Take a Break: Send Halloween Images

 I happen to love Halloween, so it’s a bit disturbing to see all the Christmas merchandise stacked up just itching to push out the witches, goblins, ghosts and assorted eerie and scary stuff. Fortunately, you can download all sorts of fun Halloween images on-line. Have some fun today by downloading images to send to friends that will enjoy them.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Life with Chronic Disease: How to Avoid Prescription Sticker Shock

Recently,  a friend who has spent her career in a health related field, posted the following to her Facebook page, "Prescription drug 90 day supply same drug : Aetna Medicare Part D Mail order preferred Plan $140, Wegman’s Pharmacy $48, Used Good Rx coupon on my phone at Wegman’s and paid $15.27."  As it turned out, there was more to this post.  This was a new script that the doctor electronically submitted to my Medicare Part D Preferred Mail Order Pharmacy so I did pay $140 for the first 90 day supply, sticker shock, so I went shopping.

My friend’s experience is all too common and many are finding prescription plans aren't actually saving them money. Medicare is supposed to make your prescription drugs affordable. But, as many are learning that’s not the case due to the infamous "donut hole" and the fact that some drugs aren’t covered.

Regardless of your age, condition or insurance status, paying for prescription medications can be a real challenge.

How to Prevent Rx Sticker Shock

When your medical provider says you need a prescription, ask the following questions:

• What is the name of the medication and what is it being prescribed for?

• What happens if I don’t take it?

• Are there side effects?

• Is there a comparable generic?

• Can lifestyle changes be implemented in place of the medication?

• How much does the drug cost?

• Are there similar medications but less costly?

• Does your provider offer samples and/or drug coupons?

Note that some of these questions you may need to discuss with your pharmacist.

If this is a drug you know you’ll need to take, review your insurance plan. Plans differ so it’s important to know how much they’ll pay for the medication, recognizing certain medications may not be covered. Have this information with you when you go for medical appointments in order to help them select the best medication that is affordable to you.

Check for manufacturer coupons: Brand name drugs will often have websites where discounts are offered. Note that there may be a time or refill limit for these programs. Also be sure to read the fine print, as some types of coverage such as Medicare, Medicaid, Tricare, or other federal or state government-funded programs will not allow use of coupons.

Comparison shop: Prices for prescriptions can vary significantly from one pharmacy to another. In addition, while a pharmacy may be the cheapest for one medication, it may be considerably higher for another. If you are using different pharmacies, in order to get the best prices for your meds, please inform all pharmacists of the medications you may be taking. Use the GoodRx comparison shopping feature.

Utilize Patient Assistance Programs

• Medicine Assistance Tool: PhRMA’s Medicine Assistance Tool (MAT) is a search engine designed to help patients, caregivers and health care providers learn more about the resources available through the various biopharmaceutical industry programs. MAT is not its own patient assistance program, but rather a search engine for many of the patient assistance resources that the biopharmaceutical industry offers.

• Rx Assist: Patient assistance programs are run by pharmaceutical companies to provide free medications to people who cannot afford to buy their medicine. RxAssist offers a comprehensive database of these patient assistance programs, as well as practical tools, news, and articles so that health care professionals and patients can find the information they need. All in one place.

• GoodRx:  Compare prices for every FDA approved drug at over 70,000 US pharmacies, including the pharmacy nearest to you.. Print free coupons or send them to e-mail or text message. Show them to your pharmacy and save. You can download their app to your phone or tablet and show it to your pharmacist. You can get the app for free at their website. You can also order a free discount card from the website.  GoodRx also has a program to help with pet medications.

• Community Cares Rx: Receive up to 20% off on brands and 70% off on generics with this card.

• Script Save WellRx

• RxOutreach:  For generic medications, RXOutreach.com is a respectable, non-profit, mail-order pharmacy that offers generic medications at a discounted rate to qualifying patients with a household income at or below 300 percent of the federal poverty level. You may qualify for their services, even if you already have a prescription drug plan (including the federal plans), and may find the medications are even less expensive than using your insurance.

• Check out store prescription plans: Many of the chain drug stores, pharmacies at grocery stores, and big box discount stores may offer savings on a select number of prescription medications through drug-savings programs that you can join for free or at a small cost.

• Local chapters of condition specific organizations (e.g. American Parkinson Disease Association), hospitals and health care centers will sometimes have coupons to distribute. Definitely inquire and be sure to visit the vendor displays at condition specific conferences you might attend.

