger dosage or by buying smaller doses and doubling up. But, don't compromise on your health. Be careful not to take the wrong dosage. Understand that pills labeled "time-release" or "long-acting" usually are not safe to split.
2.) Cut costs on eyeglass frames. The least expensive frames typically are available at large stores and optical chains. If you prefer the higher quality frames sold at doctors' offices or boutiques, negotiate or ask about coupons or seasonal sales. The markup on frames usually is very high, so if you ask for 20 percent off of the price of a second pair of glasses, you may get it. Also, many Lions Club chapters provide eyeglasses to those with limited means. However, the least expensive frames usually are not the best frames. You should ask whether options such as scratch-proof coating, plastic rather than glass lenses or UV protection can be included in the price of better frames rather than buying cheaper frames.
3.) Seniors may qualify for drug coverage under Medicare and also may be eligible for a Medicare savings program that can help pay for Medicare out-of-pocket expenses. Contact Medicare at 1-800-633-4227 or www.medicare.gov. Look for discounts at mail-order pharmacies at www.medicarerights.org. Or see www.pharmacychecker.com, www.pricegrabber.com, www.destinationrx.com and, for seniors, www.aarp.org/comparedrugs.
4.) Try alternative treatments, especially for chronic ailments. See whether your insurance covers acupuncture, massage therapy or yoga for back pain or stress-related illnesses. But, keep your primary-care physician informed of alternative treatments. Conventional medicine is recommended for acute problems including infections, broken bones and bleeding.
5.) A network provider will cost less under your health plan. The insurance company should have a list of network providers. Also, a nurse practitioner usually charges less than a doctor. An independent nurse practitioner may have a private office or work in a clinic at a large pharmacy or in stores such as CVS, Target, or Wal-Mart. A visit to one of these clinics may cost $25 to $60.

Saving money, especially for insurance, medical bills, or any other health related issue is no laughing matter. You can help your financial health and strengthen your household bottom line when you follow steps to keep expenses as low as possible to take care of your health, both physically and financially, for you and your family.

Until next time. Let me know what you think.

Wednesday, October 21, 2009

Health Care and Migraines

Have you ever had a migraine? Are you headache prone and sometimes have head splitting pain that causes severe medical symptoms? Migraines and other types of headache -- such as tension headache and sinus headache -- are painful and can rob you of quality of life, according to WebMD.com. Migraine symptoms include a pounding headache, nausea, vomiting, and light sensitivity. Headache remedies include various types of pain relievers. Migraine treatments may also include antinausea drugs and medications to prevent or stop headaches.

Migraines are chronic headaches that can cause significant pain for hours or even days, according to the Mayo Clinic. Symptoms can be so severe that all you can think about is finding a dark, quiet place to lie down. Some migraines are preceded or accompanied by sensory warning symptoms or signs (auras), such as flashes of light, blind spots or tingling in your arm or leg. Although there's no cure, medications can help reduce the frequency and severity of migraines. If treatment hasn't worked for you in the past, it's worth talking to your doctor about trying a different migraine medication. The right medicines combined with self-help remedies and lifestyle changes may make a tremendous difference. Migraines usually begin in childhood, adolescence or early adulthood. A typical migraine attack produces some or all of these signs and symptoms:
---Moderate to severe pain, which may be confined to one side of the head or may affect both sides.
--Head pain with a pulsating or throbbing quality.
--Pain that worsens with physical activity.
--Pain that interferes with your regular activities.
--Nausea with or without vomiting.

According to the National Headache Foundation (NHF), more than 29.5 million Americans suffer from migraine, with women being affected three times more often than men. This vascular headache is most commonly experienced between the ages of 15 and 55, and 70% to 80% of sufferers have a family history of migraine. Less than half of all migraine sufferers have received a diagnosis of migraine from their healthcare provider. Migraine is often misdiagnosed as sinus headache or tension-type headache.

According to the Mayo Clinic, when untreated, a migraine typically lasts from four to 72 hours, but the frequency with which headaches occur varies from person to person. You may have migraines several times a month or much less frequently. Not all migraines are the same. Most people experience migraines without auras, which were previously called common migraines. Some people have migraines with auras, which were previously called classic migraines. Auras can include changes to your vision, such as seeing flashes of light, and feeling pins and needles in an arm or leg. Whether or not you have auras, you may have one or more sensations of premonition (prodrome) several hours or a day or so before your headache actually strikes, including:
--Feelings of elation or intense energy.
--Cravings for sweets.
--Thirst.
--Drowsiness.
--Irritability or depression.
--Sensitivity to light and sound.

According to the Migraine Awareness Group, after a century of society and the medical community blaming Migraines on their sufferers, advanced technology and the age of information gave us the knowledge to begin to understand this debilitating disease. However, dangerous and outdated myths surrounding the Migraine disease have not yet been dispelled on a widespread basis. Not only are such myths believed by many loved ones and co-workers of those with Migraines, but by those with Migraines themselves (Migraineurs). Furthermore, such myths continue to be unwittingly reported in the media. The Migraine disease is a serious health and disability problem that affects approximately 32 million Americans, most of whom are women, with up to 38 million Americans having Migraine genetic propensity. There is no known cure for the Migraine disease, only treatments for the symptoms. Furthermore, such treatments are not yet wholly effective and Migraineurs may show a diminished tolerance to a variety of medications, treatments, and pain management regiments. More information about this disease can be found on their site at http://www.migraines.org/myth/mythreal.htm .

