Health News

05/10/2012 Cell Phone ICE: Car accidents and medical emergencies happen all the time too. If you were unconscious, would first responders know how to contact your family? Could paramedics find out about your medications, allergies, or health conditions? Fortunately, it takes five minutes and zero dollars to make sure those first responders can reach your emergency contacts if you’re the one unconscious. You just have to “ICE” your cell phone. “ICE” stands for “in case of emergency.” If you add the prefix “ICE” to your emergency contacts in your phone’s contact list, first responders will know to call them first. So if Jane Doe is your emergency contact, simply change her entry in your contact list from “Jane Doe” to “ICE: Jane Doe.” A paramedic in the United Kingdom, Bob Brotchie, came up with the idea. Perhaps you remember when he promoted the ICE system in 2005, gaining a lot of media attention as the system caught on in other countries, especially after the London bombings that summer. Even though the ICE system made national headlines in the United States, haven’t “iced” their phones. If you haven’t, stop what you’re doing and update your phone contact list right now. It won’t cost you more than a few minutes – and it could save your life some day. Here are tips for getting the most out of your icing…  Don’t password protect your phone or icing it is pointless. Alternatively, some phones have programmable ICE buttons that a first responder can press to call your emergency contacts without having to unlock the phone. Ask your carrier if your phone has this ability.  “ICE” multiple emergency contacts. In case one emergency contact can’t get to the phone when the paramedics call, pick two or three emergency contacts. Some people who have multiple ICE contacts label them something like “ICE1: Jane Doe,” “ICE2: John Doe,” etc. That way, the paramedics will know you have multiple emergency contacts, regardless of which one they scroll to first.  Use relationships instead of names. For example, your ICE contact might be labeled “ICE: mom” instead of “ICE: her name”. Do this for non-ICE contacts too, just in case. So my brother is in my phone as “brother” instead of “Peyton.” If a person finds your and is nice enough to try to return it, he/she would knew which would be a good contact to call to let you know where the phone could be picked up.  Supplement your ICE. If you have any medical conditions or drug allergies or take any medications, you should have more than ICE for emergencies. If not a medical bracelet, put something in your wallet.  ICE friends and family. Next time you talk to your folks or others you love that could benefit from ICEing, tell them about it. And if they’re tech-challenged, do it for them. [Source: MoneyTalksNews Karla Bowsher article 22 Mar 2012 ++] ************************** Alzheimer’s Update 09: A researcher at the Veterans Affairs Greater Los Angeles Healthcare System has pinpointed how vitamin D3 works with some of the body’s cells to help clear the brain of amyloid beta, the main component of plaques that are seen in Alzheimer’s disease. Vitamin D3 may activate certain genes and cellular signaling networks to trigger the immune system to clear amyloid beta. An abstract of the study is available under the “pages 51-62″ section on the Journal of Alzheimer’s Disease website at http://www.j-alz.com/issues/29/vol29-1.html. [Source: Military.com article 26 Mar 2012 ++] ************************** Marine Corps DSTRESS Line: The Marine Corps recently awarded a contract to TRIWEST for a new “DSTRESS Line” that offers peer-to-peer counseling services. Marines, former Marines or their family members that think they need help coping with the challenges and stress of combat or deployments, grief and loss, parent-child relationships, couples counseling, or other rigors of life as a Marine or Marine family member can call any time. The DSTRESS Line operates 24/7/365 providing anonymous phone, chat and online access for solution-focused counseling. Counselors specifically trained in Marine Corps culture are prepared to field questions and concerns. The DSTRESS Line can be accessed by calling 1-877-476-7734. The DSTRESS Line is active now and TRIWEST officials say it will provide global Corps-wide support beginning March 23. [Source: NAUS Weekly Update 16 Mar 2012 ++] ************************** Saving Money: Twenty percent of Americans get fewer than six hours a night of sleep, according to the National Sleep Foundation. Those folks are probably spending a large part of what researchers say the sleep industry rakes in: $23 billion a year. Some of that money goes to things everybody needs occasionally – like a new quality mattress (every 10 years) and pillows (one or two years). But a lot goes to sleeping medication, which can be an expensive and ultimately ineffective solution. So what’s more effective and cheaper than sleeping pills? Changing your habits. Here’s how… 1. Get comfy. Dr. A room that’s dark, a temperature you like, blankets and pillows that feel nice. The sound of a fan or the A/C helps some people (including me) sleep better too. When you’re uncomfortable in bed, that’s often all you can think about. 2. Ditch distractions. Minimize stimuli – things that keep your attention – in the bedroom. No TVs, no computers, no radios, no smartphones – not even books. The idea is to make your bedroom the place where the only thing you do (with perhaps one exception) is sleep. If you want to read or watch TV at night, do it elsewhere. When you get sleepy, go in your room and shut your eyes. 3. Schedule sleep. The Sleep Foundation says snoozing should be on your to-do list like everything else. If you get into bed thinking about work (instead of how soft and warm those blankets are), you may have trouble. A consistent sleep schedule (including weekends) also helps your body know when to rest. 4. Create a wind-down routine. Get into the habit of making the hour before bedtime relaxing. Whether it’s a long hot bath, listening to a soothing playlist, or reading a novel with a glass of milk (caffeine or food before bed are bad), do something that transitions you into rest mode. 5. Use your bed as intended. According to The Sleep Foundation, beds are for only two things: sex and sleep. If you work on the laptop or tablet or do anything else from bed, even during the daytime, your body may become more geared for those other activities instead of sleep. 6. Get healthy. Incorporating exercise into your daily schedule can help you sleep better – not only are you wearing yourself out in a healthy way, but it helps fight a vicious cycle. Being overweight puts you at higher risk of conditions like sleep apnea, which make it harder to breathe in bed and thus harder to stay asleep. And people who don’t get enough sleep are often too tired and poorly motivated to exercise properly, so the problem perpetuates itself. Smoking also contributes to the problem. 