If it’s a new medication, try a smaller quantity to make sure you aren’t allergic to it.

Talk to your pharmacist: Your pharmacist can often make suggestions for other options if you let them know you can’t afford a prescription. Often times there is more than one medication option to treat a condition. By working with both the pharmacist and your provider can help you find the most affordable option.

Take a Break: Carve something other than a pumpkin for Halloween

There are so many ways to make fruits and veggies delicious and spooky for Halloween.

For starters, watermelons, pineapple, cantaloupe, oranges, tangerines, grapefruits, peppers and melons can all be carved the same way you carve a pumpkin. Cut off the top, scoop out the guts and carve away. The textures of the fruit definitely lend themselves to unique projects, such as a mummy cantaloupe.

One of my favorites is the avocado sugar skull.

Also fun are the Veggie Skeleton and Apple Teeth Treats.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Journal Watch October 2019

PAIN

The effectiveness of electrical stimulation in producing spinal fusion: Researchers from The Johns Hopkins University School of Medicine performed a systematic review and meta-analysis of published data on the effect of electrical stimulation therapies on spinal fusion. They found significant improvement overall in the rates of bone fusion following a course of electrical stimulation in both preclinical (animal) and clinical (human) studies. Journal of Neurosurgery

Experimental Growth Factor May Aid Knee Osteoarthritis: An experimental growth factor therapy, sprifermin, may prevent a worsening of osteoarthritis by increasing the thickness of cartilage in the knee, according to a study published in the Oct. 8 issue of the Journal of the American Medical Association.

Caution Urged When Taking Patients Off Opioid Painkillers: Doctors should be more cautious when taking chronic pain patients off opioid painkillers, according to a new U.S. Department of Health and Human Services guidance released.

 

Steroid Injections in the Knee and Hip Can Cause More Damage Than Previously Realized: A new study finds that corticosteroid shots may accelerate arthritis in knee and hip joints, even as it removes pain. Radiology 

Osteoarthritis can increase your risk for social isolation: When older adults become lonely -- a condition health professionals call "social isolation" -- their health and well-being can suffer. In fact, there may be a link between being socially isolated and osteoarthritis (arthritis) which causes joint pain and can limit your ability to get around. Journal of the American Geriatrics

Physical Therapy, Lifestyle Advice Underused in Knee OA: For patients with knee osteoarthritis (KOA), physical therapy (PT) and lifestyle counseling seem to be underutilized, while medication use has increased, according to a study published online Oct. 8 in Arthritis Care & Research.

 

COMPLEMENTARY & ALTERNATIVE MEDICINE

Massage and Music Therapy May Be Better Than Pills for Certain Dementia Symptoms: Massage, music therapy, and other non-drug interventions are effective at treating dementia symptoms such as aggression and agitation suggests a new studyTrusted Source published  in the Annals of Internal Medicine.

Chairy oga more effective than music therapy in older adults with advanced dementia: Researchers assessed the ability of older adults with advanced dementia to participate in non-pharmacological interventions and compared chair yoga with chair-based exercise and music therapy. Results showed that participants with moderate-to-severe dementia could safely adhere to non-pharmacological interventions; more than 97 percent fully engaged in each session. The chair yoga group reported a higher quality of life score, including physical condition, mood, functional abilities, interpersonal relationships, and ability to participate in meaningful activities. American Journal of Alzheimer's Disease & Other Dementias

Cultivating joy through mindfulness: An antidote to opioid misuse, the disease of despair: New research shows that a specific mind-body therapy, Mindfulness-Oriented Recovery Enhancement (MORE), increases the brain's response to natural, healthy rewards while also decreasing the brain's response to opioid-related cues. Science Advances

Mindfulness may reduce opioid cravings, study finds: People suffering from opioid addiction and chronic pain may have fewer cravings and less pain if they use both mindfulness techniques and medication for opioid dependence, according to researchers.

Drug and Alcohol Dependence

FDA ACTION

• Approved Mavyret as 8-Week Treatment for Hep C, Compensated Cirrhosis

• Approved Vaccine for Prevention of Smallpox, Monkeypox

• Approved Reyvow (lasmiditan) tablets for acute treatment of migraine

• Approved Scenesse (afamelanotide), a melanocortin-1 receptor agonist, for adult patients with a history of phototoxic reactions from erythropoietic protoporphyria

• Approved Descovy (emtricitabine 200 mg and tenofovir alafenamide 25 mg) for HIV-1 preexposure prophylaxis (PrEP)

• Approved Rituxan (rituximab) injection to treat granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) in combination with glucocorticoids in children 2 years and older

PREVENTION

Don't make major decisions on an empty stomach, research suggests: The study found that hunger significantly altered people's decision-making, making them impatient and more likely to settle for a small reward that arrives sooner than a larger one promised at a later date. Psychonomic Bulletin & Review

Dog ownership associated with longer life, especially among heart attack and stroke survivors: Dog ownership may be associated with longer life and better cardiovascular outcomes, especially for heart attack and stroke survivors who live alone, according to a new study and a separate meta-analysis published in Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association.

