Health Care and Swine Flu

This month, the latest health care scare comes out of Mexico in the form of Swine Flu. Scores of individuals have died there over the past several weeks, and a real fear exists of a pandemic outbreak with devastating effects. So far, the results have been favorable in the U.S. with only 1 fatality to date, and those who have contracted it have suffered with lighter symptoms than those who have it living in Mexico. But the medical community is on high alert, as are major transportation facilities including bus transport and airlines. There have been several thousand reported cases in Mexico and some in other countries. Shortages for face masks and hand sanitizer in Mexico are critical. Very scary stuff!

According to OwningPink.com, swine influenza, or “swine flu”, is a highly contagious acute respiratory disease of pigs, caused by one of several swine influenza A viruses. Morbidity tends to be high and mortality low (1-4%). The virus is spread among pigs by aerosols and direct and indirect contact, and asymptomatic carrier pigs exist. Outbreaks in pigs occur year round, with an increased incidence in the fall and winter in temperate zones. Many countries routinely vaccinate swine populations against swine influenza. Swine influenza viruses are most commonly of the H1N1 subtype, but other subtypes are also circulating in pigs (e.g., H1N2, H3N1, H3N2). Pigs can also be infected with avian influenza viruses and human seasonal influenza viruses as well as swine influenza viruses. The H3N2 swine virus was thought to have been originally introduced into pigs by humans. Sometimes pigs can be infected with more than one virus type at a time, which can allow the genes from these viruses to mix. This can result in an influenza virus containing genes from a number of sources, called a “reassortant” virus. Although swine influenza viruses are normally species specific and only infect pigs, they do sometimes cross the species barrier to cause disease in humans.

According to the Washington Post, experts said there are several possibilities: Victims in Mexico may be more vulnerable because of nutritional deficiencies, other infections or some other factor; medical care may be better in the United States and elsewhere; the virus could be weakening as it spreads; or too few cases may have occurred outside Mexico for severe illnesses to emerge. Several experts said they think the most likely reason for the milder illnesses outside Mexico was that there have been too few cases reported elsewhere to see the full spectrum of disease the virus is causing. And, the result so far is that there is small number of people developing complications, some of whom have gone on to have to fatal outcomes.

According to eHow.com, swine flu symptoms include runny nose, muscle aches, lethargy, lack of appetite, fever over 101 and sudden onset. It is difficult to distinguish from other flu types, and does require a diagnosis. Researchers are not yet sure if antiviral medicines such as Tamiflu or Relenza may remain effective against swine flu, although these antiviral medicines are working against the current strain. The Swine Flu is a combination of four known strains including Avian flu, Human Influenza, and two other viruses.

A toddler who died in Houston, according to the Washington Post, was very ill when brought in from Mexico and died after being airlifted from Brownsville, Texas. Houston health officials said the toddler who died had traveled by plane with his family from Mexico City to a town near the U.S. border on April 4. He then crossed into the United States to visit relatives in the border town of Brownsville, and developed flu symptoms April 8. Several days later, with his condition worsening, the boy was admitted to a Brownsville hospital. He was transported to Houston for additional treatment the next day. It is not known whether the child contracted the virus in Mexico or on the U.S. side of the porous border. The child, who officials said had underlying health problems, died Monday. His relatives are healthy and have not been infected. The toddler's death is a tragic case of a severe lack of health care education by the parents and family.

According to ArcaMax Health online, the Centers for Disease Control and Prevention in Atlanta, said that their study involved the development of news test kits for doctors to swab the mouth of patients and send the results to a laboratory as part of a process to monitor the spread of influenza. The CDC is sending test kits to states so that states will be able to do their own testing, and there is a stockpile of medication and other supplies helpful in managing an outbreak. This is 11 million courses of anti-viral drugs, about 25% of the total stockpile. And according to the Washington Post, U.S. authorities are monitoring the spread of the virus carefully, and urged local authorities to report all suspected cases and close schools where infections are reported to minimize spread of the disease. Private citizens should take care to wash their hands frequently, stay home from work or school if they are sick, and cover their mouths when coughing.

Around the world, governments are closely monitoring the swine flu outbreak. According to the Washington Post, in addition to the U.S. and Mexican cases, at least six have been confirmed in Israel, at least two in Spain, five in Britain and two in New Zealand, according to the World Health Organization. Israeli officials said they had confirmed two more cases, both in men who recently returned from Mexico. German health officials said three citizens who recently returned from Mexico had tested positive for swine flu. The patients were all expected to make a full recovery, officials said, though they warned that the virus was likely to spread and that they were monitoring other suspected cases in Germany. Britain has heightened airport checks of travelers who might have the flu and significantly expanded its stock of anti-viral medicines, and those few infected are responding well to the Tamiflu vaccine. The government had also ordered millions of extra face masks and planned to deliver information leaflets to every household in the country on the swine flu. Cuba and Argentina have banned travel from Mexico, although the WHO has not recommended that option. Several countries, including France, Britain, the Netherlands and Italy, advised residents to avoid unnecessary trips to Mexico. In India, officials were searching for 500 British tourists to check them for swine flu and said they would increase the number of health surveillance booths at nine international airports to screen travelers. And, Chinese officials have reported no confirmed cases on the mainland.

Worldwide, the swine flu outbreak is causing concern that the disease could reach critical mass in a short time frame. But so far, there is no genuine pandemic. According to HealthCare IT News online, both the WHO and the Centers for Disease Control and Prevention are using technology to help track the fast-moving flu and disseminate information and communicate among countries. In the United States, state officials are working with hospitals to ensure they are prepared in the event the number and severity of cases grows. Google maps, RSS feeds and Twitter are among the methods of communication employed by officials, and the public is sharing information at a faster rate than ever before. The CDC and WHO are posting on their Web sites up-to-the-minute information about new cases of the flu. They also offer recommendations on how the public and local and state officials should respond to the threat.

According to OwningPink.com, it is likely that most of people, especially those who do not have regular contact with pigs, do not have immunity to swine influenza viruses that can prevent the virus infection. If a swine virus established efficient human-to human transmission, it can cause an influenza pandemic. The impact of a pandemic caused by such a virus is difficult to predict: it depends on virulence of the virus, existing immunity among people, cross protection by antibodies acquired from seasonal influenza infection and host factors. Swine influenza viruses can give a rise to a hybrid virus by mixing with a human influenza virus and can cause a pandemic. Swine influenza has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs. The swine influenza virus is killed by cooking temperatures of 160F/70C, corresponding to the general guidance for the preparation of pork and other meat.

The single best way to prevent seasonal flu is to get vaccinated each year, but good health habits like covering your cough and washing your hands often can help stop the spread of germs and prevent respiratory illnesses like the flu. There also are flu antiviral drugs that can be used to treat and prevent the flu. The CDC has several tips to avoid the flu:
1.) Avoid close contact: Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
2.) Stay home when you are sick: If possible, stay home from work, school, and errands when you are sick. You will help prevent others from catching your illness.
3.) Cover your mouth and nose: Cover your mouth and nose with a tissue when coughing or sneezing. It may prevent those around you from getting sick.
4.) Clean your hands: Washing your hands often will help protect you from germs.
5.) Avoid touching your eyes, nose or mouth: Germs are often spread when a person touches something that is contaminated with germs and then touches his or her eyes, nose, or mouth.
6.) Practice other good health habits: Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

Additional tips to stay healthy and avoid the swine flu are provided by eHow.com:
--Hand Sanitizer: Carry hand sanitizer with you. If you have things others have touched, use your hand sanitizer to avoid swine flu infection. In addition, avoid shaking hands or other hand to hand contact whenever possible. Also avoid kissing on the cheek or other face to face contact as a greeting method.
--Public Facilities: Touch public handles and pens as little as possible. These are loaded with germs that may carry the swine flu virus.
--Air Travel: When you fly, be most diligent about following these guidelines. Transferring any flu, including swine flu, is most likely in close quarters like an airplane.
--Clean Your Produce: The life span of a virus is different for each and can vary from as much as 48 hours to 100 years depending on the hardiness of the virus. Although there have been no known cases of swine flu transmission through fruit and vegetable consumption, there does seem to be some concern about the possibility. The best bet is to buy locally grown fruits and vegetables if possible. Make sure you wash your fruits and vegetables with water, and soak for greater effectiveness. Washes and using chlorinated rinses have not been proven to work. So far there have been no cases of swine flu transmission through fruits and vegetable sources.
--Avoid Crowds: Stay out of crowds as much as possible. Close proximity to other people will heighten your chances of to get swine flu. Wear a surgical mask in areas of high traffic concentration. Try to stay at least 3-6 feet away from people.
--Eating and Drinking: Do not eat or drink after others without complete sanitization of containers or utensils. Swine flu can be transmitted by contact with infected eating utensils.
--Visit Your Doctor: Get to a doctor immediately if you develop symptoms of swine flu including high fever and body aches. Swine flu can be deadly, and it is imperative to get to a physician immediately if you think you have swine flu symptoms and think you might have contracted the swine flu virus. Both Tamiflu and Relenza are antiviral medicines that are currently effective against some strains of Swine Flu. These medicines should be taken within 36 hours of flu infection for maximum effectiveness.

