Who can pay even with insurance?

…Sarah Rubenstein (WSJ, June 16, 2008), says the Center for Studying Health System Change has concluded that an increasing number of people who have insurance are delaying health care because the fees they do have to pay are too high.

…No kidding! Hello?

…They surveyed 18,000 people with insurance, and 20% had put off treatment in the last year, as compared with 14% the year before.

…Even people with employer-provided insurance have shouldered more bills in the form of large deductibles (the amt people eat in cash before the insurance starts paying) or large coinsurances (the percentage you owe of the bill).

…Copays at the doctor’s office can also be a factor discouraging treatment. It is for HA--$35 is money in her world (this on top of the $700 a mo for the insurance and the $3,000 deductible).

…Either these costs have reached a tipping point at which consumers simply stop going or the feeble economy is the reason—they are not sure.

…The uninsured—now a whopping 38%--often go without treatment, foreseeing a bill in the hundreds or thousands. But now a lot of those with insurance are priced out of the market.

…One guy in the story sliced off half his thumb, but turned down the multi-$$$ helicopter ride to have it reattached, settling for $5100 in cleanup—of which he was socked with $1400.

…HA was in the ER on Memorial Day and left rather than spend the night waiting around for a specialist to come in (they are supposed to come…big “supposed to”). The staff threatened her with paying full price for all tests she had had if she left.

…She is still in discussions with the hospital. Seems like she saved the insurance company money, so they should not screw her.

…Oh, what is she saying…insurance company!

Older women and yoga

….HA is officially the Tin Woman some days. Yet, in the Wayback, she did yoga six times a week (the swami was very cute, oh, shut up, she knew he was a swami).

…Jeannine Stein, LA Times, Apr 14, 2006, writes about a small study at Temple that looked into whether a nine-week Iyengar yoga (http://www.iyengar-yoga.com/iyengaryoga) regimen could benefit women over 65.

…Twenty-four women participated and the research showed an increase in their walking speed from 1.04 meters per second to 1.09. Stride lengths went from 1.11 meters to 1.16 meters on the left foot…oh, whatEVER, what is with the metric system all the time?...stride lengthened a measurable amount.

…More importantly, range of motion improved and the women could stand on one foot longer, meaning balance had improved.

…All this contributes to preventing falls. A lot of people HA knows are toppling over these days.

…Maybe some yoga? Depends on how cute the swami is.

…HA freely admits headstands are now out.

Do you ever forget your medical past?

…Connie Midey, writing in the Arizona Republic (June 24, 2008), talks
about preparing a medical packet.

…HA thinks all the time she must do this—must do it—always in future tense. For herself, for her mother.

…It is also good to do this for your kids, even the ones in college.

…HA knows of people who keep this on a memory stick, which supposedly ER docs could plug into a computer. HA has her doubts about that happening, but it’s a nice idea.

…Your packet should contain meds you are taking, allergies, blood type, emergency contacts, living will, medical power of attorney, insurance info and anything else you can think of. Also mention any big condition you have such as heart disease or diabetes.

…If it’s a notebook—mark it with a big Red Cross. The idea is that paramedics may scoop it up.

…One hospital here in AZ distributes a big old yellow envelope for this info. There is a matching sticker for the fridge door—assuming paramedics would look there.

…At very least, you can take this with you to the ER if you are going consciously. Whether emergency personnel would find it is, to HA, questionable.

….Have you tried anything like this? Share! HA really must get to it.

How sweet life can be

…HA loves a book called Candy and Me (A Love Story) by Hilary Liftin. Enter “candy and me” on Amazon.com.

…Liftin, whom HA once interviewed, tells her life story through the deeply meaningful candy she discovered and enjoyed along the way.

…Associated Press’s Martha Irvine is also writing about candy during our little recession here. People are staying home, clipping coupons, chasing discounts—but still having their candy.

…Americans buy billions of dollars worth of candy a year. Candy, left’s face it, is a cheap vice.

…In fact, it’s considered recession-proof.

…Gas tanks, $100. Candy bar, one buck.

…In the Depression, candy was jokingly compared to real food. There was a bar named Chicken Dinner.

…Often people buy candy at the gas station, though, so sales are down. The big candymakers are consolidating.

…Remember Root Beer Barrels and orange slices? Those peanuts that tasted like banana?

…Liftin’s favorite is Bottle Caps—her husband even put her engagement ring in a box. And there was 15 lbs of candy on each table at their wedding.

…She once told HA she was worried about having kids and dealing with Halloween. Could she do it?

…Hope the little tykes are strong or Mom is getting that bag.

ZAP!

