Health Care and Lupus

One of the most difficult medical problems for any health care provider to diagnose is a disease called Lupus, primarily because it effects everyone differently. Over time, the malady can cause symptoms are similar to other health care problems, and people have varying degrees of symptomatic behavior.

According to the Mayo Clinic, diagnosing lupus is difficult because signs and symptoms vary considerably from person to person. Signs and symptoms of lupus may vary over time and overlap with those of many other disorders. No one test can diagnose lupus. The combination of blood and urine tests, signs and symptoms, and physical examination findings leads to the diagnosis. Lupus is a chronic inflammatory disease that occurs when your body's immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs.

Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks — occurs in many but not all cases of lupus. Some people are born with a tendency toward developing lupus, which may be triggered by infections, certain drugs or even sunlight. While there's no cure for lupus, treatments can help control symptoms, according to the Mayo Clinic. Much more detailed info can be found at this site: http://www.mayoclinic.com/health/lupus/DS00115.

According to the Lupus Foundation of America, no gene or group of genes has been proven to cause lupus. Lupus does, however, appear in certain families, and when one of two identical twins has lupus, there is an increased chance that the other twin will also develop the disease. These findings, as well as others, strongly suggest that genes are involved in the development of lupus. Although lupus can develop in people with no family history of lupus, there are likely to be other autoimmune diseases in some family members. Certain ethnic groups (people of African, Asian, Hispanic/Latino, Native American, Native Hawaiian, or Pacific Island descent) have a greater risk of developing lupus, which may be related to genes they have in common. While a person’s genes may increase the chance that he or she will develop lupus, it takes some kind of environmental trigger to set off the illness or to bring on a flare. Examples include:

--ultraviolet rays from the sun.
--ultraviolet rays from fluorescent light bulbs.
--sulfa drugs, which make a person more sensitive to the sun, such as: Bactrim® and Septra® (trimethoprim-sulfamethoxazole); sulfisoxazole (Gantrisin®); tolbutamide (Orinase®); sulfasalazine (Azulfidine®); diuretics.
--sun-sensitizing tetracycline drugs such as minocycline (Minocin®).
--penicillin or other antibiotic drugs such as: amoxicillin (Amoxil®); ampicillin (Ampicillin Sodium ADD-Vantage®); cloxacillin (Cloxapen®).
--an infection.
--a cold or a viral illness.
--exhaustion.
--an injury.
--emotional stress, such as a divorce, illness, death in the family, or other life complications.
--anything that causes stress to the body, such as surgery, physical harm, pregnancy, or giving birth

Hormones are the body’s messengers and they regulate many of the body’s functions, according to their site Lupus.org. In particular, the sex hormone estrogen plays a role in lupus. Men and women both produce estrogen, but estrogen production is much greater in females. Many women have more lupus symptoms before menstrual periods and/or during pregnancy, when estrogen production is high. This may indicate that estrogen somehow regulates the severity of lupus. However, it does not mean that estrogen, or any other hormone for that matter, causes lupus.

Because lupus can affect so many different organs, a wide range of symptoms can occur. These symptoms may come and go, and different symptoms may appear at different times during the course of the disease. The most common symptoms of lupus, which are the same for females and males, are:

--extreme fatigue (tiredness).
--headaches.
--painful or swollen joints.
--fever.
--anemia (low numbers of red blood cells or hemoglobin, or low total blood volume).
--swelling (edema) in feet, legs, hands, and/or around eyes.
--pain in chest on deep breathing (pleurisy).
--butterfly-shaped rash across cheeks and nose.
--sun- or light-sensitivity (photosensitivity).
--hair loss.
--abnormal blood clotting.
--fingers turning white and/or blue when cold (Raynaud’s phenomenon).
--mouth or nose ulcers.

Many of these symptoms occur in other illnesses besides lupus. In fact, lupus is sometimes called "the great imitator" because its symptoms are often like the symptoms of rheumatoid arthritis, blood disorders, fibromyalgia, diabetes, thyroid problems, Lyme disease, and a number of heart, lung, muscle, and bone diseases. A significant additional amount of information about Lupus can be found at this site: http://www.lupus.org/newsite/index.html.

According to the Lupus Research Institute (LRI), although the broad term "lupus" usually refers to Systemic Lupus Erythematosus or S.L.E., this is only one type of lupus. Other types of lupus are:

1.) Cutaneous or “skin” lupus erythematosus. This form of lupus mainly affects the skin—not the rest of the body. Signs include a rash on the face, scalp, or elsewhere that may last for days or years, and can recur. Unlike systemic lupus, cutaneous lupus does not threaten the health of other organs and tissues in the body. And although it’s clearly a concern, it’s not that common for cutaneous lupus to turn into systemic lupus. A type of cutaneous lupus called “discoid” lupus involves potentially scarring sores with inflammation, typically on the face, scalp, and ears. These lesions can scar.