Although swine flu can be highly contagious and very deadly, following the guidelines noted in this post should go far to help you avoid the disease. And like all health care emergencies, given some time, common sense, and effective communication to the public, the disease will pass. Then on to the next epidemic du jour. All kidding aside, stay smart and stay safe, and stay healthy. Don't end up as the next story on the 6 o'clock news.

Until next time. Let me know what you think.

Health Care and Environmental Allergies

Millions of Americans have airborne allergies. Typically, these are a result of exposure to allergens in the environment in which they live, work, and play. According to TheHealthPages.com, environmental allergies are your body's response to substances you inhale at your home, school or workplace. They can be caused by dust, animal dander, mold spores or mildew, or feathers. Dust and mold allergies are different from pollen allergies because they cause problems all year round--not just at certain seasons.

Environmental allergies may cause symptoms such as sneezing, runny or stuffy nose, itchy eyes and they may cause coughing and wheezing according to TheHealthPages.com. The best way to control environmental allergies is to avoid the things that cause them. The first step is to find out what is producing the allergic reaction. For example, if your reaction develops at night or when you wake up in the morning, the cause may be a feather pillow or dust mites in the bedding. Or, perhaps you notice a reaction when you sit on a couch where your pet likes to sleep. If a reaction occurs when you clean house, you may be allergic to house dust. Once you think you've found the case, try to eliminate it from your environment. For example, use a dacron or polyester pillow (but not foam rubber, because mold spores can grow in it). Use synthetic blankets. If house cleaning sets you off, have someone else do it or at least wear a mask while you clean. If your reaction dies down when you leave your house, it may be caused by a pet. Vacuum carpets, furniture and other places where pets have been. Keep pets out of the bedroom. If the problem persists, you may have to find a new home for the pet or at least keep it outdoors. If the cause is dust mites, dust mite avoidance measures are helpful. Dust mites are microscopic bug-like creatures that live in pillows, blankets, mattresses, stuffed animals, carpets and cloth-covered furniture. 95% of house dust allergies are caused by dust mites. You can help by covering your pillows, mattress, and box spring with a zippered, soft plastic cover that is labeled "allergy proof".

You can buy the allergy proof covers at bedding shops and large department stores according to the TheHealthPages.com. A bare floor is best, with only a small area rug. If you must have carpet, choose a synthetic or cotton carpet with a tight weave and a very short pile. Change the central heating filter once a month to cut down on dust and other allergens in the air. If you can't eliminate or avoid the cause of your reaction, you may be able to control the allergy. And, antihistamine medications can help. If they don't provide enough relief, call your health care provider. Your provider can evaluate your problem, and perhaps prescribe a stronger medication. Your provider may send you to an Allergist for further evaluation, including a detailed history of your allergy problem and possibly skin test to identify substances that cause it. You may then be given desensitization injections or "allergy shots". Whether the treatment is non-prescription antihistamines, a doctor's prescription, or injections, the treatment works best if you combine it with avoidance of the things that cause your allergic reaction.

Remember these key points:
1.) Environmental allergies may be caused by a variety of substances, especially animal dander, molds and dust mites.
2.) To identify the cause, note where you have an allergic reaction; then take steps to avoid the probable cause.
3.) When you know the cause, continue to avoid it. If that does not work, your health care provider can evaluate your condition and make recommendations, prescribe medication, or possibly refer you to an Allergist for further study.

According to the Cleveland Clinic, medicines help treat your allergy symptoms once you have them, but there are several steps you can take to prevent symptoms before they occur. The following recommendations can help you avoid allergy attacks whether you're at home, outdoors, or out on the town.
1.) At home:
--Keep windows closed and use air conditioning if you are allergic to pollen; don't use fans, as they can stir up dust.
--Filter the air. Cover air conditioning vents with cheesecloth to filter pollen and use a high efficiency particulate air filter (HEPA) if you have a forced air furnace. Clean air filters frequently and air ducts at least once a year.
--Keep the humidity in your house below 50 percent to prevent mold growth. Avoid areas where molds may collect, including basements, garages, crawl spaces, barns, compost heaps; clean these areas often.
--Install dehumidifiers in basements and other areas of the house where mold may collect; clean these devices every week. Air out damp clothes and shoes (in the house) before storing.
--If you have pets, consider keeping them outside, or perhaps ask someone else to take care of them; animal dander and saliva are common allergens for many people. Otherwise, do not allow pets in the bedroom and be sure to bathe pets often. Do not allow pets to sit on the furniture.
--Close air ducts in the bedrooms.
--Remove laundry from the washing machine promptly; don't leave wet clothes in the washer.
--Wash shower curtains and bathroom tiles with mold-killing solutions.
--Don't collect too many indoor plants, as the soil encourages mold growth.
--Store firewood outside.
--Use plastic covers for pillows, mattresses, and box springs. Avoid overstuffed furniture and down-filled bedding or pillows. Remove stuffed animals from the bed.
--Wash your bedding every week in hot water, hotter than 130 degrees F.
--Don't allow smoking in your house.
--Wear a mask and gloves when cleaning, vacuuming, or painting to limit dust and chemical exposure.
--Vacuum twice a week.
--Limit throw rugs to reduce dust and mold. If you do have rugs, make sure they are washable.
When possible, choose hardwood floors instead of carpeting. If you must have carpeting, choose low pile material.
--Avoid Venetian blinds or long drapes, as they collect dust. Replace old drapes and use window shades instead.
--Make sure there is an exhaust fan over the stove to remove cooking fumes.
2.) Driving:
--Keep windows closed and set the air conditioner on re-circulate if you are allergic to pollen.
3.) Outdoors:
--Minimize walks in wooded areas or gardens.
--Check the forecast; stay indoors as much as possible on hot, dry, windy days when pollen counts are generally the highest.
--Try to avoid extreme temperature changes, as they are triggers for some people with asthma.
--If possible, stay indoors between 5:00 a.m. and 10:00 a.m. when outdoor pollen counts are usually the highest.
--Wear a mask (such as an inexpensive painter's mask) when mowing the lawn if you are allergic to grass pollen or mold; if possible, avoid mowing and being around freshly cut grass.
--Wear a mask when gardening, as flowers and some weeds release pollen and can cause allergy symptoms.
--Avoid raking the leaves or working with hay or mulch if you are allergic to mold.
--After being outdoors, take a shower, wash your hair, and change your clothes to remove pollen that may have collected in your clothes and hair.
--Wear shoes and long pants and sleeves, and do not wear scented deodorants, perfumes, shampoos, or hair products in order to protect yourself from insect stings.
--Dry clothes in a dryer. Don't hang clothes or linens out to dry, as pollen and molds may collect in them and can make your allergies worse.
4.) Traveling:
--Pack your medications with you in your carry-on bag.
--Bring an extra supply of medications in case you need them.
5.) Hotel stays:
--Ask for a nonsmoking room.
--Remove feather pillows and ask for synthetic, non-allergenic pillows, or bring your own pillow or plastic pillow cover from home.
--If possible, keep the vent on the room air conditioner shut.
6.)Dining:
--Eat in smoke-free restaurants.
--For food allergies: avoid the foods that cause your allergy symptoms by carefully reading ingredient labels and asking about the food preparation methods when dining out. Choose fresh foods rather than prepared or processed foods. If you have severe symptoms, such as anaphylaxis, carry an epinephrine injection kit (EpiPen or Ana-Kit or Twinject) with you at all times.
7.) For children in school:
--Discuss your child's allergies with school personnel.
--Inform school personnel about the medications your child is taking and make arrangements to leave necessary medications at school.
--Encourage sports participation, but inform coaches of medications that your child may need to take before activities.

Symptoms depend on what you're exposed to, how much of it, how often, and for how long according to HowStuffWorks.com. They can include itching and burning eyes, rashes, sore throat, headaches, dizziness, and fatigue. Factors that contribute to susceptibility include your age, a history of allergies, your general health, and your overall level of stress. Environmental allergies are difficult to pinpoint and harder to avoid.

Allergy season can be a rough time of the year for those people who suffer from hayfever and other outdoor allergens. However, if you are dealing with chronic allergy symptoms, see your doctor for tips on what to do to prevent ongoing problems. There are great medications that can control allergies or soften the blow if you have severe problems. Even over the counter medications such as Claritin, Zyrtec, and Benedryl can help. Talk to your pharmacist to find what may be available options if you are not currently needing an allergist or family doctor. The important factor is to lessen the sneezing, coughing, and other physical problems related to allergies. A little common sense and practical treatment will go a long way to make you feel better. Do yourself a favor, and get help for the common problems associated with allergies.

Until next time. Let me know what you think.

Health Care and Laughter

Americans love to laugh. According to About.com, research has shown health benefits of laughter ranging from strengthening the immune system to reducing food cravings to increasing one's threshold for pain. There's even an emerging therapeutic field known as humor therapy to help people heal more quickly, among other things. Humor also has several important stress relieving benefits. Laughing while you are sick is not the first remedy that any sane person would consider. However, the benefit of using humor to lighten a serious health issue can help the patient to recover with a better attitude and improve his overall mental and physical health.