Approximately one-fifth of migraine sufferers experience aura, the warning associated with migraine, prior to the headache pain, according to the National Headache Foundation. Visual disturbances such as wavy lines, dots or flashing lights and blind spots begin from twenty minutes to one hour before the actual onset of migraine. Some people will have tingling in their arm or face or difficulty speaking. Aura was once thought to be caused by constriction of small arteries supplying specific areas of the brain. Now we know that aura is due to transient changes in the activity of specific nerve cells. The pain of migraine occurs when excited brain cells trigger the trigeminal nerve to release chemicals that irritate and cause swelling of blood vessels on the surface of the brain. These swollen blood vessels send pain signals to the brainstem, an area of the brain that processes pain information. The pain of migraine is a referred pain that is typically felt around the eye or temple area. Pain can also occur in the face, sinus, jaw or neck area. Once the attack is full-blown, many people will be sensitive to anything touching their head. Activities such as combing their hair or shaving may be painful or unpleasant. Diagnosis of migraine headache is made by establishing the history of the migraine-related symptoms and other headache characteristics as well as a family history of similar headaches. By definition, the physical examination of a patient with migraine headache in between the attacks of migraine does not reveal any organic causes for the headaches. Tests such as the CT scan and MRI are useful to confirm the lack of organic causes for the headaches. There is currently no test to confirm the diagnosis of migraine.

According to the Mayo Clinic, migraines are often undiagnosed and untreated. If you experience signs and symptoms of migraine, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches and decide on a treatment plan. Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different. See your doctor immediately or go to the emergency room if you have any of the following signs and symptoms, which may indicate other, more serious medical problems:
--An abrupt, severe headache like a thunderclap.
--Headache with fever, stiff neck, rash, mental confusion, seizures, double vision, weakness, numbness or trouble speaking.
--Headache after a head injury, especially if the headache gets worse.
--A chronic headache that is worse after coughing, exertion, straining or a sudden movement.
--New headache pain if you're older than 50.

Abortive medications are most effective when taken early in an attack, while the pain is still mild and before skin sensitivity increases, according to the NHF. The goal is complete relief of pain and associated symptoms, allowing the sufferer to quickly return to normal functioning. If patients have frequent migraine attacks, if the attacks do not respond consistently to migraine specific acute treatments, or if the migraine specific medications are ineffective or contraindicated because of other medical problems, then preventive medications should be given to reduce the migraine frequency and improve the response to the acute migraine medicines. Cost considerations also may lead to increased use of preventive medications. The FDA has approved four drugs for migraine prevention. These include propranolol (Inderal®), timolol (Blocadren®), topiramate (Topamax®) and divalproex sodium (Depakote®). These have had many years of use and make up the majority of the items considered 'first line' therapy for migraine prevention. Amitriptyline, which is an antidepressant, may also be very effective as a migraine preventive. All migraine preventive medications require that adequate doses of the medicine be given for a sufficient length of time to determine the effectiveness. Titration of the doses may be needed to reduce adverse effects to medicines. There are a host of alternative choices for patients whose headaches do not respond to the first line medications. These include calcium channel blockers, NSAIDs, a variety of antidepressants and several miscellaneous medications. As an alternative to drug therapy, bio-feeback training uses special equipment that monitors physical tension to teach the patient how to control the physical processes that are related to stress. Once familiar with this technique, people can use it, without the monitoring equipment, to stop an attack or reduce its effects. Self-hypnosis exercises are also taught to control both muscle contraction and the swelling of blood vessels. This patient-directed therapy, with the clinician serving as a guide or teacher, should be practiced daily. Children have an excellent response to biofeedback training, since they are open to new methods, learn quickly and have not become firmly entrenched in a chronic pain pattern.

Any way you go, migraines are extremely painful, and can lead to other more serious health issues--some of which can be life threatening. If you are prone to migraines on a regular or frequent basis, visit your health care provider or primary care physician to receive care. Although no cure exists, you can certainly take preventive measures to help alleviate the pain.

Until next time. Let me know what you think.

Monday, October 19, 2009

Health Care and Telemedicine

Telemedicine is the practice of health care delivery, diagnosis, consultation, treatment and the transfer of medical data through interactive audio, video or data communications that occur in the physical presence of the patient, including audio or video communications sent to a health care provider for diagnostic or treatment consultation, according to Telemed.org. Thanks to factors including a looming physician shortage, the health care reform debate and the increasing willingness of insurance companies to pay for the practice, telehealth is on the verge of becoming routine, according to the Baltimore Sun. Remote consultation and diagnosis are ways for medicine to become more efficient even as physicians and other health professionals are increasingly in short supply. For patients living away from advanced hospitals in urban areas, they add, it's potentially lifesaving. Telehealth systems can screen patients for diabetes, eye disease, kidney problems, nerve damage, vascular disease and complicated pregnancies.

According to the American Telemedicine Association (ATA), telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients' health status. Closely associated with telemedicine is the term "telehealth," which is often used to encompass a broader definition of remote healthcare that does not always involve clinical services. Videoconferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education and nursing call centers are all considered part of telemedicine and telehealth. Telemedicine is not a separate medical specialty. Products and services related to telemedicine are often part of a larger investment by health care institutions in either information technology or the delivery of clinical care. Even in the reimbursement fee structure, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services. More info about the Association can be found at their website: http://www.americantelemed.org/i4a/pages/index.cfm?pageID=3308 .

According to the Baltimore Sun, the technology is available and relatively inexpensive. It's the regulatory hurdles that present the challenge. Because of licensing restrictions, specialists might have trouble treating and prescribing medicine for patients they are examining electronically across state lines. Also, only a handful of states require insurers to cover telehealth care. Telehealth equipment can be installed in physicians' offices, small clinics, hospitals, and even workplaces for from $10,000 to $100,000. Hardware could include an electronic records system, digital diagnostic equipment, video monitors and cameras. With federal subsidies toward incorporating the latest electronic systems, physicians and hospitals have at least some incentive to upgrade their computer networks. Such technology isn't intended to replace patients' connection to a primary care physician. Instead, it's meant to hook them up quickly to specialized care that's sometimes difficult to find.

