Health care mess:No real solutions?

By ANN McFEATTERS

At a recent town hall meeting, widely shown on cable TV, a nearly hysterical, sobbing woman was saying that her insurance company had denied home health care for her bedridden husband.

The congressman listened to her, promised that his staff would look into the matter and went on to say that the trouble with America today is government.

Americans in such situations have to turn to each other for help, he said, warning there is too much dependence on government.

Leaving aside the obvious fact that the congressman-who-hates-government is part of government -- and gets his paycheck from taxpayers, how many neighbors have the proper nursing skills and the time to help with rigorous daily care for someone who is not a relative?

A few days later a report by the National Conference on Citizenship reported that Americans have cut back on the amount of volunteering and civic works they do, largely attributable to the recession.

Their annual "civic health index," based on polling data from May, reports that 72 percent of Americans said they have "cut back on time engaged in civic participation, which includes time spent volunteering, participating in groups or performing other civic activities in their communities."

It also said 66 percent of Americans say they feel others are responding to the recession by "looking out for themselves."

The report quotes the conference's chairman, Michael Weiser, as saying, "The economic crisis has triggered civic foreclosure," although he added, "The good heart of Americans is still very evident, though, as they refocus on basic needs."

One way President Obama is proposing to pay for health-care insurance reform is to cut back on charitable deductions taxpayers now take. Taxpayers earning more than $250,000 a year now give about $81 billion annually to charity. By one estimate, that could drop by nearly $4 billion if the tax deduction decreases. Needless to say, the philanthropic community is concerned.

At the same time, many charities, hit hard by the economic downturn, had intended to rely more on volunteers.

But all this overlooks the fact that most health care for the elderly -- the biggest users of health care in America -- is provided by relatives, usually spouses and daughters. Very little is being done to help them, as witnessed by the panicked woman at the town meeting.

Despite the heated rhetoric, we are far, really far, from solving the health care mess in this country. The unwieldy, convoluted 1,017-page health insurance reform bill passed by the House (America's Affordable Health Choices Act of 2009 to "provide affordable, quality health care for all Americans and reduce the growth in health care spending") is full of inconsistencies, vague promises and loopholes.

As summer draws to a close, the Senate still has no version. (If Democrats push through a version with no Republican support or input, it will be disastrous. The country will rebel.)

And we still have no clear idea what President Obama wants or where his line in the sand is although health care is allegedly his top priority.

Health-care costs account for 15 percent of our entire Gross Domestic Product, a figure that the Congressional Budget Office predicts will be 49 percent by 2082 if nothing is done. And 47 million Americans remain uninsured, with thousands more losing insurance every day. Yet, despite Obama's latest deadline of September, a compromise plan has yet to emerge.

We begin September with no comprehensible package in hand, with anger and fear on all sides from the residue of riotous town meetings, with little leadership from the White House even as we hope for serious negotiations.

It would be nice if the sentiment over the death of Sen. Edward M, Kennedy would spur compromise and action, although that is unlikely.

This whole endeavor has been so badly handled by nearly everyone involved, it's heartbreaking. If nothing is done, millions more will lose their faith in government. If nothing is done, government then truly will be the problem, not the solution.

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Weight Loss and Calorie count

What is calorie?It's a pretty simple question,but the answer is more important than you might expect.Calories-knowing how to to find them,how to to count them and how to cut them are keys to lose weight .Calorie counting is easy and effective.
To your weight loss success

How To Calculate Body Mass Index

Calculate Body Mass
The body mass index calculator can be used to identify if you are overweight. A drawback of the calculation is that if you are muscular it can suggest you are overweight due to muscle density.



The definition of obesity, issued by the National Heart, Lung, and Blood Institute, overweight is value between 25 and 29.9 and obese is a BMI value greater than or equal to 30.

The formula for calculating BMI is:



BMI=KG/m2
Enter your weight and height
height in cms
weight in kgs


Your BMI is:

The table below indicates the category your BMI falls into:

BMI value category
below 20 underweight
20-25 normal
25-30 overweight
over 30 obese

We'd highly recommend the BMI calculators and information on the halls.md website, they have more advanced features than the one here, and provide more specific calculations based on your gender and age.

More
Some other sites providing BMI calculators and information we have found useful:

Body Mass Index Calculator - your body mass index indicates if you are overweight.

medindia.net - body weight calculator and charts

Can Dietry Changes Help Rhuematoid Arthritis?

Patients Want to Know -- What Dietary Changes Stop Rheumatoid Arthritis?
It's one of the first questions someone with rheumatoid arthritis asks: "What dietary changes should I make to stop this disease?" Not only are people who ask the question looking for a quick fix -- they want a fix that will keep their rheumatoid arthritis symptoms in some form of remission. They want to stop the pain and stiffness that come with having rheumatoid arthritis. If they could find out one or more dietary changes that would make a difference, they would be committed to at least trying it.

Most of what I have read over the years on the subject of diet and arthritis suggested that, at most, some people may have food allergies or food sensitivities that make their arthritis worse. People are not the same, though, so there is only the process of elimination that will help determine which food is causing the sensitivity. That's a pretty daunting task -- to eliminate foods one by one to see if they change how you feel.

Some patients swear that a dietary change helped them, while others are equally emphatic that dietary changes made no difference in their arthritis symptoms. Similarly, there have been clinical trials performed with mixed results.

Cochrane Review Analyzes 15 Studies
The 15 studies included in the Cochrane Review involved 837 patients. Here's what researchers found:


•Fasting followed by 13 months of a vegetarian diet (no meat but allows eggs and milk) reduced pain by 1.89 on a scale of 0 to 10 -- but had no effect on physical function or morning stiffness.


•A 12-week Mediterranean diet (high in fruits, vegetables, cereals, legumes, fish, olive oil -- low in red meat) reduced pain by 14% but had no effect on physical function or morning stiffness.


•Two studies assessed an elemental diet (hypoallergenic, easy-to-digest food -- usually a liquid diet) and there were no significant differences in pain, function and stiffness among rheumatoid arthritis patients.


•Studies of vegan diets (no meat, fish, eggs, or milk products) and elimination diets (where foods are removed from the diet to see if improvement in symptoms occurs) were deemed inconclusive.

Other Study Findings
Interestingly, of the study participants who were placed on a diet, twice as many dropped out as participants not put on a diet suggesting that, even if helpful, these diets are hard to stick to. Also, study participants who did change their diet had unintentional weight loss -- up to 6 1/2 pounds. That may sound good to you, but researchers were concerned about vitamin and mineral deficiencies that may have resulted from dietary changes.

There may be "side benefits" for rheumatoid arthritis patients who attempt certain dietary changes, though. Consider common comorbid conditions that are associated with rheumatoid arthritis, such as cardiovascular disease and osteoporosis. Some of the diets may lower the risk of those and other comorbid conditions in rheumatoid arthritis patients. Researchers concluded that the Mediterranean diet, for example, is heart-healthy and would do little harm to a rheumatoid arthritis patient even though its direct effect on rheumatoid arthritis would likely be insignificant.

Source:

Dietary interventions for rheumatoid arthritis. Hagen KB, et al. The Cochrane Database of Systematic Reviews 2009.
http://www.cochrane.org/reviews/en/ab006400.html

Heath Care Reform - What Arthritis Patients Are Saying

with Carol & Richard Eustic


Health care reform -- a hot topic to say the least. Most Americans believe we need it, but there's less agreement about how to achieve it. We pitched the topic of health care reform in our arthritis forum and there have been some interesting responses -- especially those offered by forum members in the U.K. and Canada. Both expressed their displeasure with what's been said about their health care systems -- and they were quick to defend what seems to be working.

As for those living on American soil, there seemed to be concern over how health care reform will be paid for, forced changes that may be a consequence of reform, and trusting information that comes out of the White House. Are these valid concerns in your opinion? Do you have other concerns? Share your opinion on Health Care Reform.

Remedy For High Blood Pressure;beetroot juice

What is Beetroot Juice?
Beetroot juice (also known as "beet juice") is rich in essential nutrients such as folate, potassium, and vitamin C. In juicing or juice fasts, beetroot juice is typically blended with other vegetables and fruits to achieve certain health effects.

Benefits of Beetroot Juice
Here's a look at several beetroot juice benefits researched in scientific studies.

1) Beetroot Juice for Lower Blood Pressure

Drinking just over two cups of beetroot juice daily may help keep your blood pressure in check, according to a 2008 study. Within three hours of drinking 500 milliliters (about 17 ounces) of beetroot juice, volunteers showed a significant decrease in blood pressure. What's more, that drop in blood pressure was sustained for up to 24 hours after the juice was consumed.

The study's authors suggest that nitrate—a nutrient found in green, leafy vegetables in addition to beets—may be responsible for beetroot juice's blood-pressure-lowering effects.

2) Beetroot Juice for Better Stamina

In a small study published in 2009, scientists discovered that drinking beetroot juice may boost exercise stamina. For the study, eight men drank 500 milliliters of beetroot juice daily for six consecutive days before undergoing a series of cycling-based fitness tests. Results showed that the participants were able to cycle for an average of 92 seconds longer after drinking beetroot juice (compared to their cycling time after drinking blackcurrant cordial for six consecutive days).

The researchers also observed that study members had lower resting blood pressure after drinking beetroot juice.

3) Beetroot Juice to Fight Inflammation

Beetroot juice may benefit obese people by curbing inflammation (a risk factor for cardiovascular disease, type 2 diabetes, and cancer), according to a study published in 2009. The study also showed that beetroot juice may fight free radicals (chemical by-products known to damage DNA).

Beetroot Juice Recipes
Since beetroot juice has such a strong flavor, it should be blended with other juices (such as carrot, apple, and lemon) before drinking.