Some researchers, according to WebMD, think laughter just might be the best medicine, helping you feel better and putting that spring back in your step. Yet researchers aren't sure if it's actually the act of laughing that makes people feel better. A good sense of humor, a positive attitude, and the support of friends and family might play a role, too. But while we don't know for sure that laughter helps people feel better, it certainly isn't hurting. People who believe in the benefits of laughter say it can be like a mild workout -- and may offer some of the same advantages as a workout. And laughter appears to burn calories, too. A researcher from Vanderbilt University, conducted a small study in which he measured the amount of calories expended in laughing. It turned out that 10-15 minutes of laughter burned 50 calories. While the results are intriguing, don't be too hasty in ditching that treadmill. One piece of chocolate has about 50 calories; at the rate of 50 calories per hour, losing one pound would require about 12 hours of concentrated laughter!

However, most studies of laughter have been small and not well conducted, according to WebMD. Too many researchers have an obvious bias: they go into the study wanting to prove that laughter has benefits. Studies of laughing have often not looked at the effects of other, similar activities such as screaming. the most convincing health benefit he's seen from laughter is its ability to dull pain. Numerous studies of people in pain or discomfort have found that when they laugh they report that their pain doesn't bother them as much. One of the biggest problems with laughter research is that it's very difficult to determine cause and effect. For instance, a study might show that people who laugh more are less likely to be sick. But that might be because people who are healthy have more to laugh about. Or researchers might find that, among a group of people with the same disease, people who laugh more have more energy. But that could be because the people who laugh more have a personality that allows them to cope better. So it becomes very hard to say if laughter is actually an agent of change, or just a sign of a person's underlying condition. But we all know that laughing, being with friends and family, and being happy can make us feel better and give us a boost -- even though studies may not show why. Regardless of whether laughter actually improves your health or boosts your energy, it undeniably improves your quality of life.

According to Oxford Journals online, there are a few studies that have examined the effects of humor or laughter on psychological outcomes, such as stress. However, there are a very limited number of studies that document the effects of laughter on physiological outcomes, and no controlled studies have been identified that document the effects of laughter on clinical health outcomes. So what do we really know about the role of sense of humor, use of humor by patients with various illnesses, or the effects of laughter on various health related outcomes? Is use of humor an approach that physicians should implement in their practices and/or recommend to their patients? A full discourse on humor theory is beyond the scope of this review, but certain basic definitions are essential. From a psychological perspective, humor involves cognitive, emotional, behavioral, psycho-physiological and social aspects. The term humor can refer to a stimulus, which is intended to produce a humorous response (such as a humorous video), a mental process (perception of amusing incongruities) or a response (laughter, exhilaration). Laughter is the most common expression of humorous experience. Humor and laughter are also typically associated with a pleasant emotional state. Humor can be defined as a stimulus that helps people laugh and feel happy. Laughter is a psycho-physiological response to humor that involves both characteristic physiological reactions and positive psychological shifts. Sense of humor is a psychological trait that varies considerably and allows persons to respond to different types of humorous stimuli.

Can a laugh every day keep the heart attack away? Maybe so, according to the University of Maryland Medical Center (UMMC). Laughter, along with an active sense of humor, may help protect you against a heart attack, according to a recent study by cardiologists at the UMMC in Baltimore. The old saying that 'laughter is the best medicine,' definitely appears to be true when it comes to protecting your heart. We don't know yet why laughing protects the heart, but we know that mental stress is associated with impairment of the endothelium, the protective barrier lining our blood vessels. This can cause a series of inflammatory reactions that lead to fat and cholesterol build-up in the coronary arteries and ultimately to a heart attack. The most significant study finding was that "people with heart disease responded less humorously to everyday life situations." They generally laughed less, even in positive situations, and they displayed more anger and hostility. The ability to laugh -- either naturally or as learned behavior -- may have important implications in societies such as the U.S. where heart disease remains the number one killer. We know that exercising, not smoking and eating foods low in saturated fat will reduce the risk of heart disease. Perhaps regular, hearty laughter should be added to the list; and it may be possible to incorporate laughter into our daily activities, just as we do with other heart-healthy activities, such as taking the stairs instead of the elevator.

According to HelpGuide.org, laughter activates the chemistry of the will to live and increases our capacity to fight disease. Laughing relaxes the body and reduces problems associated with high blood pressure, strokes, arthritis, and ulcers. A good hearty laugh can help:
--Reduce stress
--Lower blood pressure
--Elevate mood
--Boost immune system
--Improve brain functioning
--Protect the heart
--Connect you to others
--Foster instant relaxation
--Make you feel good.


Among the many salient points about using laughter in health care, the site http://www.helpguide.org/life/humor_laughter_health.htm has much to say about the effects of laughter including the following:
1.) Laughter lowers blood pressure: People who laugh heartily on a regular basis have lower standing blood pressure than the average person. When people have a good laugh, initially the blood pressure increases, but then it decreases to levels below normal. Breathing then becomes deeper which sends oxygen enriched blood and nutrients throughout the body.
2.) Humor changes our biochemical state: Laughter decreases stress hormones and increases infection fighting antibodies. It increases our attentiveness, heart rate, and pulse.
3.) Laughter protects the heart: Laughter, along with an active sense of humor, may help protect you against a heart attack, according to the study at the University of Maryland Medical Center (cited above). The study, which is the first to indicate that laughter may help prevent heart disease, found that people with heart disease were 40 percent less likely to laugh in a variety of situations compared to people of the same age without heart disease.
4.) Laughter gives our bodies a good workout: Laughter can be a great workout for your diaphragm, abdominal, respiratory, facial, leg, and back muscles. It massages abdominal organs, tones intestinal functioning, and strengthens the muscles that hold the abdominal organs in place. Not only does laughter give your midsection a workout, it can benefit digestion and absorption functioning as well. It is estimated that hearty laughter can burn calories equivalent to several minutes on the rowing machine or the exercise bike.
5.) Humor improves brain function and relieves stress: Laughter stimulates both sides of the brain to enhance learning. It eases muscle tension and psychological stress, which keeps the brain alert and allows people to retain more information

About.com has listed Stress Management Benefits of Laughter:
1.) Hormones: Laughter reduces the level of stress hormones like cortisol, epinephrine (adrenaline), dopamine and growth hormone. It also increases the level of health-enhancing hormones like endorphins, and neurotransmitters. Laughter increases the number of antibody-producing cells and enhances the effectiveness of T cells. All this means a stronger immune system, as well as fewer physical effects of stress.
2.) Physical Release: Have you ever felt like you "have to laugh or I'll cry"? Have you experienced the cleansed feeling after a good laugh? Laughter provides a physical and emotional release.
3.) Internal Workout: A good belly laugh exercises the diaphragm, contracts the abs and even works out the shoulders, leaving muscles more relaxed afterward. It even provides a good workout for the heart.
4.) Distraction: Laughter brings the focus away from anger, guilt, stress and negative emotions in a more beneficial way than other mere distractions.
5.) Perspective: Studies show that your response to stressful events can be altered by whether you view something as a 'threat' or a 'challenge'. Humor can give you a more lighthearted perspective and help us view events as 'challenges', thereby making them less threatening and more positive.
6.) Social Benefits of Laughter: Laughter connects us with others. Also, laughter is contagious, so if you bring more laughter into your life, you can most likely help others around you to laugh more, and realize these benefits as well. By elevating the mood of those around you, you can reduce their stress levels, and perhaps improve the quality of social interaction you experience with them, reducing your stress level even more!

To quote Bobby McFerrin, "Don't worry. Be happy!" Let laughter be a good guide to feeling better.

Until next time. Let me know what you think.

Health Care and Discount Dental

According to ArticlesBase.com, Dental plans are totally different from dental insurance. Dental insurance reimburses you for all dental care expenses, but discounted dental plans offer much more. Dental plans offer you a generous discount on every dollar you spend on dental care. Dental Insurance can be rather expensive to opt for and it mostly becomes difficult to pay for expensive dental insurance premiums. More than 100 million people in USA are estimated to be not covered by any dental insurance plan. This is where these dental plans which are reasonably priced but offer great discounts come handy and take the pressure off you and your family.

You can also use dental plans and dental insurance together to increase savings. You can pay lower prices for dental treatment using your membership card even if you're covered by insurance. The best part of the plan: 30-Day Money Back Guarantee! Most of the discounted dental plans offer 30-day money back guarantee. Companies like Careington (around since 1979), located in the Dallas, Texas, area offer even a longer period of 45 days for a refund policy. You can always cancel your subscription if you are not satisfied. You are entitled to receive a complete refund of your money too if the plans are not up to the mark for you. When you're a member of any discount dental plan, then you can always assure your self of a healthy discount by showing your membership card at any of their sponsored dentists. Careington also reports that an average family can save as much as $1200 a year using a discount dental plan. You can get a discount right away on all types of dental treatments, including cosmetic work and orthodontia, like:
• Dental examinations
• Dental cleanings
• X-rays, including Bitewings and Panoramic views
• Fluoride treatments
• Dentures
• Gum surgery and other periodontal work
• Oral surgery, such as extraction of wisdom teeth
• Restorative dental work including fillings, crowns, bridges, etc.

Discount dental plans have various discount dental plans that cover individual members and all household residents. There are absolutely no health restrictions, and you get instantly approved to save between 10% and 60% on all dental expenses. There's absolutely no paperwork to file, because it is the dentist that you pay at the time of your visit and get discounts when receiving the dental service. No age limits are required and even no background checks, including citizenship, are required for a simple plan membership. No problem if you have another bad tooth within just a few days, because there are no limits on the amount of work or visits to the dentist; and you can still avail yourself of discounted dental work. Some discount dental and health plans will also save your money on other healthcare equipment, prescription drugs, eye-glasses, hearing aids, and more health services. The internet has made it quite easy for all people to research dental plan prices with the click of a mouse. It’s essential to research first to find the most cost effective and the best. Since plans are priced based on geographic region, and you will need to enter your zip code first to get the relevant quotes.