2.) “Drug-induced lupus” is triggered by the use of certain medicines. It usually goes away once the triggering medicines are stopped. Symptoms of this form of lupus are often relatively mild.

Lupus is chronic and complex, and is often difficult to diagnose. According to the LRI, there is no single laboratory test that can determine if a person has lupus. To complicate matters, many symptoms of lupus are similar to those of other diseases, and can come and go over weeks and months. It can often take years for a diagnosis to be made. To diagnose lupus, a doctor should be able to find physical or laboratory evidence of the condition, such as swelling of joints, protein in the urine, fluid around the lungs or heart, or a skin biopsy (test of a sample) that shows evidence of the disease. The doctor also will look at a person’s medical history and special tests to rule out other diseases. More information can be found at their site: http://www.lupusresearchinstitute.org/lupus/lupus_diagnosis .
 
Lupus affects mainly the joints, kidneys and skin. It can range from mild to serious. Yet, there is much reason for hope. Improvements in treatment have greatly improved these patients' quality of life and increased their lifespan, according to the American College of Rheumatology. Here are a few fast facts:

--Lupus affects 10 times as many women as men.
--Treatment depends on the symptoms and their severity.
--Because it is a complex disease, lupus requires treatment by or consultation with a rheumatologist, a doctor who is an expert in treating diseases like lupus.
--People can live well with lupus if they actively work toward good health.

Health care providers may combine a few medications to control lupus and prevent tissue damage. Each treatment has risks and benefits, according to Rheumatology.org. Most immune-suppressing medications, for instance, may cause major side effects. Side effects of these drugs may include a raised risk of infections as well as nausea, vomiting, hair loss, diarrhea, high blood pressure and osteoporosis (weak bones). Rheumatologists may lower the dose of a drug or stop a medicine because of side effects or when the disease goes into remission. As a result, it is important to receive careful and frequent health exams and lab tests to track your symptoms and change your treatment as needed.
 
Even when it is not active, lupus may cause problems later. Some of these problems can be fatal. One of these problems is atherosclerosis (clogging of the arteries) that may develop in younger women or may be more severe than usual. This problem raises the risk of heart attacks, heart failure and strokes. Thus, it is vital that patients with lupus lower their other risk factors for heart disease, such as smoking, high blood pressure and high cholesterol. It is also important to have as active a lifestyle as possible.

Treatment of lupus has improved, and people with the disease are living longer. But, it is still a chronic disease that can limit activities. Quality of life can suffer because of symptoms like fatigue and joint pain. Furthermore, some people do not respond to some treatments. Also, you may not be able to predict when lupus will flare. Such problems can lead to depression, anger, loss of hope or loss of the will to keep fighting, according to Rheumatology.org. The best way to control lupus is to follow these tips:

1.) Form a support system. A good doctor-patient relationship and support from family and friends can help you cope with this chronic and often unpredictable illness.

2.) Get involved in your care. Take all medications as your doctor prescribed, and visit your doctor often. Learn as much as you can about lupus and your medications, and what kind of progress to expect.

3.) Stay active. Exercise helps keep joints flexible and may prevent heart disease and strokes. This does not mean overdoing it. Switch off doing light to moderate exercise with times of rest.

4.) Avoid excess sun exposure. Sunlight can cause a lupus rash to flare and may even trigger a serious flare of the disease itself. When outdoors on a sunny day, wear protective clothing (long sleeves, a big-brimmed hat) and use lots of sunscreen.

5.) Pregnancy. If you are a young woman with lupus and wish to have a baby, carefully plan your pregnancy. With your doctor's guidance, time your pregnancy for when your lupus activity is low. While pregnant, avoid medications that can harm your baby.

Lupus is treatable, but the conditions causing it are complex and hard to diagnose. If you suspect that you or someone in your family are suffering some recognizable symptoms, visit your primary care physician and ask for a referral to a rheumatologist who can help you figure out what's going on with your health. At least, they can guide you with options for testing and proper diagnosis. Plus, your overall health may be a risk for even greater complications if you don't follow their guidance, or if you continue to ignore your issues or delay getting help. Find a solution to your symptoms, and prevent any additional problems from developing over time.
 
Until next time.