Sources:

Bailey SJ, Winyard P, Vanhatalo A, Blackwell JR, Dimenna FJ, Wilkerson DP, Tarr J, Benjamin N, Jones AM. "Dietary nitrate supplementation reduces the O2 cost of low-intensity exercise and enhances tolerance to high-intensity exercise in humans."

Scientically Proven Principle That Will Have Your Body Producing More Insulin Naturally

What do you think would happen to this 'vehicle'?
THAT'S RIGHT – IT BREAKS DOWN.
If you keep pouring in fuels that your body can't process
properly… then eventually your “motor” starts experiencing
serious difficulties.
Some people develop tumors. Other people have
Cholesterol levels that are through the roof. For you, your diet
and lifestyle is causing you to damage one very specific organ
called the pancreas... the organ happens to be responsible for
producing and releasing insulin.
This organ has become so severely damaged by your diet,
that it eventually produced less and less insulin until you were
diagnosed with Diabetes.
If you really think about it…
Diabetes is not a disease about not having enough
“insulin”… but a disease of the organ that produces
insulin: The pancreas !
In reality‚ diabetes is not the “disease” at all. It is a
"symptom" – an outward "signal" – of a damaged pancreas
that simply is too damaged to produce the insulin your body
needs to regulate the levels of sugar in your blood!

Scientically Proven Principle That Will Have Your Body Producing More Insulin Naturally (Ctd)

The body is designed to heal itself—provided it has what it
needs to do its job.
And your diet is one of the major influences on your
Diabetes condition.
You've probably heard the old adage, "We are what we eat."
This statement seems closer to the truth when it comes to
diabetics, than many people would imagine.
How can our diet have such a big impact on our
body?
I’ll explain with a metaphor. Picture your body as a car, that
was designed to function on all-natural, organic, fuel. The car is
a living, breathing machine not unlike the human body. For 2
million years, this car has been using fuel such as:
water / seeds / nuts / grasses / herbs / roots / fruits /
vegetables / cereals.
THAT'S the fuel it is used to.
MOREOVER, THAT'S the fuel its entire system is based
upon. It was MADE from that stuff.
Then, suddenly, after 2,000,000 years… that car switches
over to – for the last 100 years – a new, modern mixture of:
sugar / sweets / biscuits / crisps / chocolate / coffee / cocacola
/ fats & oils / cigarettes / alcohol / vinegar / pharmaceutical
drugs / chemicals, pesticides, and preservatives (loads of
them) / etc.TO be continued

Scientically Proven Principles That Will Have Your Body Producing More Insulin Naturally (Ctd)

...terrifying for pharmaceutical companies to realize
that this natural discovery, without the use of medicine, is
helping people cure their Diabetes completely.
How is that possible, you ask? “I thought Diabetes couldn’t
be cured?”
You’re right. At least, partially.
With traditional medicine, Diabetes can never be cured.
Traditional medicine “fights” Diabetes through drugs that treat
the symptoms of the disease, but never deals with the root
cause of the problem.
In fact, doctors acknowledge they have no idea WHAT
causes Diabetes, they don't know how to cure it—but here is a
prescription for some drugs anyway. (sound familiar?)
Does that make sense to you? Why would you take drugs if
doctors don't know what Diabetes is, what caused it, or how to
cure it? Yet, people do just that for every physical condition,
such as Cancer, Multiple Sclerosis, Cholesterol, Arthritis,
Cardio-Vascular diseases, And… Diabetes.
In the West, we have a high incidence of these diseases
that practically don’t exist in “undeveloped” parts of the world.
This has been known for a long time, and for years, top leading
microbiologists and medical scientists have searched for an
answer.
Well they finally discovered the answer. They discovered
that it is our modern lifestyle that is actively causing these
diseases.

Proven Priciples That Will Have Your Body Producing More Insulin Naturally

“If you're tired of being financially exploited by doctors
and drug companies while YOU suffer from Diabetes,
an entirely curable condition, then this will be the
most important report you'll ever read!”
I’m writing because I want you to know about a
breakthrough scientific discovery in Diabetes. If you read it… I
promise you'll be immensely rewarded. If you fully understand
it, you won't want to miss a single day of your life without it.
Let me explain...
There is new research out for people with Diabetes…
thousands of people like you have systematically and
effectively reversed their condition.
And chances are, you won't hear or read about this
anywhere else, because it isn't in the interest of pharmaceutical
companies or medical professionals to inform you. “Why?” You
might ask.
If everybody knew about it, pharmaceutical companies
couldn't sell their life-long maintenance drugs anymore.
Pharmaceutical companies and medical professionals
would lose millions of dollars in profits. This is why you will only
hear about this through word of mouth, or, on the Internet.To be continued don't go away

The Truth About Curing Diabetes

Diabetes doesn't just happen, it is the
direct result of a breakdown inside your
body.
We're not paying attention to the
SOURCE of our problems
and until we do,
these problems are going to continue
and even get worse.

How do I Get Rid of Acne?

by maryann
How do I get rid of acne? This is the most universal skin care complaint among teenagers and adults alike. In fact, acne accounts for the greatest visits to the doctor for skin related conditions. Unfortunately, there is no known cure for acne, but it is readily treatable and controllable. Some of the methods you can use for how do I get rid of acne, are just a little adjustment in everyday habits.

Unlike popular belief, acne is not caused by poor hygiene. Don’t fall prey to this notion as a strategy to use to answer the question of how do I get rid of acne. This will only irritate your skin and make you more prone to breakouts. So don’t be tempted to over do it with your washing. Yes, wash your face, but don’t over scrub it. Use your hands and a mild acne soap, and gently clean it. Two to three times a day is adequate. Don’t use antibacterial soaps, soaps with strong fragrances. The chemicals in these cleansers are far to strong for acne sensitive skin.

Cloth harbors the bacteria which acne thrives on. Inadvertently, we spread the acne with the clothes we wear, the sheets we sleep on, and the towels we dry with. Daily, use a fresh, clean changes of clothes, towels, sheets etc. Make it a habit as your technique on how do I get rid of acne. Like the soap we use for our body, the detergent used in washing machines should be mild as well. Hypo-allergenic or brands purchased in health products stores are a better choice.

Talking about bacteria zones, keep your hands away from your face. Many of us touch our face out of habit, and are not aware that are contaminating our skin with the hundreds upon thousands of bacteria we inadvertently pick up over the course of a day. Wash your hands frequently, carry a little bottle of hand sanitizer around, and make it a practice to keep your hands clean. How do I get rid of acne could be answered with just this one practice.

On that note, avoid squeezing pimples unless they are absolutely ready. While it’s not recommended to squeeze a pimple, the jury is still out on that matter. Squeezing is so tempting, but doing so before they are ready will just introduce more bacteria, and ultimately make the acne worse. Acne at its worst, can develop into cysts and lead to scarring. However, if the pimple has come to a head, then squeeze it the correct way, by soaking it with hot water until it is soft, and gently applying pressure with cotton gauze between your skin and your fingers.

Many of us have hectic life styles, but it is important to remember to keep care of ourselves. How do I get rid of acne may be answered by maintaining good health. Follow a healthy diet. Eat lots of fruit, veggies, and whole grain. Keep your intake of fast food and caffeine to a minimum. Drink plenty of water, get lots of exercise and plenty of sleep.

A note about makeup and hair styling products. These products wreck havoc with acne prone skin. The oils and chemicals in them plug pores and contribute to further skin irritation. If you are going to wear make up, make sure it is either ‘oil free’ or non-codmedogenic. And never, never go to bed without removing your make-up.

Acne prone people are still going to experience pimples and blemishes, even after the best skin care routine. If prevention answer your question of how do I get rid of acne, then you have other resources available.

We have for our use, many home remedies such as toothpaste, crushed aspirin made into a paste, honey, or garlic. If this does not appeal to you, the drug store has a variety of ointments, creams, wipes, and lotions that will do the trick. Another route for control is advice from homeopathic practitioners that might recommend a holistic approach. Still, your doctor or dermatologist may recommend oral antibiotics or even stronger measures to get rid of acne.

Just remember to be patient with acne. Easier said than done, but important. It can take any amount of time to clear up, from several days to several months. There is no clear cut healing time. It depends on the severity and extend of the acne. The best thing for anyone to do when tackling acne is remember, it is something that is dealt with on a continuous practice until such a time that it goes away by itself.

Get Rid of Acne

Acne is a broad description that covers a variety of skin conditions. Normally we tend to call them zits, blemishes, pimples, blackheads, whiteheads, or lesions, but what ever we choice to call them, they are fact of life. Even though acne is more known to be a problem amongst teenagers, this condition can strike at any age. While preventative measures are the best for controlling the outbreak of acne, there are treatments to get rid of acne so that it greatly diminishes or disappears entirely.

Treatments vary as do the results. Some people choose to use over-the-counter medications to get rid of acne. Others must resort to medical help such as a dermatologist. Many people like to try approaches that comprise of the ordinary and out of the ordinary methods. Some of the ideas to get rid of acne are common sense, some are time and truth tested methods that have been passed down by word of mouth over the generations.

Here are some products from your medicine cabinet that are said to work to get rid of acne:
1. Aspirin. - Take one aspirin and crush it. Add some water or lemon juice to make a thick paste. Apply liberally to the affected area. This remedy works by both reducing the inflammation and enhancing the healing process.
2 Toothpaste ( not the gell) - Before you go to bed, apply the toothpaste on your face or where ever the acne is at its worst. Toothpaste has an astringent nature that helps reduce the swelling of the acne making the appearance of pimples look less pronounced.
3. Shaving cream- Strange but true. If you think about it, shaving cream has ingredients that soothes skin that is being shaved. The same applies to acne. Gently rub it in before you go to bed, and wash it off in the morning.
4. Eye drops for red eyes - Applying eye drops with a cotton swap or wipe and leaving it on for a short time is said to conceal acne.
5. It is important enough to mention that these products are strong chemicals that may very well cause a reaction with your skin. Test them on a small area of your skin before you go ahead and use it elsewhere. The last thing you need on top of your acne, is a horrible skin rash or burn on your skin.