When comparing prices, it is necessary to:
1.) Compare prices from several discount dental plan providers. Today, dental plans are much more competitive, and you are sure to find inexpensive membership prices when there is more competition.
2.) A familiar name doesn’t necessarily guarantee better service. Some plans are national and others are local. National plans will usually more famous and recognizable.
3.) Review all the features of each dental plan provider. See if the plans include vision correction options, prescription, and healthcare benefits.
4.) Search for participating dentists in your area, and verify with the provider that their office still is taking the plan.

According to Money Magazine online, it is crucial to understand that this is not insurance; it's simply a way to snag lower fees. Participating dentists cut their rates because they don't have to go through the time and expense of filing an insurance claim and waiting for payment, since you pay the bill before leaving the office. Typical savings: between 20 and 30 percent, though it can be higher depending on the procedure--some savings can be as much as 60% on preventive procedures. If you currently play dental roulette by paying for all your dental work out of pocket, forking over $100 or so a year to enroll in a dental plan provides a bit of a cushion if you run into major costs. And even if you have other dental coverage, discount dental may be a smart way to pay for cosmetic procedures, which generally are not covered by insurance, and orthodontics, which is usually only partially covered. Beware, however--there is a history of fraudulent discount dental firms collecting membership fees without providing any service. So make sure you are working with a legitimate firm by sticking with major players like Careington, Aetna, Cigna and WellPoint's Uni-Care affiliate, and by checking with your state insurance commissioner to make sure the firm is registered. (You can reach your state insurance office by starting at www.naic.org.) Don't send in money before you receive plan documents, which should include a fee schedule for participating dentists in your area. And check that there are indeed in-plan dentists and dental specialists near you and that they're providers you'd actually like to go to in your area.

According to Smart Money Magazine online, some people simply don't feel comfortable without some type of protection. But again, there aren't many options available to individuals beyond the dental discount-card plans. And while some make sense, many aren't worth your money. For a small monthly fee of about $10, these plans give you access to a network of dentists who will charge you a discounted fee for each procedure. The discount can be as generous as 50% off normal charges. The largest and best-known plans are offered by Careington International , with over 70,000 participating locations nationwide, and AmeriPlan USA. Trouble is, some dentists think there's a stigma attached to accepting a discount plan. So you may find the network of dentists quite small in certain regions. Dentists in New York City, for example, rarely participate in such plans. However, there are thousands of dentists who participate in NYC with Careington. Yet, just across the river in New Jersey, plenty of dentists participate. Residents of California and Texas should have no problem finding a strong network of doctors offering their services at discounted rates. Residents in less populated states such as Maine or Montana, on the other hand, are out of luck. It's often very hard for these plans to break into smaller towns where there are two or three established dentists who don't need more business. If you can find a plan with a dentist you trust, the savings can be substantial. Unlike with traditional insurance plans, there are no deductibles or caps on benefits you can receive; and all pre-existing conditions are included. But, plenty of smaller fly-by-night companies that should be avoided. (And, since these plans aren't technically insurance companies, they don't need to be licensed by each state they do business in.) Some of these plans are out-and-out scams. They take your money and vanish in the night. Others over promise, advertising that certain dentists are part of their network even though these doctors have never agreed to participate.

How can you identify the good discount plans from the bad? Smart Money reports the following ways you can find out who the good guys are:
--Avoid any company that asks you to send in your money before it mails you membership information. All legitimate plans will be more than happy to send you their marketing materials before you lay out any cash.
--Call a few doctors on the network list to make sure they are indeed part of the plan.
--Check with the secretary of state in your state to see if the company has registered, a requirement for any legitimate business. You may even be able check for this online.
--Ask for the company's national or local office address. Be wary if the person on the other end of the phone will only provide you with a post office box.
--Find out if the discount companies participate in the trade watchdog Consumer Health Alliance as a member company.

You can save a huge amount of money using a discount dental plan. In a down economy, every little bit helps, especially in dental and health care. Do your homework before joining one, but use your plan frequently to maintain good dental health. Reports have been published about how poor dental hygiene leads to more critical health issues. Save money up front with a reputable discount dental plan, and save more money over the long term with maintaining proper dental health.

Until next time. Let me know what you think.

Health Care and Twitter

Americans are all about social interaction. How else can you explain the explosion of websites in our internet-connecting, tech savvy, digital age? Have you set up an account on Facebook, Linked In, Flickr, MySpace, Plaxo, or Twitter? Do you follow anyone, or do they follow you online? The newest rage for exchanging info is with Twitter. Even companies are in on the act. It is one of the fastest ways to get a message to consumers. While individual cell phone users are texting away like mad in the billions of texts per month, tweeting is the new buzz.

According to AISHealth, Nearly 5 million people are tweeting, Facebook just registered its 200 millionth user, YouTube recently surpassed 100 million U.S. viewers, and Flickr claims 6,311 photo and video uploads every minute. Social media experts say it's only the beginning of a revolution that's changing the nature of our relationships — with each other and with the companies we do business with. And if you think health insurers and providers are immune from the fallout, think again. People are tweeting their friends about everything from health benefits to late-breaking treatment advancements. A great presentation is available on Twitter relative to health care at http://www.slideshare.net/philbaumann/140-health-care-uses-for-twitter-presentation . The slide show is definitely worth reading.

According to Social-Marketing.com, since Twitter can be used via mobile devices as well as computers, many of the same concepts behind using mobile phones and SMS for social change are applicable as well. So, for some, Twitter will always just be a place to tick away the moments that make up a dull day, to fritter and waste the hours in an offhand way. For smart social marketers, though, Twitter can be a powerful tool for education and action. The site lays out some of the benefits and limitations of using Twitter that you should take into account when determining whether the tool will work for your purposes:
1.) Benefits:
--Speed: Using twitter, you can very easily publish information more than once per minute. If distribution speed is critical, regardless of the information being distributed, Twitter may be the tool for you.
--Non-website (source) based alerts: Instant messaging, SMS/text messages on cell phones, RSS/Atom feeds, email alerts, badges/widgets on other sites, and other methods of distribution are available. If your community can’t be tethered to a website for it’s communications, Twitter can provide other methodologies to get that information out to them.
--Community publishing: There are a few (slightly more technical) ways of aggregating a group of twitterers posts, which means you could have more people — even your community — pitching in to help publish pertinent information.
2.) Limitations:
--Only text and links can be posted. No maps. No photos. No videos. Text and links are all you get.
--Only a 140 character limit. URLs will get shortened wherever possible, but 140 characters is tough to get used to.
--No conversation threading. This can be tough to deal with when you’re used to discussion forums and such. Connecting with your community in this way is almost limited to real-time dialogue, which can limit the conversation’s depth and longevity.
--The API has a 70 post per hour limit; the web UI doesn’t have this limit, but they wouldn’t like you posting more than that unless it was an emergency anyway.

Health Care Service Corporation (HCSC), which operates Blues plans in Illinois, Texas, New Mexico and Oklahoma, began using Twitter this past December according to AISHealth. The company selected Twitter as its launch pad because the medium provides a mechanism for real-time communications with customers who otherwise might not contact a call center with their questions or concerns. HCSC also monitors Twitter to find out what people are saying about the company, health issues in general and their health insurance. Also, HCSC is now looking at Facebook and LinkedIn, among other media, to see how they might support the company's customer experience philosophy. All age groups are now using social media, so insurers must incorporate the media into their larger outreach and engagement initiatives. HCSC sees Twitter as a customer engagement and service vehicle and not a direct sales tool.

Also, according to AISHealth, the Mayo Clinic has moved into the social space, and has a word of advice for the timid: Move fast. Mayo jumped on Twitter and Flickr the minute they started gaining traction, and largely because of an unfortunate learning experience with MySpace. When Mayo went to stake its claim on MySpace, the name was already taken by a British rock band called Mayo Clinic. Mayo began producing longer podcasts and posting them on a blog. In 2007, Mayo launched its own Facebook page, followed by YouTube. Aase says that Mayo's Facebook fan club jumped from 3,300 last December to 5,000 this month. YouTube now hosts 300 Mayo medical, research and patient story videos. This past January, Mayo launched Sharing Mayo Clinic (http://sharing.mayoclinic.org), described as a "culture blog" that will serve as the hub for all Mayo social media platforms, including Twitter, Flickr and whatever follows. Additionally, other companies have followed suit. CIGNA is now exploring Twitter and other media.

Additional thoughts and concerns about using Twitter for health care are voiced by Patient Centric Healthcare:
--The one to many concept of Twitter with the opt-in concept (preference-based marketing), but it doesn’t personalize to the individual the way the information is delivered.
--It definitely provides a stream of consciousness which is interesting, including a lot of application for a reality show type of health tools…like Biggest Loser via Twitter.
--The idea of posting a question to a broad audience for quick response, such as research showing the impact of statins on asthma patients.
--Not much for helping with patient to provider communications. Do you really want my blood sugar posted to Twitter and sent to my physician from my smart device? Does the physician really want to see all that real-time data? No. What about HIPAA…Twitter is not meant to contain confidential information. There are plenty of rules engines which can be used to capture data; look for things outside the norm; and then send an alert.
--A lot of healthcare information has caveats and requires more than 140 characters to get across the message. Most clinical things couldn’t be send this way.
--As with most inbound things--such as registration or login, or search criteria--Twitter feeds get those that know what they are interested in and are active in their health management. It still doesn’t help to drive action from those that aren’t engaged in their healthcare.
--Provide an alert to information; but since one tip to productivity is to batch things, do you really want them broken out during the day in a bunch of Twitter feeds. Most physicians would rather get a daily synopsis from a website (which might be created by Twitter feeds).