Regular exercise is good for your heart, no matter how old you are! Regular exercise is highly beneficial for all patients with cardiovascular disease regardless of age, report investigators in the Canadian Journal of Cardiology. Their results showed that the patients who benefited most from cardiac rehabilitation were those who started out with the greatest physical impairment.

Increase health benefits of exercise by working out before breakfast: According to a new study, published in the Journal of Clinical Endocrinology and Metabolism, health scientists Birmingham found that by changing the timing of when you eat and exercise, people can better control their blood sugar levels. The six-week study, which involved thirty men classified as obese or overweight and compared results from two intervention groups (who ate breakfast before / after exercise) and a control group (who made no lifestyle changes), found that people who performed exercise before breakfast burned double the amount of fat than the group who exercised after breakfast.

Cancer patients who exercise have less heart damage from chemotherapy: Patients with cancer should receive a tailored exercise prescription to protect their heart, reports a paper published today in the European Journal of Preventive Cardiology

Violence linked to social isolation, hypervigilance and chronic health problems: Exposure to violence can negatively impact a person's physical and psychosocial health, according to two new studies. The studies were based on in-person surveys of more than 500 adults living in Chicago neighborhoods with high rates of violent crime, and in predominantly racial and ethnic minority groups. Health Affairs

CTE risk, severity increases with years playing American football: The risk and severity of developing chronic traumatic encephalopathy (CTE) increases with the number of years playing American football according to a new study that appears online in Annals of Neurology. These findings reaffirm the relationship between playing tackle football and CTE, and for the first time quantify the strength of that relationship. In a sample of 266 deceased former amateur and professional football players, the study found that the risk of developing CTE increased by 30 percent per year played, meaning that for each 2.6 additional years of football played, the odds of developing CTE doubled. Among those with CTE, for each additional 5.3 years played, the odds of developing severe CTE doubled.

Cleaning with Bleach Can Release Harmful Airborne Particles: When bleach fumes mix with a citrus compound found in many household cleaners, they can form ultrafine particles like those found in smog. This compound is called limonene and is usually relatively mild but in large amounts can irritate the eyes, throat, lungs and skin.  Some green products may be safer than traditional bleach, but some experts say using vinegar and baking soda can also be non-toxic way to clean your home.

 

Ex-smokers,light smokers not exempt from lung damage: A new study shows that smoking even a few cigarettes a day is harmful to lungs and that former smokers continue to lose lung function at a faster rate than never-smokers for decades after quitting. People who smoke fewer than five cigarettes a day cause long-term damage to their lungs, according to a new study. The Lancet Respiratory Medicine

Flight Attendants Avoid Drinking Tap Water on Planes. You Should Too: Recent testing found the tap water on airplanes isn’t very sanitary and the quality varies greatly between different airlines. Researchers advise airline passengers to never drink water aboard an airplane unless it’s sealed in a bottle. That includes coffee or tea. They also advise passengers to avoid washing your hands in the bathrooms. Use hand sanitizer instead. Airline Water Study 2019,

What Is IQOS, and How Is It Different from Vaping or Smoking? Smoking giants Philip Morris and Altria have launched IQOS, a “HeatStick” that heats up rather than burns tobacco, for sale in the United States. IQOS looks like other e-cigarettes.  It is being pitched as a safer product than vaping. At this juncture it’s soon to know if it’s a safer choice and what the long term effects might be. As with any tobacco product, there are health risks. Healthline

NUTRITION/SUPPLEMENTS

Panel Votes Yes to Current Level of Red, Processed Meat Intake: An international panel suggests that adults continue their current levels of consumption of red or processed meat based on evidence from five systematic reviews published online Oct. 1 in the Annals of Internal Medicine.  Since the study was released, a number of members of the scientific community have come out against the study, which is in opposition to the current belief. Equally concerning is a new report that found ties between the lead author and the food industry, which he failed to disclose. The study was funded by International Life Sciences Institute (ILSI), an industry trade group heavily funded by big business.