Universal coverage could clog the healthcare system unless new care-delivery models are created, such as telehealth and online doctor appointments, according to a survey from PricewaterhouseCoopers and reported by Modern Medicine. Fifty percent of consumers surveyed said they would be willing to seek healthcare through the internet or other computer technology instead of face-to-face, non-emergency visits. E-mail consultation was the top choice (76 percent), followed by telehealth, question-answer consults and an online forum monitored by a doctor. The second alternative to access was retail and worksite clinics for patients. Of consumers surveyed, 37 percent said they would likely use a worksite clinic, and 36 percent said they would use a retail health clinic. The third alternative was the use of telehealth technologies. This method could expand access to specialty physicians for patients in remote and underserved areas. Seventy-three percent of consumers said they would use biometric electronic remote monitoring services to track their condition and vital signs. A fourth alternative is shared medical appointments (SMAs). Of consumers surveyed, 28 percent said they would be willing to participate in a shared medical appointment. This would consist of a 60- to 90-minute session that includes a private or personal exam, integrated with patient education and discussion with a group of 10-to-15 people.

Twitter, according to Telemed.org, the increasingly popular social networking tool that was at first merely a convenient way to stay in touch with friends and family, is emerging as a potentially valuable means of real-time, on-the-go communication of healthcare information and medical alerts, as described in latest issue of Telemedicine and e-Health. Physician groups, hospitals, and healthcare organizations are discovering a range of beneficial applications for using Twitter to communicate timely information both within the medical community and to patients and the public. Short messages, or "tweets," delivered through Twitter go out from a sender to a group of recipients simultaneously, providing a fast and easy way to reach a lot of people in a short time. This has obvious advantages for sharing time-critical information such as disaster alerts and drug safety warnings, tracking disease outbreaks, or disseminating healthcare information. Twitter applications are available to help patients find out about clinical trials, for example, or to link brief news alerts from the Centers for Disease Control and Prevention (CDC) to reliable websites that provide more detailed information. The use of social media and Internet-based outlets such as Twitter to communicate medical information requires a high degree of caution, however, to preserve confidentiality and patient privacy in the clinical care setting, and to ensure that information sources are accurate, reliable, and current.

Dozens of large and small companies are turning to wireless technology to achieve a health-care system that keeps people healthier for less, according to the Wall Street Journal. But claims about cost savings from new technology often don't pan out; and, if reimbursements from Medicare or private insurers don't cover the cost of high-tech approaches, doctors and hospitals won't want to deploy them. Using wireless technology has the potential to reduce costs in part because part of the infrastructure already is in place. With more than four billion cellphones sold to date, a large percentage of the world's population has access to devices and networks that can send medical data to doctors. Private health insurance companies have yet to create separate reimbursements for telemedicine that can cover the cost of equipment and technical support, according to the Buffalo News.

According to the American Telemedicine Association, telemedicine and telehealth to be interchangeable terms, encompassing a wide definition of remote healthcare. Patient consultations via videoconferencing, transmission of still images, e‐health including patient portals, remote monitoring of vital signs, continuing medical education, consumer‐focused wireless applications and nursing call centers, among other applications, are all considered part of telemedicine and telehealth. While the term telehealth is sometimes used to refer to a broader definition of remote healthcare that does not always involve clinical services. Telemedicine is closely allied with the term health information technology (HIT). However, HIT more commonly refers to electronic medical records and related information systems while telemedicine refers to the actual delivery of remote health services using technology.

According to the ATA, telemedicine has been growing rapidly because it offers three fundamental benefits:
• Improved Access – For over 40 years, telemedicine has been used to bring healthcare services to patients in distant locations. Not only does telemedicine improve access to patients but it also
allows physicians and health facilities to expand their reach, beyond their own offices.
• Cost Efficiencies ‐ Reducing or containing the cost of healthcare is one of the most important
reasons for funding and adopting telehealth technologies. Telemedicine has been shown to reduce the cost of healthcare and increase efficiency through better management of chronic diseases, shared health professional staffing, reduced travel times, and fewer or shorter hospital stays.
• Patient Demand ‐ Consumers want telemedicine. The greatest impact of telemedicine is on the
patient, their family and their community. Using telemedicine technologies reduces travel time and related stresses to the patient. Over the past 15 years study after study has documented patient satisfaction and support for telemedical services. Such services offer patients the access to providers that might not be available otherwise as well as medical services without the need to travel long distances.

Telemedicine has measurable cost effective results and the ability to transfer live saving data during critical needs diagnosis. The need to upgrade current medical offices and health care providers is urgent to help save precious dollars and time in order to effectively better treat patients. Those companies and professionals who make best use of telemedicine for their practices should see more efficiences on a clinical basis as well as increased profitability and return on investments. Patients who learn how to access telehealth points of service have the ability to increase options to manage their health care and be able to save money and time.

Until next time. Let me know what you think.

Thursday, October 15, 2009

Health Care and Dental Tourism

With only half the U.S. population covered by dental insurance, Americans are flocking overseas for high-quality, low-cost dental care as reported by BusinessWeek.com. Also, according to the National Coalition on Health Care, more than 500,000 Americans traveled abroad to receive medical and dental work in 2006. And this is not an isolated trend. As reported by Worldental.com, dental procedures are a common choice because only about 50 percent of Americans have insurance for such care. And those people who are insured often face stiff dental bills. Plus, insurance plans, typically offered through employers, require patients to pay a significant share of the costs of procedures beyond standard preventive care. Every year, millions of patients from around the globe flock to some of the hottest dental tourism destinations in order to receive five-star dental treatment at unbelievable low prices. Dentists can charge $300 to $400 for a Dental Filling in USA & Europe. It costs only $20 to $40 in Dental Tourism countries. A root canal is $3,000 in the West but only $100 to $200 in the East. Dentures can cost $1,000 overseas but only $200 in Dental Tourism countries.

According to BusinessWeek, the U.S. is facing a dental crisis. Only about 50% of the population has dental insurance, compared with the 85% who have medical benefits. Medicare doesn't cover dental procedures, despite the fact that aging teeth are just like aging bodies—vulnerable and brittle. That means more and more patients will be traveling abroad to take care of their pearly whites. The problem in the U.S. is aggravated by the fact that even people with dental insurance aren't that well covered. The vast majority of policies have a $1,500 annual cap on payouts, a level that hasn't changed since the 1970s, though premiums have been rising. That $1,500 can easily be wiped out by one complicated root canal or a crown.

