By: Eric Bitet LMHC, MA, MPH

As spring begins to knock on our doors, this is a good time to give an early first quarter review of our healthy behaviors and reflect on the famous New Years resolutions most people set for themselves annually. For some, this means evaluating your progress towards meeting your health related goals you’ve set.  But for others, it already means looking back on a ‘flash in the pan’ idea that didn’t make it through the first few weeks of January and has already been converted to statements like, “I’ll start before the summer” or “soon” and maybe even something like “I’ll start before my birthday.”  The fact of the matter is everyday can be New Years.  If you have already slipped up on your New Years resolution to live healthier in some way this year, it is never too late or too soon to start now!

I want you to think about your resolution and where you stand with it right now!  Was it similar to some of the very common ones such as dieting, exercising, or quitting smoking?  Maybe you wanted to be more health aware and planned to get your physical examination but haven’t got to it yet.  Whatever it may have been, you can still be successful at living healthier in 2010.  After all, it is only February!  By the way, for those of you whose resolutions had nothing to do with your health, hopefully this article can plant a seed or act as a light bulb turning on for you.  Are you out of shape?  Overweight?  Do you smoke cigarettes or have some other aspect of your health that you want and need to improve?  Now is the time to start thinking long and hard about this!

So what do you need to do?  It is always very important to consult your physician and inform them of your intentions.  They can guide you and give you expert advice based on your current health status and age and guide you towards what you should be doing.  Once that is done, a good start would be to develop a plan.  Make a schedule for yourself and stick to it!  A former mentor once said you have to plan your work and work your plan!  In translation, you must take action!  But it is important that you start small, develop a foundation of healthy living habits, and make steady progress.  The old cliché goes “Rome wasn’t built in a day” and we can’t transform ourselves in a days time.  If your goal is to eat better or go to the gym and exercise, make a daily schedule for yourself that is realistic with specific times to exercise and follow it strictly.  You will see that after two weeks these new behaviors will start to become routine.  The same goes for dieting.  You must follow a set schedule by mapping out your meals on a daily basis and keeping score for yourself.  For those of you who have interest in cutting back on smoking cigarettes, it is important that you consult your physician or your local health department for guidance on what to do and for access to smoking cessation aids and educational materials.  In addition to these common target areas, there are many other areas that a person can focus on to begin to live a healthier life and improve their overall health and well-being.

Maybe you want to improve your health but you just don’t know what to focus on and where to start.  According to many health experts, here are some uniform good habits that you can follow to live healthy, improve your quality of life, and overall increase your chances for longevity.

At the top of the list are diet and exercise.  Eating right and being physically active are very important in maintaining healthy body weight and cardiovascular health as well as reducing the risk of cardiovascular disease, hypertension, and diabetes.  It also has been shown to improve mood and reduce stress levels in the body.  In addition to physical activity, the brain must also be exercised and kept active!  Research shows that mental activity such as reading, writing, solving crossword puzzles or math equations can help keep the person’s cognitive and analytical functions intact for a longer period of time.  It is also a good habit to get the proper amount of sleep.  Sleep has been shown to improve cognitive functions such as memory and concentration as well as enhance one’s mood and immune and cardiovascular systems.  The average requirement for sleep is 8 hours per night but many people can function well with 6 hours of sleep.  Ultimately, the most important aspect of sleep is that it gives the individual the energy they need on a daily basis.

Moreover, social activity has also been shown to have positive health effects.  Those who spend more time with family and friends and socialize regularly have been shown to be healthier than others who are isolated and alone.  It is important for the spirit that we make connections with others, share our time, and very importantly unwind and laugh!  Finally, it is recommended that we get regular medical examinations including physicals every 6 to 12 months.  This of course is the key in keeping aware of the status of our health and detecting the development of diseases like many different forms of cancer in their early stages.