…Each year, 50 people are—literally—struck my lightning. Killed!

…Summer is instant death time. There are more thunderstorms and people are outside more.

…Even if you survive a lightning strike, it’s like being a little electrocuted—you can have chronic pain, brain injury, and mental problems. Oh—and sleep disorders, memory loss, numbness, dizziness, stiff joints, depression and the inability to sit for long.

…Do you know what to do if you are out in a lightning storm? A quarter of those struck were under a tree—so don’t go there. Another quarter were near water—so get away from water.

…Lightning can also be tricky—it can strike far from where you see rain coming down.

…The rule is: When thunder roars—go indoors.

…If you are outside, try to locate a building nearby.

..If you can’t find a building, find a hardtopped car, bus or truck.

…Keep away from non-cell phones, computers and video games.

…Lightning comes snaking in on a phone line sometimes. Or the cable.

…When the lightning subsides wait 30 minutes before resuming your activities or going home.

…For some reason, people often get hit my lightning more than once in a lifetime. Makes ya think.

Wacky quackies

…Writing on Bloomberg.com, Justin Blum says the FDA has told 25 companies and people to stop making fraudulent claims for their pills, teas, salves, and creams to
”cure” cancer or other ailments.

…Herb Time of St. Augustine and Ageless Cures of Houston were among the companies cautioned.

…The big danger is not that these weird herbs and shark innards and other substances don’t work (they don't), but that using them will cause people to forgo more effective approaches.

…There have been no deaths or injuries from the 125 products covered by the warning letters—the FDA is “just sayin.’”

…BUT—these products also have not been FDA-approved. If the companies don’t comply, the stuff could be seized and the owners prosecuted.

…In one example, a skin cream (P.D.Q.) was advertised for skin cancer—with the claim, No Failures. Apparently, the makers claimed the cream upped the immune system to dissolve the skin cancer.

…Another, C-Herb, also supposedly removed cancers and warts. AND warts?

…Now—HA wants to know—what the heck are those little pads you put on the bottom of your feet and they turn all black? She has socks that do that.

Placebo this!

…In the Spring 2008 issue of Univ of Chicago Medicine on the Midway is a story on how some doctors are passing the sugar pills to patients in the hopes that their belief in this “cure” will help.

…231 docs were surveyed—half had prescribed placebos.

…Now this part is really wacky, if it is to be believed. Supposedly, a third of those recommending fake medicine said, “This is substance that may help and will not hurt.” Nine percent said it’s “medicine with no specific effect.”

…They justify this because the human mind is so strong it can sometimes talk people into feeling or being better.

…HA also read about some placebos for kids some parents have concocted and are selling. The theory seems to be that small children demand medicine and need to be satisfied with bogus elixirs.

…HA has enough reservations about the doctor-patient relationship in this, the first decade of the 21st century. Thinking of these people trying to fake her out and pharmacies stocking M&Ms or whatever as medicine…well, don’t ask.

...Or maybe we should. Ask, that is. "What is this stuff, doctor? Fake or fabulous?"

...Get a name. Look it up. Ask the pharmacist. Something!

Outside! Why didn't anyone think of this before?

…Alana Samuels, LA Times (June 18, 2008), says people are broke, gyms and gas are expensive—and oh, what to do?

…Some people have come up with the idea of hiking or exercising in the park.

…Out LA way, anyhow, there are even free yoga classes in the park—or tai chi.

…A lot of trainers say people have bid them adieu—the industry is hurting.

…The writers strike also dampened the exercise ardor in H’wood.

…If you still like the gym, see if they are dealing. Many are lowering fees.

…The (pumping) irony is people are more stressed economically and when you are stressed, exercise helps.

…Also people are walking or biking more—making the treadmill less necessary.

…Anyway, said one hiker, this way you can see new things every day.

Stick it to ya

…HA’s favorite bumpersticker is: My other ride is your Mom.

…She laughs every time.

…Writing in the Washington Post, Shankar Vedantam says they did a study at Colorado State showing that bumperstickers, vanity plates, and other “territorial markers” can denote a driver who is likely to to respond to slowness or bad signals with tailgating, honking, and other road rage approaches.

…Recently, out here, a pregnant woman driving with a guy got furious with an older woman in the car with her grandkids, followed them, and the guy shot the grandmother dead and injured the kids.

…Strangely, even the nice stickers—World Peace, My Kid is an Honor Student—denote territorial intentions and can signal trouble.

…People with no visible markers on their cars still fume, but the researchers found they did not tend to act up or you know, murder people.

…HA guesses the stickers are saying, “Look at me. I have opinions. I demand respect and obedience.”