Health Care and Health Savings Accounts

Saving money is important for most all families and individuals, especially for medical expenses and health care in general. To have multiple options when it comes to finding the best deals financially to cover health costs whether it's dental care, vision needs, prescriptions, or doctor visits, your best bet is to find affordable coverage that helps offset the bills when you have a qualified medical expense. One way to help is to have a Health Savings Account, or HSA. Typically, these are purchased in tandem with a high deductible health plan (HDHP).

Today, you can usually see deductibles in the $5,000 to $25,000 range. But remember, when buying a HDHP, you need to balance the monthly premium against your budget, and what comfort level you have with the amount of the deductible. Many employers offer these types of plans, along with standard PPOs and HMOs for health insurance coverage. You'll want to pick the plan that suits your personal financial needs the best. However, having an HSA with a HDHP is a great way to use pre-tax dollars to offset the day to day health care needs for you and your family.

According to the US Treasury, Health Savings Accounts (HSAs) were created in 2003 so that individuals covered by high-deductible health plans could receive tax-preferred treatment of money saved for medical expenses. Generally, an adult who is covered by a high-deductible health plan (and has no other first-dollar coverage) may establish an HSA. For tax implications and IRS regulations about this type of financial vehicle, you can find more details at their site: http://www.treasury.gov/resource-center/faqs/Taxes/Pages/Health-Savings-Accounts.aspx.

According to HSA for America, by allowing you to deposit tax-deductible funds into a health savings account that you can use to cover medical costs, Health Savings Accounts enable you to take control of your own health care decisions. One of the key aspects to health savings accounts is a system that is responsive primarily to individual consumers, rather than to third-party payers. This concept is known as consumer driven health care. First, you must have a high-deductible health insurance plan that qualifies to be partnered with a Health Savings Account. These plans are available through various insurance companies, depending upon what part of the country you live. The plans are all similar in the fact that they have deductibles (for 2012) between $1,200 and $6,050 for singles, and between $2,400 and $12,100 for families. Once your insurance policy has become effective, you may begin to fund your Health Savings Account.

Health Savings Accounts allow you to legally avoid federal income tax by depositing (in 2012) up to $3,100 for singles or $6,250 for families, into your Health Savings Account. For 2011, you could deposit up to $3,050 for singles or $6,150 for families,whatever you deposit into your account up to April 15, 2012 is an "above the line" tax deduction for your 2011 taxes, meaning you get a federal income tax deduction for money you put in even if you take the standard deduction and don’t itemize deductions. If your employer makes a Health Savings Account contribution for you, it is “excluded” from income, and not subject to any income tax or FICA. Either way, this will immediately reduce your federal income tax due for the year. Most states also allow you to take a state income tax deduction for HSA contributions. This website has lots of details about HSAs: http://www.health--savings--accounts.com/.

The Kiplinger Newsletter has detailed FAQs about HSAs:

1.) Who can get an HSA?: Anyone who buys a qualified high-deductible health insurance policy can contribute to an HSA, although you cannot make new contributions to an HSA after you sign up for Medicare.

2.) How and where can I open a health savings account?: It depends on if you're buying coverage on your own or getting it through your employer.

--On your own. You can find HSA-eligible policies from several insurers in most states at eHealthInsurance.com, or can search for a local agent who knows which policies are available in your area at the National Association of Health Underwriters web site.

--Through your employer. If you get health insurance through your employer, you may have seen an HSA-eligible option during last-year's open-enrollment period (generally in the fall). If not, talk to your benefits manager to see if HSAs will be on your health insurance menu. Choosing an HSA could knock down your share of premiums significantly, and some employers may choose to fund all or part of the HSA for you -- perhaps even adding a 401(k)-style match.

3.) Would I fund an HSA with pre- or post-tax dollars?: If your employer offers a high-deductible health insurance policy, you may be able to make pretax contributions, like you would with a flexible-spending account. If you open the HSA on your own, your contributions will be deductible when you file your taxes, even if you don't itemize.

4.) What's the difference between HSAs and the flexible-spending accounts? It seems they are for the same purpose. The tax benefits of both plans are quite similar, but there are several differences. The biggest and most important difference is that your HSA balances can roll over from year to year and continue to grow tax-deferred. Money in your flex plan (FSA) must be spent by the end of the plan year or you lose it. That may sound like a big negative, but flex plans can save you a lot of money even if you don't spend every nickel. Also, you can open a flexible-spending account only if the plan is offered by your employer, and you don't need to have a high-deductible health insurance policy. And, usually the entire FSA contribution is available day one of your plan year as opposed to HSA money that is only available after contributions are made throughout the year.

5.) Do contributions to an HSA in any way affect one's ability to contribute to an individual retirement account?: No. Your HSA contributions won't affect your IRA limits. It's just another tax-deferred way to save for retirement. 