Check out your kitchen pantry or fridge. There are some fast and easy items that help get rid of acne.
1. Yeast - Yes, yeast is not only for making bread. Yeast mixed with a anti inflammatory oil, such as tea tree oil works wonders. The active ingredient in the yeast opens the pores, and the anti inflammatory tea tree oil reduces the swelling. Mix the two ingredients together to make a paste, apply to skin and leave on over night or a period of several hours. Covering with a bandage is recommended but not always possible.
2. Cider vinegar. Cider vinegar is said to be a miracle food. It can be taken internally or used as a wash. The best kind of cider vinegar is unfiltered and organic. Sponge it on the affected areas undiluted, or drink 1/4 cup diluted with water over the course of a day.
3. Honey - Honey is one of natures best antibacterial agents. Wash the infected area first with a warm salt water solution then apply honey. Let it sit for 15-30 minutes and wash off. Repeat as necessary.
4. Garlic - Another of natures best healing herbs. Garlic can be applied directly to the skin in a paste, juice, or oil. A little smelly, but it works to reduce the inflammation of acne.
5. Water - Drink plenty of water. Water is the bodies best resource for new cell growth and healing.

Acne is a fact of life, but it does not have to rule our lives. Try these home remedies to get rid of acne. After all, these remedies have been used and proven to work. The least they will do is give you some relief. In some instances, if the acne is very severe, then more aggressive measures may have to be taken to get rid of acne. They may include stronger over-the-counter medications, or prescriptions medications.

Creating Subtainable Healthcare for the 21st Century

from 2020healthsolution

•Medicare, the largest payer for healthcare services in the nation, is projected to be insolvent by 2019 if the current system is not changed
•Employers, who primarily fund healthcare for working Americans, are finding it increasingly necessary to reduce or eliminate healthcare benefits due to rapidly escalating costs
•The wave of 76 million baby boomers retiring will be at its’ peak in the early 2020s, placing an unprecedented strain on the healthcare system
•The shortage of primary care physicians and nurses is expected to worsen in the coming decade
•The explosion of chronic diseases will continue to accelerate as the population ages, placing an overwhelming economic burden on the nation if our system is not restructured
Can a sustainable healthcare system for the 21st century be created, funded and continuously improved to meet the needs of everyone in our society? We believe the answer is a resounding “Yes!” We have developed a simple but efficient blueprint that refocuses the attention, expertise and financial resources of our nation to provide better care at a lower cost.

From deep roots in the homecare segment of healthcare, and with backgrounds from all across the care continuum, we have created a unique approach to true reform. In addition, our solution is not just theoretical: we are applying what we have developed in real-world situations every day.

We invite you to explore this website to learn more about 2020 Health Solutions and our proposal to redefine healthcare in America

What is Binocular Vision?

What is Binocular Vision?
BINOCULAR: Of or involving both eyes at once.

BINOCULAR VISION: Vision wherein both eyes aim simultaneously at the same visual target; vision wherein both eyes work together -- simultaneously, equally and accurately -- as a coordinated team.

Healthy binocular vision produces important visual perceptual skills which are part of normal human vision: binocular depth perception and stereopsis.

STEREOPSIS: (stereopsis or stereoscopic vision) vision wherein two separate images from two eyes are successfully combined into one image in the brain.

Stereopsis is an aspect of "normal" healthy vision. Here's how it works. First, both eyes must be accurately aimed at the same target (that's binocular vision, but it's not yet stereoscopic vision!) Then, because the two eyes are located in different positions, each takes in a unique view from its own perspective. The two separate images are sent on to the brain for processing. When the two images arrive simultaneously in the back of the brain they are united into one picture. The combined picture appears three-dimensional (3-D) because it has the added depth dimension. That's stereo vision. Stereo vision gives you depth perception.

American Health Packaging Unit Dose - Safety Every Step of the Way

Patient safety is a critical issue for health systems. As a result, many health systems seek bar coded products to dispense to patients. Bar coded products, in conjunction with bedside point-of-care (BPOC) systems, automate the "five rights." American Health Packaging supports this health systems' priority with its growing line of unit dose products. Located in Columbus, Ohio, American Health Packaging has been in business for over 15 years.

Bar coded to the dose level, our unit dose line has grown substantially in recent years. The line now contains over 250 SKUs. Recent launches include psychiatric care items, neuromuscular care products as well as those that support pain management.

Our products are stability tested to ensure extended shelf life. An added safety feature, specially designed color-coded labels with “tall man” lettering help to different product (and strengths) on the pharmacy shelf.

Our products are awarded to top GPO's and are stocked by the major wholesalers. New items are launched regularly. Visit americanhealthpackaging.com monthly for information on our recently launched unit dose products.

It's Important to Control Your Blood Pressure, Too

Diabetes Disease
(LifeWire) - The need for people with diabetes to closely monitor and control their blood glucose levels is common knowledge and constantly stressed. But with all the attention paid to blood sugar, it's possible to overlook a serious related medical issue -- high blood pressure, also known as hypertension.

Blood pressure control is important for people with diabetes for many reasons. Diabetes increases a person's risk for various conditions, including heart disease, stroke, kidney damage and eye problems. High blood pressure itself increases these risks, too. Unfortunately, the two diseases often go hand-in-hand. As many as two-thirds of people with diabetes also have high blood pressure, meaning they have a compounded risk of these various other conditions.

A Lower Blood Pressure Goal for People with Diabetes
Experts usually recommend that people with diabetes keep their blood pressure under 130/80 mm/Hg. This is a lower goal than the one set for most adults. The American Diabetes Association (ADA) recommends that people with diabetes get their blood pressure checked by a medical professional at least two to four times per year.

Lifestyle Changes for High Blood Pressure Control
The good news is that the lifestyle changes recommended for people with diabetes are pretty much the same as those recommended for people with high blood pressure. (Added bonus: They'll help control blood cholesterol levels, too.
•Diet
A diet rich in fruits, vegetables, whole grains, lower-fat proteins (dairy, fish and nuts), and monounsaturated fats (in place of saturated and trans fats) is usually recommended for people with diabetes. Of course, attention must also be paid to carbohydrate consumption, but this basic diet is effective for diabetes management.
A very similar eating plan is recommended for controlling high blood pressure. The DASH (Dietary Approaches to Stop Hypertension) diet puts the same emphasis on fresh produce and low fat choices, but also limits sodium to 2,400 milligrams per day. Essentially, the DASH diet helps control both diabetes and high blood pressure.


•Exercise
Again, the lifestyle modifications recommended for diabetes are very similar to those for hypertension. Taking a brisk walk or engaging in some other form of cardiovascular exercise for 30 minutes, five days per week will help manage or reduce risk for both conditions.

•Weight Control
Being overweight or obese raises risks for both diabetes and high blood pressure. Achieve calorie balance -- work to take in the same number of calories each day that you burn to maintain a healthy weight. If you need to lose a few pounds to get to your healthy weight, work to take in fewer calories than you burn. This will help control both conditions.

•No Smoking
Because smoking is a powerful risk factor for heart disease -- and both hypertension and diabetes raise heart disease risk -- it's essential that anyone with diabetes stop smoking as soon as possible.

Medications May Be Required
While these changes can help many people control high blood pressure and/or diabetes, sometimes even the most sincere efforts at lifestyle modification won't be enough to keep blood pressure in a healthy range. In these cases, a doctor may recommend medication. Experts have found that for most people with diabetes, more than one medication is required to control high blood pressure.

Sources:

Bakris, George. "Lower Blood Pressure Goals for Patients with Diabetes." Journal of Clinical Hypertension, 2:6(2000): 369-371.

Revealed:Have You Ever Noticed that Anxious Thoughts are like a Broken Record?

by JOE BARRY
I know with Ipods etc. it's a bit outdated to be
using a record analogy here but it works well to
illustrate a key point about anxious thoughts.

Remember when a record got scratched it made
a very unpleasant sound and caused the needle to
get stuck on the same groove.

The same one line would play over and over again
ad nauseam until you picked up the needle and moved
it past the scratch.

Anxious thoughts are bit like this. You might be
happily going about your day and then something
triggers an anxious thought.

The worry the thought creates sends an unpleasant
shock wave through your nervous system. (The scratch on the record).
Then once you start reacting to the anxious thought it is
hard to stop thinking about it over and over again.
(The needle stuck in a groove)

The repetitive anxious thought can last minutes,
hours , days depending on how upset you become
by the thought.

I want to share with you a quick technique to jump out
of this anxious groove. This technique is you learning how
to pick up the record needle and move it past the scratch.

Here it is:

1, Observe
2, Trust
3, Move

Observe the anxious thought and label it. Say

"Oh there is fear X again, imagine that"

Try your very best to not get sucked into reacting
emotionally to the thought.

Then

Trust that what you are worrying about will in all
probability never come about. Almost all the anxious
thoughts we have are a complete waste of our energy.
Trust that things will work out fine.

Joseph Cossman said "If you want to test your memory,
try to recall what you were worrying about one year ago today."

If you are religious/spiritual then hand your anxious
thought over to a higher power. Trust that there is nothing
to fear and you will be looked after.

Trust and let it go.

"Every evening I turn my worries over to God.
He's going to be up all night anyway. " ~Mary C. Crowley


Lastly,

Move your attention elsewhere. Focus on something
positive that takes your mind out of the anxious groove.
Replace the anxious thought with a positive thought.

You are not trying to suppress the anxious thought, you
are simply moving your attention elsewhere. To continue
the record analogy, you pick the record needle up
(your attention) and move it out of the groove it was caught in.