…When they don’t get the above (and who does?), Wham!

…Probably “My other ride is your Mom” might even be a tad in-your-face.

May not be a romp in the park

…HA has a confession to make. She loves those small claims court shows—Alex, Joe and Judy.

…Several times, recently, the cases have centered around a dog let loose in a dog park and attacking or being attacked—and potentially endangering humans nearby.

…Writing in the Arizona Republic (June 14, 2008), Chelsea Schneider says taking your dog to the run-free park takes some planning.

…She quotes a dog trainer saying some dogs don’t want to be around other dogs, despite what you have heard about their propensity to run in a pack. They are picky about packs!

…Puppies, especially, should not be taken off the leash and shoved in the park.

…Even if your dog is fine around other dogs at home, the park might be a different story.

….If your dog looks stressed, the trainer said, he or she might not be dog park material. One little cocker took a look at the other dogs and took off running, followed by 20 dogs chasing. How would you like that?

…Also dog parks are no substitute for a regular walk or structured exercise. “They are Disneyland,” the trainer said. You don’t go to Disneyland every day.

…Seriously, do you think Judge Alex is kind of cute?

Recession forcing nurses back to work

…A few years ago, all we heard about was the coming nurse shortage. The nurses were retiring, hospitals would have to close, and so on.

…Now, with food and gas prices soaring, nurses are coming out of retirement or getting more shifts, according to Conor Dougherty (WSJ, May 7, 2008).

…Still, nursing schools have limited capacity and are turning people away. Analysts say if the economy picks up, nurses will disappear again.

…For now, hospitals are offering bonuses, recruiting overseas, and letting nurses write their own tickets.

…Hospitals also organized lift teams, so older nurses don’t have to horse patients around and injure themselves.

…If you are a nurse thinking of getting refresher training or a person thinking of entering the field, make sure your school is accredited. Many fly-by-nighters are willing to take your borrowed money, but then you can’t get a job.

…One hospital said a recent grad of one of these could not even put on a Band-Aid.

Working dogs

…This seems to be the rage—pooches next to the desk. HA loves her dog Jim, and yes, he lies on a pillow by her desk most of the day.

…But he also starts barking when she is on the phone. Or goes to the door and sees two molecules of air or something else only dogs can object to and starts carrying on.

…Scientists and doctors she is interviewing have one of two reactions: “Oh, what kind of dog is that?” or, “Is that a DOG barking?” The former get excellent press.

…HA works at home, though. Seventeen percent of workplaces, apparently, allow dogs to come to the office.

…June 20th is Take Your Dog to Work Day. Yes, there is such a thing.

…Some companies, according to Newsweek, are er, “putting on the dog,” with boneshaped cakes and doggie masseuses.

…If you have a dog allergy, HA guesses your barking will go unnoticed.

…Even at the most dog-lovin’ offices, unhousetrained or molecule-annoyed dogs like Jim get fired.

…Another piece of advice HA read is don’t leave your dog alone in the office with other dogs. Nuh-duh—ever heard the term “hostile takeover”?

…Biting the boss would also be a huge mistake dogwise.

…PS. HA also has three cats, but they show no interest whatsoever in boosting her morale, although one does like to jump on the desk while HA is interviewing sources and knock the pencil out of HA’s fingers.

…She’s the one with the sense of humor.

What you can do with this paper

……On Trisha Torrey’s blog, Every Patient’s Advocate (http://trishatorrey.com/), HA learned about a program being offered to doctors by a company called Medical Justice.

…These geniuses like to call it “a vaccine against libel.” HA likes to call it blackmail or censorship. Don’t sign, don’t see the doc.

…The way it works is patients sign a form promising not to make any comments on any website—good or bad—about their experiences with a doctor. Presumably this includes those many, many doc-rating websites.

…Why a doctor would need this company to do this, HA has no idea.

…They are hazy on what will happen to the patient if he or she does make observations about medical care they received, but the company seems to be telling docs this will protect them against patients who can go to urls and type things.

…Would you sign this? Isn’t all that HIPAA blather enough?

…Oh, people will sign.

…HA goes to doctors’ offices all the time where everyone sits there passively waiting for the healer to usher them in. They probably don’t go to blogs, most of them. Recently, a person passed off a questionable doctor action to HA with, “They are the professionals.”

…Hard to fight that system. But HA will never sign. To her, this is like giving all the blood in her body. Bad idea.

With fava beans and a nice you-know-what

…Gary Allen is a foodie. He loves food. Cooks it. Writes about it. And has the coolest monthly newsletter of food sites you can get (drop him a note at gallen@hvi.net).