For New York City residents, the New York City Department of Health and Mental Hygiene (NYCDOHMH) along with the Fund for Public Health New York (FPHNY) recommend these 10 steps to living healthier:

• Have a regular doctor or other health care provider
• Be tobacco-free
• Keep your heart healthy
• Know your HIV status
• Get help for depression
• Live free of dependence on alcohol and drugs
• Get checked for cancer
• Get the immunizations you need
• Make your home safe and healthy
• Have a healthy baby

To look at each of these steps in detail and to read about the reasons why these areas are targeted please visit http://www.nyc.gov/html/doh/html/tcny/index.shtml.

All in all, it is up to us to take action for ourselves!!  No one can keep that next Big Mac and large soda out of our mouths or run our next mile and lift the next weight for us!  There isn’t an individual who can be forced to quit smoking, drinking, or make a doctor’s visit.  These responsibilities to take care of ourselves lay solely on us.  It is the choices made now that will shape the future of our health and wellness.  We often don’t look back on something with regret until something has already happened and it is too late.  The heart attack victim and the smoker who developed lung cancer most likely wished they lived differently.  But that doesn’t have to be you.  Take a stand and choose to live a healthier life.  Reinstitute that lost New Years resolution with a new one!  With all this in mind, ask yourself, how’s your health in 2010?

by Kimberly Mayo-Achan MA, CCC-SLP

In today’s fast paced society, people are encouraged to live efficiently and take advantage of all of the modern technologies and short cuts that are now available to give us more “productive” time in a day. Whether that short cut be sending an e-mail instead of a letter through the postal system or getting information through the internet instead of reading hard copy books, almost all of us take advantage of them because we have fallen away from waiting for something to get done. And gone are the days where a family has time to sit down together for a home cooked meal, because both parents are working and have the convenience of a microwave.

Pre-packaged and frozen dinners have become the norm for many families today. More likely than not, if you have a grandparent make you dinner, everything will be freshly prepared and cooked in their own kitchen on, believe it or not, the stove or in the oven! But, since the invention of the microwave, in addition to the stress of having to work full time jobs, it is easier and more time efficient to pop a premade dinner into the microwave, which can mean more time together at the table for some families. If you are a “frozen-food fanatic”, then at least make sure meal time is a healthy time. It is very important for families to gather together at meal time, but this does not mean it is ok to place just anything on the table.

Consumer reports magazine has just released a study evaluating dietary value and information on 22 different types of frozen and pre-packaged brands of food. They evaluated these brands based on cost, taste and nutrition. The findings, while not very impressive, were very interesting, as all three criteria showed a considerable improvement from previous studies. Almost half of these meals provided 5 grams or more of fiber per serving, and 6 out of the 22 provided 20% of the recommended daily intake of calcium. On the contrary, the majority of these meals had over 600 milligrams of sodium, while only 3 had less than 450 per meal. It was also found that many of these “meals” were not, in fact, entire meals in itself. In order to obtain adequate nutrition, servings of fruits and vegetables need to be added to each meal to make them complete.

The overall conclusions were that there are sensible prepared meals to serve to your family, with Kashi being the clear front runner. However, frozen and pre-packaged dinners should not take the place of fresh, home cooked food every day of the week. These meals are highly processed and often contain partially hydrogenated vegetable oil, which is known to have a negative effect on the cardiovascular system. It is better to make a few meals over the weekend and freeze your own foods for the upcoming week.

The bottom line is to try to find other ways during the day to make the most out of your time so that you have a few extra minutes to prepare a healthy meal. It doesn’t have to be fancy, but it doesn’t have to come in a package either.

For the full report on packaged meals, you can subscribe to ConsumerReportsHealth.org or log onto http://www.walletpop.com/consumer-reports/insurance/article/consumer-reports-packaged-diet-meal/847476?icid=main|search3|dl4|link3|http%3A%2F%2Fwww.walletpop.com%2Fconsumer-reports%2Finsurance%2Farticle%2Fconsumer-reports-packaged-diet-meal%2F847476 for an abbreviated version of the study.

by Kimberly Mayo-Achan MA, CCC-SLP

It’s the most wonderful time of the year…or at least that’s how the song goes! For many of us, while the holidays may be fun, festive and joyous, they can also be very stressful. The long lines in the stores, worrying about giving the perfect gift, getting all of the decorations up on time, and of course, cooking and over eating can all contribute to the hustle and bustle of the holiday season. Take a minute to yourself, read this article, and re-strategize your holiday headaches!