7. Find professional help. If none of this advice works for you, try visiting a sleep expert. SleepCenters.org can help you find a doctor in your area recommended by the American Academy of Sleep Medicine. The trip won’t be as cheap as the rest of this advice, but you can’t put a price on quality sleep. Bottom line – Pills are the most expensive way to get a good night’s rest, and they’re the worst way. Sleep experts can help you save money – and while a mattress stuffed with cash probably won’t help you rest better, their advice will. [Source: MoneyTalksNews Brandon Ballenger article 7 Oct 2011 ++] *************************************** 05/10/2012 Food Myths Update: When the subject of food comes up, we are usually overwhelmed because of the different opinions and options concerning what food we should or should not eat. Consequently, keeping up with food trends can be extremely difficult. So, what is really fact or fiction when it comes to eating healthy? If you need more information, visit http://www.eatright.org , or if you have questions, contact a VA Registered Dietitian at (713) 791-1414 ext. 3976, 4296, or 6166. The following covers the truth about some food myths: Myth 1. “I am diabetic so I should not eat anything white.” Truth: Avoiding an entire group of food is never a good idea. A person may feel they are being cheated and eat more than they normally would at the next meal. Diabetics should monitor the amount of carbohydrates they consume; but, they should not completely avoid them. Other names for carbohydrates are “carbs” or “starches.” White foods such as potatoes, rice, bread, and sugar do contain carbohydrates. However, many foods that are not white such as corn, peas, brown rice, fruit juice, and soda also contain carbohydrates. For example, a cup of orange juice would elevate your blood sugar as much as a piece of white bread. Therefore, “white” foods can fit into a diabetic diet as easily as other foods. Eating healthy is all about balance which includes a proper diet adjusted to your body needs and activity level. Myth 2. “Artificial sweeteners are bad for me.” Truth: Artificial sweeteners are also called sugar substitutes (SS). Examples of sugar substitutes are Sweet ‘N Low, Equal, Splenda, and Truvia. They are regulated by the Food and Drug Administration (FDA). The FDA must approve foods as safe before they can be sold. However, SS have a bad reputation as something that can cause cancer. Current research has found no clear link between their use and the risk of cancer in humans. Myth 3. “Sea salt is better than table salt.” Truth: Sea salt has the same amount of sodium (salt) as table salt. If you are looking for a salt substitute, try herbs or salt-free seasonings. Also, check the ingredient list on foods you purchase to make sure the food is truly salt-free. Myth 4. “Eggs are bad for me” Truth: Eggs have a bad reputation because the yolks are high in cholesterol. Nevertheless, eggs are good to eat in modest amounts of three or four a week. Also, eggs are a great source of protein, Vitamin A, Vitamin D, and Vitamin B12. Furthermore, if your cholesterol is high try eating just the egg whites or low cholesterol eggs. Myth 5. “Eating before bedtime makes me gain weight.” Truth: The food you eat before bedtime will not make you gain any more weight than food you eat during the day. Weight gain occurs when you consume more calories than you burn with exercise or physical activity. So, if you exercised enough in the day to burn off the calories in the late night snack, you will not gain weight. One thing to consider is that late night snacking occurs because you are bored. Thus, if you are snacking out of boredom, not hunger, those late-night calories probably will catch up with you which will result in weight gain. [Source: VA Star Mar/Apr 2012 ++]     04/16/2012 Bulletin Content Validation: One of the oldest pieces of advice to avoid getting duped by false information is to resist believing everything you read. This might be especially true on the Internet, where anybody can play expert and the pressure to break genuine news often leaves little time for fact-checking, even by reputable sources. The RAO Bulletin is no exception. Its makeup consist of articles sourced from the Internet and edited to fit its format. This is why in the Welcome Aboard message (you received upon being added to the Bulletin’s directory) it said, “… The information contained in the Bulletin just that – informational (FYI). The objective is only to PASS THE WORD in order to keep the military community informed. The Bulletin is not an “Official” DoD sanctioned newsletter and as such should not be quoted as an authoritative source on DoD policy. It is the responsibility of readers to verify exactly how information applies to them if they intend to expend funds or time in following up on the data provided in the articles.” Due to the number of articles presented in the Bulletin it is impossible for me to verify every item in the Bulletin and still have time remaining to edit and publish it. Almost every Bulletin article contains its primary source to enable you to contact if your are uncomfortable with the content. To help you determine the accuracy of its information or any other you come across on the Web, plenty of sites provide tools for fact-checking and getting background material. Following are a few:  FactCheck.org, [ http://www.factcheck.org/ ] a project of the Annenberg Public Policy Center, was one of the first political fact-checking websites, founded in 2003. It describes itself as “a nonpartisan, nonprofit consumer advocate for voters that aims to reduce the level of deception and confusion in U.S. politics.”  PolitiFact, [ http://www.politifact.com/ ] launched by the Tampa Bay Times, and Truth Needle [ http://seattletimes.nwsource.com/html/truthneedle/ ] launched by the Seattle Times, are two of the most visible newspaper-based fact-checking operations. Many newspapers are launching or joining fact-checking initiatives, which are typically open to the public, perhaps as a way to differentiate themselves from strictly Internet-based sources of news.  Snopes.com [ http://www.snopes.com/ ] founded by a husband and wife team of researchers and writers, Barbara and David Mikkelson, is the best-known site for getting to the bottom of “urban legends, folklore, myths, rumors, and misinformation.” You can do a keyword search or browse through categories from autos to weddings.  Infoplease [ http://www.infoplease.com/ ] a descendent of the paper almanac Information Please and before that a radio quiz show of the same name that first aired in 1937, is owned by Pearson, which publishes the Financial Times and numerous books through the Penguin Group of book publishers. At Infoplease, you can search by keyword through the entire site or browse through various categories. There’s also a biographical dictionary, atlas, compact encyclopedia, and homework center for kids.  Bio.com [ http://www.biography.com/ ], Dictionary.com [ http://dictionary.reference.com ], and Acronym Finder [ http://www.acronymfinder.com ] are specialized sites that can help you delve deeply into the background of people or words.  