If you are engaged in an activity then move your attention
fully there. Be 100% present in the moment. If you are walking
focus on the surroundings, if you are driving observe
all the sights and sounds. If you are with someone focus
all your attention on them.

By moving your attention into the present moment there is
no room for anxious thoughts to dominate your mind.

Play around with both moving your attention to positive
thoughts or into the present moment. Different people find
one or the other is easier to accomplish. The key thing is
to move your mind out of the anxious groove and put
you back in your natural flow.

So to sum up remember O.T.M.
Observe, Trust, Move

It takes a bit of practice but as long as you remember
the above 3 steps you will be able to dramatically eliminate
anxious thoughts from your day.

Finally Revealed:Scientically Proven Principles That Will Have Your Body Producing More Insulin Naturally II

How can our diet have such a big impact on our body?

I'll explain with a metaphor. Picture your body as a car, that was designed to function on all-natural, organic, fuel. The car is a living, breathing machine not unlike the human body. For 2 million years, this car has been using fuel such as:

water / seeds / nuts / grasses / herbs / roots / fruits / vegetables / cereals.

THAT'S the fuel it is used to.

MOREOVER, THAT'S the fuel its entire system is based upon. It was MADE from that stuff.

Then, suddenly, after 2,000,000 years... that car switches over to - for the last 100 years - a new, modern mixture of:

sugar / sweets / biscuits / crisps / chocolate / coffee / coca-cola / fats & oils / cigarettes / alcohol / vinegar / pharmaceutical drugs / chemicals, pesticides, and preservatives (loads of them) / etc.

What do you think would happen to this 'vehicle'?

THAT'S RIGHT - IT BREAKS DOWN.

If you keep pouring in fuels that your body can't process properly... then eventually your "motor" starts experiencing serious difficulties.

Some people develop tumours. Other people have Cholesterol levels that are through the roof. For you, your diet and lifestyle is causing you to damage one very specific organ called the pancreas... that happens to be responsible for producing and releasing insulin.

This organ has become so severely damaged by your diet, that it eventually produced less and less insulin until you were diagnosed with Diabetes.

If you really think about it...

Diabetes is not a disease about not having enough "insulin"... but a disease of the organ that produces insulin: The pancreas!

In reality, diabetes is not the "disease" at all. It is a "symptom" - an outward "signal" - of a damaged pancreas that simply is too damaged to produce the insulin your body needs to regulate the levels of sugar in your blood!
BY MATT TRAVERSO

Finally Revealed:Scientically Proven Principles That Will Have Your Body Producing More Insulin Naturally

Finally Revealed: Scientifically Proven Principles That Will Have Your Body Producing More Insulin Naturally.
Unconditionally Guaranteed to Normalize Your Blood Sugar Levels and Reverse The Root Cause of Diabetes!
Sit down where you can concentrate and...

Read this entire letter to discover simple steps to stimulate your pancreas to produce more insulin...
Dear Friend,

Are you sick and tired of constantly...

•worrying about all the long-term diabetes complications...
•being held prisoner by your diabetes...
•being fed up with daily insulin injections and finger pricks...
•facing an 80% risk of dying from heart disease or stroke...
•being afraid or guilty to have a wholesome dinner with your family...
•being concerned with not being able to lose weight, which the medicine seems to put on and keep on...
•being overwhelmed by the daily care and vigilance the disease requires...
•dealing with the "side-effects" of your medications...
If you're tired of being financially exploited by doctors and drug companies while you suffer from this entirely curable condition, then this will be the most important letter you'll ever read.

I'm writing you today because I want to tell you about a breakthrough scientific discovery about Diabetes. If you read it... I promise you'll be immensely rewarded. If you fully understand it, you won't want to miss a single day of your life without it.

Let me explain...

There is new research out for people with Diabetes... thousands of people like you have systematically and effectively reversed their condition.

And chances are, you won't hear or read about this anywhere else, because it isn't in the interest of pharmaceutical companies or medical professionals to inform you. "Why?" You might ask.

•If everybody knew about it, pharmaceutical companies couldn't sell their life-long maintenance drugs anymore.
•Pharmaceutical companies and medical professionals would lose millions of dollars in profits. This is why you will only hear about this through word of mouth, or, on the Internet.
•It is terrifying for pharmaceutical companies to realize that this natural discovery, without the use of medicine, is helping people cure their Diabetes completely.
How is that possible, you ask? "I thought Diabetes couldn't be cured?"

You're right. At least, partially.

With traditional medicine, Diabetes can never be cured. Traditional medicine "fights" Diabetes through drugs that treat the symptoms of the disease, but never deals with the root cause of the problem.

In fact, doctors acknowledge they have no idea WHAT causes Diabetes, they don't know how to cure it - but here is a prescription for some drugs anyway. (sound familiar?)

Does that make sense to you? Why would you take drugs if doctors don't know what Diabetes is, what caused it, or how to cure it? Yet, people do just that for every physical condition, such as Cancer, Multiple Sclerosis, Cholesterol, Arthritis, Cardio-Vascular diseases, And... Diabetes.

In the West, we have a high incidence of these diseases. Until recently, they practically didn't exist in rest of the world. But that has changed. Now the Epidemic is World Wide!

This has been known for a long time, and for years, top leading microbiologists and medical scientists have searched for an answer. Well they finally discovered the answer. They discovered that it is our modern life style that is actively causing these diseases.

The body is designed to heal itself, provided it has what it needs to do its job.

Your DIET is one of the major influences on your Diabetes condition.

You've probably heard the old adage, "You are what you eat." This statement seems closer to the truth when it comes to diabetics, than many people would imagine.

Health-care Reform;An Original And simple proposal

With over 300,000,000 people in America, it figures there must be someone who has the experience and skill set to reliably solve the health insurance and access problems besetting our country without throwing away the most excellent and caring medical system in the world.

Recently, when an old friend, a seasoned educator, and I, a seasoned physician, got together on a vacation in Colorado, he asked me if I had a simple solution for the medical insurance and access problems on the front pages of America's newspapers.

I told him "Yes, I do," but that it is so simple and inexpensive, without taxes or cuts in medical quality, that no one would believe me. It was he who insisted I put pen to paper because he felt there was an audience for a common sense solution to the health care ailments of America.

So here is the distillation of my 40 years' observation.

First, we should change the current 50 state patchwork of private insurance programs -- which cannot cross state borders -- to a national clearinghouse of private insurance choices that can compete across the whole country. Meanwhile, we should regulate the competing companies so that they must take all comers, regardless of pre-existing conditions.

Secondly, we should return health care insurance companies to the pre-1984 federal regulations that limited their fees to administration only (about 15% of medical dollars), without excessive profits going to their boards of directors, CEO's or shareholders. The provision of medical care is not the type of profession that can be treated as a simple commodity. The corporatization of health care was a bad idea, and it's getting worse. It has contributed tremendously to the crisis we're in now where hospitals and doctors feel squeezed -- forcing some of them to shut their doors or quit -- while insurance company profits soar.

Third, we need to make health insurance plans completely portable for individuals with life changes, in order for the insurance companies to compete on a flat playing field for the whole U.S. population. Ideally we should move away from employment-based health care. If employers do not have to pay the soaring costs of healthcare for their employees, they can raise their employees' salaries in a commensurate manner, and the employees, in turn, can choose which level of health care plan they want to purchase.

Of course, people who can afford it should be required to purchase health insurance, in the same way that we are required to purchase car insurance, but they would have the choice of which plan to purchase.

And last, the health care overhaul should include meaningful tort reform that caps frivolous malpractice suits. Such a policy has seen great success in California for 34 years.

With the four above changes, competition across the whole country should prompt health insurance companies to improve efficiency and cost-effectiveness (similar to what GEICO has done in the car insurance arena). Notice that the government has not had to spend significantly or nationalize health care to accomplish this. All that is needed is thoughtful insurance company regulation, and the mandatory participation of all citizens who can afford what will be competition-driven reduced premium costs.

But what about the indigent and illegal alien populations who still need access to good medical care? How do you take care of them without an extra tax burden on the working population? This is easy for me to envision because I did it for decades via the model of our USC/Los Angeles County Medical Center -- the busiest teaching hospital in the United States.

"County USC" handles hundreds of thousands of clinic visits by indigent and illegal alien patients every year, allowing for wonderful experience for our doctors-in-training under the guidance of a great faculty. Because our hospital has 2000 penetrating-wound (knife or gunshot) patients per year, the U.S. military rotates its trauma surgeons here for 6 months at a U.S. Naval sub-station, before deploying them to Iraq and Afghanistan.

Thus, the final no new-tax solution to the health care problem is to get all of the urban medical schools back to serving their local indigent populations, with a standing "open door" policy, and no dumping of those patients off to other private hospitals or clinics while still obtaining Federal Grants (such a dumping policy was recently disclosed to have taken place at the University of Chicago Medical School).

If the large urban medical schools remember that "school" is in their name, they will use the teaching environment to promote great care as we've done for over 100 years at County USC. Also, in carrying out this primary teaching function, the schools could be subsidized (as has been done for decades by Federal, state and county funds), but with the money going directly to the delivery of medical care, rather than the expansion of bricks and mortar.

Great American-style medical care can be provided cost-effectively in simple perk-free settings, as in the U.S. military hospitals, without requiring the private rooms and flat screen TV's for every patient that have contributed to bankrupting many hospitals.

Federal regulations and mandates of all U.S. medical schools to emulate the County USC model would address the load of indigent patients and give our medical schools back the patient experience they sorely need for continued training of our physicians.