Cosmetic dentistry is booming in the UK and Europe in general, according to Worldental. The number of people engaging in veneers or other cosmetic dentistry procedures has tripled. The demand for tooth whitening, repair of worn teeth, or dental implants is soaring. A major underlying reason for this is that many people abhor the visual effects of age. The teeth and the mouth have a major impact on our smile and thus our appearance so that people are increasingly looking for ways and means to look younger. Cosmetic dental surgery is one way this can be achieved. Yet, dental surgery in Western Europe and the US is horribly expensive. There are three major factors that decrease the cost of dental surgery in other countries:
--The quality of materials used may be lower, for example cheaper implants may be used.
--The costs of living in those countries are lower than in the West so that dentists charge less.
--The costs of running a dental practice is lower because wages are low and other associated costs such as rent and materials are also low.
In the West, on the other hand, overheads form a great part of the cost. The dentist will need to pass these costs to the patient in order to survive economically.

According to MedicalNewsToday.com, levels of satisfaction among the thousands of dental tourists recently questioned by RevaHealth were very high on average. Patients who had travelled abroad to receive treatment revealed an average satisfaction rating of 84%, along with an average cost saving of $6,400, or 60% of the cost of their treatment locally. More than 95% of respondents stated that cost was the main reason why they considered Dental Tourism in the first place, but when it came to choosing which clinic to visit, quality was the deciding factor. Patients reported wide variations in the amount of the money they saved and in the abilities of certain clinics to communicate effectively. Unsurprisingly, there were also variations in satisfaction between countries as a whole, with patient satisfaction highest overall for clinics in Hungary, Poland and Thailand. Only 54% knew exactly what treatment they needed, and a full 30% had no idea of where they intended to travel to. In addition to this only 50% of patients had visited their local dentist prior to making their enquiry with an overseas clinic.

According to BusinessWeek, certain areas of Budapest, Prague, Tijuana, and Bangkok are lined with dental clinics advertising their services and prices in foreign languages. For years dental tourism has been a thriving subset of medical tourism, as American and European patients seek affordable care for decaying teeth. Some surveys estimate that as many as 30% of the population along the Texas side of the Rio Grande cross the border into Mexico for cheaper dental services. British dental patients have long traveled to Eastern Europe for care. The savings those patients rack up can more than compensate for their travel costs. Teeth caps that range from $750 to $1,000 in the U.S. cost $150 in Mexico. In Hungary, a top-quality crown costs $780, compared with $1,200 to $2,000 in the U.S. However, dental tourists are seeking far more than cosmetic improvements. Dental problems can be painful, can prevent a person from eating nutritiously, and can affect one's ability to talk, smile, and even find a job—it's tough to make a good impression if you're missing teeth. Links have also been found between advanced gum disease and heart disease, stroke, and bacterial pneumonia.

The American Dental Association does not take an official position on dental tourism, according to BusinessWeek; and, it is possible to get high-quality dental care in places other than the U.S., but patients should be aware there are no international standards. There may be few legal protections if things go wrong, and the advice to people seeking to go overseas for care: you should find a dentist overseas the same way you find a dentist in the U.S.—through referrals. So, according to Worldental, while price seems to be the preponderant factor that motivates people in their choices of dental treatment, there are significant downsides to seeking dental solutions abroad. Firstly, follow-ups and after care service are generally out of the question, unless you are willing to book another flight to visit your dentist. Secondly, even the best dental surgeons have bad days. In the case of implants, about 5% of them will fail. In these cases, it is much cheaper to contact your local dentist rather than making the trip back to the other end of the world. A very important consideration is the aspect of quality of care. British and European dentists have to abide by very stringent regulations that are enforced by their respective dental councils. But what about care in developing countries or third world locations? Moreover, there is an inherent unease in trusting your mouth to a stranger. In most cases, people are familiar with their neighborhood dentist and have developed a rapport with them. At every incident, he can be contacted for a rendezvous. Familiarity with the dentist is sometimes a motivation for patients to visit them!

Dental tourism, according to Worldental, can be organized by the individual himself or through a travel agency. If you have gone to a country, you try to find out the charges of the local dentists. You may then take an appointment and have your treatment scheduled. The disadvantage is that you may not be aware of the level of professionalism of these dentists or you may have to rely on the advice of people you are not really familiar with. The experience of the dentist as a professional and in the treatment of foreign patients is essential criteria for you to look at before choosing a dentist. A second option is the travel agency who may contact the dentist for you beforehand and pre-plan the treatment before you actually board the plane. Even then, you would not be sure of the quality of the dentists being contacted. A third option is an agency specializing in dental tourism. There are not that many but the services they offer would offset some of the fears associated with treatment abroad. The dental tourism agency would be based locally but would already have contacts with dentists or dental institutions abroad. They would offer a consultation with a local dentist but the treatment would be done overseas. Thus, in the case of a problem, the agency can still be contacted for help.

Careington International, a national leader in discount dental and health care plans, has just announced the opening of a new affiliate in the UK with a network of about a thousand dental provider locations that have a strong new plan for dental, vision, and cosmetic procedures at a 20% discount from UCR (usual and customary rates). Members pay a fee to join the plan at a low nominal monthly rate, and visit participating dentists in the network. The plan is administered in the UK by Munroe Sutton. Consumers and sponsors can find more information about the plan, the savings, and how it works at www.healthydiscounts.co.uk . The plan can be used upon purchase with no waiting, claims, or maximums. The Healthy Discounts plan is a great way for those living or traveling in the UK to save money on dental expenses. Some of the advantages of this plan include the following:
--Save 20 percent on major dental work, including root canals, cleanings, exams, dentures and crowns, and more.
--Save 20 percent on eye exams, glasses and contact lenses.
--Save on selected cosmetic procedures, including Botox.
--Take advantage of unlimited usage regardless of existing health issues.
--Include your whole family with affordable fees-
--Access a wide network of local dentists and opticians.