InteliHealth [ http://www.intelihealth.com/IH/ihtIH/WSIHW000/408/408.html ] affiliated with Harvard University, and MayoClinic.com [ http://www.mayoclinic.com ] are two excellent sites for checking health information.  RxList [ http://www.rxlist.com/script/main/hp.asp ] and the National Library of Medicine’s Medline Plus Drug Information [ http://www.nlm.nih.gov/medlineplus/druginformation.html ] provide information about pharmaceutical drugs and nutritional supplements. [Source: MOAA Reid Goldsborough article & RAO Bulletin Editor/Publisher 20 Mar 2012 ++]   3/27/2012 Cancer Update from John Hopkins Cancer Research Center 1. Every person has cancer cells in the body. These cancer cells do not show up in the standard tests until they have multiplied to a few billion. When doctors tell cancer patients that there are no more cancer cells in their bodies after treatment, it just means the tests are unable to detect the cancer cells because they have not reached the detectable size. 2. Cancer cells occur between 6 to more than 10 times in a person’s lifetime. 3. When the person’s immune system is strong the cancer cells will be destroyed and prevented from multiplying and forming tumors. 4. When a person has cancer it indicates the person has nutritional deficiencies. These could be due to genetic, but also to environmental, food and lifestyle factors. 5. To overcome the multiple nutritional deficiencies, changing diet to eat more adequately and healthy, 4-5 times/day and by including supplements will strengthen the immune system. 6. Chemotherapy involves poisoning the rapidly-growing cancer cells and also destroys rapidly-growing healthy cells in the bone marrow, gastrointestinal tract etc, and can cause organ damage, like liver, kidneys, heart, lungs etc. 7. Radiation while destroying cancer cells also burns, scars and damages healthy cells, tissues and organs. 8. Initial treatment with chemotherapy and radiation will often reduce tumor size. However prolonged use of chemotherapy and radiation do not result in more tumor destruction. 9. When the body has too much toxic burden from chemotherapy and radiation the immune system is either compromised or destroyed, hence the person can succumb to various kinds of infections and complications. 10. Chemotherapy and radiation can cause cancer cells to mutate and become resistant and difficult to destroy. Surgery can also cause cancer cells to spread to other sites. 11. An effective way to battle cancer is to starve the cancer cells by not feeding it with the foods it needs to multiply. *CANCER CELLS FEED ON: a. Sugar substitutes like NutraSweet, Equal, Spoonful, etc are made with Aspartame and it is harmful. A better natural substitute would be Manuka honey or molasses, but only in very small amounts. Table salt has a chemical added to make it white in color Better alternative is Bragg’s aminos or sea salt. b. Milk causes the body to produce mucus, especially in the gastro-intestinal tract. Cancer feeds on mucus. By cutting off milk and substituting with unsweetened soy milk cancer cells are being starved. c. Cancer cells thrive in an acid environment. A meat-based diet is acidic and it is best to eat fish, and a little other meat, like chicken. Meat also contains livestock antibiotics, growth hormones and parasites, which are all harmful, especially to people with cancer. d. A diet made of 80% fresh vegetables and juice, whole grains, seeds, nuts and a little fruits help put the body into an alkaline environment. About 20% can be from cooked food including beans. Fresh vegetable juices provide live enzymes that are easily absorbed and reach down to cellular levels within 15 minutes to nourish and enhance growth of healthy cells. To obtain live enzymes for building healthy cells try and drink fresh vegetable juice (most vegetables including bean sprouts) and eat some raw vegetables 2 or 3 times a day. Enzymes are destroyed at temperatures of 104 degrees F (40 degrees C).. e. Avoid coffee, tea, and chocolate, which have high caffeine Green tea is a better alternative and has cancer fighting properties. Water-best to drink purified water, or filtered, to avoid known toxins and heavy metals in tap water. Distilled water is acidic, avoid it. 12. Meat protein is difficult to digest and requires a lot of digestive enzymes. Undigested meat remaining in the intestines becomes putrefied and leads to more toxic buildup. 13. Cancer cell walls have a tough protein covering. By refraining from or eating less meat it frees more enzymes to attack the protein walls of cancer cells and allows the body’s killer cells to destroy the cancer cells. 14. Some supplements build up the immune system (IP6, Flor-ssence, Essiac, anti-oxidants, vitamins, minerals, EFAs etc.) to enable the bodies own killer cells to destroy cancer cells.. Other supplements like vitamin E are known to cause apoptosis, or programmed cell death, the body’s normal method of disposing of damaged, unwanted, or unneeded cells. 15. Cancer is a disease of the mind, body, and spirit. A proactive and positive spirit will help the cancer warrior be a survivor. Anger, un-forgiveness and bitterness put the body into a stressful and acidic environment. Learn to have a loving and forgiving spirit. Learn to relax and enjoy life. 16. Cancer cells cannot thrive in an oxygenated environment. Exercising daily, and deep breathing help to get more oxygen down to the cellular level. Oxygen therapy is another means employed to destroy cancer cells. 1. No plastic containers in micro. 2. No water bottles in freezer. 3. No plastic wrap in microwave.. Johns Hopkins has recently sent this out in its newsletters. This information is being circulated at Walter Reed Army Medical Center as well. Dioxin chemicals cause cancer, especially breast cancer. Dioxins are highly poisonous to the cells of our bodies. Don’t freeze your plastic bottles with water in them as this releases dioxins from the plastic. Recently, Dr Edward Fujimoto, Wellness Program Manager at Castle Hospital , was on a TV program to explain this health hazard. He talked about dioxins and how bad they are for us. He said that we should not be heating our food in the microwave using plastic containers. This especially applies to foods that contain fat. He said that the combination of fat, high heat, and plastics releases dioxin into the food and ultimately into the cells of the body. Instead, he recommends using glass, such as Corning Ware, Pyrex or ceramic containers for heating food. You get the same results, only without the dioxin. So such things as TV dinners, instant ramen and soups, etc., should be removed from the container and heated in something else. Paper isn’t bad but you don’t know what is in the paper. It’s just safer to use tempered glass, Corning Ware, etc. He reminded us that a while ago some of the fast food restaurants moved away from the foam containers to paper The dioxin problem is one of the reasons.