First and foremost, get organized! Before you do any shopping or any decorating, sit down and write a long list of what needs to get done and what gifts need to be bought. This will serve two main purposes. First, it will provide you with a concise visual of what needs to get done and will allow you to make a functional plan of how and when to get everything accomplished. Put a calendar next to you and pencil in your activities. Second, it will lessen your chances of wondering around aimlessly in store after store, spending valuable time and money on items you would not have otherwise purchased. If you are not sure what to get someone, a gift card to a store of their liking with a well written holiday greeting card is often appreciated. Websites such as redenvelope.com also offer an array of personal gifts for everyone on your list.

If you are doing the holiday cooking, make a list of all of the dishes you plan to make along with the ingredients for each meal. Look into a home delivery grocery service, such as peapod from Stop and Shop, and this will save you time, aggravation and a bad back, by not having to haul in numerous heavy bags. It will also help keep money in your wallet by not allowing you to play supermarket sweep and fill your shopping cart up with unnecessary items for your home. Many home delivery services, such as peapod, are offering $15.00 off for first time customers.

Contrary to what people may think, there is no rush, race or competition to have all of your decorations up by a certain date. Sure, they look beautiful, but it’s ok if you give yourself a couple of days to get it all done. If you are putting up a Christmas tree, try having the tree up the day before you decorate. This will allow you to enjoy placing your special ornaments without the stress of maneuvering your tree. If you don’t have a tree in your home, consider taking some of your ornaments and decorate that lonely tree in front of your house. Do your outdoor decorating during the day and dress accordingly. Have your kids, spouse, neighbors or friends lend a hand.

Understand that food is a very important part of the holidays; there is no avoiding it! The smell of gingerbread cookies, stuffing with gravy, potato pancakes or a fresh turkey is enough to make any mouth water. Set realistic expectations for yourself. Drink plenty of water during the day and have a light snack before you attend a holiday party. When you make yourself a plate, walk away from the buffet or main source of food. Take a few bites of everything on your plate to satisfy your palate. Indulging in smaller portions of what you are craving will decrease the likelihood of binge eating later on. When you are finished eating, take a walk over to some of your neighbors homes and deliver some fresh baked desserts or a nice holiday bouquet. This will help spread some holiday cheer while shedding those excess calories you ingested when eating grandma’s apple pie. If it’s too cold or rainy to walk outside, get out your favorite holiday tunes and dance away that ham and sweet potato pie! Also, choose your beverages wisely. Remember that just because it’s liquid doesn’t mean it’s not full of empty calories! In one cup of egg nog there are 343 calories and 19 grams of fat! Try swapping the egg nog for a home made hot chocolate, which has 1/3 the calories! For more “eat this, not that!” ideas, check out the following website:http://health.msn.com/weight-loss/articlepage.aspx?cp-documentid=100247658.

Finally, remember not to over schedule yourself. Don’t wear yourself out. It’s never easy when you have to get to your uncle’s house by 1, your best friends house by 5, your business holiday party by 7 and then host more family at your house the following day. Make plans that you are able to realistically adhere to. Plan ahead as much as your can. Take 15 minutes a day for yourself. And remember, have fun! This time only comes but once a year! ‘Tis the season.

International Trachoma Initiative

By: Erin Lieber

Unless you have been living under a rock for the past few decades, chances are you have heard of HIV/AIDS, Tuberculosis, Malaria and other, for lack of a better word, “popular” diseases, that tend to get a lot of attention. Whether you have been to a U2 concert where the band’s lead singer, Bono, advocates for support of HIV/AIDS in sub-Saharan Africa or have seen the star studded ads for the ONE campaign, or have been stopped in the mall by M.A.C. cosmetics to “unite against AIDS”, it is evident that celebrities, media, and donors have rallied for the cause. In fact, some research shows that donor contributions have quadrupled since the early 1990’s. This unprecedented amount of attention has been invaluable to raising funds, dispelling the stigma of AIDS and contributing to the prevention and treatment of this high profile disease.