Twittering definitely gets messages out quickly, but health care is much like the Titanic in its efforts to adapt to any new concept. The medical community, insurance companies, and health care providers in general are a long way from effective use of this electronic medium. Individuals are more inclined to make use of Twitter much faster than their primary care physician, medical clinic, emergency room, or hospital. Twitter may be the new wave. But so far, health care is still waiting at the dock to board ship for the morning tide.

Until next time. Let me know what you think.

Health Care and Alcoholism

Alcoholism affects millions of Americans. According to the Mayo Clinic, Alcoholism is a chronic disease that makes your body dependent on alcohol. You may be obsessed with alcohol and unable to control how much you drink, even though your drinking is causing serious problems with your relationships, health, work and finances. It's possible to have a problem with alcohol, but not display all the characteristics of alcoholism. This is known as "alcohol abuse," which means you engage in excessive drinking that causes health or social problems, but you aren't dependent on alcohol and haven't fully lost control over the use of alcohol. Although many people assume otherwise, alcoholism is a treatable disease. Medications, counseling and self-help groups are among the therapies that can provide ongoing support to help you recover from alcoholism.

According to eHow.com, in most cases, the financial effects of alcoholism can have on a family are tremendous, if not treated immediately. Keep in mind that alcoholics often consume alcohol in excess on a regular basis. This means that during work they are sometimes susceptible to consuming some alcohol. With increased finances leaving the family and going to the increased need for an alcoholic to consume, money is constantly leaving the budget on a revolving basis. Financial duties, such as bill payments, can be put at risk because it is 'necessary' for the alcoholic to get a fix. Beyond money leaving the family budget, alcoholics often put their job security in jeopardy. Mixing alcohol and work can produce inconsistencies that are generally noticed by supervising factions. Erratic behavior at work can add strain to working relationships. Since work is not being performed on a steady basis by the person afflicted with alcoholism, his family may ultimately be subject to constant job changes and standards of living as the alcoholism progresses.

According to ezinearticles.com, Alcoholism is a debilitating personal and social problem worldwide. It refers to a preoccupation with or compulsion toward the consumption of alcohol and an impaired ability to recognize the negative effects of excessive alcohol consumption. And, destructive consequences of alcoholism include health problems, legal complications such public disorder complaints and drunk driving, loss of employment, marital conflict, domestic violence, and criminal activity.

In America it is said that more than 17 million people drink in excess according to eHow. Of the 17 million that drink in excess, 9 million are classified as alcoholics. The vast majority of these alcoholics are in fact involved in the child rearing or a familiar structure of some sort in which they have the power to influence. Young children who see the abuse of alcohol become more susceptible to abusing alcohol themselves and at an early age. Parental duties are often neglected, leaving children in charge of themselves. This becomes an obvious recipe for disaster as toddlers to teenagers need extensive attention for proper development. Children who are alcoholics become disconnected from their parental figures and often develop disdain for the family structure. Increased risky activity develops as well with those who are underage alcoholics, who are more susceptible to risky situations, such as pregnancy or the contracting of sexually transmitted diseases. Depression is often side effect of alcoholism, and this can place strain on relationships with everyone who is involved with the alcoholic. Marriages in which there is only one alcoholic often end in divorce. Alcoholics can often become physically and verbally abusive affectively severing emotional ties in the family relationship. The family can be solicited to lie for the alcoholic to cover his dependency to bill collectors, other family members, and agencies whose job it is to investigate the home environment standards.

Also, according to eHow, among the emotional and financial implications alcoholism can have on a family, are also the increased physical risks on the alcoholic. The excessive drinking of alcohol means that the alcoholic is constantly wreaking havoc on their bodies internally. Alcoholism can cause major damage to the body specifically the liver, and can trigger a host of problems including diabetes. Withdrawal symptoms include nausea, anxiousness and sweating when a craving is experienced by an alcoholic. Alcoholics typically become withdrawn from social activity in order to dedicate more time to their physical dependency. With a heightened tolerance to alcohol through abuse, alcoholics often don't know when to stop drinking. This serves to increase the risk that they will need to be hospitalized due to their drinking in excess. If financial dependency of the family is staked in anyway on the alcoholic, often times this is a gamble that is lost. Decreased production because of illness serves to deprive the family of necessities, because of the alcoholics inability to provide to the same standard. Treatment for alcoholism is costly and if it is not sought in time, death can ultimately be experienced. This is a burden that is carried by all those who are left behind whether family or friends.

As noted on ezinearticles.com, the World Health Organization estimates about 140 million people throughout the world suffer from alcohol dependence. In a broader, societal level examination of alcoholism's effects, this large number translates into millions of dollars spent annually on health care and litigation. This additional financial strain also stresses resources, as many doctors and lawyers are involved with the treatment and repercussions of alcohol dependence instead of aiding other non-preventable societal problems. Health complications resulting from alcoholism include cirrhosis of the liver, epilepsy, alcoholic dementia, heart disease, increased chance of cancer, nutritional deficiencies, sexual dysfunction, and death. Treatment of alcoholism generally includes intervention, detoxification, and rehabilitation. Intervention is an important step because many people with drinking problems do not realize alcohol is preventing them from reaching their goals. Following intervention is detoxification, which is performed in a controlled, medical setting. Withdrawal is usually achieved within a week and a healthy, balanced diet is necessary to support the alcoholic's body as it going through major changes. Finally, rehabilitation, generally consisting of counseling, support groups, or learning new life skills, occurs. However, once a person completes all of these steps, long-term support from role models is usually helpful as the temptation to drink abounds in society. Unfortunately, once a person successfully quits their alcohol dependence, long term complications may linger including health and legal issues. Additional health problems and complications include brain degeneration, cancers of the larynx, esophagus, liver, and colon, depression, liver disease, and insomnia. Legal problems can follow a recovered alcoholic for the rest of their life and prevent them from getting new employment opportunities, having a fair chance in a child custody battle, or getting a necessary loan from the bank.

About half of the alcoholics in the United States seem to be free of cognitive impairments according to National Institute of Health (NIH). In the remaining half, however, neuropsychological difficulties can range from mild to severe. For example, up to 2 million alcoholics develop permanent and debilitating conditions that require lifetime custodial care. Examples of such conditions include alcohol-induced persisting amnesic disorder (also called Wernicke-Korsakoff syndrome) and dementia, which seriously affects many mental functions in addition to memory (language, reasoning, and problem-solving abilities). Most alcoholics with neuropsychological impairments show at least some improvement in brain structure and functioning within a year of abstinence, but some people take much longer. Unfortunately, little is known about the rate and extent to which people recover specific structural and functional processes after they stop drinking.

According to the NIH, alcoholism's effects on the brain are diverse and are influenced by a wide range of variables. These include the amount of alcohol consumed, the age at which the person began drinking, and the duration of drinking; the patient's age, level of education, gender, genetic background, and family history of alcoholism; and neuropsychiatric risk factors such as alcohol exposure before birth and general health status. Overall physical and mental health is an important factor because comorbid medical, neurological, and psychiatric conditions can interact to aggravate alcoholism's effects on the brain and behavior. Examples of common comorbid conditions include: medical conditions such as malnutrition and diseases of the liver and the cardiovascular system. Neurological conditions such as head injury, inflammation of the brain (encephalopathy), and fetal alcohol syndrome (or fetal alcohol effects). Psychiatric conditions such as depression, anxiety, post-traumatic stress disorder, schizophrenia, and the use of other drugs. These conditions also can contribute to further drinking.

Excessive drinking may also depress one’s nervous system, damaging the vital brain centers, according to AlcoholismDiseaseFree.com. This leads to a stage wherein the alcoholic completely loses control over his tongue and postures. Alcoholism may also cause fatigue, memory loss for a short term, weakness of eye muscles, and paralysis. In the last stage, the patient may even go into a coma, which can be life-threatening. In addition, alcoholism causes the following health disorders:
1.) Liver disorders: Excessive drinking causes alcohol hepatitis, a condition that is characterized by inflammation of the liver. Its symptoms include appetite loss, vomiting, nausea, abdominal pain, fever, tenderness, jaundice, and dizziness. Upon continued excessive drinking, hepatitis may lead to cirrhosis, which is characterized by progressive scarring and destruction of the liver tissues.
2.) Gastrointestinal problems: Excessive drinking may also cause inflammation of the stomach, giving rise to a condition called gastritis. In this condition, alcohol disrupts the stomach’s ability to absorb vitamin B such as folic acid and thiamin. Alcohol, when consumed in heavy quantities, also damages the pancreas and interferes with the organ’s creation of hormones that regulate metabolism of the body by creating enzymes for digestion.
3.) Cardiovascular problems: Excessive drinking may cause high blood pressure or damage the heart muscle, giving rise to a condition called cardiomyopathy. Such a condition increases the chances of a heart attack.
4.) Diabetes complications: High alcohol intake inhibits the liver from releasing glucose, which increases the risk of hypoglycemia, which is characterized by low blood sugar. This condition is dangerous for an individual who is already suffering from diabetes and is taking insulin to reduce the level of sugar in the blood.
5.) Sexual function and menstruation: Prolonged alcohol abuse can give rise to erectile dysfunction in men and menstrual problems in women. Alcohol abuse during pregnancy could be very dangerous, as it can give rise to fetal alcohol syndrome. In such a case, the child is born with defects such as a small head, short eyelids, heart defects, and other abnormalities.
6.) Other health risks: Heavy alcohol intake on a regular basis causes chemical imbalances in the individual’s brain. For instance, it alters the composition of chemicals such as gamma-aminobutyric acid (GABA responsible for inhibiting impulsiveness) and glutamate (stimulates nervous system). Excessive drinking can also deplete these chemicals, in the absence of which the body seeks alcohol to ward off negativity. Such a condition when left untreated may fatally damage an individual’s health. Moreover, research also indicates that continued alcohol abuse places one at higher risk of cancer and diseases of larynx, esophagus, colon, and liver.