…But his little nephews like to tell their friends he’s a cannibal. They they run away.

…Gary is not a cannibal, but he has spent many hours musing on the language and customs of man-eat-man.

…And now, he and Ken Albala have published an anthology of cannibal lit they call Human Cuisine. Check out: www.hvinet.com/gallen/HC.html.

…Like most taboos, this one has been deeply embedded in the language and folklore of every culture. HA particularly likes the pair's rundown on language.

…We no longer tear into our enemies with our teeth (most of us) or try to swallow their essence or bravery. Instead we “roast” them, “rake them over the coals,” and “lambaste” them.

…People are left to “stew in their own juices,” “fry in their own grease,” or become “dead meat.”

…In trouble? You are in “hot water.” Or someone may make mincemeat of ya or have you for breakfast.

…This is the tamer stuff from the book. How far you go with this depends on your “tastes,” but way to go, Gary—at least you got this done! To a turn.

Double trouble

…Don Mueller, PhD, is a physicist who enjoys enlightening people about issues in science and health.

…To create new neural pathways and have a few laffs, he taught himself to play tennis with two hands at the same time.

…Check out: http://drbonesshow.com/links/ambidextrous-tennis.html.

…He even serves with a racket in each hand. He tosses the ball with one, he told HA, then delivers it with the other.

…He has at least one fan, who writes: “So cool!” The player said she tried it and it was extra weight (second racket) but no more than a newer, heavier racket would be.

…He also calls this "two forehand tennis"—easier on the elbows, he maintains.

…If anyone tries it, check back in and let us know how it went, OK? HA’s tennis days are behind her.

…Way back there someplace, her family had a court and people wore white and drank spritzers after from a silver salver.

…Oh, forget the salver. She made that up.

…Also, HA is pretty sure there are rules about how many rackets you can use—so this is just a retrain your brain thing unless you can get your partners to bring a second racket.

Child seat--back and center

…Yipes! HA did it wrong the whole time.

…According to a study in Pediatrics, parents often place the seat on either side of the backseat, since it’s easier to heave the tot into place.

…Not good, say researchers at the Univ of Pennsylvania.

…GM and For provide anchoring systems in the center rear, they say. If this doesn’t work on a Graco or Evenflo seat, sometimes seatbelts can be used to hold the seat in the center.

…Some seats fit in the center and some don’t.

…Just having the child in a seat can cut fatalities by 71% for infants and and 54% for toddlers.

…The lowest risk is in the seat in the center.

…And the little ones, under a year, should face backwards.

…Even as they grow, keep them in a safety seat of some sort until they are 4’9” or the seatbelt fits properly. And for all kids under 13—backseat only!

…HA knew that backwards thing, but sure blew the center idea.

All gone--already?

…Writing in the AZ Republic (May 29, 2008), Cathryn Creno says you’re right—the Cheerios box is a little on the light side these days—a lot of products are being offered in the same size box, but you are getting less for your money.

…They call it “package shrink” (those word merchants).

…Ice cream cartons contain 1.5 quarts instead of 1.75.

…Soap is smaller.

…”Right Size, Right Price” is the General Mills cereal promo—meaning less cereal, more bucks, HA guesses they mean right for them, not us.

…Wrigley gum is going to contain 15 sticks, not 17.

…Shamrock Farms’s organic milk’s largest bottle is ¾ gallon, not one gallon.

…The price is for a gallon, though.

…For some people, the big discount places like Costco are the answer, but one woman said she was throwing out all the extra and buying smaller amounts locally was saving her money.

…A variation is the double strength detergents. They save the money on packaging. You have to be sure to put in half as much.

…To all this, HA says. “We are not dumb, we are not morons, but we are busy and we need to eat stuff, so straighten up. At least be honest.”

..The least they could do is put a banner on the package: "New smaller size.
Contents less likely to go stale."

...I know--HA has a rich fantasy life.

Splish splash

…HA is a quickie person--two short showers a day. Living in Sweat City, USA (Phoenix), you need to rinse but also to conserve the old haitch-2-oh.

…In the April issue of Allure, we learn that 22% of American women hop in twice a day.

…27% of men do.

…The first bathtub was excavated on Crete in 1700 BC.

…By two centuries before Christ, there were 5 bath houses per block in Rome.

…When Rome fell 600 years later, bathing decreased all over Europe (no jokes, we are friends with them now).

…In 1927, in the US, cleanliness began to be pushed in schools.

…92% of people say they wash their hands after using the john, but only 77% do.

…And 2% have obsessive compulsive disorder and don’t stop washing.

