It’s the last Wednesday in September and the last of the “take a breaks” that feature apples. I wanted to do something very special. I was inspired by David Sedaris new book, a series of fables using animals This started me thinking how apples have become part of stories and myths-Adam and Eve’s downfall from eating an apple in the Garden of Eden; Snow White falling into a deep sleep thanks to a poisonous apple; and it was an irate apple tree that pelted the Tin Man, Cowardly Lion, Dorothy and Scarecrow with fruit on their way to Oz. Since this is a blog about health, we can’t forget “an apple a day keeps the doctor away.”
Today’s break is to write a short fable, story, myth or phrase involving apples. Cartoons also would be fun. Below is my quick attempt at a story.
A gala and a concord apple were resting in their respective bins at the local grocery store. The Gala commented that the music was too loud, while the Concord didn’t mind the music but detested the grubby hands touching her skin. “What’s the problem? Am I not shinny enough? Always touching but never buying,” she complained.
“Maybe it’s the music that’s causing your blemishes.”
“What blemishes?”
“Well I just thought that if people weren’t buying you maybe there was a problem with your skin.”
The Concord didn’t like this conversation one bit, and promptly replied how she was picked after the first frost so was guaranteed to be the best eating. The Gala insisted that she was so tasty they had to import her from another country.
Not an inspiring conversation, but that’s the way it went for several hours until someone bought both apples and put them in a bag along with three golden delicious apples, that were located three bins away.
Having been selected, they were quietly pleased when they were placed on the counter. “How many apples?” whined the 16-year-old clerk. “Three,” replied the customer. “So what kind are they? Ya got two reds and three greens. They should be bagged by type.” Weighed separately, even though they were all the same price per pound, the apples were once again in the same bag.
The customer and her two daughters proceeded to each eat one of the Golden Delicious Apples on their way home from the store. Yum!
As for the Gala and Concord apples, they ended up being stuck in the back of the refrigerator, under a pile of other fruits, and were promptly forgotten until the smell of rotting apples required their immediate removal to the compost pile.
Wednesday, September 29, 2010
Tuesday, September 28, 2010
Do you Check Your Medical Bill?
Many people don’t bother to read the charges in their medical and/or hospital bills. This can be a very costly mistake, particularly when you expect your insurance or Medicare to be covering the costs and they don’t. Recently, Jane Brody, of the New York Times wrote about this in Put Your Hospital Bills Under a Microscope.
According to Medical Billing Advocates of America, a group that checks bills for consumers, 8 out 10 hospital bills it scrutinizes contain multiple errors. Keeping a health log of visits, medications and treatments received (see Managing Health Information on-line ) as well as reviewing bills as you receive them, can go along way to help reduce errors. The following tips on what to look for come from Consumer Reports Health.
Incorrect basic data: If information such as your name or your insurer's group number is wrong, the amount the plan covered is likely to be off, too.
Duplicate orders for medications, lab work, or room fees: For example, a hospital might bill a patient for a procedure even though a doctor canceled it, or you might get a bill for 11 cholesterol tests instead of one.
Unbundled fees: If you were charged for several lab tests in one day, call your insurer to see whether the charges should have been bundled under one fee. And look for the words kit, tray, and room fees. Each of those charges should cover many items; operating room fees, for example, should include sheets, gowns, and gloves. Call your insurer to see what's included so you can be sure you didn't receive any duplicate charges.
Operating-room times: If you had surgery, your anesthesia record will state when your surgery began and ended. That gives you a way to check for appropriate costs. Operating-room use is generally billed at rates that vary from $69 to $270 per minute. You might find, for example, that you were billed 240 minutes for a procedure that took only 180 minutes.
Up-selling: : It occurs when you have a stay in the hospital and your doctor orders a generic drug, but the hospital provides you with a more costly brand-name version. Because you are not an expert at determining whether a drug is generic, you are not responsible for the increased charge.
Fraud Guides has also compiled a list of the most common medical billing errors and what you can do to protect yourself:
• Repeat billing: ensure you haven't been charged twice for the same procedure, supplies or medications.
• Length of stay: Double-check the dates of your admission and discharge. Were you charged for the day you checked out? Most hospitals will charge for the day you arrived, but not for day you left.
• Correct charge for type of room: If you were in a shared room, confirm you're not being charged for a private one.
• Time in OR: Sometimes hospitals charge based on an "average" time needed to perform an operation. Contrast the charge you received against your anesthesiologist's records.
• Up coding: Happens when a doctor changes an order for medication and/or service from an expensive version to one that costs less, like generic medications. And yet you're billed at the higher rate. And sometimes you're billed for both. Keep on top of this one; it's the most widespread of all the common billing errors.
• Keystroke mistake: Happens to the best of us, an innocent slip up on the keyboard that can result in significant overcharges or in some cases an undercharge.
• Canceled service: Occasionally a medication, procedure or service that was prearranged and then canceled later will still show up on your final invoice.
If you find a mistake, call the billing office and go over it. It may take some persistence, but the more proof you have going into it, the better off you’ll be.
According to Medical Billing Advocates of America, a group that checks bills for consumers, 8 out 10 hospital bills it scrutinizes contain multiple errors. Keeping a health log of visits, medications and treatments received (see Managing Health Information on-line ) as well as reviewing bills as you receive them, can go along way to help reduce errors. The following tips on what to look for come from Consumer Reports Health.
Incorrect basic data: If information such as your name or your insurer's group number is wrong, the amount the plan covered is likely to be off, too.
Duplicate orders for medications, lab work, or room fees: For example, a hospital might bill a patient for a procedure even though a doctor canceled it, or you might get a bill for 11 cholesterol tests instead of one.