The bottom line is that alcoholism is a killer. The best course of action is abstinence from any beverage that contains alcohol. Many people think that they will never get hooked, and it all starts with the first drink. Maintain propriety when consuming any alcoholic drink. And the best option is just to stay away from any alcohol consumption.

Until next time. Let me know what you think.

Health Care and Vitamin Supplements

Americans have a love affair with Vitamin Supplements. Any given day of the week, you will see TV ads, print media, and mail coupons for vitamins--for children, adults, and seniors. There are even vitamin supplements for pets. Americans spend billions of dollars each year to swallow vitamins in pill and liquid forms. Yet, according to the Mayo Clinic, can you skip your daily servings of fruits and vegetables and take a vitamin and mineral supplement instead? Unfortunately, no. Vitamins and minerals are substances your body needs in small but steady amounts for normal growth, function and health. Together, vitamins and minerals are called micronutrients. Your body can't make most micronutrients, so you must get them from the foods you eat or, in some cases, from dietary supplements. Dietary supplements can complement your regular diet if you have trouble getting enough nutrients. But they aren't meant to be food substitutes. Dietary supplements can't replicate all of the nutrients and benefits of whole foods, such as fruits and vegetables. So depending on your situation and your eating habits, a daily dietary supplement may not be worth the expense.

According to Reuters, more than 30% of multivitamins tested recently by ConsumerLab.com contained significantly more or less of an ingredient than claimed, or were contaminated with lead, the company reports. ConsumerLab.com, based in White Plains, New York, is privately held and provides consumer information and independent evaluations of products that affect health and nutrition. According to the company, it is neither owned by nor has a financial interest in any companies that make, distribute or sell consumer products. And, several multivitamin products tested, including three for children, exceeded tolerable upper limits established by the Institute of Medicine for ingredients such as vitamin A, folic acid, niacin and zinc, according to the report posted on http://www.consumerlab.com/.

Also, according to the report, for example, the Institute of Medicine sets a recommended daily allowance of 1,300 international units of vitamin A for children ages 4 to 8 years and an upper tolerable limit of 3,000 IU. However, one multivitamin tested provided 5,000 IU of vitamin A.
In the short term, too much vitamin A may cause nausea and blurred vision, and, in the long-term, may lead to bone softening and liver problems. Upper tolerable limits for niacin and zinc were also exceeded by some of the supplements for young children tested. Excess niacin may cause skin tingling and flushing and high levels of zinc may cause immune deficiency and anemia.
Tests turned up problems with some men's multivitamin products as well. Two of three men's multivitamins failed to pass testing. One contained too much folic acid, which may increase the risk of prostate cancer, while another was contaminated with lead. Among four women's multivitamins tested, one provided only 66% of its claimed vitamin A; one of five seniors' multivitamins selected contained only 44% of its vitamin A; and among three prenatal vitamins, one was short on vitamin A. Two out of five general multivitamins were short on ingredients: one provided only 50 percent of its claimed folic acid and the other was missing 30% of its calcium. A vitamin water tested by ConsumerLab.com had 15 times its stated amount of folic acid, so drinking one bottle would exceed the tolerable limit for adults; less than half a bottle would put children over the limit, the company warns on its Web site.

According to the Mayo Clinic, whole foods are your best sources of vitamins and minerals. They offer three main benefits over dietary supplements:
--Greater nutrition. Whole foods are complex, containing a variety of the micronutrients your body needs — not just one. An orange, for example, provides vitamin C plus some beta carotene, calcium and other nutrients. A vitamin C supplement lacks these other micronutrients.
--Essential fiber. Whole foods provide dietary fiber. Fiber, as part of a healthy diet, can help prevent certain diseases, such as type 2 diabetes and heart disease, and it can also help manage constipation.
--Protective substances. Whole foods contain other substances recognized as important for good health. Fruits and vegetables, for example, contain naturally occurring food substances called phytochemicals, which may help protect you against cancer, heart disease, diabetes and high blood pressure. Many are also good sources of antioxidants — substances that slow down oxidation, a natural process that leads to cell and tissue damage.

According to KidsHealth.org, vitamins and minerals are substances that are found in foods we eat. Your body needs them to work properly, so you grow and develop just like you should. So, when it comes to vitamins, each one has a special role to play. For example:
--Vitamin D in milk helps your bones.
--Vitamin A in carrots helps you see at night.
--Vitamin C in oranges helps your body heal if you get a cut.
--B vitamins in leafy green vegetables help your body make protein and energy.

There are two types of vitamins according to KidsHealth: fat soluble and water soluble. When you eat foods that contain fat-soluble vitamins, the vitamins are stored in the fat tissues in your body and in your liver. They wait around in your body fat until your body needs them.
1.) Fat-soluble vitamins are happy to stay stored in your body for awhile — some stay for a few days, some for up to 6 months! Then, when it's time for them to be used, special carriers in your body take them to where they're needed. Vitamins A, D, E, and K are all fat-soluble vitamins.
2.) Water-soluble vitamins are different. When you eat foods that have water-soluble vitamins, the vitamins don't get stored as much in your body. Instead, they travel through your bloodstream. Whatever your body doesn't use comes out when you urinate. These kinds of vitamins need to be replaced often because they don't stick around. This crowd of vitamins includes vitamin C and the big group of B vitamins — B1 (thiamin), B2 (riboflavin), niacin, B6 (pyridoxine), folic acid, B12 (cobalamine), biotin, and pantothenic acid.

According to the Mayo Clinic, if you're generally healthy and eat a wide variety of foods, including fruits, vegetables, whole grains, legumes, lean meats and fish, you likely don't need dietary supplements. However, if you can't or don't eat enough healthy foods, or can't or don't eat a variety of healthy foods, you may need a daily dietary supplement. Dietary supplements may be appropriate if you:
--Don't eat well or consume less than 1,600 calories a day.
--Are a vegetarian and don't substitute or complement your diet appropriately.
--Are pregnant, trying to get pregnant or breast-feeding.
--Are a woman who experiences heavy bleeding during your menstrual period.
--Are a postmenopausal woman.
--Have a medical condition that affects how your body absorbs, uses or excretes nutrients, such as chronic diarrhea, food allergies, food intolerance or a disease of the liver, gallbladder, intestines or pancreas.
--Have had surgery on your digestive tract and are not able to digest and absorb nutrients properly.
Talk to your doctor or a dietitian about which supplements and what doses might be appropriate for you. Be sure to ask about possible side effects and interactions with other medications.

Your body is one powerful machine, capable of doing all sorts of things by itself. But one thing it can't do is make vitamins according to KidsHealth. That's where food comes in. Your body is able to get the vitamins it needs from the foods you eat because different foods contain different vitamins. The key is to eat different foods to get an assortment of vitamins. Though some children take a daily vitamin, most kids don't need one if they're eating a variety of healthy foods. Here is the benefit of each of the alphabet vitamins A through K:
--Vitamin A: This vitamin plays a really big part in eyesight. It's great for night vision. Vitamin A helps you see in color, too, from the brightest yellow to the darkest purple. In addition, it helps you grow properly and aids in healthy skin. Foods like liver and dark green leafy vegetables are good natural sources.
--Vitamin B: The B vitamins are important in metabolic activity — this means that they help make energy and set it free when your body needs it. So the next time you're running a race, thank those B vitamins. This group of vitamins is also involved in making red blood cells, which carry oxygen throughout your body. Every part of your body needs oxygen to work properly, so these B vitamins have a really important job. Great sources include dairy, eggs, fish, and peas.
--Vitamin C: This vitamin is important for keeping body tissues, such as gums and muscles in good shape. C is also key if you get a cut or wound because it helps you heal. This vitamin also helps your body resist infection. This means that even though you can't always avoid getting sick, vitamin C makes it a little harder for your body to become infected with an illness. Citrus fruits, tomatoes, and kiwi fruite are excellent sources for this vitamin.
--Vitamin D: No bones about it . . . vitamin D is the vitamin you need for strong bones! It's also great for forming strong teeth. Vitamin D even lends a hand to an important mineral — it helps your body absorb the amount of calcium it needs. Egg yolks, milk fortified with vitamin D, and liver are great natural sources.
--Vitamin E: Everybody needs E. This hard-working vitamin maintains a lot of your body's tissues, like the ones in your eyes, skin, and liver. It protects your lungs from becoming damaged by polluted air. And, it is important for the formation of red blood cells. Great sources for this vitamin include whole grains, leafy green vegetables, sardines, and egg yolks.
--Vitamin K: Vitamin K is the clotmaster! Remember the last time you got a cut? Your blood did something special called clotting. This is when certain cells in your blood act like glue and stick together at the surface of the cut to help stop the bleeding. You can find this vitamin in dairy products, broccoli, and soybean oil.