Here's an interesting statistic about the popularity of HSAs: The percentage of Individuals contributing $1,500 or more to their Health Savings Account plans has increased from 21% in 2006 to 44% in 2011, according to Employee Benefit Research Institute Press latest survey.

According to the Mayo Clinic, like any health care option, health savings accounts have advantages and disadvantages. When considering a health savings account (HSA), think about your anticipated health care expenses, your financial situation and how much control you want over your health care spending. If you're generally healthy and want to save for future health care expenses, an HSA may be an attractive choice. On the other hand, if you anticipate needing expensive medical care in the next year and would find it hard to meet a high deductible, an HSA might not be your best option. Much  more details about the pros and cons of HSAs can be found at this site: http://www.mayoclinic.com/health/health-savings-accounts/GA00053.

Health Care Reform: Few Changes for Health Savings Accounts, according to this website: http://www.hsainsights.com/health-care-reform-and-hsas.html----

Individuals with Health Savings Accounts (HSAs) will not be greatly affected by the recent enactment of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Tax Credits Reconciliation Act of 2010. Following are the main changes to HSAs:

• A change in the definition of a "qualified medical expense" that impacts reimbursements and withdrawals under HSAs: Beginning last year in 2011, expenses incurred for over-the-counter (OTC) medications without a prescription are no longer be eligible for payment or reimbursement from an HSA.

• An increase in the tax penalty on HSA withdrawals that are not used for qualified medical expenses were increased from 10 percent to 20 percent in 2011. Some of the new law's provisions will have an impact on High Deductible Health Plans (HDHP) sold in the future.

One interesting side note is that when you are paying all qualified medical expenses out of pocket until you reach your deductible with a HDHP, your HSA account can work well with a discount health plan membership. Medical discount plans usually cost less than $30 per month, and they can save you quite a bit of money with participating health care providers for physician visits, prescriptions, dental, vision, chiropractors, diabetes supplies, and much more. Plus, you can use your HSA dollars to pay for the health care expenses at a discounted rate to stretch those pre-tax monies, just not the membership fee.

Health Savings Accounts are a very good way to keep medical costs to a minimum, and they serve a financial purpose also for your tax situation. Always talk to a professional to see how HSAs and other tax deferred instruments affect your personal financial situation. Although HSAs are good for many households, they are not applicable to everyone. Your health care needs are not identical to other families and individuals, so you must make sure that whatever you choose for your health coverage, that it best suits your own situation.

Until next time.

Health Care and Alcohol Poisoning

Drinking alcohol in moderation has certain health benefits as noted by numerous articles that have been published over the last few years. Information published by many notable sources states that certain antioxidents in fermented red grapes provide a way to help improve cholesterol.

According to the Mayo Clinic, antioxidants may help prevent heart disease by increasing levels of "good" cholesterol and protecting against artery damage. While the news about red wine might sound great if you enjoy a glass of it with your evening meal, doctors are wary of encouraging anyone to start drinking alcohol. That's because too much alcohol can have many harmful effects on your body. Still, many doctors agree that something in red wine appears to help your heart. It's possible that antioxidants, such as flavonoids or a substance called resveratrol, have heart-healthy benefits.

However, drinking too much can lead to detrimental health effects on your body. Alcohol poisoning can happen to anyone, but it is very common among adolescents and college students. According to CollegeDrinkingPrevention.gov, some people laugh at the behavior of others who are drunk. Some think it's even funnier when they pass out. But there is nothing funny about the aspiration of vomit leading to asphyxiation or the poisoning of the respiratory center in the brain, both of which can result in death.

Do you know about the dangers of alcohol poisoning? When should you seek professional help for a friend? Sadly enough, too many college students say they wish they would have sought medical treatment for a friend. Many end up feeling responsible for alcohol-related tragedies that could have easily been prevented. Common myths about sobering up include drinking black coffee, taking a cold bath or shower, sleeping it off, or walking it off. But these are just myths, and they don't work. The only thing that reverses the effects of alcohol is time-something you may not have if you are suffering from alcohol poisoning. And many different factors affect the level of intoxication of an individual, so it's difficult to gauge exactly how much is too much.

Alcohol depresses nerves that control involuntary actions such as breathing and the gag reflex (which prevents choking). A fatal dose of alcohol will eventually stop these functions. It is common for someone who drank excessive alcohol to vomit since alcohol is an irritant to the stomach. There is then the danger of choking on vomit, which could cause death by asphyxiation in a person who is not conscious because of intoxication. You should also know that a person's blood alcohol concentration (BAC) can continue to rise even while he or she is passed out. Even after a person stops drinking, alcohol in the stomach and intestine continues to enter the bloodstream and circulate throughout the body. It is dangerous to assume the person will be fine by sleeping it off. More info can be found at this site: http://www.collegedrinkingprevention.gov/otheralcoholinformation/factsaboutalcoholpoisoning.aspx .