But what about the diseases many of us have never heard of? Have you been to a fancy benefit lately to support lymphatic filariasis or trachoma? How many celebrity designed t-shirts have you seen at upscale boutiques to support hookwork infection or ectoparasitic infections like scabies? Have you seen many famous people using their celebrity to advocate for onchocerciasis on the red carpet?

There is a category for diseases of this kind in Global Health circles, called Neglected Tropical Diseases or NTDs. These conditions are the highest contributors to the overall burden of disease, despite the fact that they are not as high in mortality as some other diseases. Instead, the poorest people in the world suffer from NTDs and live with the debilitating conditions. Since NTDs are largely co-endemic, meaning they often occur simultaneously in one person, inhabitants of many poverty stricken nations often suffer from 4-5 types of these types of ailments at one time. The pictures in this post are that of Trachoma, which is a slow progressing and painful infectious bacterial disease of the eye leading to irreversible blindness. Often transmitted by flies, repeated infections can cause eyelashes to turn inward and scratch the cornea. For more information specifically on Trachoma, visit: http://www.trachoma.org/core/sub.php?cat=trachoma&id=faq. This is just a preview of the horrific nature of some of these diseases. For more information please visit The Neglected Tropical Disease coalition at:  http://neglectedtropicaldiseases.org/.

International Trachoma Initiative

Disturbing and unpleasant? Yes. However, the devastation of HIV/AIDS often paints just as desperate a picture and we have seen a tremendous amount of commendable celebrity humanitarianism for this “popular” disease. The good news? NTDs are amenable to control methods such as mass drug administration and eye surgeries to provide relief to those living with these conditions and a concentrated effort can effectively improve quality of life and in some cases eradication.

So, the answer to the question posed in the title? NTDs do, in fact, have a celebrity face and it’s that of Alyssa Milano. The point is, I don’t think Ms. Milano’s representation is wide spread knowledge, and these diseases deserve all the attention we can afford to give them. Celebrities do a great job of raising awareness for a cause, so let’s hope we see NTDs on the their radar in the near future, sharing some of the spotlight.

The Kambia Appeal

By: Erin Lieber

Each year, childbirth and near term complications take the lives of roughly 529,000 women, with the most deaths taking place in sub-Saharan Africa (Blum et al. 2006). Most developing countries have adopted a multi-pronged approach in an effort to reduce maternal mortality. The strategy stems from the “Safe Motherhood” (SM) campaign and concentrates on family planning, antenatal care, including proactive education and reassurance, skilled assistance at delivery and access to emergency obstetric care for complicated and high risk labor. “Safe Motherhood” was introduced in the 1980’s and research shows that the success and execution of each of these aspects significantly varies. While coverage for antenatal care is estimated at 70-90%, coverage of skilled assistance at delivery, defined as a trained health professional such as a midwife, nurse or doctor, is only 30-40%. There are many barriers that contribute to the challenge and low coverage of skilled assistance at delivery such as inadequacies of local health systems, patient perceptions of quality causing women to bypass their local centers, as well as financial constraints of accessing a skilled birth attendant.

A significant factor in health system demand constraints includes low quality of local facilities and patients choosing higher level care although further away geographically. Research shows that more than 40% of women who chose to deliver in a poor rural area of Tanzania, bypassed their nearest health facility, choosing to deliver at the government hospital or mission facility (Kruk et al. 2009). Although there are often health centers close to the patients home, the perceptions of quality of those centers is low. Tanzania, for example, has invested in designated village level primary care facilities, often called dispensaries, to be the main point of care for uncomplicated births, an effort that led to 90% of the population living within 10km of a health center (National Bureau of Statistics, Tanzania and Macro International 1997). Despite effective proximity, research cites poor quality as a concern in dispensaries in both delivery of care and the degree of skilled labor. A recent study in Tanzania even found that providers in rural areas tend to be less skilled than those in urban areas (Leonard and Masatu 2007).