…Since 2002, hand sanitizer sales have tripled almost.

…Only 60% of people change their undies everyday. OK—TMI, sorry, HA just reports, not judges, but ewwww.

…It takes eight hours for skin to recover moisture after soap is used.

…60% of women prefer a long shot shower to TV (sure, the kids are near the TV).

…In 1907, came deodorant. And our lives were changed forever. At least on the subway.

I never eat. You?

…Writing in Allure (April 2008), Rory Evans explores the phenom of women who won’t order “fattening” food if anyone else at the table is ordering a low-cal entrée.

…HA’s mother used to do this before she sort of lost the thread to dementia—she would pointedly order something low-cal so that HA would somehow follow suit. HA's mother would not eat bread or meat. So of course, HA always got a steak sandwich.

…But apparently, not everyone is such a crazed rebel.

…Evans talks about women who all order the chicken Caesar with dressing back because each is afraid to select something more caloric and appear to be the “fatty,” as one gal charmingly put it.

…If one woman picks and leaves the potatoes behind, chances are all the women at the table will do the same.

…It is no accident, Evans says, that the last piece of anything—cake, for instance—is called “the old maid’s portion.” If you snag it, you are doomed to Sudoku for life.

…Hunger has nothing to do with it. Even if they fasted (in a study), women who had not eaten would pick if their girlfriends were not digging in.

…Care to guess what happened after these dainty meals? The women went home and grazed through everything in the house.

…The best story was of two fashion editors side by side in a plane to Europe. When one did not eat the airline meals, the other also waved it off. The funniest thing, though—each did it because the other did. They were both hungry!

…A recent study showed that women with an overweight friend, even if they don’t live in the same city, tend to be more accepting of their own added pounds. But this can work the opposite way, too—if one friend goes on a diet, the other will.

…Remember this if you're watching to see if your friends order a Cosmo or ask for the dessert cart: Monkey see, monkey do.

…One banana won’t kill ya.

Scientists do the unlikeliest things

…Chris Morgan, McClatchy Newspapers, says scientists have discovered that alligator blood kills bacteria, including some resistant kinds.

….Researchers at LSU and McNeese State Univ say it will take years to prove out, but that “gator aid,” as they called it (heh), might be OK for human use.

…Something has kept these guys alive for 80 million years. Could be it be a grrr-eat
immune system?

…Alligators lead a violent lifestyle, ripping parts off each other creating wounds that could then become infected. Supposedly, this has helped rather than hurt them—made them stronger, in other words.

…Do not try this limb ripping thing at home—this is alligators we’re talking about.

…HA was a little insulted to see the author of this saw fit to inform us that we could not set up gator-to-guy transfusions and that crocodilian peptides would be studied and perhaps synthesized.

…Good to know. HA was visualizing two cots side by side, one kinda wet and muddy.

Don't rush to the surgeon

…Ranit Mishori, MD, writing in Parade (USA Today Weekend, May 25, 2008), says more than 70 million Americans face the knife each year. Not all of those surgeries are necessary.

…”There is always the possibility that something can go wrong when someone sticks a sharp blade in your body,” notes Mishori, with a colorful flair for the turn of phrase that HA cannot help but admire.

…Sometimes less-invasive (knifey) options should be tried first.

…Take knee surgery, the doctor says. More than 13 million Americans suffer from osteoarthritis of the knee. Many doctors try ani-inflammatories, physical therapy or injections into the joint.

…But, alas, one in four will still be candidates for surgery. This is successful sugery—90% of patients are helped.

…But Mishori is no fan of arthroscopy—the less invasive form that does not replace the joint or parts of it, but smooths off the bone surfaces. Here, he says, the placebo effect may lead patients to think their knee feels better. He even talks about “sham” surgery in which only one little cut is made and basically nothing is done. (Please bring whoever does that over here so HA can start the slapping.)

…Back surgery is another tricky one. Ninety percent of “slipped disk” people will get better over time. It may take 6 weeks to 12 months of rest and medication, but it will happen.

…Surgery may be required for spinal stenosis, in which the nerves of the spinal cord get squeezed.

…Sinus surgery is another one that gets recommended all the time. Surgery for inflamed sinuses is controversial. If you are a mess for 12 weeks or more, it might be an option.

…Your eyes and brain are close to those sinuses, Mishori notes. Check out your surgeon very carefully.

…This is elective surgery. You are electing, or deciding. Find out, at very least, what the downside of waiting is.

…No one is exactly the same after surgery. Stuff has been cut, even thrown out (HA has no lens in her eye now). Ideally, what is left works better. Try to be sure it will.