For those who need quality dental work, a dental tourism package may be the best way to save money if you wish to combine your vacation and get some dental work done at the same time. If your costs in the US may be significant, the savings with a certified dentist, especially in the UK, may be well worth the cost of travel. A plan like Healthy Discounts for those who need a great way to save money is also a very good option. Do your homework, and then get those pearly whites to sparkle in the sun.

Until next time. Let me know what you think.

Wednesday, October 14, 2009

Health Care and Constipation

Constipation is one of those topics few like to talk about, according to WebMD.com. If you've suffered from this problem, though, you know it can be both painful and frustrating. Almost everyone gets constipated at some time during his or her life. It affects approximately 2% of the population in the U.S. Women and the elderly are more commonly affected. Though not usually serious, constipation can be a concern. Constipation occurs when bowel movements become difficult or less frequent. The normal length of time between bowel movements ranges widely from person to person.

According to WebMD, some people have bowel movements three times a day; others, only one or two times a week. Going longer than three days without a bowel movement is too long. After three days, the stool or feces become harder and more difficult to pass. You are considered constipated if you have two or more of the following for at least 3 months:
--Straining during a bowel movement more than 25% of the time.
--Hard stools more than 25% of the time.
--Incomplete evacuation more than 25% of the time.
--Two or fewer bowel movements in a week.

What's considered normal frequency for bowel movements varies widely, according to MayoClinic.com. In general, however, you're probably experiencing constipation if you pass fewer than three stools a week, and your stools are hard and dry. Fortunately, most cases of constipation are temporary. Simple lifestyle changes, such as getting more exercise and eating a high-fiber diet, can go a long way toward alleviating constipation. Constipation may also be treated with over-the-counter laxatives.

According to the Mayo Clinic, although constipation may be bothersome, it is usually not serious. Most people who have constipation don't seek a doctor's care. However, chronic constipation may lead to complications or be a symptom of a serious underlying disorder. See your doctor if you experience an unexplained onset of constipation or change in bowel habits, or if symptoms are severe and last longer than three weeks. Also seek medical care if you experience any of the following signs or symptoms, which might indicate a more serious health problem:
--Bowel movements occurring more than three days apart, despite corrective changes in diet or exercise.
--Intense abdominal pain.
--Blood in your stool.
--Constipation that alternates with diarrhea.
--Rectal pain .
--Thin, pencil-like stools.
--Unexplained weight loss.

According to WebMD, constipation is usually caused by a disorder of bowel function rather than a structural problem. Common causes of constipation include:
--Inadequate water intake.
--Inadequate fiber in the diet.
--A disruption of regular diet or routine; traveling.
--Inadequate activity or exercise or immobility.
--Eating large amounts of dairy products.
--Stress.
--Resisting the urge to have a bowel movement, which is sometimes the result of pain from hemorrhoids.
--Overuse of laxatives (stool softeners) which, over time, weaken the bowel muscles.
--Hypothyroidism.
--Neurological conditions such as Parkinson's disease or multiple sclerosis.
--Antacid medicines containing calcium or aluminum.
--Medicines (especially strong pain medicines, such as narcotics, antidepressants, or iron pills).
--Depression.
--Eating disorders.
--Irritable bowel syndrome.
--Pregnancy.
--Colon cancer.
In some cases, lack of good nerve and muscle function in the bowel may also be a cause of constipation.

According to FamilyDoctor.org, there are ways to help prevent constipation by observing certain diet options. Eat plenty of fiber. At least 2 cups of fruits and 2 1/2 cups of vegetables per day is recommended. It is suggested that men age 50 and younger consume at least 38 grams of fiber per day, while women age 50 and younger should consume at least 25 grams per day. Add extra fiber to your diet by eating cereals that contain bran or by adding bran as a topping on your fruit or cereal. If you are adding fiber to your diet, start slowly and gradually increase the amount. This will help reduce gas and bloating. Make sure to drink plenty of water, also. You may have to retrain your body to go without laxatives or enemas if you've been using them for a long period of time. This means eating plenty of fiber, possibly using a bulk-forming laxative, drinking plenty of water, exercising and learning to give yourself time to have a bowel movement. If you've used laxatives and enemas for a long time, your family doctor may suggest that you gradually reduce the use of them to give your body a chance to return to normal. Be patient because it may take many months for your bowels to get back to normal if you've been using laxatives or enemas regularly. Talk with your family doctor about any concerns you have. Additionally, more info can be found at http://digestive.niddk.nih.gov/ddiseases/pubs/constipation/.

According to MedicineNet.com, The goal of treatment in constipation should not be a bowel movement every day, but a bowel movement every two to three days without difficulty (without straining). Start with the simple things.
--Don't suppress urges to defecate. When the urge comes, find a toilet.
--With the assistance of your physician and pharmacist, determine if there are drugs that you are taking that could be contributing to the constipation. See if the drugs can be discontinued or changed.
--Increase the fiber in your diet by consuming more fruits, vegetables, and whole grains. (There are other health benefits from this recommendation as well.)
--It may be difficult to get enough fiber in the diet to effectively treat constipation, so don't hesitate to take fiber supplements if necessary (wheat bran, psyllium, etc.).
--Use increasing amounts of fiber and/or change the type of fiber consumed until there is a satisfactory result.
--Don't expect fiber to work overnight. Allow weeks for adequate trials.

