Friday, March 24, 2017
It's that time again.
Still, allergist Stephen Tilles, MD, president of the Am College of Allergy, Asthma and Immunology (ACAAI.org), says there are some simple ways to make allergies more bearable.
Spring cleaning. Sweep away the cobwebs, do some deep scrubbing (mold, pet hair). Vacuum pet beds and wash their bedding often.
Pollen. Two-thirds of those with asthma have an allergy...conversely, your "allergy" may be asthma. If you can't get rid of a cough or are short of breath, get checked for asthma.
Clear the air. Do NOT get an ionic air filter. The ionization makes particles stick to the wall or any surface, where you will pick them up anyway. Also--the produce ozone, which can create problems. Instead, get a HEPA room air cleaner rated with Clean Air Delivery Rate (CADR). Central air? Change your filters every three months and used filters with a MERV rating of 11 or 12.
Fresh air. Forget it--don't open windows and let the spring come in. Turn on the AC with the new filer you just put in.
Also forget Dr Google. Sneezing a lot--ask an allergist. There are medications, even shots, that can help ease your suffering.
The Old Wives did not know everything.
Thursday, March 23, 2017
Three-quarters of Americans have seen their health costs rise and not go down--so for many, this means avoiding medical care.
---One in five Americans avoid going to the doctor because of the cost--this includes 56% of people without insurance and 27% of Millennials.
--Forty-nine percent say they don't have enough info on what things will cost to determine what they will have to pay. A broken arm? Almost half of those asked said it would cost them under $500--the real cost, almost $1200. (And that is probably with insurance.)
--In 2015, 41% of Millennials asked for a cost estimate--but only 21% of Boomers and 18% of seniors. HOWEVER--34% of the time, the final bill was higher than the estimate.
Strapped Americans also are not saving for health care. Only 32% contribute to a Health Savings Account.
Bottom line: People who could not afford an unexpected bill over $100 without borrowing--37%. If the bill were more than $2,000 77% said they would have to borrow.
And now--we have a health proposal to make this worse. It's sickening.
Wednesday, March 22, 2017
First, they found the fear of losing a job to a robot is real. This is a "substantial portion" of the American population--37%--identified as technophobes.
Technophobes, according to this study, are very afraid or just afraid of robots in the workforce, decision-making robots, and technology they don't understand, such as artificial intelligence.
--Women, non-whites, and women report being most phobic.
--Technophobes are three times as like to fear losing their jobs, and three times as likely to fear not having enough money in the future.
--Technophobes also are 95% less likely to be able to stop or control worrying.
All this is published in the Social Science Computer Review.
But isn't automation going to cause unemployment? Mark Cuban said it was. Bill Gates, also no dummy, said robots should be taxed and the money used to retrain people (presumably for jobs robots don't want--notice how intelligent I made them there?).
Fear of automation is not new, of course. People said cars would not catch on.
But it's coming on a scale we have not seen.
Visionaries may see blue skies ahead with more leisure time and fabulously fulfilling, non-routine jobs for people.
But--the fear remains--and maybe it is realism and not mental illness. Think?
Tuesday, March 21, 2017
|Just another day for someone with afib.|
But over a decade ago, a doctor discovered I had irregular heartbeat--known as atrial fibrillation. One in five Americans have it--my brother does, also a maternal aunt. For once, this is not related to being fat!
Basically, this is when a clump of regulating cells near the heart go off track somehow and cause the heart to beat funny. One doctor kept referring to mine as my "hippety-hoppety heart."
This funny beat, in turn, can cause blood in the upper chamber of the heart to get sort of churned up into a clot that can travel to other parts--and cause a stroke. People with afib, as they call it, have a greater chance of a stroke as those with "normal sinus rhythm."
Some people get a fluttery feeling and are "in" afib for a time, then revert to normal. Others--like me--are always in afib. My pulse is sort of like BEAT BEAT...Slidy slurry BEAT...PAUSE...BEAT....
At first, they put me on a med called amiodarone to regulate the beat. This drug made me so sick I ended up ion the hospital and later they said they didn't know if I was coming out alive. I did!