Large, long-term study suggests link between eating mushrooms and a lower risk of prostate cancer: Results from the first long-term cohort study of more than 36,000 Japanese men over decades suggest an association between eating mushrooms and a lower risk of prostate cancer. International Journal of Cancer

Science Finds Simple Way to Lower Diabetes, High Blood Pressure Risk: New research finds a diet high in fiber, like shredded wheat, can help combat effects of type 2 diabetes and hypertension. Those on a high-fiber diet had lower cholesterol, lower blood pressure, and lower blood sugar.  Only 25 percent of adults get the recommended amount of fiber daily. American College of Cardiology Conference

In major meta-analysis of clinical trials, omega-3 fish oil supplements linked with lower cardiovascular disease risk People who increase their consumption of sugary beverages-whether they contain added or naturally occurring sugar-may face moderately higher risk of type 2 diabetes. The study also found that drinking more artificially sweetened beverages (ASBs) in place of sugary beverages did not appear to lessen diabetes risk. However, diabetes risk decreased when one daily serving of any type of sugary beverage was replaced with water, coffee, or tea. Diabetes Care.

Vitamin D and fish oil show promise in prevention of cancer death and heart attacks: The VITamin D and OmegA-3 Trial (VITAL) is the largest and most recent to test whether vitamin D or fish oil can effectively prevent cancer or cardiovascular disease. Results to date have been mixed but show promise for some outcomes, now confirmed by updated pooled (meta) analyses.T he North American Menopause Society (NAMS) Annual Meeting in Chicago

Alcohol consumption may increase dementia risk for people with mild cognitive impairment: Adults age 72 and older with mild cognitive impairment (MCI) who drank more than 14 alcoholic drinks a week were 72% more likely to progress to dementia over an eight-year period than those who drank less than one drink a week. For participants without MCI, alcohol consumption was not associated with higher dementia risk.

Replacing less healthy foods with nuts could help lower risk of long-term weight gain: People who ate a daily half-serving of nuts (about a handful) instead of the same amount of refined grains, red meat, or dessert gained less weight over a 24-year study period than those who ate nuts less frequently. Diabetes

Vitamins B-6 and B-12 linked with increased risk of hip fracture: A study of postmenopausal women in the Nurses’ Health Study found that a combined high intake of vitamins B₆ and B₁₂ was associated with an increased risk of hip fracture. The intakes were far higher than the recommended dietary allowances. These findings add to previous studies suggesting that vitamin supplements should be used cautiously because adverse effects can occur. JAMA Open Network

 

Frequent drinking is greater risk factor for heart rhythm disorder than binge drinking: Drinking small amounts of alcohol frequently is linked with a higher likelihood of atrial fibrillation than binge drinking, according to new research. EP Europace

Drinking more sugary beverages of any type may increase type 2 diabetes risk: People who increase their consumption of sugary beverages -- whether they contain added or naturally occurring sugar -- may face moderately higher risk of type 2 diabetes. Diabetes Care

Vitamin C therapy linked to better survival rates after sepsis: New research suggests that patients with sepsis and septic lung injury could have a better chance of survival and recover more quickly when treated with vitamin C infusions. On average, the vitamin C group spent three fewer days in the ICU at day 28 and a week less in the hospital overall by day 60 than the placebo group. JAMA

 

To fight effects of sleep deprivation, reach for healthy snacks: In a study of 245 Stanford physicians, researchers found that a better diet is associated with reduced side effects of sleep deprivation. Stanford Medicine

TREATMENT

Commonly used drug for Alzheimer's disease doubles risk of hospitalization: A drug commonly used to manage symptoms of Alzheimer disease and other dementias -- donepezil -- is associated with a two-fold higher risk of hospital admission for rhabdomyolysis, a painful condition of muscle breakdown, compared with several other cholinesterase inhibitors, found a study in CMAJ (Canadian Medical Association Journal).

 

Rivaroxaban Cuts Recurrent Blood Clots in Obese Patients: Real-world evidence shows that rivaroxaban reduces the risk for recurrent venous thromboembolism (VTE) in morbidly obese patients, with similar safety and efficacy as warfarin, according to a study published in the October issue of Thrombosis Research.

Nivolumab Therapy Prolongs Survival in Advanced Melanoma: More patients with advanced melanoma receiving nivolumab plus ipilimumab or nivolumab alone have sustained long-term survival at five years compared with those receiving ipilimumab alone, according to a study published online Sept. 28 in the New England Journal of Medicine.