What if constipation does not respond to these simple, safe measures? According to MedicineNet, these efforts should not be discontinued but other measures should be added. If the constipation is infrequent, that is, every few weeks (as it can be when due to the menstrual cycle), it probably doesn't matter what other measures are added-emollient, saline, or hyper-osmolar laxatives, enemas, and suppositories. Even stimulant laxatives every four to six weeks are unlikely to damage the colon. Unfortunately, the tendency when using stimulant laxatives is to unconsciously increase the frequency of their use. Before you know it, you're taking them every week, or more often, and permanent damage might result. If constipation is a continuous rather than an intermittent problem, probably the safest laxatives to take on a regular basis are the hyper-osmolar laxatives. They require a prescription and, therefore, necessitate a call to a physician. As with fiber, increasing doses of different hyper-osmolar laxatives should be tried over several weeks until a satisfactory type and dose of laxative is found. Hyper-osmolar laxatives, however, can be expensive. Milk of magnesia is the mildest of the saline laxatives, is inexpensive, and provides a good alternative. Most patients can adjust the dose of milk of magnesia to soften the stool adequately without developing diarrhea or leakage of stool.

According to MedicineNet, prunes and prune juice have been used for many years to treat mild constipation. There is no evidence that the mild stimulant effects of prunes or prune juice damage the colon. Stronger stimulant laxatives usually are recommended only as a last resort after non-stimulant treatments have failed. Many people take herbs to treat their constipation because they feel more comfortable using a "natural" product. Unfortunately, most of these herbal preparations contain stimulant laxatives and their long term use raises the possibility that they also may damage the colon. Each part of the intestine (stomach, small intestine, and colon) has a network of nerves that controls its muscles. A great deal of research is being done in order to gain an understanding of how these nerves control each other and ultimately the muscles. Much of this research involves the study of neurotransmitters. (Neurotransmitters are chemicals that nerves use to communicate with each other.) This research is allowing scientists to develop drugs that stimulate (and inhibit) the various nerves of the colon which, in turn, cause the muscles of the colon to contract and propel the colonic contents. Such drugs have great potential for the treatment of constipation that is due to colonic inertia. The first of these drugs is in clinical trials and is likely to be available soon. These drugs are an exciting development because they offer a new treatment for a difficult-to-treat form of constipation.

If a primary doctor is not comfortable performing the evaluation or does not have confidence in doing an evaluation, he or she should refer the patient to a specialist. Gastroenterologists evaluate constipation frequently and are very familiar with the diagnostic testing described previously. If you are suffering from an ongoing and long term problem with constipation, please see your doctor instead of using home remedies.

Until next time. Let me know what you think.

Tuesday, October 13, 2009

Health Care and Kidney Disease

More than 26 million Americans—one in nine adults—have kidney disease. Millions more are at increased risk for getting it, and most don’t know it. Kidney disease can be found and treated early to prevent more serious kidney disease and other complications. Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by doing the jobs listed, according to the National Kidney Foundation. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

Chronic kidney disease is a growing health problem in the United States. A report by the Centers for Disease Control (CDC) determined that 16.8% of all adults above the age of 20 years have chronic kidney disease. Thus, according to eMedicineHealth.com, one in six individuals have kidney disease, and over 400,000 patients are on dialysis or have received kidney transplants. About 67,000 people die each year because of kidney failure. The prevalence of chronic kidney disease has increased by 16% from the previous decade. The increasing incidence of diabetes mellitus, hypertension (high blood pressure), obesity, and an aging population have led to this increase in kidney disease. Chronic kidney disease is more prevalent among individuals above 60 years of age (39.4%). Kidney disease is more common among Hispanic, African American, Asian or Pacific Islander, and Native American people. Much info is located on their website about kidney disease: http://www.emedicinehealth.com/chronic_kidney_disease/article_em.htm .

The kidneys, a pair of bean-shaped organs, are located at the bottom of the ribcage in the right and left sides of the back, according to LabTestsOnline.org. Although the body is equipped with two kidneys, you can function with one reasonably healthy kidney if the other is damaged or removed. The kidneys receive blood from the aorta, filter it, and send it back to the heart with the right balance of chemicals and fluid for use throughout the body. The urine created by the kidneys is moved out of the body via the urinary tract.

According to LifeOptions.org, many people who have chronic kidney disease don't know it, because the early signs can be very subtle. It can take many years to go from chronic kidney disease (CKD) to kidney failure. Some people with CKD live out their lives without ever reaching kidney failure. However, for people at any stage of kidney disease, knowledge is power. Knowing the symptoms of kidney disease can help you get the treatment you need to feel your best. If you or someone you know has one or more of the following symptoms of kidney disease, or you are worried about kidney problems, see a doctor for blood and urine tests. Remember, many of the symptoms can be due to reasons other than kidney disease. The only way to know the cause of your symptoms is to see your doctor. Note the following 10 symptoms:
1.) Symptom 1: Changes in Urination. Kidneys make urine, so when the kidneys are failing, the urine may change. How?
--You may have to get up at night to urinate.
--Urine may be foamy or bubbly. You may urinate more often, or in greater amounts than usual, with pale urine.
--You may urinate less often, or in smaller amounts than usual with dark colored urine.
--Your urine may contain blood.
--You may feel pressure or have difficulty urinating.
2.) Symptom 2: Swelling. Failing kidneys don't remove extra fluid, which builds up in your body causing swelling in the legs, ankles, feet, face, and/or hands.
3.) Symptom 3: Fatigue. Healthy kidneys make a hormone called erythropoietin (a-rith'-ro-po'-uh-tin) that tells your body to make oxygen-carrying red blood cells. As the kidneys fail, they make less erythropoietin. With fewer red blood cells to carry oxygen, your muscles and brain become tired very quickly. This condition is called anemia, and it can be treated.
4.) Symptom 4: Skin Rash/Itching. Kidneys remove wastes from the bloodstream. When the kidneys fail, the buildup of wastes in your blood can cause severe itching.
5.) Symptom 5: Metallic Taste in Mouth/Ammonia Breath. A buildup of wastes in the blood (called uremia) can make food taste different and cause bad breath. You may also notice that you stop liking to eat meat, or that you are losing weight because you just don't feel like eating.
6.) Symptom 6: Nausea and Vomiting. A severe buildup of wastes in the blood (uremia) can also cause nausea and vomiting. Loss of appetite can lead to weight loss.
7.) Symptom 7: Shortness of Breath. Trouble catching your breath can be related to the kidneys in two ways. First, extra fluid in the body can build up in the lungs. And second, anemia (a shortage of oxygen-carrying red blood cells) can leave your body oxygen-starved and short of breath.
8.) Symptom 8: Feeling Cold. Anemia can make you feel cold all the time, even in a warm room.
9.) Symptom 9: Dizziness and Trouble Concentrating. Anemia related to kidney failure means that your brain is not getting enough oxygen. This can lead to memory problems, trouble with concentration, and dizziness.
10.) Symptom 10: Leg/Flank Pain. Some people with kidney problems may have pain in the back or side related to the affected kidney. Polycystic kidney disease, which causes large, fluid-filled cysts on the kidneys and sometimes the liver, can cause pain.