This plan represents my simple solution to preserving all of the best aspects of choice and quality and access in the American medical system, without the need for new taxes at all. Nor does it require nationalizing under a government-run plan, which is guaranteed to increase bureaucracy as well as the delay of essential medical services, such as seeing a specialist, undergoing surgery, or obtaining cancer treatments.

And an added plus is that our medical schools can get back to their teaching mission as best exemplified by the County USC model, while providing great training for our future doctors
by Dr Paul Toffel

Whole Lot of Sense on Health-care Reform

by Don Boudreaux


Rather than increase government spending and control, we need to address the root causes of poor health. This begins with the realization that every American adult is responsible for his or her own health.

What People Don't Know about Health Insurance Exchange

by Peter Lee


and John Grgurina






Much of the heat so far in the debate over how health care reform will expand coverage to uninsured Americans has been about whether or not there should be a public plan option. That has overshadowed one of the most important issues – how to design effective health insurance exchanges to meet the needs of small employers and individuals.

Both houses of Congress have now proposed frameworks for expanding coverage that rely on exchanges. A health insurance exchange is simply a structured marketplace where people can choose among health plan options. The exchange offers information to help people make informed choices, and it provides administrative services such as simplified processing of enrollment, subsidies and premium payment. This can be of great value to small employers and individuals who don’t have access to employer-sponsored group plans.

Plenty of academic experts have written about the ideal design of an exchange, but we bring a unique, real-world perspective. We know why exchanges have and haven’t worked based on our experience running one of the largest voluntary health insurance exchanges in the country, PacAdvantage, which served over 10,000 small employers in California from 1993 to 2006, at its peak providing insurance for 150,000 enrollees.

Health insurance exchanges can provide huge value, but they are bound to fail if not structured correctly. PacAdvantage, even though it grew to a large size, failed because of what economists call “adverse risk selection” – the same reason similar programs have failed across the country in the past fifteen years. People with higher medical costs enrolled in PacAdvantage, while lower-risk people obtained coverage outside the exchange where they could find less expensive insurance. This drove up premiums inside the exchange, causing healthier people to drop out. This is known in the insurance business as a classic “death spiral.”

We must learn from these lessons in order to avoid the problems that have doomed exchanges in the past. We must design exchanges to be sustainable and prevent them from being relegated to the dustbin of well-intentioned but flawed health reform proposals not anchored in the real world.

What has caused the adverse selection “death spiral” in past health insurance exchanges? In the health insurance market for small employers, insurers usually insist on being the “sole source” for an employer group; insurers feel threatened if employees are free to choose among competing health plans. As a result, insurers often steer lower-risk people to their products outside of the exchange. The exchange is left with higher cost enrollees, which drives up the premiums and creates a death spiral.

Doctors Who Don't Take Insurance:What Does It Mean For Patients?

By Maggie Mahar

Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, her work has appeared in the New York Times, Barron's and Institutional Investor. She is the author of Money-Driven Medicine: The Real Reason Why Healthcare Costs So Much, an examination of the economic forces driving the healthcare system. A fellow at the Century Foundation, Maggie is also the author the increasingly influential HealthBeat blog, one of our favorite healthcare reads, where this piece first appeared.

More and more doctors are fed up with private insurers. It’s not just a question of how stingy they are, but how difficult it is to get reimbursed. Paperwork, phone calls, insurers who play games by deliberately making reimbursement forms difficult to interpret…

Some physicians have just said “no” to insurers.

What does this mean for patients? Business models vary. Some doctors charge by the minute. I recently read about a physician who punches a time-clock when the appointment begins. She has calculated that her time is worth $2 per minute. Fifty-nine minutes = $118. Will you be paying cash, or by charge today?
Somehow, I think the meter would make me nervous. I suspect I might begin talking very quickly. But this is only one model.

Rather than charging by the minute, some doctors charge fee-for-service. In those cases, many physicians mark up their fees well beyond what an insurer would pay. But, they point out, they also spend more time with their patients. No one feels rushed.

A story in a New Jersey newspaper describes how physicians in Northern Jersey have begun following in the footsteps of “elite Manhattan doctors and are withdrawing from all insurance plans.” The article compares fees with and without insurance. On the right, the fees that insurers typically pay for these services; on the left, the fees that Jersey doctors who don’t take insurance charge:

•Mastectomy: $5,000 / $900Ruptured abdominal aneurysm: $8,000 / $1,800
•Routine screening mammogram: $350 / $100
•Initial neurological consultation: $400 / $100
Some Doctors Share Savings with Patients

Other physicians find that if they don’t take insurance, they can cut their overhead, and actually charge patients less.

Over at Revolution Health “Dr. Val and the Voice of Reason” tells how Dr. Alan Dappen has set up his practice:

“He is available to his patients 24 hours a day, 7 days a week, by phone, email and in person. Visits may be scheduled on the same day if needed, prescriptions may be refilled any time without an office visit, he makes house calls, and all records are kept private and digital on a hard drive in his office.”

“How much do you think this costs? Would you believe only about $300/year?”

Dappen has stream-lined his practice. It’s not just that he doesn’t need an assistant to keep up with stacks of insurance paper work. In general, he keeps his overhead low, offers full price transparency, has “physician extenders” who work with him, and “charges people for his time, not for a complex menu of tests and procedures.”

The key is that Dappen practices very conservative medicine.

"I believe in doing what is necessary and not doing what is not necessary,” he says. “The healthcare system is broken because it has perverse incentives, complicated reimbursement strategies, and cuts the patient out of the billing process. When patients don't care what something costs, and believe that everything should be free, doctors will charge as much as they can. Third party payers use medical records to deny coverage to patients, collectively bargain for lower reimbursement, and set arbitrary fees that reward tests and procedures. This creates a bizarre positive feedback loop that results in a feeding frenzy of billing and unnecessary charges, tests, and procedures. Unlike any other sector, more competition actually drives up costs."

Dappen has it right about competition in the healthcare marketplace. Studies show that in areas where there are more hospitals competing with each other, hospital bills are higher. This is in a part because hospitals jousting for market share all invest the same cutting-edge equipment. The only way to pay for it is to use it. So they do more tests and more procedures, driving hospital bills higher.

Dappen, who practices in Fairfax Virginia, told Dr. Val Jones that “after building a successful traditional family medicine practice he felt morally compelled to cease accepting insurance so that he could be free to practice good medicine without having to figure out how to get paid for it. He noticed that at least 50% of office visits were not necessary—and issues could be handled by phone in those cases. Phone interviews, of course, were not reimbursable by insurance.”

Dappen also casts a skeptical eye on the pricey annual physical: "The physical exam is a straw man for reimbursement. Doctors require people to appear in person at their offices so that they can bill for the time spent caring for them. But for longstanding adult patients, the physical exam rarely changes medical management of their condition. It simply allows physicians to be reimbursed for their time.”

Again, Dappen is spot on, as Niko reported on HealthBeat here.

“Cutting the middle man (health insurance) out of the equation allows me to give patients what they need without wasting their time in unnecessary in-person visits,” Dappen explains. “This also frees up my schedule so that I can spend more time with those who really do need an in-person visit."

How many readers have found themselves sitting in a doctor’s waiting room, not because they were sick, but because they needed to renew a prescription? Since insurers don’t pay doctors for the time it takes to read an e-mail or to take a phone call and then write a new prescription, many insist that patients come in whenever they need a renewal—that way, the doctor can bill the insurer. This makes sense if the doctor needs to check your blood pressure to see whether the medication is working. But if he’s simply going to chat for a few minutes and write the script, the visit is a waste of time.

“Health insurance is certainly necessary to guard against financially catastrophic illness. And the poor need a safety net beyond what Dr. Dappen can provide” Johnson observes. “But for routine care,” a practice like Dappen’s “can make heathcare affordable to the middle class, and reduces costs by at least 50% while dramatically increasing convenience.”

Concierge Medicine

Dr. Val calls Dappen’s practice “concierge medicine for the masses.” Other physicians practice more traditional “concierge medicine”: customized, round-the-clock care for the elite.

In California, the Ventura County Star reports that local doctors opting out of insurance “spend more time with patients—and make more money.”

Some doctors charge payments an annual “membership fee”—rather like the fee you might pay to belong to a country club.

“I wish I had done it a long time ago," says Dr. Edward Portnoy. An internist, Portnoy once had a practice of about 2,800 patients. Now he sees roughly 380 people but takes home “about the same profit” thanks to the $1,800 membership fee that each patient pays yearly.

Portnoy spends roughly twice as much time with each patient as he did when he accepted insurance. He explains that he “has more time to do intensive physicals and help patients stay healthy, rather than running from one crisis to the next like a war surgeon doing meatball surgery.”

At Dr. Stanley Frochtzwajg's family practice in Ventura, patients don't face annual fees but pay “at the office for whatever services they receive,” the paper observes. “A routine office visit is about $80.” Patients are then given the paperwork to submit to their insurance companies themselves. “One patient said she ends up paying about 30 percent of the bill but is happy with her care and willing to pay for it.”

The paper reports that doctors “don’t really like the term ‘concierge’ or ‘boutique’ medicine. They prefer labels like personalized, preventive care.”

That’s understandable; they don’t want to sound snobbish. But in truth: "There's not a lot of people who can afford it," says Anthony Wright, executive director of the consumer advocacy group Health Access California. "The reason some people call it boutique medicine is that this is for a well-to-do clientele."

Wright is concerned: “I don't think systems that shift more burden onto the patients are the answer to our broken system or will evolve into more than an isolated alternative…The trend of boutique medicine sends the consumers in the direction of you're on your own. Everyone for themselves."

On the other hand, the paper notes, “Carol Miller of Thousand Oaks thinks the $3,600 she and her husband pay in annual fees to see Portnoy is worth it because it brings peace of mind. The money covers an annual physical and a battery of screenings for everything from Alzheimer's to sleep apnea. The fee also covers follow-up that focuses on preventive care.