 

3/7/2012

Dementia Update 02: A two-minute memory test can uncover many cases of dementia that otherwise go unnoticed by doctors, according to Minneapolis VA researchers who concluded that the screening “should be considered in all older adults.” The test, known as the “mini-cog,” was given to more than 8,000 older veterans to see if it could work as an early warning sign for Alzheimer’s and other memory disorders. Nearly 11 percent of the patients aged 70 or older were diagnosed with some form of cognitive impairment, compared to 4 percent in clinics that didn’t use the test, according to the study by the Minneapolis Veterans Affairs Medical Center. The results are part of a growing movement to identify cognitive problems early. “I think there’s increasing data in the last few years that unrecognized cognitive impairment leads to worse health outcomes,” said Dr. Riley McCarten, a neurologist at the Minneapolis VA who led the study.

People with memory problems may have trouble following medical advice or taking their blood pressure pills, he said, and yet their doctors may be in the dark. “Most people with dementia, particularly in the early and even moderate stages, look completely normal,” he said. “If you don’t test them, you don’t know they’re impaired.” The mini-cog is one of a number of memory tests that have started to pop up in routine checkups for older patients around the country, including at Allina clinics in Minnesota. In this case, the test involves memorizing three words and drawing the face of a clock. The idea of routine testing for memory problems has been gaining acceptance, said Maria Carrillo, a senior medical director at the Alzheimer’s Association in Chicago. “The field in general has started to move toward the idea of trying to identify Alzheimer’s earlier.” She said her organization is part of a national working group trying to identify which tests are most effective. The mini-cog is probably one of the quickest and most popular, but she said there’s no consensus on which test is best.