Then they put me on blood thinners--a blood thinner--warfarin. Every month, I had to go to a lab and get a blood test...they would call and say eat a spinach salad--vitamin K in spinach affects your blood thinness. It was wacky...then my intestine bled, leading to a terrible hospitalization for a colonoscopy. Can't have that with thinners on board, so they tried to counteract the thinner with blood plasma. The colonoscopy could not be completed.
I stayed on thinners. They said to. Eventually, I experienced another bleed--in my right eye, leading to terrible clots, a fully detached retina, four surgeries, and now a blind eye.
I quit warfarin. Now I am on an aspirin only and have been for 10 yrs.
There are two other approaches to afib--ablation (try to kill the rogue cells with radio waves or heat) or the "paddles"--shock you into proper rhythm. I refused both
Long story longer, research from the Intermountain Medical Center Heart Institute in Salt Lake City now says there is an effective way to tell if someone needs thinners. First, you do a questionnaire called the CHA2DS2-VASc (see what I mean by "weeds"?) and then a second scoring--the Intermountain Mortality Risk Score.
The first is not predictive of outcomes, but has been used for years anyway. It is oversinmplified, the researchers say--a woman over 65 would automatically get a thinner, even though this is not a comprehensive way to tell is she needs one.
The new Intermountain score adds more variables.
Well, fine and dandy...I am seeing my ninth cardiologist next week--to see if I can withstand hernia surgery. Wonder if he will recommend this.
As I peer into the screen with my one remaining eye--I have no idea.
Monday, March 20, 2017
More parents were confident of getting same-day phone advice (60%) than a same-day appointment (53%).
In other words, the researchers said, many parents are frustrated about getting timely advice when they have a sick child.
While retail clinics (in stores) or urgent care clinics may seem convenient, they may not have the child's history and can be expensive. And don't even ASK about the ER--see below.
Most doctors' office have a limited number of "sick" visits a day. I remember my daughter's pediatrician gave out a booklet of when to call or make an appt. I about had it memorized.
Discuss this with the doctor before deciding on a provider--the researchers recommended.
Most often, for a number of reasons, the primary care doctor's office is your best bet.
I will admit I often consider other venues. I even got so desperate with stomach pains two weeks ago, I went to the ER, knowing I could get imaging, testing, and an opinion in one place...and not be shuffled one day to a lab, the next to an x-ray place.
But the bottom line for that six hours...$11,600!!! My part was way less, of course, but someone thought that was what the services were worth,
I think the entire health care system is hardly worthy of the name system these days.
Friday, March 17, 2017
The youngest group surveyed, the Millennials are the healthiest. In fact, they utilize health care less often than previous generations did at their age. Only 35% of these even have a primary care provider. One in four say they use an alternative facility--say an urgent care center--when sick.
The Millennials, however, tend to have a high degree of trust. Also, they tend to be over-sharers (social media) and favor a more open doctor-patient relationship. They are not afraid to engage authority--their parents have taught them their voice matters. Millennials also use digital media--such as doctor reviews. They also tend to trust institutions with their health data.
These are in their late 30s and 40s. They don't trust doctors or the system. They tend to believe doctors are more about money than helping. They hate to open up with their doctors. They are less likely to follow up on advice--and only 56% have a primary care doctor. In fact, one in four say they have lost trust in a doctor or institution in the last two yrs--more than any other generation.
This generation, being oldest, is the unhealthiest. They have a high rate of chronic disease, more disability, and lower self-rated health than any previous generation at the same age.
Therefore--83% of Boomers have a doctor. They prefer a team approach, though. They value a doctor who will discuss treatment options in detail. They also expect doctors to work at least a 50-hour week like they do and keep up on medical information. To find a doctor, Boomers rely more on recommendations from friends and family than the internet.
This seems to track with what I have observed. What do you think?
Thursday, March 16, 2017
The quality of sleep, the researchers pointed out, was more important than the length or number of hours.
They even quantified the benefits--equal to winning 200,000 pounds in the lottery.
Moreover, positive changes in quality of sleep, over time, using less sleep medication, improved scores on the General Health Questionnaire, used to determine mental well-being.
A person's physical health is also improved. And lack of sleep, and bad sleep quality lead to worsened states.
Bottom line: The benefits of sleep are accessible to everyone.