Unbundled fees: If you were charged for several lab tests in one day, call your insurer to see whether the charges should have been bundled under one fee. And look for the words kit, tray, and room fees. Each of those charges should cover many items; operating room fees, for example, should include sheets, gowns, and gloves. Call your insurer to see what's included so you can be sure you didn't receive any duplicate charges.
Operating-room times: If you had surgery, your anesthesia record will state when your surgery began and ended. That gives you a way to check for appropriate costs. Operating-room use is generally billed at rates that vary from $69 to $270 per minute. You might find, for example, that you were billed 240 minutes for a procedure that took only 180 minutes.
Up-selling: : It occurs when you have a stay in the hospital and your doctor orders a generic drug, but the hospital provides you with a more costly brand-name version. Because you are not an expert at determining whether a drug is generic, you are not responsible for the increased charge.
Fraud Guides has also compiled a list of the most common medical billing errors and what you can do to protect yourself:
• Repeat billing: ensure you haven't been charged twice for the same procedure, supplies or medications.
• Length of stay: Double-check the dates of your admission and discharge. Were you charged for the day you checked out? Most hospitals will charge for the day you arrived, but not for day you left.
• Correct charge for type of room: If you were in a shared room, confirm you're not being charged for a private one.
• Time in OR: Sometimes hospitals charge based on an "average" time needed to perform an operation. Contrast the charge you received against your anesthesiologist's records.
• Up coding: Happens when a doctor changes an order for medication and/or service from an expensive version to one that costs less, like generic medications. And yet you're billed at the higher rate. And sometimes you're billed for both. Keep on top of this one; it's the most widespread of all the common billing errors.
• Keystroke mistake: Happens to the best of us, an innocent slip up on the keyboard that can result in significant overcharges or in some cases an undercharge.
• Canceled service: Occasionally a medication, procedure or service that was prearranged and then canceled later will still show up on your final invoice.
If you find a mistake, call the billing office and go over it. It may take some persistence, but the more proof you have going into it, the better off you’ll be.
Saturday, September 25, 2010
Am I’m Being Phased Out?
Am I’m Being Phased Out?
I learned today, via e-mail, that I was found “not to be a good match” for a job that I was more than qualified for. Being overqualified, or having no background for many of the jobs available where I live, has resulted in a constant stream of rejection letters for the last five years. This has been humbling and frustrating.
In discussing this latest rejection with my husband, he noted that we are being “phased out.” While he thinks in terms like this because he can’t buy film for his video camera that’s18 years old, many people my age (baby boomer generation) believe they are being phased out because they can’t find work. They are among the first to be let go if there is a lay off. Interviews are scarce and more often then not, they end with a letter (or now e-mail) that says “thanks but no thanks.” Many believe they are lucky to have a job at all, and are concerned that they will never have the financial stability their parents enjoyed.
How much of it is age? Are we intimidating because we are often more qualified and experienced than the person interviewing us? Even when we are willing to work for much less, are we still too scary for those younger with less knowledge and experience?
So what does this have to do with chronic conditions? The fact is, many of the baby boomer generation are either living with a chronic condition, will have one in the not too distant future and/or are caring for someone that has one. Many are sandwiched between adolescent kids (or grandchildren in some cases) and elderly parents.
In the traditional work model, being older, having a chronic illness, and/or being a caregiver aren’t characteristics that are perceived by employers to be of value. However, it’s the boomers perceptions of themselves as unique, trendsetters and a belief they can make the world better that can help us thrive. Below are some things to consider:
• People with purpose live longer and are generally happier. Happier people live longer than those who aren’t. Purpose isn’t determined by a job title or a paycheck. Money doesn’t equal purpose.
• The older you are, the more you’ve dealt with situations, be it caregiver or person living with a chronic condition, the more skill sets you’ve developed. While this may not translate into a 9-5 job, it definitely makes you very qualified to participate in one of the newest social movements-Time Banks. For every hour you spend doing something for someone in your community, you earn one Time Dollar. Then you have a Time Dollar to spend on having someone do something for you. I know people with major chronic illness who participate in such programs and they are able to contribute according to their schedule. Check out what’s available in your area by going to Time Banks or googling “barter programs” and your location. If there is nothing available, start talking to friends, family and neighbors about starting one in your area.
• Volunteer. Sometimes volunteer positions can become jobs.
• If you are reading this on-line, particularly if it’s your own computer, you’re a step ahead. Check out eHow’s tips on “How to Make Money Using Your Computer.”
• Write or tell your story. In the process of doing so, note the trends in how you’ve coped in the past. Are their situations, which you thought were total disasters but ultimately led you to make changes that improved your life? As the coordinator of my local historical society, this type of writing is among the most useful in understanding how past generations functioned. When I find a farm journal, where the writer shares their story of what they are facing and how they deal with it, it helps me put my own life in a much better perspective.
• Live simply. It’s amazing how little we really need. Unfortunately, our economy is built on the “buy buy buy” model, so there are lots of media messages to that effect. When I think about all the purchases I’ve made in my life, the two that I enjoy the most are my computer and my sofa. The latter is just the right size for stretching out and reading. I should also say that I really appreciate my car, as she runs like a dream even though she’s 11 years old and has 200,000 miles on the odometer. Check out Live Simple for some ideas on ways to reduce.
• There are organizations designed specifically to help you find work. Contact your local community action agency to find out what’s available in your community.
I am fortunate that I work part time for a historical society. More than anything it provides me with a sense of how people have lived, worked, grown old and died in my town. Their stories, be they written or told through the items they once used, date back hundreds of years. They have seen good times and bad. At the end of the day, we are more alike then different and our differences are often what help us move forward as people and community.