Several years ago, the Minneapolis VA started offering the mini-cog during routine checkups of veterans 70 or older with no known history of memory problems. Nearly everyone (97 percent) agreed to take the test; of those, 26 percent failed, according to the report. Anyone who failed was offered a more thorough evaluation. Of those who agreed to a follow-up, 75 percent turned out to have dementia, the study found. In fact, even a few people who passed the mini-cog asked for further evaluation and turned out to have dementia as well, McCarten said. In those cases, “people tend to come forward and say, ‘You know what, I think I do have a problem.’” At the same time, McCarten said nearly three-fourths of those who failed the mini-cog refused follow-up. Sometimes it takes several visits — and several failed tests — before they’re ready for an answer. “We think of it as a process,” he said. “This is foreign to most people. They don’t usually get a quiz when they go to the doctor.” When it’s part of their routine checkups, he said, “they may be more accepting of having further evaluation.”

Carrillo, of the Alzheimer’s Association, noted that some memory problems are caused by medications or depression and might be reversible. But even if they’re not, she said, patients and families can benefit by finding out about the dementia sooner rather than later. McCarten agrees. “Just because somebody doesn’t have a diagnosis doesn’t mean you’re not dealing with their problems,” he said. Often, it takes a crisis to realize someone is impaired and unable to care for himself. “You make a big impact if you can diagnose this and avert some of those crises,” he said. The study is published in 13 FEB Journal of the American Geriatrics Society. [Source: Star Tribune Maura Lerner article 13 Feb 2012 ++]

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Vitamin Supplements Update 04:The best way to get crucial vitamins and minerals is by eating the right balance of healthy foods. But for people over age 50, even the best diet may not provide enough of some important nutrients. Not many seniors can claim to be getting the full complement of what they need from their diet each day. The following addresses vitamins, minerals and supplements that are most important for older adults so you can be sure to consume them regularly. (Note: If you have certain diseases, such as cancer or diabetes, your body may have special nutritional needs. Also, certain medications can have adverse interactions with vitamins and other dietary supplements. Be sure to speak with your doctor or pharmacist about the vitamins, minerals and supplements you take.) Abbreviations: IU=international units, MG=milligrams, MCG=micrograms

Vitamin A

How much to you need? Men: 900 mcg. Women: 700 mcg

Why you need it: Promotes good vision; helps keep immune system healthy.

Good to know: In supplements, look for vitamin A as beta carotene, not as retinol or retinoic acid, which increases the risk of bone fracture.

Food sources: Dairy products, fish, darkly colored fruits and vegetables.

Vitamin B1 (thiamine)

How much do you need? Men: 1.2 mg. Women: 1.1 mg

Why you need it: Thiamine is necessary for healthy nerve and brain cells; helps convert food to energy.

Good to know: Antacids and some diuretics may lower thiamin levels by decreasing absorption and increasing urinary secretion.

Food sources: Liver, whole grains, enriched breads and cereals.

Vitamin B2 (riboflavin)

How much do you need? Men: 1.3 mg. Women: 1.1 mg

Why you need it: Riboflavin is important for red blood cell production; helps convert food to energy.

Good to know: Older men and women may be especially susceptible to riboflavin deficiency, which can cause cracking or sores at the corners of the mouth, skin irritation or weakness.

Food sources: milk, eggs, fortified bread products and cereals.

Vitamin B3 (niacin)

How much do you need? Men: 16 mg. Women: 14 mg

Why you need it: Niacin is necessary for the proper functioning of the digestive system, skin and nerves; helps convert food to energy.

Good to know: Can cause skin flushing; may be prescribed to treat high cholesterol but should be used only under a doctor’s care because of potentially severe side effects.

Food sources: Meat, fish, poultry, eggs.

Vitamin B6 (pyridoxine)

How much do you need? Men: 1.7 mg. Women: 1.5 mg

Why you need it: Vitamin B6 aids in the formation of red blood cells; strengthens the immune system.

Good to know: Too high doses of supplements may cause nerve damage, numbness and trouble walking.

Food sources: Beans, nuts, eggs, whole grains.

Vitamin B12 40

How much do you need? Men and women: 2.4 mcg

Why you need it: B12 is essential for keeping nerves and red blood cells healthy.

Good to know: As many as a third of people over 50 do not absorb enough B12 from diet alone; inadequate absorption may lead to neurological and balance problems.

Food sources: Fish, shellfish, meat, dairy products.

Vitamin C

How much do you need? Men: 90 mg. Women: 75 mg. (Smokers should add an extra 35 mg.)

Why you need it: Important for wound healing; boosts immune system; required for growth and repair of tissues in all parts of body.