“There are other perks. People in Portnoy's waiting room find a basket filled with Cliff bars, crunchy peanut butter and chocolate chip bars. Tea and Snapple is served.

Crunchy peanut butter and chocolate bars? Is this part of the emphasis on preventive care?

Some worry about what the larger trend means. Are the Millers, who receive an annual “battery of screenings” being overtreated? If insurers reimburse for even 70 percent of unnecessary treatment, are we all paying for boutique medicine?

Dr. Bob Gonzalez, medical director at Ventura County Medical Center, also talked to the reporter and confided that he worries “that less reliance on insurance means fewer people getting healthcare. They won't be able to afford it.

“The specter of more doctors downsizing their practices and seeing fewer patients also alarms Gonzalez. It means patients won't be able to find any doctors or could be dumped on an already overburdened doctor.

“So yes, he said, more money, less insurance and more time with patients may be good for individual doctors.

“But whether it's good for society or good for patients is the overall question.”

How to Rein in Medical costs,RIGHT NOW

By GEORGE LUNDBERG



I believe that there are still many ethical and professional American physicians and many intelligent American patients who are capable of, in an alliance of patients and physicians, doing "the right things". Their combined clout is being underestimated in the current healthcare reform debate.

Efforts to control American medical costs date from at least 1932. With few exceptions, they have failed. Health care reform, 2009 politics-style, is again in trouble over cost control. It would be such a shame if we once again fail to cover the uninsured because of hang-ups over costs.

Physician decisions drive the majority of expenditures in the US health care system. American health care costs will never be controlled until most physicians are no longer paid fees for specific services. The lure of economic incentives to provide unnecessary or unproven care, or even that known to be ineffective, drives many physicians to make the lucrative choice. Hospitals and especially academic medical centers are also motivated to profit from many expensive procedures. Alternative payment forms used in integrated multispecialty delivery systems such as those at Geisinger, Mayo, and Kaiser Permanente are far more efficient and effective.

Fee-for-service incentives are a key reason why at least 30% of the $2.5 trillion expended annually for American health care is unnecessary. Eliminating that waste could save $750 billion annually with no harm to patient outcomes.

Currently several House and Senate bills include various proposals to lower costs. But they are tepid at best, in danger of being bought out by special interests at worst.

So, what can we in the USA do RIGHT NOW to begin to cut health care costs?

An alliance of informed patients and physicians can widely apply recently learned comparative effectiveness science to big ticket items, saving vast sums while improving quality of care.

1.Intensive medical therapy should be substituted for coronary artery bypass grafting (currently around 500,000 procedures annually) for many patients with established coronary artery disease, saving many billions of dollars annually.


2. The same for invasive angioplasty and stenting (currently around 1,000,000 procedures per year) saving tens of billions of dollars annually.


3.Most non-indicated PSA screening for prostate cancer should be stopped. Radical surgery as the usual treatment for most prostate cancers should cease since it causes more harm than good. Billions saved here.


4.Screening mammography in women under 50 who have no clinical indication should be stopped and for those over 50 sharply curtailed, since it now seems to lead to at least as much harm as good. More billions saved.


5.CAT scans and MRIs are impressive art forms and can be useful clinically. However, their use is unnecessary much of the time to guide correct therapeutic decisions. Such expensive diagnostic tests should not be paid for on a case by case basis but grouped along with other diagnostic tests, by some capitated or packaged method that is use-neutral. More billions saved.


6.We must stop paying huge sums to clinical oncologists and their institutions for administering chemotherapeutic false hope, along with real suffering from adverse effects, to patients with widespread metastatic cancer. More billions saved.


7.Death, which comes to us all, should be as dignified and free from pain and suffering as possible. We should stop paying physicians and institutions to prolong dying with false hope, bravado, and intensive therapy which only adds to their profit margin. Such behavior is almost unthinkable and yet is commonplace. More billions saved.
Why might many physicians, their patients and their institutions suddenly now change these established behaviors? Patriotism, recognition of new science, stewardship, and the economic survival of the America we love. No legislation is necessary to effect these huge savings. Physicians, patients, and their institutions need only take a good hard look in the mirror and then follow the medical science that most benefits patients and the public health at lowest cost. Academic medical centers should take the lead, rather than continuing to teach new doctors to "take the money and run".

Physicians can re-affirm their professionalism and patients their rights, with sound ethical behavior without undue concern for meeting revenue needs. The interests of the patients and the public must again supersede the self interest of the learned professional.

Panic Attack and Your Imagination

People who experience panic attacks will often say that
they feel out of control as soon as the panic is in full swing.

Christian Nevell Bovee once wrote:



“Panic is a sudden desertion of us, and a going over
to the enemy of our imagination.”



Doesn’t that sum it up well?



A confident self assured person can suddenly feel powerless
and vulnerable as soon as the panic manifests. As the bodily
sensations race, the mind jumps from logic and reason to wild
fears fueled by the imagination.



The hardest part for most people to get their heads around is why
they feel so suddenly powerless during a panic attack?



The automatic reaction for most to the sensations of a panic attack
are to fight against it. To shut it down and end it as soon as possible.

Coping techniques like deep breathing and distraction are mildly
effective at best. When these techniques fail to get results, that is
when the person really leaps over to ‘the enemy of their imagination’.



It goes something like this:



“I used all my coping techniques but I still feel very anxious,
in fact it may be getting worse!



“What if this keeps getting worse and no help can get to me here?”



Where people run with this type of thinking their imagination will
continue to escalate the fear, leaving them feeling more and more
vulnerable and out of control.



The secret to regain control and come back to yourself, is to learn
how to respond to the panic in an appropriate manner.



The solution is to work with the bodily sensations
rather than against them.



Let me give you a small example. If you were sitting
on a train and started to feel sensations that indicated
the beginning of a panic attack, instead of trying to stop
the experience do the opposite. Acknowledge that
you are safe, label the sensations and then tell the sensations that
scare you, to get worse. If you are sweating tell your body to
sweat more, if your heart is racing, tell it to race faster.



Move into the experience rather than against it.





The real panic only begins as soon as you hand over reason
and control to your imagination. By moving into the experience
voluntarily, you become the decision maker and therefore
retain control. If you're going to have a panic attack
it is going to happen on your terms.





You empower yourself because you are directing the whole
experience not handing “over to the enemy of our imagination.”
by Joe Barry
PanicAway.com

Deep Brain Stimulation and Weight Gain in Parkinson's

By Patrick McNamara, Ph.D


Subthalamic deep brain stimulation (DBS) is a surgical procedure that works well to reduce dyskinesias associated with long term use of levodopa. But patients, their families and their doctors have noticed that many people with Parkinson's disease who undergo the procedure later put on a lot of weight. One recent study followed 22 patients who had the surgery. No patient was underweight before surgery and 50% were overweight. By contrast, 68% were overweight or obese 3 months after surgery and 82% after 16 months. The scientists were also able to determine that this weight gain was mainly due to an increase in fat mass in both men and women. What is it about subthalamic brain stimulation that contributes to weight gain? Scientists do not yet know. The thalamus and subthalamic regions of the brain are very near the hypothalamus and the hypothalamus controls appetite by signaling satiety. “Hey stop eating I’m full!” If the surgery for some reason also influences the hypothalamus it may inadvertently interfere with eating habits. Until more is known about these things people who undergo the procedure for subthalamic DBS should be provided with a diet management plan and a physical training schedule appropriate for them.
Source: Bannier S, Montaurier C, Derost PP, Ulla M, Lemaire JJ, Boirie Y, Morio B, Durif F. (2009). Overweight after deep brain stimulation of the subthalamic nucleus in Parkinson disease: long term follow-up. J Neurol Neurosurg Psychiatry. 80(5):484-8. Epub 2008 Dec 5.

Take a Cruise And Battle Your Parkinson's Disease

By Patrick McNamara, Ph.D., About.com Guide to Parkinson's Disease

One of the great ideas that Parkinson's disease groups have come up with are vacations and cruises for people with PD. These sorts of vacations are relaxing but also informative. One such organization is the The Parkinson Research Foundation --a nonprofit health organization providing Parkinson's research, information and advocacy. The mission of the organization is to cure Parkinson's and to improve the lives of all people affected by the disease. A great way to improve the lives of people with PD is to offer them these sorts of vacations and getaways. The Parkinson Research Foundation will sponsor the inaugural New Hope for Parkinson’s Cruise, leaving the Port of Miami on January 8th, 2010. This 3-night cruise aboard Norwegian cruise lines, is designed for Parkinson’s disease patients, caregivers and their families, and will provide a series of seminars and lectures about this disease. What will you get if you go: a break from your day to day lonely battle with PD. Instead you will battle the disease in the company of others who are facing the same challenges as you. You will also hear presentations by prominent Parkinson’s disease physicians and clinicians. There will be support group meetings, exercise classes and wellness seminars. And don't forget there will be entertainment, relaxation, sunshine, ocean breezes and peace.

Ginseng Root - Supplement -Uses -Health Benefits - Side Effects

Ginseng Root - Supplement - Uses - Health Benefits - Side Effects
Ginseng is a dietary supplement. Information on the common uses, health benefits, and side effects of ginseng. Ginseng root (Panax) has been used as a herbal remedy for thousands of years. You should compare ingredients of all ginseng products, since there are several types of ginseng species with different uses, benefits, and potential side effects.

Exhaustion Can Trigger Anxiety

Why do some people have a problem with anxiety
and others do not?



This is a question almost everyone who experiences

anxiety asks themselves at some point or another.

Why me?



My understanding of anxiety is that yes, some people
seem more susceptible than others but that the key trigger
tends to be exhaustion. By exhaustion I mean
mental, physical, or emotional exhaustion.