According to several studies and research that has been conducted on the causes, signs and symptoms of alcohol poisoning, there are more than 50,000 cases of reported alcohol poisoning each year in the United States and there is approximately one death per week as a result of alcohol poisoning, as stated by the website AlcoholWithdrawalSymptoms.org. Alcohol poisoning, also referred to alcohol overdose, is a life threatening condition that occurs when someone consumes excessive amounts of alcohol. When the amount of alcohol consumed increases beyond the normal level of blood in the human body, the body cannot metabolize the alcohol as quick as it is being ingested, resulting in a variety of unpleasant symptoms and the serious consequence of alcohol poisoning. The alcohol poisoning symptoms begin to manifest as a way of showing the body that it has reached its peak in alcohol and the system is no longer capable of handling it. Understanding the causes of toxic reactions and the symptoms of alcohol poisoning, as well as the responsible approaches to avoiding the situation, may help prevent the fatal results of alcohol poisoning.

Although there are significant symptoms of alcohol poisoning, it is important to keep in mind that everyone may not present the signs and symptoms in the same order. Alcohol is a depressant and it will have an effect on the part of the nervous system that controls involuntary actions including gag reflexes and breathing. Vomiting is typically one of the first signs of alcohol poisoning, however, it is possible for someone to pass out and vomit while unconscious. The following are the typical order in which alcohol poisoning symptoms occur:

■ Feeling ill, nausea and vomiting: Alcohol is irritating to the stomach, so vomiting is common; however, alcohol poisoning may cause the person to have violent and drawn-out episodes of vomiting. If they want to lie down, it is important that the head is turned to the side in order to prevent choking.

■ Mental confusion and/or stupor: Someone with alcohol poisoning may become extremely dizzy, disoriented and confused. They may have slurred speech, difficulties making eye contact and/or display erratic behavior.

■ Seizures: A seizure from alcohol poisoning is due to the intoxication of the brain cells and diminishing reflexes of the body, which result in muscular spasms. If the person is shaking uncontrollably, it is vital that safety be the primary concern. If they are lying on their back, roll the person on their side in case of vomiting during the seizure to prevent choking.

■ Irregular and slowed breathing: Alcohol is a depressant to the central nervous system, which can cause someone to stop breathing. Slow breathing, less than eight breaths per minute is a sign of alcohol poisoning. A sign of irregular breathing is when there are gaps lasting ten seconds or longer between breaths.

■ Hypothermia: Hypothermia, low body temperature is an extremely dangerous symptom of alcohol poisoning. The skin may feel clammy or cold to the touch. The skin will become pale or blue-tinged. When the body temperature has a dramatic drop, it may lead to cardiac arrest.

■ Unconsciousness or passing out and cannot be roused: It is important to remember that even after the person has stopped drinking, the alcohol level in the bloodstream continues to rise. The absence of reflexes while unconscious depresses the gag reflex and increases the risk of choking on vomit. It is common to think that if someone passes out, they will sleep off the effects of the alcohol; however, this instead can lead to a coma and eventually death. The loss of consciousness is the most critical alcohol poisoning symptom as the persons system has begun to shut down due to the high levels of alcohol.

Treatment for alcohol poisoning basically depends on the stage of advancement. Vomiting is the first step because it will help to purge the alcohol from the system. Medical personnel will typically pump the stomach or if the person is awake, they may be given a drinkable charcoal treatment. Typically when someone is admitted to the hospital for alcohol poisoning, they are given oxygen therapy, fluids through an IV to prevent dehydration, given glucose and thiamin, they are monitored for breathing difficulties and/or choking. Alcohol poisoning is an extremely serious condition. When treatment is not immediately administered, the person can suffer with severe consequences including irreversible brain damage and in the worst case scenario, death. More details can be found on this site: http://www.alcoholwithdrawalsymptoms.org/46/alcohol-poisoning-symptoms/ .
 
Drinking irresponsibly is not smart, and in fact is very dangerous. The more alcohol you consume and the faster you consume it in a short time frame can send your brain and body into cataclysmic results. Be very careful when you have the opportunity to drink alcohol. And, by far, abstinence from alcoholic beverages is best. However, if you must drink, do so in moderation and be very careful not to mix drinks. Also, have a designated driver available if you have over inbibed. Your health, your brain, and your body will all thank you profusely for avoiding alcohol poisoning.
 
Until next time.