Financial constraints also contribute to low coverage of skilled workers, as highly trained clinicians such as doctors or midwives require higher compensation, which generates the need for various fees that may discourage woman from using these services. This, in turn, decreases funding for skilled care at delivery, and the overall number of workers with specific obstetric skill sets decrease as well.

There are many initiatives working on solutions to improve maternal health in low-resource countries and they are emphasizing the skilled care approach in their strategies. Some ways to improve the coverage of skilled care include increasing the number of skilled birth attendants and quality care in the dispensaries closest to the women’s home. An organized referral system should also be in place so that higher risk and complicated births are taken to the next closest higher level facility in an efficient manner. This sort of organization will provide quality data to plan for investments in each both types of facilities, so that confidence is restored in the local facilities and woman do not bypass the first facility unless referred. Education and awareness on the quality of first level dispensaries is extremely important within the community so that women are comfortable not only with prenatal and preventive obstetric care but also with giving birth at these facilities. A strong commitment to strengthen local health centers will give donors the confidence to invest more in increasing the coverage of skilled birth attendants and quality care in an effort to reduce maternal mortality in developing countries.

Do me a favor: Try to imagine you have just gotten off a long flight from North America to Africa and you are driving from the airport into the city of Kampala, the largest city and capital of Uganda. Now imagine a gigantic billboard centered around a well dressed, smiling African man, tie and all. Above his head are the words “Would you let this man be with your teenage daughter? “ Below him are the words “So why are you with his?” Now imagine these billboards plastered all over the city and imagine that they are supported by the Uganda Ministry of Health, Youth AIDS and various other reputable organizations. Welcome to Uganda, where a “Say No To Sugar Daddies” campaign is in full effect to stem the growing problem of societal norm that is significantly contributing to the prevalence of AIDS among young women in African: cross generational sex. A pattern of older men infected with HIV, offering to pay for teenage girls school fees and travel, and even cell phones and new clothes, in exchange for sex, has had a devastating effect on the spread of HIV among young women between the ages of 15 and 24. This phenomenon helps to explain why women in this age group are 4-5 times more likely than their male peers to be HIV-positive. If this is the first you are hearing about the Sugar Daddy dilemma, I hope it is as eye opening for you as it was for me.

I learned about this campaign in a Global Health Policy class and it served as a realization to me that there is not only a lot that I don’t know about what is contributing to the AIDS pandemic, but even more that I am misinformed about. Through some additional research, I learned that younger women are more susceptible to HIV than older women. I got to thinking, if the Sugar Daddy phenomenon is such a problem that an entire campaign is centered around it, and the number of infected teenage girls and young women so greatly outnumbers their male counterparts, how many women are infected with HIV worldwide? The answer astounded me: almost half. That’s right, woman, not gay men and intravenous drug users, make up 15.7 million of the total population of people living with HIV.

While the first of December marked World AIDS Day 2009, initiatives around the world raised awareness and funds for the HIV/AIDS crisis that we face as an international community. For many, this day served as a reminder that HIV/AIDS is still very much a problem and a major contributor to the global burden of disease, with over 33.4 million people living with AIDS and 2 million AIDS related deaths. (UNAIDS 2009 Epidemic Update). For many, and quite possibly most, this day has passed without a whole lot of thought provoking reflection. And for many, like myself, this day was a realization that I have a lot to learn about HIV/AIDS in order to contribute to the solution.

Flickr: Elja Vellekoop

By  Eric Bitet, LMHC, MA, MPH

Did you ever stop and consider the cost of talking to a professional about your problems?  Have you been feeling increasingly depressed or anxious recently, overly stressed or worried about your job, finances, or your shrinking property value?  Have you been overcome by malaise or sadness as you remember a lost loved one during this holiday season and wanted to speak to a therapist but were scared of what your out-of-pocket expense would be?  If your answer is “Yes,” you are not alone and many people struggle with problems like these.  These are a few examples of stressors that affect millions of people in the United States and around the globe every year.  The American Psychology Association (APA) reports that in any given year, 1 in 10 Americans overall suffer some disability from mental illness.  Of these millions of American, many have insurance that offers limited benefits for mental health while others are uninsured and must qualify for their state Medicaid programs to have access to treatment.