Ultimately my husband is right that products, such as his video camera, are being phased out. However, we aren’t our “stuff,” and as people, while we will die, the ultimate phase out, we can leave a legacy that helps those who come after us.
I learned today, via e-mail, that I was found “not to be a good match” for a job that I was more than qualified for. Being overqualified, or having no background for many of the jobs available where I live, has resulted in a constant stream of rejection letters for the last five years. This has been humbling and frustrating.
In discussing this latest rejection with my husband, he noted that we are being “phased out.” While he thinks in terms like this because he can’t buy film for his video camera that’s18 years old, many people my age (baby boomer generation) believe they are being phased out because they can’t find work. They are among the first to be let go if there is a lay off. Interviews are scarce and more often then not, they end with a letter (or now e-mail) that says “thanks but no thanks.” Many believe they are lucky to have a job at all, and are concerned that they will never have the financial stability their parents enjoyed.
How much of it is age? Are we intimidating because we are often more qualified and experienced than the person interviewing us? Even when we are willing to work for much less, are we still too scary for those younger with less knowledge and experience?
So what does this have to do with chronic conditions? The fact is, many of the baby boomer generation are either living with a chronic condition, will have one in the not too distant future and/or are caring for someone that has one. Many are sandwiched between adolescent kids (or grandchildren in some cases) and elderly parents.
In the traditional work model, being older, having a chronic illness, and/or being a caregiver aren’t characteristics that are perceived by employers to be of value. However, it’s the boomers perceptions of themselves as unique, trendsetters and a belief they can make the world better that can help us thrive. Below are some things to consider:
• People with purpose live longer and are generally happier. Happier people live longer than those who aren’t. Purpose isn’t determined by a job title or a paycheck. Money doesn’t equal purpose.
• The older you are, the more you’ve dealt with situations, be it caregiver or person living with a chronic condition, the more skill sets you’ve developed. While this may not translate into a 9-5 job, it definitely makes you very qualified to participate in one of the newest social movements-Time Banks. For every hour you spend doing something for someone in your community, you earn one Time Dollar. Then you have a Time Dollar to spend on having someone do something for you. I know people with major chronic illness who participate in such programs and they are able to contribute according to their schedule. Check out what’s available in your area by going to Time Banks or googling “barter programs” and your location. If there is nothing available, start talking to friends, family and neighbors about starting one in your area.
• Volunteer. Sometimes volunteer positions can become jobs.
• If you are reading this on-line, particularly if it’s your own computer, you’re a step ahead. Check out eHow’s tips on “How to Make Money Using Your Computer.”
• Write or tell your story. In the process of doing so, note the trends in how you’ve coped in the past. Are their situations, which you thought were total disasters but ultimately led you to make changes that improved your life? As the coordinator of my local historical society, this type of writing is among the most useful in understanding how past generations functioned. When I find a farm journal, where the writer shares their story of what they are facing and how they deal with it, it helps me put my own life in a much better perspective.
• Live simply. It’s amazing how little we really need. Unfortunately, our economy is built on the “buy buy buy” model, so there are lots of media messages to that effect. When I think about all the purchases I’ve made in my life, the two that I enjoy the most are my computer and my sofa. The latter is just the right size for stretching out and reading. I should also say that I really appreciate my car, as she runs like a dream even though she’s 11 years old and has 200,000 miles on the odometer. Check out Live Simple for some ideas on ways to reduce.
• There are organizations designed specifically to help you find work. Contact your local community action agency to find out what’s available in your community.
I am fortunate that I work part time for a historical society. More than anything it provides me with a sense of how people have lived, worked, grown old and died in my town. Their stories, be they written or told through the items they once used, date back hundreds of years. They have seen good times and bad. At the end of the day, we are more alike then different and our differences are often what help us move forward as people and community.
Ultimately my husband is right that products, such as his video camera, are being phased out. However, we aren’t our “stuff,” and as people, while we will die, the ultimate phase out, we can leave a legacy that helps those who come after us.
Friday, September 24, 2010
HealthCare.Gov
A new website Healthcare.gov has been launched to help people understand the new insurance options as well as the new health law's benefits. Included are details on government sponsored programs and plans from over a thousand private insurers.
Wednesday, September 22, 2010
Take a Break: Three Ways with Apples
It’s official, fall is here !
In keeping with the apple theme this month, today’s “take a break” is all about making delicious apple dishes. Below are three of my favorites:
Apple Pie
I generally make only a top layer of crust. The crust recipe makes two tops or a top and bottom for one pie.
Crust
3 cups all purpose flour
1/2 t salt
3/4 c canola oil
8 T of apple cider (you can use water)
Mix dry ingredients together with a fork. Mix wet ingredients together. Make a well in the dry ingredients and pour in the wet. Blend with a fork until it forms a ball. Wrap in wax paper and chill while you make the apples. Roll out between two sheets of wax paper.
Filling for one pie
6 cups sliced tart apples
3/4 cup sugar (I use raw sugar)
1/4 cup flour
1 t cinnamon
1/4 t Nutmeg (I generally just grate some over the dish)
1/4 t cloves
2 T apple cider
Mix the filling and either pour into a deep dish pan that’s been greased or has a crust bottom. Some people dot with butter, but I don’t really find that I need it. Cover with a top crust. Make slits in the crust and bake at 425 for 15 minutes, then reduce heat to 350 and bake for 30 minutes. Serve it warm or cold, with out without ice cream or cheese.