According to eMedicineHealth.com, although chronic kidney disease sometimes results from primary diseases of the kidneys themselves, the major causes are diabetes and high blood pressure. Note the following medical issues that can cause kidney disease:
--Type 1 and type 2 diabetes mellitus cause a condition called diabetic nephropathy, which is the leading cause of kidney disease in the United States.
--High blood pressure (hypertension), if not controlled, can damage the kidneys over time.
--Glomerulonephritis is the inflammation and damage of the filtration system of the kidneys and can cause kidney failure. Postinfectious conditions and lupus are among the many causes of glomerulonephritis.
--Polycystic kidney disease is an example of a hereditary cause of chronic kidney disease wherein both kidneys have multiple cysts.
--Use of analgesics such as acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) regularly over long durations of time can cause analgesic nephropathy, another cause of kidney disease.
--Certain other medications can also damage the kidneys.
--Clogging and hardening of the arteries (atherosclerosis) leading to the kidneys causes a condition called ischemic nephropathy, which is another cause of progressive kidney damage.
--Obstruction of the flow of urine by stones, an enlarged prostate, strictures (narrowings), or cancers may also cause kidney disease.
--Other causes of chronic kidney disease include HIV infection, sickle cell disease, heroin abuse, amyloidosis, kidney stones, chronic kidney infections, and certain cancers.

If you have any of the following conditions, you are at higher-than-normal risk of developing chronic renal disease, according to eMedicineHealth. Your kidney functions may need to be monitored regularly if you have any of the following medical issues:
--Diabetes mellitus type 1 or 2.
--High blood pressure.
--High cholesterol.
--Heart disease.
--Liver disease.
--Kidney disease.
--Amyloidosis.
--Sickle cell disease.
--Systemic Lupus erythematosus.
--Vascular diseases such as arteritis, vasculitis, or fibromuscular dysplasia.
--Vesicoureteral reflux (a urinary tract problem in which urine travels the wrong way).
--Problems of the joints or muscles that require regular use of anti-inflammatory medications.
--If you have a family history of kidney disease.

Important treatments for kidney disease are tight control of blood glucose and blood pressure. Blood pressure has a dramatic effect on the rate at which the disease progresses. Even a mild rise in blood pressure can quickly make kidney disease worsen. Four ways to lower your blood pressure are losing weight, eating less salt, avoiding alcohol and tobacco, and getting regular exercise. Not everyone with diabetes develops kidney disease. Factors that can influence kidney disease development include genetics, blood sugar control, and blood pressure. The better a person keeps diabetes and blood pressure under control, the lower the chance of getting kidney disease. According to the American Diabetes Association, once kidneys fail, dialysis is necessary. The person must choose whether to continue with dialysis or to get a kidney transplant. This choice should be made as a team effort. The team should include the doctor and diabetes educator, a nephrologist (kidney doctor), a kidney transplant surgeon, a social worker, and a psychologist.

Kidneys are remarkable organs, according to the American Diabetes Association. Inside them are millions of tiny blood vessels that act as filters. Their job is to remove waste products from the blood. Sometimes this filtering system breaks down. When our bodies digest the protein we eat, the process creates waste products. In the kidneys, millions of tiny blood vessels (capillaries) with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood. In time, the stress of overwork causes the kidneys to lose their filtering ability. Waste products then start to build up in the blood. Finally, the kidneys fail. This failure, ESRD, is very serious. A person with ESRD needs to have a kidney transplant or to have the blood filtered by machine (dialysis) as previously noted.

Treatment varies depending on the type of kidney or urinary disease present, according to LabTestsOnline.org. In general, the earlier kidney or urinary disease is recognized, the more likely it is to be treatable. Dietary restrictions, drug therapy, and surgical procedures may be appropriate. If the kidneys can no longer effectively remove waste and water from the body, a dialysis machine used several times a week can take over kidney filtration. Also, as previously mentioned, kidney transplant surgery is another option when kidneys fail. If you have diabetes or hypertension, control of your blood pressure and blood sugar is extremely important to prevent or minimize kidney damage.

Until next time. Let me know what you think.

Friday, October 2, 2009

Health Care and Cellulite

Jello. Ever see it wiggle? Does it make you cringe when you see that same effect on parts of your body like your legs, thighs, and buttocks? Cellulite is that condition of the human body where the skin of the lower limbs, abdomen, and pelvic region becomes dimpled after puberty, according to Wikipedia. This appearance is much more common in women than in men because of differences in the way fat, muscle, and connective tissue are distributed in men and women's skin, according to MedicineNet.com. The lumpiness of cellulite is caused by fat deposits that push and distort the connective tissues beneath skin, leading to the characteristic changes in appearance of the skin. Cellulite is not related to the condition known as cellulitis, which is a spreading bacterial infection of the skin and tissues beneath the skin.

According to MedicineNet.com, the dimpled appearance of cellulite can be considered to be a normal variant -- one way that many perfectly normal human beings look. Heredity, skin thickness, gender, the amount and distribution of body fat, and age can all influence the extent to which cellulite is present or visible. While cellulite is more common in women than men, men can also be affected. Cellulite occurs in people of all races living all around the globe. Although female hormones may play a role in contributing to this pattern of fat distribution, cellulite is not treatable by hormone therapy.