If you decide to take a vitamin or mineral supplement, according to the Mayo Clinic, consider these factors:
--Check the supplement label. Read labels carefully. Product labels can tell you what the active ingredient or ingredients are, which nutrients are included, the serving size — for example, capsule, packet or teaspoonful — and the amount of nutrients in each serving.
--Avoid supplements that provide 'megadoses.' In general, choose a multivitamin-mineral supplement that provides about 100 percent of the Daily Value (DV) of all the vitamins and minerals, rather than one which has, for example, 500 percent of the DV for one vitamin and only 20 percent of the DV for another. The exception to this is calcium. You may notice that calcium-containing supplements don't provide 100 percent of the DV. If they did, the tablets would be too large to swallow. More importantly, divide your calcium intake throughout the
day.
--Look for 'USP' on the label. This ensures that the supplement meets the standards for strength, purity, disintegration and dissolution established by the testing organization U.S. Pharmacopeia (USP).
--Look for expiration dates. Dietary supplements can lose potency over time, especially in hot and humid climates. If a supplement doesn't have an expiration date, don't buy it. If your supplements have expired, discard them.
--Store all vitamin and mineral supplements safely. Store dietary supplements in a dry, cool place. Avoid hot, humid storage locations, such as in the bathroom.
--Store supplements out of sight and away from children. Put supplements in a locked cabinet or other secure location. Don't leave them on the counter or rely on child-resistant packaging.

Vitamins are a vital part of a daily regimen by eating a good diet. Eat foods that will give them to you naturally, and supplement when recommended. Don't abuse vitamin supplements, as too much of even a good thing can hurt you. Follow a healthy routine including eating balanced meals and exercise. Taking vitamins can help, but be careful not to overdo it.

Until next time. Let me know what you think.

Health Care and Your Footprint

Even people with good health coverage are paying a larger fraction of their health care bills these days, in the form of co-pays, deductibles and other out-of-pocket expenses according to Third Age Health & Wellness. There's a direct personal interest in reining in costs, not just a societal one. According to the Miami Daily Herald online, individual responsibility and action can both set an example and make a contribution. It all adds up.

Here are a dozen suggestions for making your health care footprint a bit smaller, according to Third Age Health and reported in the Daily Herald:
1.) Develop a good working relationship with a primary care physician. A primary care doctor who knows you, your medical history and your circumstances stands a much better chance than a relative stranger of making decisions and giving you advice that will keep you healthy, out of the hospital and in no need of specialized medical care. She or he can take care of you in context.
The catch is that primary care physicians are in short supply. And primary care may be evolving into more of an ensemble approach, with the physician being the head of a large supporting cast.
In a few years, the relationship you have with the physician may be less primary than, say, the one you have with the health coach - someone who works with the physician and whose job it is to cajole, remind and motivate people to take better care of themselves.
2.) Don't use the emergency department unless absolutely necessary. Call your doctor or his service and try to get some advice over the phone - or, better yet, in person. Emergency care is fantastically expensive partly because the doctors and nurses often need to order a lot of tests so they can make diagnostic and treatment decisions quickly.
3.) Get - and stick - with the program. Most of American health care these days is devoted to treating chronic conditions like arthritis, diabetes, heart disease and high blood pressure, and to care at the end of life. Taking medications as prescribed, getting regular checkups (regular eye examinations if you have diabetes, for example), and adhering to lifestyle changes can keep those diseases under control at relatively (we stress relatively) modest cost.
4.) Don't go directly to a specialist without checking with your primary care doctor, even if your insurance allows it. Medical care is increasingly specialized, but as much as possible, you should let your primary care physician coordinate that care. If she or he doesn't know what's going on, it can lead to wasteful - and possibly harmful - over-testing and duplication of treatments.
5.) Ignore the drug ads. The heyday of pharmaceutical advertising may be winding down (remember the Dorothy Hamill Vioxx ads?), but there are still plenty of slick direct-to-consumer come-ons being broadcast and published. New drugs may have real advantages over older ones, but the virtues of the old standbys, which don't have big ad budgets behind them, often get overlooked. Older drugs are frequently just as effective (if not more so) and safer - and almost certainly cheaper.
6.) Go generic. Spending on pharmaceuticals has slowed down, in large part because of competition from generic drugs, which cost less than their brand-name equivalents. Most insurers have higher co-pays for brand-name drugs, so using generic medications can mean a cost savings both for you and for the health care system. But check with your doctor and your pharmacist about what's available as a generic. It can be confusing. For example, there's a generic form of mupirocin ointment, but as a cream, the antibiotic is available only as brand-name Bactroban. See a list of other examples of this kind of inconsistency at www.health.harvard.edu/health .
7.) Fight inertia. If you're taking a medication, discuss with your physician how long you've been taking it, whether it's working, and if it isn't, not taking it anymore. Many people take medications for years without knowing if they are helping in any way. Antihistamines, nasal steroid sprays and antireflux medications are prime candidates for this sort of pharmacological inertia. You can avoid this problem by talking to your doctor about a trial period when you start a drug. Get some instructions about signs that would show if the drug is working, and see the doctor if it's not.
8.) Screen the screening tests. Screening tests can save lives by catching a disease at an early, more treatable stage. But a screening test can also cause a lot of mischief: false alarms, a false sense of security if a disease is missed, and unnecessary diagnostic testing and treatment. There are more doubts about some well-established screening tests than many people realize. For example, many men believe they must get the prostate-specific antigen (PSA) test for prostate cancer. Not so, say the federal government's prevention guidelines, which characterize the evidence as insufficient to recommend PSA testing. And in 2008 the guidelines were revised to say men ages 75 and older shouldn't get a PSA test. These are just guidelines: Men need to discuss the pros and cons of PSA testing with their doctor - with the clear understanding that they are entering a gray area.
9.) Question the need for expensive tests. Don't push to get new, expensive tests just because you think new is better. And if a doctor orders an expensive test like an MRI or CT scan, you can ask why it's necessary and how it will make a difference. The number of imaging tests being done in the United States has exploded, and by some reckonings almost a third of them are unnecessary. Some tests, like CT scans to evaluate coronary artery disease, are being debated because it's unclear how much they really add to standard tests. Health care experts Ezekiel Emanuel and Victor Fuchs have pointed out that the hospitalization rate in the United States is actually lower than in many European countries. We also go to the doctor less often on a per-capita basis. It's the expensive inputs into our health care - all the drugs, tests, high-tech treatments, highly compensated specialists - that drive up the collective medical bill, not so much the volume.
10.) Wait, and it may go away. Often it's critically important to get medical care straightaway. Prompt treatment of a heart attack or stroke can save your life or prevent devastating disability. But people frequently get tests and treatments for aches, pains and other discomforts that might have gone away on their own because the illness-producing stress of work or school lets up, for example, or the immune system fights off the infection. If you are feeling sick, by all means get evaluated, but if your doctor suggests the test of time, take the test.
11.) Discuss end-of-life issues with your family and physicians. Medical care near the end of life is a big-ticket item. Roughly a fifth of the money that Americans spend on health care goes for care in the last year of life. Living wills and advance directives don't necessarily save money - people sometimes want more care, not less, as they become more frail - but they may help. And so may talking about your preferences. A study published in The Journal of the American Medical Association in 2008 found that cancer patients who had discussed end-of-life care with their physicians received hospice care sooner and had lower rates of ventilation, resuscitation and admission to an intensive care unit. Because they talked to their physicians, these people were treated the way they wanted to be and avoided a waste of precious resources.
12.) Stay healthy! Not needing health care is perhaps the surest way of spending less money on it, both yours and society's. So don't smoke, and get help quitting if you do. A good diet (replacing refined starches with whole grains and lots of fruit and vegetables) will lower your cardiovascular risks. Exercise helps with - well, you name it. Sleep is fast becoming the third pillar of wellness. Studies have shown that averaging eight hours a night may prevent colds and keep arteries open.

The buzz word today is "footprint" when it comes to totaling up how much space you take up on the planet. Much of the discussion is focused on environmental concerns, but Americans must be conscious of their health care issues related to costs of benefits, use of facilities, economics of care, and other needs. Providers must spend resources to care for patients, insurance companies must compensate for coverage when claims are submitted, and taxpayers are on the hook to pay for the uninsured in many cases. The U.S. is still a long way from controlling ever increasing health care expenses. The bottom line is that individual expenses increase due to labor, governmental mandates, research, medicine, and other ongoing natural costs of doing business, health care will continue to be more and more expensive for everyone. As all these issues aggregate together as part of what it takes to manage health care, there will always be an uptick in the cost of health care.