Some general principles:
--No devices or blue light
--Limit liquids at night to cut bathroom runs, don't eat after 8 PM
--Alcohol before bed can make you fall asleep but then rebound awake
--Comfortable mattress, bedding, and night clothes
--Maybe separate room from spouse who snores
--Pets in or out of bed depending on your preference
See? You didn't even need to buy a lottery ticket.
Wednesday, March 15, 2017
The idea is that this is not only more convenient for minor ailments, but costs the system less, too.
A study of 300,000 people in a Blue Shield of CA HMO (Health Affairs) showed that patients probably would not have gone to the trouble of going to the doctor and so the tele-visit is an added cost.
A telehealth visit costs about $79, compared with $146 for an office visit.
The researchers found that only 12% of the telemedicine encounters replaced an in-person visit to a doctor or ER, while 88% represented new demand.
Mostly the virtual visits focused on respiratory ailments, sinusitis, bronchitis, pneumonia and tonsillitis.
Too, telehealth visits themselves may cost less than in-person, but they often result in followups, lab tests, and prescriptions, just like in-person ones do.
The costs of respiratory ailments in the group increased by $45 per user.
Of course, the honchos at telehealth companies disagree. The head of Teledoc said the numbers are outdated.
Still, to achieve real cost savings, the tele-visit must replace the in-person.
What do you think? Have you tried this? I have not, though I hate going to the doctor because my arthritis makes it so painful to gimp around.
Tuesday, March 14, 2017
The American Society of Anesthesiologists encourages you (me?) to take some steps before the "big day."
In my case, this means seeing a cardiologist (my ninth in AZ) because I have atrial fibrillation, a rhythm disorder suffered by 20% of people.
So they want to be on the safe side there, I guess, even though I don't want to tangle with another cardiologist--the two ways of treating my thing backfired on me big time and the other two ways don't last, from what I have heard. So I am not treating this, except for a mild blood thinner--aspirin,
They hate that.
Anyhow, that is one piece of advice--possible pre-op specialist visits.
--Find out who will be administering the anesthesia. They are physicians at the Society so they recommend you insist on a physician-anesthesiologist not a nurse-anesthetist. We could get into that, but not here. Physician-anesthesiologists have 12-14 years of medical ed and 12,000 to 16,00 hours of clinical training. They work with your surgeon and other members of your care team to manage you while unconscious and your pain afterward.
--Talk with this person. You need to provide detailed info on your meds (including over-the-counter, vitamins, supps), chronic issues, diseases and ailments, allergies, recreational drugs, and so on. I have found--and it just happened with my daughter's gallbladder operation, that this conversation is sketchy and takes place right before the surgery and often after you get some "soothing" medication.
--Detail your previous experience with anesthesia. Will this person want to know that the guy who numbed my eye for one of my four detached retina surgeries did it wrong and I felt the first cut--yow--followed by bam! I was out for 10 mins of more numbing then back awake? Will I sound fearful, disrespectful? Probably won't get into this--since my operation this time is not under a local.
--Tell this person your fears. Yeah, OK. I have fears.
--Ask questions. Hmmm...I would ask my odds on waking up...but I had odds on my eye that were not too meaningful, so maybe not.
--Ask about afterward. This means pain control. I will be in the hospital, I am told--this is not in-and-out surgery for me.
So--typing this has freaked me out--but that is my role. I get this stuff so you don't have to.
Monday, March 13, 2017
Anyhow, some docs got together at US San Diego and did a virtual operation on a guy to practice for his real operation.
This caught my interest for sure.
It was colon surgery (part had to be removed) and they made a lifesize model of his guts. Then the surgeon would do a run-through before "breaking ground," as it were.
The patient, a colleague, was into what he calls "the quantified self." This means knowing and understanding every aspect of your insides down to the microbes living in there.
At present, doctors are limited to imaging, patient history, physical findings, lab tests and the surgeon's experience.
When it was time for the operation in this case, though, the doctor said she looked back and forth between the computerized dry run and the patient's actual insides and it was incredibly helpful.
She admitted using this tool would take surgeons some adjustment. You see different views, she said, the actual patient, the run-through, cameras inside during the actual operation--it takes some work to put it all together.
She added that this technique brought more technology into the room to reduce risks.
I guess my surgeon will have to ready for surprises--but I bet future generations will benefit from this.