Apple Crisp
I put the following in my food processor and pulse until well mixed. If you don’t have a food processor, cut up with a knife
3/4 cup of oats (can use flour instead)
Almonds or walnuts-couple of handfuls
1 cup of raw sugar (can use brown)
1 t cinnamon
1/2 cup butter
1/4 t salt
Peel and slice tart apples-I just fill up my greased baking pan. Add up to 1/2 cup water (use less if apples are juicy). Spread the dry ingredients over the apples and bake at 350 until the apples are tender (about 30 minutes). Can serve warm or cold.
Easier to Eat Caramel Apples
Buy a bag of Kraft Caramels and follow the directions on the back. Make sure to clean and completely dry the apples before dipping in the caramel sauce. Use a fork in the apples instead of the wooden sticks they provide. After covering them with caramel, roll them in nuts and if you like the taste, after they’ve hardened, drizzle melted dark chocolate over them. Place in the refrigerator to harden. Remove before serving and slice into eighths-the fork makes it easier to cut. Remove the seeds and serve.
In keeping with the apple theme this month, today’s “take a break” is all about making delicious apple dishes. Below are three of my favorites:
Apple Pie
I generally make only a top layer of crust. The crust recipe makes two tops or a top and bottom for one pie.
Crust
3 cups all purpose flour
1/2 t salt
3/4 c canola oil
8 T of apple cider (you can use water)
Mix dry ingredients together with a fork. Mix wet ingredients together. Make a well in the dry ingredients and pour in the wet. Blend with a fork until it forms a ball. Wrap in wax paper and chill while you make the apples. Roll out between two sheets of wax paper.
Filling for one pie
6 cups sliced tart apples
3/4 cup sugar (I use raw sugar)
1/4 cup flour
1 t cinnamon
1/4 t Nutmeg (I generally just grate some over the dish)
1/4 t cloves
2 T apple cider
Mix the filling and either pour into a deep dish pan that’s been greased or has a crust bottom. Some people dot with butter, but I don’t really find that I need it. Cover with a top crust. Make slits in the crust and bake at 425 for 15 minutes, then reduce heat to 350 and bake for 30 minutes. Serve it warm or cold, with out without ice cream or cheese.
Apple Crisp
I put the following in my food processor and pulse until well mixed. If you don’t have a food processor, cut up with a knife
3/4 cup of oats (can use flour instead)
Almonds or walnuts-couple of handfuls
1 cup of raw sugar (can use brown)
1 t cinnamon
1/2 cup butter
1/4 t salt
Peel and slice tart apples-I just fill up my greased baking pan. Add up to 1/2 cup water (use less if apples are juicy). Spread the dry ingredients over the apples and bake at 350 until the apples are tender (about 30 minutes). Can serve warm or cold.
Easier to Eat Caramel Apples
Buy a bag of Kraft Caramels and follow the directions on the back. Make sure to clean and completely dry the apples before dipping in the caramel sauce. Use a fork in the apples instead of the wooden sticks they provide. After covering them with caramel, roll them in nuts and if you like the taste, after they’ve hardened, drizzle melted dark chocolate over them. Place in the refrigerator to harden. Remove before serving and slice into eighths-the fork makes it easier to cut. Remove the seeds and serve.
Sunday, September 19, 2010
Wash and Drying Your Hands for Prevention
With flu and cold season just around the corner, it’s a good reminder to go over the basics of hand washing. Interestingly, there is lots of emphasis on how to wash your hands but little on drying. Well, there is that debate about whether using a paper towel or air dryer is better for the environment. In terms of health, it doesn’t matter so long as your hands are really dry. Environmentalist will tell you to use the air dryer. Paper towel manufacturers will claim that the towel is better. However, it generally takes 30 seconds of an air dryer to equal the drying power of 15 seconds of paper toweling. It’s easy to imagine the more frequent way hand drying takes place.
According to the Centers of Disease Control and Prevention (CDC), use soap and clean water to clean your hands. If they are not available, use alcohol based products containing at least 60% alcohol. When washing with soap and water, antibacterial soap is generally not recommended. Wet your hands with water, apply soap, lather well and continue rubbing your hands for 20 seconds (or two rounds of humming “Happy Birthday.”). Rinse well under water. Dry hands on a paper towel or use an air dryer. If possible use your paper towel to turn off the faucet.
If you are using hand sanitizer, make sure it’s at least 60% alcohol based. Use the produce amount recommended on the bottle and place in the palm of your hand. Rub your hands together until all surfaces are covered and until hands are dry.
Wash you hands regularly:
• Before and after: meal preparation; eating; changing diapers; caring for someone who is sick; and treating a cut or wound
• After: using the toilet; cleaning up after someone who has used the toilet; after blowing your nose, coughing or sneezing; handling an animal or animal waste; handing garbage
There is another question that I can’t seem to find a good answer for-which is better cloth or paper towel? Environmentally, the answer is cloth. If you are in a health care and/or public setting, paper towels are going to be the top pick. In your home? I’m not turning up a whole lot on this topic. My parents didn’t use paper towels and I seldom use them. I do change my hand towels daily though.
According to the Centers of Disease Control and Prevention (CDC), use soap and clean water to clean your hands. If they are not available, use alcohol based products containing at least 60% alcohol. When washing with soap and water, antibacterial soap is generally not recommended. Wet your hands with water, apply soap, lather well and continue rubbing your hands for 20 seconds (or two rounds of humming “Happy Birthday.”). Rinse well under water. Dry hands on a paper towel or use an air dryer. If possible use your paper towel to turn off the faucet.