Good to know: No studies confirm that vitamin C prevents colds, although it may shorten the length of a cold; excessive amounts can lead to upset stomach and diarrhea.

Food sources: Citrus fruits, tomatoes, kiwi, strawberries.

Vitamin D

How much do you need? Ages 51-70: 600 IU. Age 71+: 800 IU

Why you need it: Vitamin D helps the body absorb calcium; may protect against heart disease, cancer, diabetes and several autoimmune diseases

Good to know: Very high levels of vitamin D (above 10,000 IU a day) may cause kidney and tissue damage. Some blood test results for vitamin D may lead to an inaccurate diagnosis of vitamin D deficiency.

Food sources: Sun exposure provides the body’s main supply of vitamin D; fatty fish, fortified milk and juices also contribute.

Vitamin E

How much do you need? Men and women: 15 mg

Why you need it: Vitamin E helps protect cells from damage; may reduce the risk of developing cancer, heart disease and other chronic diseases, but further research is needed.

Good to know: If you take a blood thinner, talk to your doctor before taking supplements; vitamin E increases bleeding risk.

Food sources: Vegetable oils, nuts, fruits, vegetables.

Folic Acid

How much do you need? Men and women: 400 mcg

Why you need it: A B vitamin, folic acid helps form red blood cells and produce DNA.

Good to know: High levels may mask vitamin B12 deficiency, especially in older adults. Recent research, suggests that for women, folic acid along with vitamins B6 and B12 may reduce the risk of developing age-related macular degeneration.

Food sources: Enriched cereals, whole-grain breads, dark, leafy vegetables.

Vitamin K

How much do you need? Men: 120 mcg. Women: 90 mcg

Why you need it: Vitamin K helps blood clot properly and helps maintain strong bones in older men and women.

Good to know: Can dilute the effect of blood thinners, so talk to your doctor if you take Coumadin (warfarin) or other blood thinners.

Food sources: Plant oils, green vegetables, cabbage, cauliflower.

[Source: AARP Nissa Simon article Jan 2012 ++]

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VA Caregiver Program Update 14: Caring for an ill, injured or disabled Veteran can be rewarding and exhausting. For Family Caregivers who juggle many priorities, it can take a lot out of you. Sometimes you may be left feeling run down or sick. Here are five tips for avoiding burnout:

1. Learn about the condition or illness affecting the Veteran you care for. Learn as much as possible about the condition and how it could change over time. Be prepared to expect and face the worst together.

 Having an idea of what to expect can lower your stress level.

 It will help you plan for future medical needs. It might also give you time to learn skills you will need later.

 Some health problems may cause your loved one to act out, say harmful things, or not even remember who they are. Staying educated about the illness can help you understand when this is a symptom and not act negatively toward it. Remember, sometimes your loved one isn’t sure how to deal with it either.

2. Don’t be afraid to ask for help. Think positively about the hard work you do, but remember that it’s OK to ask for help.

 Make a list of tasks you would like help with and people you can call for help.

 Ask a neighbor to pick up some items for you from the store.

 Ask family members to help with household chores, paperwork or research. You might be surprised at how willing they are to help.

 Contact your local area agencies or volunteer groups for assistance. Many groups offer meal delivery, transportation and respite care.

3. Take breaks. Find some time each day when you can safely step away from the Veteran you care for – for example, when he or she has a friend or another family member visiting. During your break:

 Go outside for a walk or go for a bike ride.

 Read a book or listen to music.

 Chat with a friend.

 Schedule respite or adult day health care weekly or monthly to give yourself breaks.

Even if you only have a few minutes free – give yourself a much-needed break. Check out our resource on Making the Most of Your Limited Time for ideas.

4. Take care of your health, too! To give the best care to the Veteran you care for, you need to stay in good health. Your health is essential to your ability to keep providing for the Veteran you care for.

 Get regular health and dental checkups, and any health screenings you may need annually.

 Make sure you get your annual flu shots.

 Try to maintain regular sleeping patterns as much as possible.

 Eat healthy meals and snacks.

 Daily physical activity can help lower stress, increase your energy, and help keep your heart healthy.

 Your mental health is important, too. Connect with other Caregivers who may be going through the same thing. Or reach out to professionals for support. VA’s Caregiver Support Line (1-855-260-3274) can be a great place to start.

5. Stay Positive! Be realistic about what you can and can’t do. It will help you keep a positive attitude.

 There are many things you can’t control, but you can control your actions. Learn to recognize the things you can’t control, and don’t lose time worrying about how you can’t change them.

 A positive attitude may help you give the Veteran you care for the best care possible.

 You may not be able to make the Veteran you care for better, but you can protect his or her dignity and do your best to help them feel safe and loved.

 Even if the Veteran you care for is not able to show happiness or appreciation, you can feel good about the care you are giving and the love he or she is receiving.