Friday, March 10, 2017
|See--you're smiling. You're welcome.|
The Consumer Guide to Dentistry lists eight components of a smile..from the frame (lips) to the buccal corridor (between the corners of the mouth and upper teeth).
It takes 11-17 muscles to prop up the corners of your lips.
Jamie Reynolds, an orthodontist and author of World Class Smiles Made in Detroit, says smiles work on the smilee and smiler.
--Your longevity could be affected. This sounds a little flimsy, but in 2010, Wayne State University measured the smiles of Major League players' 1952 baseball cards. Those with no smile lived an average of 72.9 years. The smilers lived to 79.9 years of age.
--Smiles can be therapeutic. Smiles reduce stress hormone levels and increase those yummy endorphins.
--Smiles translate universally. Almost every place, a smile is received positively.
I try to smile first thing in the AM...even if Morning Joe is not that funny--and it usually isn't these days.
Thursday, March 09, 2017
|Andy Cohen--pre-renewed workouts|
--Hint: Gen X is between the Boomers the the Millennials, meaning middle-age-y.
First, Kantor recommends a diverse exercise program--strength, cardio, core, and flexibility. But Gen X is "stressed," he says--so maybe an intense day followed by a more restorative day (yoga or Pilates).
Gen Xers should also strive for quality sleep. Wind down in the evenings, go for a walk, take a bath. Keep the room cool--no devices.
Try to take nutirtional supps instead of prescription drugs. The soil is overcropped and deficient, Kantor says--you may need supplements.
Kantor is also big on alkaline water--he says drink half your weight in ounces of it a day. (I have read several studies, though, that say this alkaline water is a fad.)
Try not to eat out--the food is heavy in fat and sodium, dyes, fructose corn syrup and other baddies.
Avoid artificially sweetened beverages, too. Aspartame, saccharin, sucralose--all have been linked to cancer. Also keep alcohol consumption down. Middle-aged people have no business "getting drunk" or experiencing hangovers.
Eat "super foods." Nuts, seeds, 9 to 11 fruits and veggies a day--with a ratio of 3 to 1 veggies over fruit.
Try massage and acupuncture.
Reduce your screen time.
Declutter, organize, purge old clothes, shred old documents. Clutter equals stress.
Try one or two for a few months. At the Gen X stage of life--too much is too much.
No, I am not calling you old, but you maybe are sort of not young.
I am listening to the Bravo Channel's Andy Cohen's diary book--titled SUPERFICIAL--and he is such a gadabout, such a fan boy and name dropper, and he is out a lot--but I notice, he always notes what time he gets to sleep--and he gets lots of massages and works out with a trainer several times a week, despite obsessing over his pudge and unwhitened teeth.
Gen X all the way.
Wednesday, March 08, 2017
But, now, researchers at Ohio State says fat can cause inflammation in nearby tissues, so cutting inflammation can reduce or prevent that pain.
It's not just quantity of food--in other words--it's the makeup of it and the quality.
Remember, overweight people are more likely to experience pain. the study, included 98 men and women from 20 to 78 (the journal Pain).
They measured fatness by BMI, waist size, and body fat percentage.
They concluded that for fat people, it's "like a cloud hanging over them---because they experience high levels of pain and inflammation."
This work is preliminary, for example biomarkers for inflammation in the blood were not examined.
But take it from THIS bountifully endowed person, pain is an everyday reality.
Some nice hummus, garlic bread, fresh fish or salad dressed with olive oil...might help ease the discomfort.
I say it's worth a try. (This diet also cuts the risk of heart disease and even some cancers.)
Tuesday, March 07, 2017
After seven fun-filled hours and a CT scan, whew--hernia...But still, a hernia requires surgery. The ER referred me to a surgeon and said good luck, call Monday.
Then some more fun began. First thing Monday I called my Medicare HMO and asked about the surgeon they recommended--sorry, not on the plan. So I asked for more names--but please someone close because we have no car and must pay cabs. I got a list. I started calling...one was a plastic surgeon...hmmmm. not her. The others were up to 20 miles away. Finally I got an appt with one.
Yes, even though I had a CT scan, blood work, an EKG, etc at the ER, I would need to visit the surgeon's office for a "consultation." This, of course, would require a referral from my "family doctor."