If you are using hand sanitizer, make sure it’s at least 60% alcohol based. Use the produce amount recommended on the bottle and place in the palm of your hand. Rub your hands together until all surfaces are covered and until hands are dry.
Wash you hands regularly:
• Before and after: meal preparation; eating; changing diapers; caring for someone who is sick; and treating a cut or wound
• After: using the toilet; cleaning up after someone who has used the toilet; after blowing your nose, coughing or sneezing; handling an animal or animal waste; handing garbage
There is another question that I can’t seem to find a good answer for-which is better cloth or paper towel? Environmentally, the answer is cloth. If you are in a health care and/or public setting, paper towels are going to be the top pick. In your home? I’m not turning up a whole lot on this topic. My parents didn’t use paper towels and I seldom use them. I do change my hand towels daily though.
Saturday, September 18, 2010
Managing Health Information On-line: Yours/Theirs
Keeping a personal health notebook is important for a variety of reasons:
• You are in charge of making health care decisions for yourself and those in your charge. This can be an overwhelming task as multiple health providers are involved and the variety of paper and information being generated from tests, treatments, to say nothing of health insurance, is mind-boggling. The more organized you can be, keeping information centralized, the easier some decisions will be to make.
• By keeping a health notebook, you can monitor trends, and share information with members of your health care team.
• For whatever reason, your chart may not be available during an office visit with your provider. Having your information in front of you helps to reduce errors.
• If something happens, what medications and other necessary information, will be available for your family and health team. This is particularly important if several people are involved in someone’s care, such as adult children caring for an elderly parent. Having centralized health information, that all have access to, helps to simplify a complex situation.
There is a growing interest in health notebooks, particularly for parents to keep for children with special needs. We developed a Personal Health Notebook at Chronic Conditions Information Network (CCIN) and have been using it for over five years. What we found is that caregiver’s tend to keep the notebooks for their charge, but rarely do it for themselves.
Insurers, health departments, hospitals, clinics and condition specific organizations are developing health notebooks that can be downloaded from their website. There is also an increasing number of websites that offer on-line health notebooks. Below are three free examples.
Google Health has recently added a new upgrade. You can use this free site to manage your health information (keep an on-line personal health notebook); set health goals; track your progress at achieving tasks such as sleeping, diet or other personal goals; and share your health information with your provider, family. Dr. Dean Ornish, founder and President of Preventive Medicine Research Institute, blogs more about Google Health.
eCare Diary provides comprehensive information, tools and resources to help those seeking and providing long term care. A unique feature is our Care Diary, a set of online tools designed to make coordination of care and sharing of information easy amongst family members and other caregivers. eCare Diary also has a comprehensive database of nursing home and home care services, guides on long term care financing and information on important health care documents everyone should have. This website was developed by John Mills, who was the caregiver for his father, a person living with Parkinson’s Disease. Mills has spent more than 20 years working in health care.
CareRunner: Designed for caregivers who are taking care of an elderly parent or someone with a long-term illness.. Our suite of Online Tools gives you one place to manage the care of your loved one, create a community to communicate with family, keep track of appointments and even store important health and prescription information.
• You are in charge of making health care decisions for yourself and those in your charge. This can be an overwhelming task as multiple health providers are involved and the variety of paper and information being generated from tests, treatments, to say nothing of health insurance, is mind-boggling. The more organized you can be, keeping information centralized, the easier some decisions will be to make.
• By keeping a health notebook, you can monitor trends, and share information with members of your health care team.
• For whatever reason, your chart may not be available during an office visit with your provider. Having your information in front of you helps to reduce errors.
• If something happens, what medications and other necessary information, will be available for your family and health team. This is particularly important if several people are involved in someone’s care, such as adult children caring for an elderly parent. Having centralized health information, that all have access to, helps to simplify a complex situation.
There is a growing interest in health notebooks, particularly for parents to keep for children with special needs. We developed a Personal Health Notebook at Chronic Conditions Information Network (CCIN) and have been using it for over five years. What we found is that caregiver’s tend to keep the notebooks for their charge, but rarely do it for themselves.
Insurers, health departments, hospitals, clinics and condition specific organizations are developing health notebooks that can be downloaded from their website. There is also an increasing number of websites that offer on-line health notebooks. Below are three free examples.
Google Health has recently added a new upgrade. You can use this free site to manage your health information (keep an on-line personal health notebook); set health goals; track your progress at achieving tasks such as sleeping, diet or other personal goals; and share your health information with your provider, family. Dr. Dean Ornish, founder and President of Preventive Medicine Research Institute, blogs more about Google Health.
eCare Diary provides comprehensive information, tools and resources to help those seeking and providing long term care. A unique feature is our Care Diary, a set of online tools designed to make coordination of care and sharing of information easy amongst family members and other caregivers. eCare Diary also has a comprehensive database of nursing home and home care services, guides on long term care financing and information on important health care documents everyone should have. This website was developed by John Mills, who was the caregiver for his father, a person living with Parkinson’s Disease. Mills has spent more than 20 years working in health care.
CareRunner: Designed for caregivers who are taking care of an elderly parent or someone with a long-term illness.. Our suite of Online Tools gives you one place to manage the care of your loved one, create a community to communicate with family, keep track of appointments and even store important health and prescription information.
Wednesday, September 15, 2010
Take a Break: Shrunken Apple People
With temps in the low 40’s at night, fall has arrived in Northern New England, and with it apple season. For the next few Wednesdays, Take a Break will feature fun things to do with apples.
Shrunken Apple People are very popular craft in my town. Periodically, our librarian will do a project with the kids. Before long, everywhere you turn you see little shrunken heads starring back at you.