When these kinds of mental health related problems arise, where do these people go for help?  Well, the first step can be to contact your primary care physician and request a referral to talk to a mental health professional whether it be a psychiatrist, psychologist, or a psychotherapist.  But how will it be paid for?  Do health insurance plans cover mental health care?  Most insurance companies do provide some level of coverage but the pressing issue here is how much?  The answer in most cases is not enough!  The readers will be the judge on whether mental health treatment coverage should be equivalent to coverage provided by insurance companies for physical illnesses but how many of us have thought critically about this issue?  Do you believe that schizophrenia and bipolar (manic-depressive) disorder should be treated the same as physical illnesses in health insurance plans by providing the same amount of cost coverage and inpatient and outpatient treatment visits?

While you ponder this question lets briefly explore the facts.  History shows that physical and mental health has long been treated with great inequality and has only begun to make strides towards parity within the last decade. The struggle of mental health advocates against cost-containment policies that restrict mental health benefits has raged on since the 1980s.  The Mental Health Parity Act of 1996 was a significant first step towards parity as it addressed “catastrophic” benefits and put the issue on the map for policymakers.  The new act prohibited lifetime and annual limits on coverage that were different for mental and physical illnesses.  This was a positive first step for mental health advocacy but barely scratched the surface of the issue as many areas were not addressed.  A report by the Surgeon General indicates that the Mental Health Parity Act did not address other forms of benefit limits such as per episode limits, visit limits, co-payments or deductibles, and substance abuse treatment.

A decade after the Mental Health Parity Act was implemented, mental health advocacy groups have continued their mission to bring parity to mental health insurance coverage and the arguments have been heard by policy and law makers in state governments and on Capitol Hill.  There are 42 states that have followed suit and since enacted their own parity laws requiring mental health coverage to be par with physical health coverage.  In 2008, after a long 10 year battle for equality, President George W. Bush passed a “Mental Health Parity” law that will mandate the equal coverage for depression, bipolar disorder and all other diagnosable mental illnesses with physical illnesses like heart disease and cancer.  As of January 2010, health insurance companies and group health plans will no longer be allowed to impose different limitations on mental health and substance abuse treatment coverage than they do for medical treatment.  At this time, the new law will only exclude those people who are employees of companies with 50 or fewer workers and those who purchase their own insurance.  So there are still some loopholes and speed bumps along the road for mental health parity, but this new law is a monumental victory for mental health advocates who have fought hard to bring mental illness to the mainstream of our society as something that is very important and to be treated seriously!

Up to this point, research indicates that cost is one of the biggest deterrents that prevent people from seeking treatment for mental health related issues.  Well now help is on the way and mental health care should come cheaper and easier for most Americans.  So where do you begin on your journey to access treatment if your experiencing some type of mental health related problem?

Here are some tips that might be helpful:

• Contact your Primary Care Physician (PCP) and make an appointment to discuss issue and request a referral to speak to a mental health specialist.
• Contact your insurance companies who have clinically trained case managers ready to take your call and refer you to the proper level of treatment.
• Many employers have Employee Assistance Programs (EAP) that are staffed with counselors that are prepared to help employees manage and cope with any type of stressful situations whether it is personally or professionally related.
• In the most severe situations, if you are having any thoughts of harming yourself or anyone else, you must call 911 or visit your nearest emergency room right away!

So as we conclude this article, I challenge you to think about what mental illness means to you and think about all the stigma associated with having a mental illness.  Have these stereotypes had an effect on how the American health care system and more importantly insurance companies viewed mental illness and why they didn’t cover its care to the same extent as medical?  Is it possible that something so serious can be taken this lightly and left in the dark for this long?  Whether the answer be yes or no will be left for you to decide!  I will leave you with one reality though; the dark ages of ignorance and prejudices against mental illness are behind us and a new age of public awareness is now here. This is depicted by these mental health parity laws and the conformity of insurance companies!  So where do you stand on this issue and so you think we are there yet?

by Leonard Achan RN, MA, ANP

Many people are skeptical about the new push for electronic medical records (EMRs). While many companies like Google are making it easy and appealing for patients to transfer all of their documents onto their secure sites, it seems almost impossible to fully trust them with your most valuable medical information.