According to MedicalNewsToday.com, cellulite is often classified using three grades. Grade 1 classification sees no clinical symptoms, but a microscopic examination of cells from the area detects underlying anatomical changes. Grade 2 cellulite requires the skin to show pallor (pastiness), be lower temperature, and have decreased elasticity in addition to anatomical changes noted by microscopic examinations. Grade 3 cellulite has visible roughness of the skin (like an orange peel) along with all grade 2 signs. The causes of cellulite are not well understood, but there are several theories that have been put forth as explanations. Among these are:
1.) Hormonal factors - hormones likely play an important role in cellulite development. Many believe estrogen, insulin, noradrenaline, thyroid hormones, and prolactin are part of the cellulite production process.
2.) Genetics - certain genes are required for cellulite development. Genes may predispose an individual to particular characteristics associated with cellulite, such as gender, race, slow metabolism, distribution of fat just underneath the skin, and circulatory insufficiency.
3.) Diet - people who eat too much fat, carbohydrates, or salt and too little fiber are likely to have greater amounts of cellulite.
4.) Lifestyle factors - cellulite may be more prevalent in smokers, those who do not exercise, and those who sit or stand in one position for long periods of time.
5.) Clothing - underwear with tight elastic across the buttocks (limiting blood flow) may contribute to the formation of cellulite.

According to ManageCellulite.com, 90% of post-adolescent women go on to develop cellulite at some time during their life although it is very hardly ever seen in men. Although it is often mistaken for obesity, cellulite is not actually obesity related because it can also take place in thin lean women. Underneath the dermis and epidermis are three specific layers of fat. Cellulite tends to develop in the subcutaneous fat layers. This layer of fat is unique in its structure compared to the other layers because its fatty parts are structured into specific chambers by strands of linked tissue around it. Hormones also help out with the storage of fat along with the body's metabolism in the subcutaneous fat layer.

Hormonal factors such as estrogen and folliculine also play a role in cellulite formation, according to ManageCellulite.com. Cellulite is for the most part found in women during their hormonal changes such as puberty, pregnancy, and menopause and also while taking birth control pills. A woman's hormones are usually responsible for the regulation of their blood flow, fat, connective tissue and lymphatic drainage. The fat cells between the two reserve fat layers situated under the subcutaneous fat layer dissolve into a slack network. A person's genetic makeup predicts their fat storage and metabolism in these layers which are predisposed by diet, exercise, and lifestyle. These layers have no responsibility for cellulite forming on a person's body. The subcutaneous fat layer in a woman is organized into large upright chambers allowing fat to be stored. In men, these chambers are organized into small slanting units. These store smaller fat quantities and are not likely to form cellulite. Cellulite's formation is a result of complex physiological changes that occur in the subcutaneous fat layer. Regular exercise and well balanced diets do not always reverse or prevent its formation, although an unhealthy lifestyle will make the overall appearance worse over time due to poor nutrition, weight gain and lack of sufficient water intake.

According to ManageCellulite.com, with age there is a loss in the thickness and tone of the connective tissue in the superficial fat layer and the dermis. Unfortunately noticeable, flaccid cellulite is the result. There are a wide variety of products on the market today which claim to remedy cellulite. Many do not perform what they claim and as it's not known or clear which do and don't work, it is very easy to become sucked in to buying expensive mistakes. Many products consist of topical treatments which alone are ineffective in the treatment of cellulite. There are also creams available which contain herbs, antioxidants, minerals and vitamins. These assist the skin to become softer, healthier and smoother and allow it to repair itself more easily. Creams which contain antioxidants and anti-inflammatories are more effective when treating cellulite as they stimulate the flow of blood. The areas which are affected by cellulite are usually dry and damaged therefore needing additional moisture, increased blood supply and protection. The appearance of cellulite can be reduced temporarily by increasing moisture to the affected area. It needs to be remembered cellulite needs to be treated from the inside as well as the outside. Of course, some women prefer to use cosmetic surgery to reduce their cellulite. While some methods like liposuction aren't really advised for cellulite, other therapies like mesotherapy and endermologie are very popular and quite effective.

According to the Mayo Clinic, cellulite isn't a serious medical condition and treatment isn't necessary. In fact, many doctors consider cellulite a normal occurrence. However, if you're concerned about the appearance of your skin, see your doctor or a dermatologist. Because appointments can be brief, and because there's often a lot to cover, it's a good idea to be well prepared for your appointment. Preparing a list of questions will help you make the most of your appointment. List your questions from most important to least important in case time runs out. For cellulite, some basic questions to ask your doctor include:
--What is the best course of action?
--What are my treatment options and the pros and cons for each?
--What will the treatments cost? Does medical insurance cover these costs?
--What results can I expect?
--What kind of follow-up, if any, should I expect?

In summary, according to MedicineNet.com, eating a healthy diet and keeping muscles toned by regular exercise seem like reasonable approaches to keeping the body as taut and smooth as it can be. Patients should be very cautious before trying out surgical procedures, dietary supplements, or elaborate techniques of unproven value. While the FDA has approved massage and combined laser/massage therapies, it is important to remember that these costly and time-consuming treatments are approved only for the temporary decrease in the appearance of cellulite and require ongoing treatments to maintain any effect. Yet, according to the Mayo Clinic, perhaps the most promising medical therapy is lasers and radiofrequency systems. One system uses combined negative tissue massage, radiofrequency and infrared light to treat cellulite. The other system delivers combined tissue massage with diode laser energy. Both systems offer improvements to cellulite after a series of several twice-weekly treatments. Results may last up to six months. There is no way to prevent getting cellulite. Keeping off excess pounds and strengthening your muscles through regular exercise, however, can go a long way toward maintaining your skin tone and texture.

Although cellulite is commonly seen as an embarrassing condition, there is no real health care concern--just social issues surrounding this skin situation. When it becomes awkward, then you may wish to find ways to alleviate cellulite by some of the more recommended medical treatments and with diet and exercise.

Until next time. Let me know what you think.