Mary Harrsch, who blogs about technology, education and history, writes, “Apple-headed dolls are part of along, fascinating history . . . one that extends back to prehistoric times, when primitive puppets appeared in ceremonial magic displays. Tribal healers in Africa and Asia often used dolls in their medicinal rituals . . . and, even today, the ancient superstition of causing sympathetic harm is preserved whenever a mob burns the stuffed figure of an unpopular person "in effigy… The Seneca Indians were reportedly the first people to make dolls out of apples . . . but the craft was later adopted by mountaineers in Appalachia, where such handmade toys are still produced as part of the area's cottage industry."
Even though Vincent Price sold a do it yourself shrunken head kit, there isn’t a lot required for this project. It’s really just as simple as peeling and carving a face into an apple. Then soak in a mixture of one-cup lemon juice with 1 T salt for 30 seconds or so and let air dry for two weeks. Keep it out of reach of dogs, other pets and small kids. If you want the face to turn a dark shade of brown, just soak in salted water.
Now is the time to start making them if you want the perfect witch, goblin or monster for Halloween. You can carve and decorate at the same time, but the head can shrink so much that the costume no longer fits. Besides, as the head is taking shape, it will inspire all sorts of ideas.
Directions for Shrunken Apple Head
Apple Head Witch Doll Directions
Virtual Shrunken Apple Head: Don’t have an apple handy? Make one on-line.
Shrunken Apple People are very popular craft in my town. Periodically, our librarian will do a project with the kids. Before long, everywhere you turn you see little shrunken heads starring back at you.
Mary Harrsch, who blogs about technology, education and history, writes, “Apple-headed dolls are part of along, fascinating history . . . one that extends back to prehistoric times, when primitive puppets appeared in ceremonial magic displays. Tribal healers in Africa and Asia often used dolls in their medicinal rituals . . . and, even today, the ancient superstition of causing sympathetic harm is preserved whenever a mob burns the stuffed figure of an unpopular person "in effigy… The Seneca Indians were reportedly the first people to make dolls out of apples . . . but the craft was later adopted by mountaineers in Appalachia, where such handmade toys are still produced as part of the area's cottage industry."
Even though Vincent Price sold a do it yourself shrunken head kit, there isn’t a lot required for this project. It’s really just as simple as peeling and carving a face into an apple. Then soak in a mixture of one-cup lemon juice with 1 T salt for 30 seconds or so and let air dry for two weeks. Keep it out of reach of dogs, other pets and small kids. If you want the face to turn a dark shade of brown, just soak in salted water.
Now is the time to start making them if you want the perfect witch, goblin or monster for Halloween. You can carve and decorate at the same time, but the head can shrink so much that the costume no longer fits. Besides, as the head is taking shape, it will inspire all sorts of ideas.
Directions for Shrunken Apple Head
Apple Head Witch Doll Directions
Virtual Shrunken Apple Head: Don’t have an apple handy? Make one on-line.
Saturday, September 11, 2010
Communication
In trying to organize an end of summer activity recently, I sent a series of e-mails to a group of friends over a period of three weeks. Some people didn’t respond to the e-mails. Consequently, I ended up calling several people by phone.
At the party, a number of people with cell phones had them out the whole evening and were texting, checking e-mail and playing games. For some, this was a bit like watching TV and doing a crossword puzzle at the same time. What was in their hand seemed to hold most of their attention, but every so often they’d take a minute to look up and maybe join in the conversation.
I found myself noting the differences in parties before everyone had cell phones and the internet. We would call to arrange activities, gather at one another’s homes, talk at length, and enjoy what we were doing. Rarely was there a phone call to interrupt us. Actually, I only remember one call when a friend needed to rush home and assist with the birth of twin lambs.
This has made me think a lot about how we communicate and the tools we have to do it with-land lines, cell phones, fax, text, tweet, Facebook, Skype, e-mail etc. Has technologies made us better communicators? Does it take us more time? Do we keep in touch more? And most important for this blog, do we have a better relationship with our health provider(s) because there are now so many ways we can “connect?”
A recent study of 35,423 people with diabetes, hypertension or both diseases, found that those who e-mailed their physicians about test results and other aspects of care, kept their blood pressure, cholesterol and blood sugar levels under much better control than those who didn’t. In short, e-mailing with your provider actually improved health. Health Affairs, July 2010
Even though many chronic conditions organizations encourage an e-mail relationship between patient and provider, it only takes place in about 1 of every 10 patients, with less than a third of physicians inviting patients to e-mail them. The reason for this is simple-health plans pay less for online consultations. E-mailing Your Doctor Can be Good For Your Health- But Not for the Physician’s Bottom Line
However, more and more medical practices and clinics see the value of e-mail connection and are providing some services, such as prescription refills, setting up appointments, simple questions etc. A number of people that I’ve worked with e-mail their provider their list of questions before they come for a face-to-face appointment. When I’m an advocate for a medical appointment, with the patient’s permission, I e-mail my summary of the visit to both the provider and the patient.
If you are not using e-mail with your provider, ask if this is an option. Be clear how you want to use it and make sure you agree on which situations merit its use and which ones don’t.
Texting, a very popular and growing way for many to communicate, is probably not a first choice for most providers. But, like most things, there is a time and place for it. During the winter, I work in first aid at one of the local ski areas. We found texting to be one of the quickest ways to reach the family and friends of our patients, since people seem to respond quicker to a text than a cell phone call.
Skype, which allows you to see the person as you talk to them, is a very interesting feature of internet connection. The son of one of the nurse practitioners I work with was away and developed a rash. Using Skype, she was able to look at it and diagnose it. Some health care facilities are starting to explore it’s potential. If you think about it, the space station has been using aspects of this for some time to track how astronauts are doing.