The majority of the population still seem to feel that there is something unsafe about having all of their medical information zipping across cyberspace. We will leave it to our readers to decide what the safest and best options are for storing their valuable information online. I will highlight the pros and cons of the top five services in a future article. For now, the focus of this article will be to tell you about an alternative which, in my experience, has helped save critical time and countless lives over the years. The big secret here is how you can gather your own medical records and safely secure them on your own computer, thumb drive or even your paper file draw. In situations where you may not be able to advocate for yourself and family is stressed and worried, you should afford yourself and your loved ones the ability to have all your records ready and available for the health care providers so that they can have all the necessary information to start treating you quickly and effectively.

We can begin by asking a simple question. When you or your loved ones have exams, tests or imaging such as X rays, ultrasounds  MRI’s, etc. do you ever ask for copies?

Did you know that when going to a physician’s office, lab or radiological center you could call ahead or even ask at the front desk (on arrival) that your images be copied onto a CD after the test?  Tell them you can wait after the test in case it only takes 10-15 minutes and that it is important that you leave with them on a CD.

When you’re admitted to the hospital or even visit an emergency room, do you ever request your medical records, your X-rays/imaging or notes from exams? Did you know that you can do that before being discharged by filling out and signing a medical information release form? They can then mail your file to you at home or you can pick it up another day. Most medical centers now have the ability to even copy those files to electronic PDF files. They charge minimal fees for this but it is priceless info to have since you may need it during your most vulnerable times.

Files copied to CD’s give you the ability to easily transfer them onto your computer. You can then organize them into a desktop file for easy management or save them onto your own thumb drive where you can keep all your records and medical images ‘portable’. If that is too technical for you, then simply keeping these CD’s and records at home in a file draw can be a lifesaver.  This makes the file ready and available at all times. Either of these options would be the best way to keep a medical record of your own. Calling your physicians office today and getting printouts of your labs or tests as well as written reports of your exams is an ideal way to start building your own medical record at home. It’s never too late as long as you know where to get your information. So make some calls today and start building your file. If you have any questions or need guidance, just ask in the comments section below.

By: Erin Lieber

This week some very surprising new breast cancer guidelines were released, through the U.S. Preventive Services Task Force. The group, made up of independent clinical experts , has amended their 2002 recommendation and gone against the early prevention guidance of the American Cancer society, which previously advised that woman should receive routine mammograms every 1-2 years after the age of 40. The new guidelines assert that women no longer need to begin the proactive mammograms at 40, but rather 10 years later, at the age of 50. What is even more surprising is that the Task Force disputes the effectiveness of self-examinations as well.

The reasons cited for the changes? Women in their 40’s are more likely to get false positive results leading to biopsies and stress. According to the Task Force, the benefits of early detection, in this age group, outweigh the risks of incorrect test results and the damage and cost of biopsies that are not necessary.

“The benefits are less and the harms are greater when screening starts in the 40s,” said Dr. Diana Petitti, vice chairwoman of the panel.

I have many concerns about the new guidelines. The first being, the precedent of ambiguity that is being set here. Whether or not it is their intention, these new guidelines contradict what so many have worked to instill in women: “Early Detection Saves Lives”. According to the U.S. Cancer Society, approximately 65% of women in their 40’s currently get a preventive mammogram every 1-2 years. Even with the old guidelines, only three quarters of woman followed the advice. Can we afford to have less than 65% of women seeing their doctors about breast cancer and getting the appropriate tests because of this new messaging? Doesn’t this go against all of the progress made by breast cancer survivors and cancer groups who have worked so hard to educate women on prevention and awareness? These new guidelines certainly don’t apply to those women who are high risk for breast cancer and have a family history of the disease, however, all woman are at risk for breast cancer. My fear is that these guidelines are inconsistent with the message that needs to be conveyed to woman on the importance of early detection, and I’m not the only one who sees this as an issue:

“Our concern is that as a result of that confusion, women may elect not to get screened at all. And that, to me, would be a serious problem,” said Dr. Len Lichtenfeld, the Cancer Society’s deputy chief medical officer.