Long-term study data shows DBS is effective treatment for most severe form of depression: A study published online on Friday, October 4, in the American Journal of Psychiatry found that deep brain stimulation (DBS) of an area in the brain called the subcallosal cingulate (SCC) provides a robust antidepressant effect that is sustained over a long period of time in patients with treatment-resistant depression--the most severely depressed patients who have not responded to other treatments.

More evidence linking common bladder medication to a vision-threatening eyecondition:A drug widely prescribed for a bladder condition for decades, now appears to be toxic to the retina, the light sensing tissue at the back of the eye that allows us to see. After an initial report last year that Elmiron (pentosan polysulfate sodium) may be associated with retinal damage, three ophthalmologists conducted a review of patients at Kaiser Permanente in Northern California. They found that about one-quarter of patients with significant exposure to Elmiron showed definite signs of eye damage, and that this medication toxicity could masquerade as other known retinal conditions, such as age-related macular degeneration or pattern dystrophy. Annual Meeting of the American Academy of Ophthalmology.

Surgery May Be Best Option for Some With Refractory Heartburn: In patients who truly have proton pump inhibitor (PPI)-refractory heartburn, including those with reflux hypersensitivity, surgery may be the best treatment option, according to a study published in the Oct. 16 issue of the New England Journal of Medicine.

Dopamine Agonists Tied to Higher Risk for Psychiatric Events: Patients with primary restless leg syndrome who begin dopamine agonist (DA) therapy may be at increased risk for adverse psychiatric events, according to a large study published in the September issue of the Journal of Clinical Sleep Medicine.

 

Some Blood Pressure Medications May Increase a Person’s Risk for Suicide: Certain types of medications used for blood pressure, kidney disease, heart failure, and diabetes could increase suicide risk. People using angiotensin receptor II blockers (ARBs) are 1.5 times more likely to die by suicide than people who take angiotensin converting enzyme inhibitors (ACE inhibitors). The research is preliminary and needs follow-up studies, but they say people with mental health issues should consult with their physicians before taking these types of medications. JAMA Network Open

Estrogen exposure may stave off cognitive decline in women: The conclusion of a study of 2,000 postmenopausal women followed for 12 years found that estrogen exposure is linked with better cognitive healthin older women. Benefits were stronger for the oldest women in the sample who started taking estrogen the earliest. Menopause

Artificial Pancreas Helps T1DM Patients Meet Glycemic Targets: Patients with type 1 diabetes using an artificial pancreas or closed-loop system spend a greater percentage of time in a target glycemic range compared with those using a sensor-augmented insulin pump, according to a study published online Oct. 16 in the New England Journal of Medicine.

OTHER

Sanofi is recalling Zantac: The pharmaceutical company Sanofi announced today that it’s undertaking a voluntary recall of Zantac due to concerns about a potential cancer-causing chemical.  This comes weeks after the popular heartburn drug ranitidine, known by the brand name Zantac, was found to contain a cancer-causing chemical. Last month, multiple drugstores decided to no longer sell the medication.

Johnson & Johnson Recalls Baby Powder Due to Presence of Asbestos: A shipment of baby powder has been recalled by Johnson & Johnson after U.S. authorities found asbestos in it. The recall comes after months of denial from the company about the presence of the cancer-causing substance in its talc-based products, The New York Times reported Friday. But the U.S. Food and Drug Administration found trace levels of chrysotile asbestos in samples from a bottle of baby powder bought from an online retailer, according to Johnson & Johnson. The recalled lot of baby powder is #22318RB and includes 33,000 bottles sold by an unidentified retailer, said company spokesman Ernie Knewitz. He added that this is the first time Johnson & Johnson has pulled its baby powder from the market, The Times reported.

25% of US Health Care Spending is Wasteful: A study published Monday in the medical journal JAMA finds that up to a quarter of all United States health care spending is wasteful. Researchers found that $760 billion to $935 billion health care dollars are wasted every year The study cited multiple reasons for the wasteful spending. The biggest driver was administrative issues related to billing and coding. That represented 28% to 35% of total waste. The second greatest contributor was what authors called "pricing failure.” This was described as waste related to the price of drugs and services "because of the absence of effective transparency and competitive markets." Other factors are over-treatment, unnecessary hospital visits, and lack of preventative care. The U.S. spends more on health care per capita than any other developed nation. JAMA

Life with Chronic Disease: Give yourself more time

I came across this article Free Up 2 Hours  from Blue Zones and marveled how much I complain about not having enough time. As it’s quickly pointed out in the article, we become quickly ingrained in habits that are total time sucks and don’t allow us to do some of the things we want to do or should be doing. It’s never about having the time, it’s about making the time.