It’s important that you discuss with your provider the best ways for you to communicate with them and vice versa. Each situation is going to be slightly different, but spelling it out upfront can help foster better health for you.
The next part of the communication issue for people dealing with chronic conditions is sharing information with families and friends. Hands down, the internet has made this much easier.
I’ve blogged about this before, but to recap-there are free websites that you can set up where people type in a password and learn how you are doing. Caring Bridge and Cares Pages are two excellent examples. I’ve seen both sites used in a variety of situations and always with good results. Many families have told me it significantly reduced the amount of time they had to explain what was going on and they really appreciated the notes of support and encouragement people left. The downside is that passwords can be given out, allowing other people to gain entry to your information.
My preference is Lotsa Helping Hands. This free site only allows entry to people who have been approved by the site moderator. They have their own unique password for their e-mail, which they need to use each time they log in. In addition to learning how the person is doing, you can sign up to help-make meals, do chores, provide rides etc. It also provides a way for a select group of people to have access to medical information. This latter feature is very helpful when adult siblings, who live in different parts of the country, are trying to arrange for care for an aged parent.
Skype is a wonderful way to keep people connected. Hospitals are recognizing the usefulness of this service and many will make arrangements to bring this to the hospital bedside. Many mobile phones and even iPod Touch include it. Skype offers a variety of free features including voice and video calls to anyone else on Skype; conference calls with three or more people; and instant messaging, file transfer and screen sharing. The potential of this service is enormous and is worth taking the time to learn and utilize.
When you are dealing with chronic and/or life threatening conditions, e-mail, texts, web, Skype etc. can all be very helpful. Truth be told, we’re still figuring out how to take advantage of this new and frequently changing technology. Just be clear with providers, families and friends what is your preferred means of communicating.
In terms of personal communication, I find I can stay connected to more people using tools like e-mail, Facebook, and blogs. Trying to organize something seems to take a lot more time, since people are developing preferences for ways they like to be contacted. I have one friend that prefers to be texted, so I find I’m communicating with them less and less as I don’t have thisg as a feature on my cell phone. For those that use cell phone primarily, the connections can be of poor quality particularly where I live. When it’s all said and done, nothing beats a face to face conversation.
At the party, a number of people with cell phones had them out the whole evening and were texting, checking e-mail and playing games. For some, this was a bit like watching TV and doing a crossword puzzle at the same time. What was in their hand seemed to hold most of their attention, but every so often they’d take a minute to look up and maybe join in the conversation.
I found myself noting the differences in parties before everyone had cell phones and the internet. We would call to arrange activities, gather at one another’s homes, talk at length, and enjoy what we were doing. Rarely was there a phone call to interrupt us. Actually, I only remember one call when a friend needed to rush home and assist with the birth of twin lambs.
This has made me think a lot about how we communicate and the tools we have to do it with-land lines, cell phones, fax, text, tweet, Facebook, Skype, e-mail etc. Has technologies made us better communicators? Does it take us more time? Do we keep in touch more? And most important for this blog, do we have a better relationship with our health provider(s) because there are now so many ways we can “connect?”
A recent study of 35,423 people with diabetes, hypertension or both diseases, found that those who e-mailed their physicians about test results and other aspects of care, kept their blood pressure, cholesterol and blood sugar levels under much better control than those who didn’t. In short, e-mailing with your provider actually improved health. Health Affairs, July 2010
Even though many chronic conditions organizations encourage an e-mail relationship between patient and provider, it only takes place in about 1 of every 10 patients, with less than a third of physicians inviting patients to e-mail them. The reason for this is simple-health plans pay less for online consultations. E-mailing Your Doctor Can be Good For Your Health- But Not for the Physician’s Bottom Line
However, more and more medical practices and clinics see the value of e-mail connection and are providing some services, such as prescription refills, setting up appointments, simple questions etc. A number of people that I’ve worked with e-mail their provider their list of questions before they come for a face-to-face appointment. When I’m an advocate for a medical appointment, with the patient’s permission, I e-mail my summary of the visit to both the provider and the patient.
If you are not using e-mail with your provider, ask if this is an option. Be clear how you want to use it and make sure you agree on which situations merit its use and which ones don’t.
Texting, a very popular and growing way for many to communicate, is probably not a first choice for most providers. But, like most things, there is a time and place for it. During the winter, I work in first aid at one of the local ski areas. We found texting to be one of the quickest ways to reach the family and friends of our patients, since people seem to respond quicker to a text than a cell phone call.
Skype, which allows you to see the person as you talk to them, is a very interesting feature of internet connection. The son of one of the nurse practitioners I work with was away and developed a rash. Using Skype, she was able to look at it and diagnose it. Some health care facilities are starting to explore it’s potential. If you think about it, the space station has been using aspects of this for some time to track how astronauts are doing.
It’s important that you discuss with your provider the best ways for you to communicate with them and vice versa. Each situation is going to be slightly different, but spelling it out upfront can help foster better health for you.
The next part of the communication issue for people dealing with chronic conditions is sharing information with families and friends. Hands down, the internet has made this much easier.
I’ve blogged about this before, but to recap-there are free websites that you can set up where people type in a password and learn how you are doing. Caring Bridge and Cares Pages are two excellent examples. I’ve seen both sites used in a variety of situations and always with good results. Many families have told me it significantly reduced the amount of time they had to explain what was going on and they really appreciated the notes of support and encouragement people left. The downside is that passwords can be given out, allowing other people to gain entry to your information.