(Under physical exhaustion I also include things
like diet or substance abuse)





For some it may be exhaustion caused by a hectic life and
never taking time to release the stress. People like that often do not
notice their stress levels are so high until they get blindsided
by a spontaneous panic attack.



For others it may be an emotional exhaustion caused by
the loss of a loved one or the break up of a long term relationship.



If the anxiety is caused by a traumatic life event it is
interesting to note that the person frequently does not

experience the anxiety until the event has passed.



You often see people dealing very well with a crisis but
then several weeks later when the dust has settled they start to
feel the anxiety. It is like they have been in shock
and are only now starting to process the experience.





The most important thing to remember about panic attacks
or general anxiety is that help is available and it is
important to get help sooner rather than later.




Burying your head in the sand hoping it will simply be
gone next week is not an effective way to treat it.
It is totally unnecessary to spend months if not years
dealing with something that can be corrected now.

Progressive Muscle Relaxation A Must Read Article

Unlike paced breathing, the this technique, called is
Progressive Muscle Relaxation, PMR for short, focuses not
on breathing, but on muscle tension.

Hold up your right arm, tense it, and make a fist with your
right hand. Go ahead, do it now. Now, at the count of three,
let go of all the tension in that arm.. One, Two, Three!

Your arm should have fallen limp into your lap or down to
your side. Now, imagine that you are with a person who has
been quadriplegic since birth. How would you explain to
that person what you just did? How did you release the
tension? Most people would say, I just thought it, and it
happened."

In essence your mind said, "Release the tension," and the
muscles in your arm obliged. But how? Explaining this
activity is difficult.

In order for someone to really understand it, one has to
experience it. The same holds true for PMR. While you can
learn what to do for PMR through reading this article,
the only way to master the procedure is through practicing
it.

PMR is in essence a procedure through which one learns to
release even very small amounts of muscle tension at will,
much in the same way you just did when you relaxed your
right arm.

The technique involves alternatively tensing and relaxing
different muscle groups throughout your body. However,
while tensing and then letting go of the tension in your
muscles may serve to make a person feel relaxed, this is
not the real purpose of this exercise.

The purpose of this exercise is to learn how to identify
and let go of tension mentally.

This is the way it works. Whenever you tense a muscle group,
you should inhale and focus on the feelings of tension in
the muscles of that body part.

In your mind's eye, see the muscle strands stretched out,
feel the rigidity in the area being tensed, and notice
anything that you can about what it feels like to be tense
in that part of your body.

Tense with about 70% of your strength only, and hold for
about five seconds.

Next, release the tension, exhale, and focus on the feelings
of relaxation in those muscles. In your mind's eye, imagine
the muscles being more smooth and supple, Notice anything
you can about what the muscles feel like now that they
are relaxed.

You may experience them as heavy, light, or warm, or you
may detect a sensation of tingling, or an occasional
muscle twitch.

More important, focus your energies on detecting the
DIFFERENCES between the feelings of tension and relaxation.

What you are doing is retraining your mind to become more
sensitive to even small levels of tension in your body.
The tensing that you do is to help you to more easily tell
the difference between tension and relaxation.

With time you will practice using only 50% of your strength
to tense, then only 30%, 10%, and finally, without tensing
at all.

At the point, you will be able to scan" your muscle groups
mentally, and, detecting any tension in any muscle group,
you will be able to "think" the tension away.

Remember to start by using 70% of your strength, tense for
five seconds, inhale, and focus on the feelings of tension.
Then, exhale, release the tension, and focus on the
difference of the feelings in those muscles.

Can Lipsuction Tighten Loose Skin?

Tumescent liposuction does not help loose skin. Suction lipectomy removes extra fat only. When skin has good elasticity, it shrinks nicely after fat sculpture. Liposuction will not manage the loose skin and hanging tissues After Major Weight Loss. Extra fat AND skin are better managed by operations such as, Female Breast Lift, , Male Mastopexy Chest Lift, Tumescent Tummy Tuck, and Tumescent Body Lift. Liposuction does not remove gland and will not tighten the skin for Female Breast Reduction, Gynecomastia Male Chest Sculpture, or Transgender FTM Top Surgery. It can be confusing for a patient to figure what type of plastic surgery is best for their problem on their own. We help our patients during the consultation or preliminary remote discussion to explore what plastic and cosmetic surgery may have to offer.

Best Soaps For Washing Your Face if You Have Dry Skin

Dry skin feels tight and can be flaky. Many people dry out their face with soaps that are too harsh mistaking that tightness they feel after washing for cleanliness. If your face is dry, avoid soaps. Use a non-foaming facial cleanser or non-foaming facial cloth.

1. Cetaphil Gentle Skin Cleanser
This is a great water-soluble facial cleanser. It's mild enough to be used on dry or eczematous skin, and it doesn't contain any fragrances that can be irritating. This cleanser is a lotion that doesn't lather, and it rinses off well without a washcloth. It doesn't remove makeup


2. Neutrogena Extra Gentle Cleanser
This cleanser is another "oldie, but a goodie" because it's a fragrance-free, non-foaming liquid cleanser that doesn't have any irritating ingredients. It is a good choice for anyone with dry or sensitive skin.

.3. Olay Daily Facials Cleansing Cloths for Sensitive Skin
Many people like the cleansing cloths because they feel refreshing. This one is a good choice for dry skin because it doesn't contain any drying ingredients and it's fragrance-free. It doesn't contain any ingredients you can't get using any of the other cleansers in this list and a washcloth. But it's handy for travelers or people who like the convenience of a face cloth.

.4. pHisoDerm Deep Cleaning Cleanser for Sensitive Skin
This cleanser sets itself apart from the others because it contains a high percentage of mineral oil which helps remove makeup and adds some moisture to the skin. It is also fragrance- and detergent-free, making it a good choice for dry or sensitive skin.

.5. Almay Cleansing Lotion for Dry Skin
This cleanser is a good choice for dry skin because it is fragrance-free and has a mild water-based detergent. It also contains a small amount of plant oil to help dissolve makeup. This product also has cucumber extract which Almay claims helps hydrate the skin. I can find no good references that suggest cucumber either hydrates the skin or is irritating. So the addition of cucumber extract in this product is a "wash." It doesn't negatively or positively effect the cleanser.
Manufacturer's Site
.6. Dove Sensitive Essentials Fragrance Free Cleansing Cloths
These cleansing cloths are a good choice for a basic, non-irritating facial cleanser. They don't contain any special ingredients but they are mild enough to use on dry skin

Acne Treatment With Topical Antibiotics

Acne is caused by the effects of hormones on the pilosebaceous unit, consisting of a hair follicle, sebaceous gland, and a hair. The follicle becomes obstructed and an overgrowth of a normal skin bacteria, Propionibacterium acnes, causes destruction of the lining of the follicle. This process allows follicular material to enter the dermis, causing an inflammatory response. For a more detailed description of this process, see What Causes Acne?

Acne Treatment With Topical Antibiotics
Topical antibiotics work by killing the Propionibacterium acnes bacteria. This not only helps reduce the small infections in the pores, but also indirectly keeps the pores open. Topical antibiotics have been around for a while without many changes to the formulations, so I'm giving only a brief summary of each. All topical antibiotics must be prescribed by a health care provider.

Acne Treatment With Clindamycin

•The most frequently used topical antibiotic for acne
•Available as a solution, lotion, or gel at 1% strength
•Applied twice a day to all acne prone areas
•Generally well tolerated but may cause some irritation
•Should not be used by people with regional enteritis, ulcerative colitis, or a history of antibiotic-induced colitis
Acne Treatment With Erythromycin

•Second most commonly used topical antibiotic used for acne
•Available as a solution, gel, and ointment at 2% strength.
•Applied twice a day to all acne prone areas
•Generally well tolerated but may cause some irritation
•Safe for use by pregnant women
Acne Treatment With Tetracycline

•Not used very often as a topical treatment
•Available as an ointment and solution at different strengths
•Contains sodium bisulfite, a sulfa derivative, and can cause allergic reactions
•May also cause yellowing of the skin
Acne Treatment With Metronidazole

•Used frequently for acne caused by rosacea
•Available as a gel at 0.75% strength
•Applied once or twice a day
•Generally well tolerated but can cause irritation

Treating Of Acne With Isotretinoin-Accutane

How Accutane Works & Starting Therapy

Isotretinoin (Accutane) is a medicine that revolutionized the treatment of acne. Accutane belongs to the family of medicines called retinoids, which are similar to vitamin A. Accutane, like other retinoids, works by altering DNA transcription. This affect decreases the size and output of sebaceous glands. It also makes the cells that are sloughed off into the sebaceous glands less sticky, and therefore less able to form blackheads and whiteheads (comedones). It also reduces the number of bacteria in the sebaceous gland and on the skin surface.

Who Takes Accutane?
Accutane is generally used for nodular, pustular acne that has not responded to full courses of several oral antibiotics. The trend in Accutane prescribing for acne has been towards using it earlier in the course of the disease, especially if there is significant scarring. While Accutane is used primarily for severe acne, it has also been used for other disorders such as psoriasis, lupus, and lichen planus, with varying degrees of success.

Starting Therapy With Accutane
Several dosing regimens are used, but the most common regimen involves starting with a low dose, then increasing the dose after several weeks. The length of the treatment course varies but generally lasts from 16 to 20 weeks. Some people notice that their acne gets worse after starting Accutane therapy. The number of acne lesions usually does not increase; rather the lesions may become redder or more painful. This is normal, lasts only a short while, and is not a reason to stop using Accutane.

Revealed Anxiety At Work Place

One of the most common times people feel anxious
at work (after getting called in to see the boss)
is at meetings where you are expected to speak
up in front of many others.



Generally these type of work meetings involve a
group of people sitting around taking it in
turns to speak. Most people anxious about speaking
in public dread their turn and hope some divine
intervention will save them from having to speak at all.