The article is adapted from Everything is Figureoutable by Marie Forleo, a handbook for training your brain for growth, creativity, and positivity in the face of setbacks. 

Try these two things:

• Read Free Up2 Hours

• Visit Marie Forleo’s website.

Take a Break: Make a Fall Kaleidoscope Picture

Either take a picture of foliage in your area, or download one from Google Images. Use Lunapic on-line. It’s free. Try various number of sides to see what gives you the best image.

Not interested in today’s activities, try the Take a Break Pinterest Board.

Life with Chronic Conditions: Celebrities are not health experts

I recently listened to a talk where Dr. Jen Gunter debunked Gwyneth Paltrow’s GOOP website. She was specifically angered about V Steam, which involves an infrared and mug wort steam cleanse for a woman’s uterus. Gunter, a gynecologist and author of “The Vagina Bible”  pointed out that the vagina and uterus are “self-cleaning ovens,” and steam may actually do more harm than good.

Gunter refers to Paltrow as the “couture’ of snake oil salesman and talks a great deal about how the wellness industry uses pseudoscience to stigmatize and control women in particular.

We don’t go to a celebrity to do our tax returns, seek their advice on plumbing or electrical problem, or to mediate a dispute with our spouse, so why do so many people think they are health experts? Why do their opinions on vaccination, surgeries, diets and treatments matter?

It’s very simple, celebrities have platforms while health care professionals do not. People with platforms command our attention. Further, as fans, we view them as trusted messengers and even friends.

Sometimes the messenger is correct, as in the case of Michael J. Fox who has used his health situation to seek a cure for Parkinson’s Disease. Other times a celebrity can bring awareness to a serious health issue because of their own status, such was the case when Charlie Sheen announced that he was HIV positive. As a result, there was a significant upswing in people being tested. Angelina Jolie made many aware of the genetic link for breast and ovarian cancers.  

However, the celebrity can be way off course and cause considerable damage. Paltrow is but one example, and the list is long including people like Tom Cruise, Jenny McCarthy, Suzanne Somers and even Dr. Oz (Green Coffee Bean extract). A study in the British Medical Journal  that looked at the impact celebrities have on medical advice concluded, The influence of celebrity status is a deeply rooted process that can be harnessed for good or abused for harm. A better understanding of celebrity can empower health professionals to take this phenomenon seriously and use patient encounters to educate the public about sources of health information and their trustworthiness. Public health authorities can use these insights to implement regulations and restrictions on celebrity endorsements and design counter marketing initiatives—perhaps even partnering with celebrities—to discredit bogus medical advice while promoting evidence based practices.

Celebrities write books on health and various aspects of wellness all the time. They run health conferences and sell ideas that are beyond absurd. Unfortunately, paying attention to them can not only cost you money, but it can delay effective treatments and at worse cause serious harm. Keep in mind that even if a celebrity has the same condition you have, chances are good that they have access to medical care that can be well beyond anything you can afford, and very possibly not something you need in the first place.

The bottom line is we all need to be wary of snake oil sales pitches be they delivered by our favorite movie star, sports figure or TV host.

How to find good health information online

• Ask your medical provider about the websites they would recommend for someone with your condition. Think of it like a health information prescription.

• Know the warning signs: If it’s a .com and is selling something, promises a cure, suggests supplements that can fix everything, offers to treat you on-line without seeing you be very wary. They are often filled with ads and sponsors information. If you do go to Web MD, don’t click on anything. Their goal isn’t so much to educate and inform as it is to generate money for those that run the site. Sites to consider with reliable health information include: National Institutes of Health; Medline Plus; Condition specific organizations such as the American Cancer Society.

 • Keep the ABCs in mind as you search:

-       Authority & Accuracy: Is the website up to date? Check the site for the date of the last update. If it’s more than a few years old it can be outdated. Who oversees the site? You can find this is the “about us” section.  Is it a medical professional? Are they an expert in their field? Can you reach the author of the site by e-mail or phone? Do they provide information from the medical literature?

-       Bias: Who pays for the site? DO NOT CLICK ON ADS as this can create a host of problems you don’t need.

-       Can you read and understand the information?