I called my family doctor--could they send the referral? No--you have to come here first because you have not been here for three months. I said--I have a medical record on this hernia--from the ER. No... Now, 36 hrs later, my family doctor has not even read the message saying (as he well knows) that my arthritis is so bad it is an ordeal to come over.
Later, that afternoon, I thought, wait a hot one...Maybe the guy the ER recommended--the close one who also operates at a close hospital--is on my plan. Why believe the insurance company? So I went on the--gulp--insurance company website, usually a place hope goes to die.
The ER-recommended doctor was on there! He is on the plan! So I called the family doctor back...I want the referral to this guy.
This morning--that had not been written down, but within the last two hrs, the note was read by the family doctor...the referral is being made without my coming over...step one...is COMPLETE.
As I sat here in PAIN, almost crying, all day yesterday...everyone I talked to ended the call with "Have a nice day!" Chirp, chirp.
This is a health care system? Some of us are not having a nice day.
Monday, March 06, 2017
Some language is strictly guff--for marketing, selling the dream as it were (silky, anti-aging). Other words may mean different things on different products. This according to Rajani Katta, MD, clinical asst professor at Baylor College of Medicine.
Example: "For sensitive skin" and "hypoallergenic" are terms not regulated by the FDA. There is no guarantee these products won't irritate your skin.
Also--be wary of "all natural." Remember--Katta says--poison ivy is "all natural." These products can also have harmful preservatives.
Other products may say "frangrance free," but there is fragrance--it's to make it more moist, rather than to add a scent, but it's there.
To protect your own skin--try a test site--say, a small amount on your forearm before slathering it all over you.
If you already have skin inflammation--nix the new products--your skin's protective barrier is already compromised.
And--bear in mind that allergic reactions can take a couple of days to show up. By then, you may not even know what caused the rash.
Above all--price is no guarantee of purity, gentleness, or effectiveness...this is from me. Some of that department store stuff can cost a fortune and still make you break out or turn red.
Friday, March 03, 2017
Plus--with the warmed winters in some areas, kids continue to play fall and summer sports in the offseason--leading to overuse injuries. Serious overuse injuries in children are on the rise.
Think about safety...
--Depending on the sport or activity, wear a helmet--in addition to preventing skull fractures and brain bleeds, helmets keep the head warm.
--Wear wrist guards. People tend to put their arms out to catch themselves (snowboarders?) and can hurt their wrists.
--Watch those ski bindings--automatic releases need to be adjusted to the child's height and weight.
--Don't forget UV protection, even on cloudy days.
--Cross-train in the offseason. This not only helps performance, but develops different skill sets.
I am sure you can think of more precautions. Heads up! I mean, surf's up.
Thursday, March 02, 2017
But orthopaedic surgeon Kevin D. Plancher, founder of Plancher Orthopaedics and Sports Medicine, says you may be injuring your knees if you don't run at a slight incline.
A zero-percent incline, he explains, is not like running on flat ground, it's like running slightly downhill, which stresses the knee and patellar tendon (front of thigh, helping the thigh straighten the leg).
Higher inclines also may be fun and challenging but can lead to sharp knee pain.
Treadmills come with inclines programmed in for a reason, Plancher says. Running at a slight incline works the big muscle groups and also helps you avoid shin splints.
The slight incline of 3% is optimal.
If something starts hurting, the doctor says, stop doing it. Try biking, swimming, or the elliptical and give your knees a break.
Well, not a break...you know what I mean.
Wednesday, March 01, 2017
At the same time, hospitals, pharmacies, manufacturers and nursing homes toss out unused meds worth billions. Often this ends up in our water or is dumped or burned.
In 1997, state legislatures began taking action on letting people donate and reuse such meds. These programs create repositories allowing such drugs to be donated and then re-dispensed to needy patients.
As of mid-2016, 38 states had such programs, although not all were fully functioning. Too, such programs do not allow people to donate drugs, just institutions.
In 2015, California opened the Better Health Pharmacy in San Jose. There is no copay for insured patients and no need to have insurance. All patients need is a valid prescription. No proof of residency, citizenship or income is needed.
The drugs most commonly distributed are for asthma, high blood pressure, diabetes and depression.
Controlled substances are not donated or distributed.
Does your state have some sort of program? You could check.