To get around this try the opposite approach.

Pretend to yourself and the group that you are
actually dying to speak. Before you enter the
room, say to yourself "I'm going to speak at
any reasonable opportunity that presents itself"

-Be positively itching to speak!

-Before the meeting kicks off, talk to everyone
around you. Don’t sit there in silence.

-If you have a short presentation to make and
you don’t like the idea of having to do it in
one go, break it up by asking those present
questions during your talk. This puts the focus
back on the group and can help you feel less under pressure.

-If everyone has to speak, it can really take
the pressure off to be first up but if you can’t
be first then start asking questions of the other
speakers when they are finished if that is appropriate.

Come across as really interested and engaged. Give
the impression to the room that you want to speak
and to be heard. Speaking up works because the anxiety
only gets worse if you sit there in total silence
waiting to be called upon. Don't wait for them to
call you -speak out.


If you take the above advice on board and it does come
to your turn to speak, you won't feel the same level
of pressure because everyone in the room is already
used to your voice and you don't feel the pressure
of hearing your voice for the first time in the room.


Everyone is used to you and you are used to speaking to them.


Great speakers love an opportunity to talk and present.
Believe it or not but you can train yourself to be like
that and it starts by pretending to yourself that you
really want that opportunity to be in the lime light.

Be hungry for it.


Instead of holding back and resisting the opportunity
to speak in public, you chase after it!


You might think "fine but how can I try this out before
my next meeting?"

The best way I know of is to join a Toastmaster group in
your area (google it) and get started there right away.
If there is no toastmaster group locally find a public
meeting or volunteer for something like a research group where
you all discuss a topic together.


There are lots of places to practice. Dive in, speak up

Why Is It That Many People Feel Anxiety Worst In The Morning

When we wake most of us feel sluggish. It takes
a while for the body to switch from the sleep mode
to being active and mentally alert.

You will often hear people say that they
are not a ‘morning person'.

People with general anxiety find this sluggish
morning feeling quite difficult as they feel more
vulnerable to anxious thoughts and bodily sensations
due to this sluggish feeling.

It is also common to 'check in' mentally first thing in
the morning to see how anxious you are feeling.

The sluggish feeling in your mind and body
does not feel positive and that in itself can
trigger worries that the anxiety problem is not improving.

If you often feel morning anxiety it is
important to understand that it is common and that
it should not be viewed as a setback or an indicator
that you are going to feel like this all day.

If you want a quick 20 minute routine to shake
morning anxiety do the following:

1.Acceptance

Wake up and try not to overanalyze how you
are feeling. If you notice that you do
feel quite anxious, accept it and remind
yourself that in just 20 minutes you will
be feeling a lot more relaxed.

2. Gratitude

Have a small note book and pen beside you bed
and as soon as you wake up jot down three
things you are truly grateful for in your life.
This short gratitude exercise will really jump
start you into a positive mental state of mind.
It is important to only jot down a few short sentences
because if you make this exercise too time consuming
you may not continue it everyday. Doing this one thing
alone will be enough to change how you feel each morning.


3.Stretch

Step out of bed, open the window for some fresh air
and then begin some light stretching. (You will find
many excellent stretching routines online). Stretching
sends a message to your body that it is morning time and
it helps release muscle tension you may have built
up over night. You will feel more flexible and
interestingly less tense mentally after
some good stretches.

4. Shower

Next take a cold shower! No, it’s not particularly pleasant
but it really kicks your mind and body into action and
you will feel mentally much more alert and far less
intimidated by any anxious sensations in your body.
If that's too intense for you then vary the temperature
between cold and warm. Studies show our body’s
immune system benefits as the number of white blood
cells produced increases with regular cold showers.


5. Breakfast.

Be sure to avoid coffee and caffeinated teas. Instead
have a cup of hot water with a slice of lemon. This is
a really great way to give your whole system (in particular
your liver) a healthy morning boost. Never skip breakfast
no matter how pushed for time you are. Be sure to eat a
nutritious breakfast as it will really help buffer you
against feelings of stress as the morning progresses.

Eat..

-Whole grains

-Low-fat protein

-Low-fat dairy

-Fruits and vegetables


If your taking natural supplemets now is a good
time to take them.



To sum up:

It is very common to feel slightly more anxious
in the morning than other times of the day. Use
the above routine for one week and notice the
difference in how you

Revealed:Alzheimer's Disease-Natural Alzheimer's Prevention

What Is Alzheimer's Disease?
Alzheimer's disease is the most common cause of dementia, a brain disorder that significantly interferes with your ability to carry out daily activities. Marked by the degeneration of healthy brain tissue, Alzheimer's triggers a gradual decline in memory and mental functioning.

In many cases, people with Alzheimer's experience difficulty recalling recent events and names of people they know. As the condition worsens, patients may have trouble reading, writing, speaking, and recognizing family members. Most people with Alzheimer's eventually require complete care.

What Are the Risk Factors for Alzheimer's Disease?
Alzheimer's typically develops after age 60. The older you get, the more your risk increases. For example, about 5 percent of people between ages 65 and 74 have Alzheimer's, while almost half the people over age 85 have the disease.

In addition to age, Alzheimer's risk factors include a family history of the disease, high blood pressure, high cholesterol, and poorly managed diabetes.

How to Prevent Alzheimer's Disease
Following a healthy diet (high in fruits, vegetables, and whole grains and low in saturated fats) may help reduce your Alzheimer's risk. Getting regular exercise, keeping mentally active (by doing crossword puzzles or learning new skills or languages, for example), and maintaining social connections as you age may also help stave off Alzheimer's disease.

Natural Approaches to Alzheimer's Disease Prevention
Here's a look at several natural substances purported to help prevent Alzheimer's disease.

1) Curcumin

A compound found in the curry spice turmeric, curcumin is known to fight inflammation (a process thought to play a role in the development of Alzheimer's). In a 2009 study of nine Alzheimer's patients and four people without the disease, scientists discovered that curcumin may fight Alzheimer's when paired with vitamin D. Study results suggested that the combination of curcumin and vitamin D may prompt the immune system to clear the brain of amyloid beta (a substance that forms the brain plaques associated with Alzheimer's disease).

Curcumin may also help protect against cataracts, skin cancer, and chronic pain.

2) Resveratrol

Resveratrol (a compound found in grapes and red wine) may also help decrease levels of amyloid beta, according to a 2005 study. After administering resveratrol to amyloid-beta-producing cells, the study authors found that levels of amyloid-beta in the treated cells were much lower than those in cells left untreated.

3) Ginkgo Biloba

Often touted as an herbal brain-booster, ginkgo biloba has been shown to have beneficial effects in Alzheimer's prevention in several clinical trials. However, a large study published in 2008 determined that six years of ginkgo biloba treatment (at a twice daily dose of 120 mg) was not effective in preventing Alzheimer's or dementia in elderly adults

Can a Woman Breastfeed if She Has Genital Herpes?

Question: Can a Woman Breastfeed if She Has Genital Herpes?
Under normal circumstances, breastfeeding is the best option for women when it comes time to feed their baby. But in the case of HIV+ women they are instructed not to breastfeed if at all possible for fear of infecting their baby. But what about other viral infections? Specifically, what about genital herpes? Can a woman breastfeed her baby if she has genital herpes?


Answer:
Simply put, the answer is yes, breastfeeding with genital herpes is safe for your newborn. Genital herpes (herpes simplex) is spread by direct contact with the virus that causes genital herpes; primarily during sexual contact.

I'm ready to start feed solids,but I,confused,When do I breastfeed?

Question: I'm ready to start feeding solids, but I'm confused. When do I breastfeed?
Breastfeeding mothers are often confused about how to go about starting solid foods with their baby. Questions often arise about whether or not to breastfeed before or after feeding the solids. Here is how to go about this process.

Answer:
The American Academy of Pediatrics recommends breast milk as the primary source of nutrition for the first 4 to 6 months of life. After that time, your baby is ready for solid foods, so what happens to the breastfeeding sessions?

The baby still needs breast milk for optimal growth. However, if breastfeeding and feeding solids are going well, it doesn't really matter which one you choose to offer first. Generally speaking, between 6 and 9 months of age, most mothers are giving the solids as "snacks" more than anything else, and you should continue to be mindful of how often she's nursing. If you are supplementing some feeds with a bottle, make sure that the baby is still getting enough for his weight. If you are breastfeeding upon wakeup and your baby is showing signs that he can eat right away, go for it! At the same time, it is fine to sit down to a "meal" midday, if that's more convenient for you. It is difficult to say how much time there should be between nursings and solid feedings at this stage because baby's needs vary. Some may need three meals a day and others are barely finishing one. Over time, the amount of solid food given to the baby will increase and by the time he is one year old, it is fine to offer the solids first, with the nursings becoming the "snacks." After one year, your pediatrician will guide you as to how many ounces of fluid she needs to get, usually between 24 and 30 ounces a day. You can continue to breastfeed for as long as you desire.

Keep an eye on the baby's fluid intake during this time. If too many nursings are replaced by solid feedings too quickly, she may not be getting enough fluid and constipation may result. Putting the baby to the breast frequently will alleviate these problems.

Here is a sample feeding schedule for an older baby (9 months to one year). Remember that there is no right or wrong way to feed meals to your baby, but if you feel that you need some guidelines, then give this a try...


•5am: Wakeup/Breastfeed
•7am: Breakfast
•8am: Nap (with or without a nursing beforehand, depending on your baby)
•10am: Breastfeed
•12: Lunch
•1pm: Nap (with or without a nursing beforehand)
•3pm: Breastfeed
•5pm: Dinner
•7pm: Bedtime/Breastfeed
•Your baby may still awaken once a night for a nursing. This is normal.