However, through proper case management, effective treatment, patient advocacy, multiple options through consumer directed healthcare, increased efficiencies through new HIT technology, transparencies for cost of care, discount health plans, and more inventive techniques to control expenses, individuals and families have a reasonably strong chance to avoid bankruptcy due to medical bills. Knowing how to be a smart health care consumer will help advance your personal case as well as having a positive affect on the total population. Reduce your health care footprint by taking charge of your own personal health.

Until next time. Let me know what you think.

Health Care and the Stimulus

The US Federal Government has just recently passed the largest economic stimulus package in history. The bill was a gargantuan hodgepodge of our tax dollars thrown into various markets to try and stimulate spending, credit, and other economic channels. However, with all the hoopla, conversation by endless talking heads, and media attention over all the hundreds of billions of promised government bailout money, little has been said as to who will get what. What we do know is that our children and grandchildren will be choking under the burden of paying for it for decades to come.

Part of the stimulus bill was devoted to health care. According to MastersInHealthCare.com, a list of the Top 10 aspects of the bill concerning health care can be found on their site--(http://www.mastersinhealthcare.com/blog/2009/10-things-you-need-to-know-about-the-healthcare-stimulus/). One of the principal goals of the package is to reform the health care system while creating jobs and insuring more Americans. Through measures to support the unemployed, integrate cutting-edge information technology systems into medical networks, and insuring more children, the act may in some way affect how you receive health care. Here is the overview:

1.) Health care industry set to go tech: One of Obama’s umbrella strategies for reforming health care and stimulating the economy involves pumping money into health care technology systems. He hopes to create a health information network for hospitals, rural and urban clinics, and other health care centers by making all medical records electronic; making existing medical technologies more accurate and effective; and reducing errors in medical care. This technology boost to the health care system will, Obama hopes, save money, create jobs, and improve the standards and delivery of health care and medical information. The Dallas Business Journal reports that the stimulus package will invest $19 billion for health information technology.

2.) The unemployed will still receive health care benefits, at least temporarily: Obama plans to ease the burden of health care costs for the unemployed and reduce the number of uninsured Americans by extending Medicaid benefits to the unemployed, at least for a time. Individuals who get unemployment checks would also be able to receive Medicaid, as would their spouses and children who are under the age of 19, reported the New York Times in January. States will receive federal aid to help ease Medicaid costs. In late February 2009, TheState.com reported that Obama "released $15 billion in economic stimulus Medicaid funds for states" to disperse.

3.) Children’s Health Insurance Program Reauthorization Act of 2009: The Senate and House reformed the Children’s Health Insurance Program under this legislation, which extends insurance to nearly 4 million more children by reworking the Social Security Act. The program will help families of low-income children who do not qualify for Medicaid pay for their health insurance, and states will still be able to set their own income eligibility requirements. The program is funded by a tax increase on cigarettes.

4.) Governors hold power over releasing funds: While the federal government has designed and approved the health care stimulus package, governors are in charge of actually releasing funds, creating eligibility requirements when appropriate, and overseeing the implementation of the stimulus plan in their states. In late February, governors like Louisiana’s Bobby Jindal (R), opposed many parts of the economic plan and may reject at least some of the money that is coming to their state from the federal government. The New Orleans Times-Picayune reports on Nola.com that Jindal will most likely accept the Medicaid supplements, but according to Medical News Today, other governors are begrudging about accepting funds that are meant to be used in a specific way. Instead, governors like New Hampshire Gov. John Lynch (D) are arguing for more flexibility in how they disperse the federal funds.

5.) Federal government helps states fund COBRA for unemployed: The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives individuals who are laid off, retired, switching between jobs, or have dependents at the time they stop working the option to continue their group health benefits for a limited time. Some beneficiaries may have to pay for the group rate insurance, however, but the U.S. Department of Labor holds that "COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage." Under Obama’s stimulus plan, the federal government will provide states with subsidies to help offset the costs of COBRA. They will pay for up to 65% of COBRA premiums "for eligible workers who are involuntarily terminated," according to the accounting firm Amper, Politziner and Mattia. Qualifying workers include those who have been involuntarily terminated on and after September 1, 2008, and qualifying employers include those who are subject to COBRA legislation, as well as small employers who are subject to State Continuation legislation.

6.) Job training funding for those entering health care industry: In another measure to stimulate the economy while improving health care standards, Obama plans to increase job training opportunities for those entering the health care industry. The stimulus budget has allotted $750,000,000 "for a program of competitive grants for worker training and placement in high growth and emerging industry sectors," $500,000,000 of which will go to renewable energy programs. The rest will be distributed by the Secretary of Labor "giv[ing] priority to projects that prepare workers for careers in the health care sector."

7.) Preventive care takes precedent: In his address to Congress in February, Barack Obama outlined the promised benefits of his economic stimulus benefits, highlighting the fact that the health care reform boasts "the largest investment ever in preventive care, because that is one of the best ways to keep our people healthy and our costs under control." According to a report by NPR, this move would also create jobs, at least in the short term, even if it did not result in sustainable medical research projects, as hoped.

8.) A contract for accountability: In order to promote accountability in health care reform and to make sure that all of this funding is actually helping the economy and the health care industry, Obama’s plan includes a contract between the federal government and the Institute of Medicine. The stimulus package outlines that the $1.5 million contract will require the Institute to "produce and submit a report to the Congress and the Secretary [of Health and Human Services] by not later than June 30, 2009, that includes recommendations on the national priorities for comparative effectiveness research" that will eventually be subjected to public commentary and review.

9.) Health IT dominates in all areas of medical industry: The stimulus package lists several ways in which new health care information systems and technologies will help the facilitation of medical care and the industry as a whole. These include the exchange of patient medical records and a subsequent reduction in wait times at hospitals and health care facilities; the increase of telemedicine technologies for those living in rural areas and who do not have access to cutting edge medical resources; "technologies that help reduce medical errors;" and "technologies that meet the needs of diverse populations."

10.) Total health care stimulus cost: $150 billion: The total cost of all these (and more) health care reforms under the American Recovery and Reinvestment Act of 2009 is $150 billion, according to the Dallas Business Journal, including $17 billion for Medicare and Medicaid incentive programs, $2 billion for technology grants, and $19 billion for a health information technology movement.

According to an article on Bloomberg.com by Betsy McCaughey, former lieutenant governor of New York and an adjunct senior fellow at the Hudson Institute, there are hidden issues that need more exploration and evalution in the health care stimulus package. The bill’s health rules will affect “every individual in the United States”. Your medical treatments will be tracked electronically by a federal system. Having electronic medical records at your fingertips, easily transferred to a hospital, is beneficial. It will help avoid duplicate tests and errors. But the bill goes further. One new bureaucracy, the National Coordinator of Health Information Technology, will monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost effective. The goal is to reduce costs and “guide” your doctor’s decisions. These provisions in the stimulus bill are virtually identical to what Tom Daschle prescribed in his 2008 book, “Critical: What We Can Do About the Health-Care Crisis.” According to Daschle, doctors have to give up autonomy and “learn to operate less like solo practitioners.” Keeping doctors informed of the newest medical findings is important, but enforcing uniformity goes too far.

Also, the report goes on to talk about penalties. Hospitals and doctors that are not “meaningful users” of the new system will face penalties. “Meaningful user” isn’t defined in the bill. That will be left to the HHS secretary, who will be empowered to impose “more stringent measures of meaningful use over time”. What penalties will deter your doctor from going beyond the electronically delivered protocols when your condition is atypical or you need an experimental treatment? The vagueness is intentional. In his book, Daschle proposed an appointed body with vast powers to make the “tough” decisions elected politicians won’t make. The stimulus bill does that, and calls it the Federal Coordinating Council for Comparative Effectiveness Research. The goal, Daschle’s book explained, is to slow the development and use of new medications and technologies because they are driving up costs.

Additionally, according to Bloomberg.com, seniors in the U.S. will face similar rationing. Defenders of the system say that individuals benefit in younger years and sacrifice later. The stimulus bill will affect every part of health care, from medical and nursing education, to how patients are treated and how much hospitals get paid. Hiding health legislation in a stimulus bill is intentional. The health-care industry is the largest employer in the U.S. It produces almost 17 percent of the nation’s gross domestic product. Yet the bill treats health care the way European governments do: as a cost problem instead of a growth industry. Imagine limiting growth and innovation in the electronics or auto industry during this downturn. This stimulus is dangerous to your health and the economy.

According to Medscape Medical News, the aim is not simply to provide relief but stimulus, with the hope of making the road to recovery less long and winding for some things that will move reform ahead. Those things include significant new appropriations for comparative effectiveness research, health information technology, and prevention and wellness.

According to National Review Online, this stimulus bill is the biggest land grab in the health sector ever attempted by the federal government, and it would be a major step toward thrusting full responsibility for health-care financing onto the American taxpayer—today and for decades to come. Also, there will be a substantial burden on employers: The bill would impose a back-door mandate for them to continue providing health insurance to workers long after those workers have left. PricewaterhouseCoopers says the ten-year cost of this provision would be up to $65 billion just for those workers currently eligible for COBRA (the current program through which people can participate in ex-employers’ health plans). The estimated costs would be even higher if many more workers retire early, as they likely will if they know they can continue their employment-based coverage indefinitely. The U.S. already spends $2.2 trillion a year on health care.

Americans must be vigilant where our tax money is spent, especially for health care. Bigger is not always better.

Until next time. Let me know what you think.