Being a Family Caregiver is tough – there is no doubt about it. You’re there to support your Veteran, and the VA Caregiver support team is available to support you. If you need additional assistance, call VA’s Caregiver Support Line (1-855-260-3274) or visit them online at http://www.caregiver.va.gov. [Source: http://www.caregiver.va.gov/pdfs/Tips_for_Avoiding_Caregiver_Burnout.pdf Feb 2012 ++]

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Second Opinions: Evidence is mounting that second opinions—particularly on radiology images and pathology slides from biopsies—can lead to significant changes in a patient’s diagnosis or in recommendations for treating a disease. Some malignancies, including lymphomas and rare cancers of the thyroid and salivary glands, are notoriously tricky to diagnose correctly; test results can be inconclusive or return false results. After a decade of annual mammograms, more than half of women will receive at least one false positive recall on a breast-cancer screening, a recent study found. And nearly half of malpractice claims at Harvard University’s medical institutions that resulted in serious patient harm or death in the past five years were diagnostic errors, according to its liability company Crico/RMF. Thomas Feeley, vice president of medical operations at MD Anderson, says as many as 25% of patients who arrive at the center with diagnoses for certain cancers such as lymphoma may receive a different diagnosis. Overall, 3% of MD Anderson patients each year end up with a significant change that affects what treatment they receive. “When you get cancer, the first thing you may want to do is jump to get treatment with the first person you talk to,” Dr. Feeley says. “But taking the time to get a second opinion about the diagnosis you have and a careful evaluation of what treatments there are can be lifesaving.” Primary-care doctors can misdiagnose common symptoms. In a study, 202 patients most commonly complained about abdominal pain, fever, fatigue, shortness of breath and rash. Incorrect diagnoses included:

 Benign viral infection 17%

 Musculoskeletal pain 10%

 Asthma/Chronic obstructive pulmonary disease 6%

 Benign skin lesion 4%

 Pneumonia 4%

Final correct diagnoses for patients misdiagnosed initially included:

 Cancer 16%

 Pulmonary embolism 6%

 Coronary artery disease 5%

 Aneurysm 8%

 Appendicitis 6%

Second opinions are important for other diseases, as well. National Jewish Health, a Denver medical center, found in a study that more than half of patients it diagnosed with chronic obstructive pulmonary disease had previously been misdiagnosed with asthma, leading to inappropriate treatments. A form of dementia is often incorrectly diagnosed as Alzheimer’s, and studies show that doctors may misdiagnose coronary artery disease as other conditions. Not everyone should have a second opinion, of course. Health-care costs would soar if they did, says Robert Wachter, chief of the division of hospital medicine at the University of California, San Francisco. “There is also a risk you can get overwhelmed by conflicting opinions when you are in a terribly vulnerable position.” In the end, he says, patients must pick a doctor they trust and go with his or her recommendation. 43

Many health insurers require a second opinion before approving major surgery or expensive treatments. Patients shouldn’t hesitate to tell a doctor they want a second opinion, and they are entitled to their slides, pathology reports and other information to take elsewhere. Major medical centers, including Johns Hopkins Medicine and MD Anderson, have second-opinion services that doctors can refer patients to, or patients can contact directly, to get an independent assessment. Hardeep Singh, chief of the health policy and quality program at Michael E. DeBakey VA Medical Center in Houston, says a growing number of centers are requiring an internal second review of pathology reports to prevent misdiagnosis. If the second opinion differs markedly, a third opinion may be necessary to get a consensus on what course of treatment is best. Pathologists changed the diagnosis of 9% of 742 cancer cases in a recent study. Some original diagnoses—and the percentage of them that were changed on second opinion.

 16% of thyroid cancers

 10% of neck cancers

 11% of salivary-gland cancers

 9% of liver cancers

 8% of pancreatic cancers

 6% of lung cancers

Misdiagnoses can come about for various reasons. Pathologists and radiologists may misread slides and scans or fail to use the latest tests or technology. Sometimes doctors may simply get stuck on the idea of one diagnosis and ignore or overlook evidence it might be something else. This month, the president of Argentina had her thyroid removed after being diagnosed with cancer from a biopsy, but the doctors announced after the surgery that she in fact had a benign condition. Jonathan Lewin, chief radiologist at Johns Hopkins Hospital, says that on an annual basis, his group sees a significant discrepancy in diagnosis in about 8% of cases, such as a brain tumor mistakenly thought to be an infection or a stroke or multiple sclerosis that initially is diagnosed as a brain tumor. “The last thing a surgeon wants to do is take out a piece of brain and find out this isn’t what we thought it was,” Dr. Lewin says. When seeking a second opinion the questions to ask are:

 Have you reviewed all the materials related to my case?

 Was the lab test/image/biopsy specimen adequate to make a firm diagnosis? Would a repeat test give us more information?

 Are we certain that this is the disease that I have? Could there be another explanation for these symptoms or results?

 If you agree with the initial diagnosis, can you confirm or suggest modifications to the first doctor’s proposed treatment plan?