Furthermore, what will these kinds of recommendations due for coverage of mammograms assuming that women within this age bracket still want to practice early detection? Will insurance companies change their policies and reimburse less or not at all for preventive mammograms within this age group?

Susan G. Komen for the Cure, the Dallas-based breast cancer advocacy group, said it won’t change its recommendation that women ages 40 to 49 get annual mammograms. “We would not want to see a change in policy or reimbursement for screening mammography at this time,” said Eric Winer, the group’s chief scientific adviser, in a statement.

What is motivating these changes? Is it more than just policy review and data extrapolated from studies over the last few years? Could this be the start of health care rationing as we see Congress and their constituents struggle with the cost of the new health care bill and insuring almost 40 million new members without a significant increase in health care workers and supplies? Will we see more of these kinds of guidelines ahead and efforts to decrease prevention as a government option unfolds in health care reform? The latest bill passed by the House included billions in tax increases without measures to control costs. Will we have to pay for health care reform at the expense of the very thing we should be trying to improve…will reform be at the cost of our health?

Flickr: Optical illusion -The University of Groningen's Medical Facility

By J.D’Abbraccio RN, MSN

The “Green” movement in hospitals has taken finally taken momentum in the United States. More and more hospitals are starting to understand the long term impact of going green. Why is that important? Did you know that the U.S. health care sector accounts for almost one tenth of the country’s carbon-dioxide emissions? A report by University of Chicago researchers published in the Journal of the American Medical Association (JAMA) showed that the health care sector accounted for 16% of U.S. gross domestic product. What was most disturbing was that health care contributed to 8 percent of the United States’ total carbon-dioxide output. The analysis found that hospitals were by far the largest contributor of carbon emission. The researchers attributed this to the high energy demands needed for temperature control, ventilation and lighting in large hospital buildings.

What does it mean to for a hospital to be “Green?”  It means a hospital is trying to be environmentally friendly and proactive about leaving a smaller carbon footprint on the planet. It means they are more efficient with energy by utilizing green technology, such as smart efficient heating and cooling systems, high-efficiency glass, solar panels, LED lights, digital thermostats, low-flow faucets, automatic on/off light switches, recycled products and material to name a few. Also, hospitals are focusing their attention on new ways to be more inventive with waste management and recycling. What kind of impact does a green hospital have on its patients?  Green health care design does promote a more healing environment through more natural daylight, outdoor views, landscaping, improved ventilation, better indoor air quality, efficient lighting, low-impact materials and furnishings, and a more relaxed atmosphere.

Why now? Many health care organizations are starting to really understand the long term financial impact of going green. Besides the numerous environmental and health benefits, the combination of affordable new green products, green grants and tax credits, and potential for huge financial savings are really driving this change. Companies like AMSOLAR (www.amsolarcorp.com ) work on innovative models for educational and medical institutions thinking of best practices and solutions on how to maximize investments made by hospitals who decide to go green. Hospitals can spend millions of dollars monthly just for energy. Why wouldn’t a hospital want to save millions by being more efficient? Hospitals are analyzing up-front costs of green technology and are determining that is will usually balance out against long-term savings. Going green may save millions of dollars over the years. Also, the competition for attracting patients plays a big role too. Many patients are looking for clean, efficient, and up to date rooms while recovering from illness. Being green gives the public an enhanced perception that a health care provider is environmental sensitive and cares about the community.

More and more hospitals are going green. It seems like the green message to save the planet is becoming clearer and clearer everyday. Reduce waste and your carbon footprints wherever you can. As a potential patient/customer, will the green movement affect where you will go for your healthcare? Do you think this will improve the quality of care being delivered? Have you been in a “green” hospital? If so, please share your experience and thoughts.