 Can you reassure me that we have explored all the options?

[Source: Wall Street Journal Laura Landro article 17 Jan 2012 ++]

 

2/15/2012

Medicare Skilled Nursing Home Coverage: Medicare to cover the cost of a post-hospital skilled-nursing home, a beneficiary must first be a hospital inpatient for at least three consecutive days. The first day of a physician-ordered hospitalization is counted as Day 1 and the day before discharge is counted as the last day. If a patient is admitted on Monday and discharged on Wednesday, Medicare counts the number of days as only two and would not cover a subsequent stay in a skilled nursing facility. Another problem concerns Medicare beneficiaries‘ status at admission and while in the hospital. Many physicians admit patients on an observation status. Patients may be in hospital beds and receiving medications, meals and tests, but they are considered outpatients if they are listed on physician-ordered-observation status. Patients and their families may be unaware that they are not inpatient. Medicare Part B, rather than Part A, pays for their hospital stay. Then when they are transferred to a skilled nursing facility for recovery, that cost is not covered by Medicare. Medicare guidelines use observational services to determine whether patients should be considered and treated as inpatient and may include short term treatment, testing and assessment. While the suggested time for observation status is 24 to 48 hours, many stays extend up to 14 days.

Beneficiaries or their families can avoid these costly surprises by asking the hospital staff or physicians the patients‘ status. This is especially important if follow-up care in a skilled-nursing home is anticipated. Once beneficiaries or their families establish that their status is as an inpatient, then any effort to move the beneficiary out of the hospital before the three-day period should be questioned and challenged if necessary. Beneficiaries or their families may request a formal notice-of-status from the hospital utilization team. If notices specify that the beneficiaries have been admitted on an observation status, then an appeal can be filed to challenge that decision. If the hospital fails to provide notices, then the beneficiaries can appeal when they receive their Medicare Summary Notices. To find out more on this subject or request publications, contact the Center for Medicare Advocacy at http://www.medicareadvocacy.org. For appeal assistance, contact your local Health Insurance Counseling and Advocacy Program (HICAP). In California, HICAP can be reached at http://www.cahealthadvocates.org/HICAP or at 800-434-0222. [Source: H.E.L.P 2012 Issue 1 article 9 Feb 2012 ++].

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Sleep Apnea Update 05: United States military veterans now have the option to use Provent® Sleep Apnea Therapy, a small, non-invasive nasal device for the treatment of obstructive sleep apnea (OSA). Ventus Medical, maker of Provent Therapy, announced 23 JAN the U.S. Department of Veterans Affairs has granted a multi-year, Federal Supply Schedule contract that would expand access to Provent Therapy among veterans. It’s estimated more than four million U.S. veterans suffer from OSA, with a 61 percent increase of diagnoses between 2008 and 2010. Experts attribute that to an enhanced awareness of OSA, and exposure to dust and sand in Afghanistan and Iraq which may compromise respiratory health. People with OSA stop breathing multiple times each hour during sleep, often for ten seconds or longer. They frequently don’t recognize the symptoms, but their bed partner complains of loud snoring and long pauses in breathing. “OSA is a chronic condition creating a significant burden on the Veterans Healthcare System. While continuous positive airway pressure (CPAP) is a safe and effective treatment, a substantial percentage of veterans don’t accept or adhere to this treatment,” said Richard B. Berry, M.D., Professor of Medicine at University of Florida. “There is a great need for access to new, clinically-proven therapies – particularly easy-to-use treatments – for the increasing number of veterans with obstructive sleep apnea.”OSA is associated with serious medical conditions including high blood pressure, irregular heartbeat, heart attack, stroke and diabetes, as well as an increased risk of motor vehicle accidents due to sleep deprivation. People with moderate to severe OSA are almost five times as likely to suffer from heart disease, and have up to 10 times as many motor vehicle accidents compared with people who don’t have OSA. “Leading sleep centers estimate that one in five veterans experience sleep apnea, a rate of OSA that is four times higher than in the general U.S. population,” said Peter Wyles, President and Chief Executive Officer of Ventus Medical, and former U.S. Marine. Provent Therapy is a proprietary medical device for the treatment of obstructive sleep apnea (OSA). The device is proven clinically effective in a series of published studies. It is easy to use, non-invasive and disposable treatment that works across mild, moderate and severe OSA. Provent Therapy utilizes nasal expiratory positive airway pressure (EPAP) to keep a patient’s airway open during. It incorporates a novel MicroValve design that is placed over the nostrils and secured with hypoallergenic adhesive. During inhalation, the valve opens allowing nearly unobstructed airflow. During exhalation, the valve closes, limiting airflow through small openings, which increases expiratory 20pressure and keeps the airway open, preventing disruption in breathing. Provent Therapy is FDA cleared. For more information, please visit http://www.proventtherapy.com . [Source: WSJ Market Watch Press Release 23 Jan ++]