My preference is Lotsa Helping Hands. This free site only allows entry to people who have been approved by the site moderator. They have their own unique password for their e-mail, which they need to use each time they log in. In addition to learning how the person is doing, you can sign up to help-make meals, do chores, provide rides etc. It also provides a way for a select group of people to have access to medical information. This latter feature is very helpful when adult siblings, who live in different parts of the country, are trying to arrange for care for an aged parent.
Skype is a wonderful way to keep people connected. Hospitals are recognizing the usefulness of this service and many will make arrangements to bring this to the hospital bedside. Many mobile phones and even iPod Touch include it. Skype offers a variety of free features including voice and video calls to anyone else on Skype; conference calls with three or more people; and instant messaging, file transfer and screen sharing. The potential of this service is enormous and is worth taking the time to learn and utilize.
When you are dealing with chronic and/or life threatening conditions, e-mail, texts, web, Skype etc. can all be very helpful. Truth be told, we’re still figuring out how to take advantage of this new and frequently changing technology. Just be clear with providers, families and friends what is your preferred means of communicating.
In terms of personal communication, I find I can stay connected to more people using tools like e-mail, Facebook, and blogs. Trying to organize something seems to take a lot more time, since people are developing preferences for ways they like to be contacted. I have one friend that prefers to be texted, so I find I’m communicating with them less and less as I don’t have thisg as a feature on my cell phone. For those that use cell phone primarily, the connections can be of poor quality particularly where I live. When it’s all said and done, nothing beats a face to face conversation.
Wednesday, September 8, 2010
Take A Break: Hodgepodge
While there are posts I’ve written on specific topics, every so often I come across some links that I would include if I had known about them. Below are some new links for old posts.
Take a Break: Read a Book/Sip Tea
Read Print Absolutely free online books. Includes such authors as Agatha Christie, George Orwell, Mark Twain and many new and aspiring writers and poets. Includes fiction, essays, non-fiction, plays, poetry and short stories.
Take a Yoga Break
Kripalu Yoga Break Downloads: This site now includes a lot more yoga breaks and the URL has changed since I first posted it.
Take a Music Break
Grooveshark Has even more music than Pandora.
Exercise: This topic has been touched on in a number of different posts. You can try all sorts of free exercise programs at Exercise TV
Take a Break: Read a Book/Sip Tea
Read Print Absolutely free online books. Includes such authors as Agatha Christie, George Orwell, Mark Twain and many new and aspiring writers and poets. Includes fiction, essays, non-fiction, plays, poetry and short stories.
Take a Yoga Break
Kripalu Yoga Break Downloads: This site now includes a lot more yoga breaks and the URL has changed since I first posted it.
Take a Music Break
Grooveshark Has even more music than Pandora.
Exercise: This topic has been touched on in a number of different posts. You can try all sorts of free exercise programs at Exercise TV
Saturday, September 4, 2010
Purpose: Take I
I have been trying to write a post on purpose since April. Why write about it? For two reasons, one is that everything I read on well being, longevity and happiness identifies purpose as being an important characteristic/quality. Second, because so many people I’ve talked to this summer have been grappling with this issue. They are questioning what they should be doing with their life, as what they are doing isn’t getting the results they desire. And what might those results be? Happiness? Contentment? Feeling useful? Well-being? Seems like I’m heading back to my first point.
Why am I finding it so difficult to write about purpose? It’s a catch all term with any number of definitions-what is it that makes you want to get up in the morning; what it is that makes one want to succeed; goals; reason for being; what matters. According to Dan Pink, the author of "A Whole New Mind," Purpose is the yearning to do what we do in the service of something larger than ourselves. Maybe that last definition is the one that makes the most sense. So for this post, that’s the definition of purpose that I’m thinking of.
How does purpose relate to chronic disease? Many people, both caregivers and those living with an illness, have told me that the best thing that ever happened to them was the diagnosis. In a sea of fear, pain, anxiety and unknown, defining their purpose is what saved them. While some started support groups, raised money or become active in finding a cure for their condition, others made major changes in how they live, and interact with people and the world around them. Most engaged in activities that helped others.
But what if you are so compromised you aren’t able to do much for yourself, let alone someone else?
A few weeks ago, I read an interesting article “Finding Meaning in a Shrinking World.” The author Kathryn Britton is a coach working with professionals to increase well-being, energy and meaning. She was visiting an 87 year old friend in a nursing home and wondered what she could tell her friend about finding meaning in her current state. Attending the Meaning Conference, she wondered about giving meaning to life when you are no longer able to serve others or contribute with your life’s passion. As a result of the conference, she came up with the following list:
• Other people find meaning in life by serving you, so your needs enhance their lives.
• Younger people — your children, grandchildren, others who serve you – also learn by watching you. If you accept your shrinking world cheerfully, you may be making it easier for them to do so when their time comes.
• There is a time in life for doing and giving, and another time for receiving. Without someone to receive, nobody can give.
• Think about what would not have been if you had not existed. The existence of those things gives witness to your existence.
• Meaning doesn’t have to come from what you do. Meaning can come from the way you are. The time for doing is past. The time for being is now. One speaker, Z. Bellin, studied how people express meaning, and whether it is more dependent on doing or being. He said our understanding of meaning tends to be over-focused on accomplishment. There are many ways to experience meaning — by coping with difficulties and through interactions with others. Meaningful experiences remind us of our aliveness in relation to the world.
Alexander Batthyany, from the University of Vienna, was a keynote speaker. He said, “Up to the last moment we can choose what will be our harvest and what will remain of us.” He suggests we ask not only “Am I getting what I want? Am I feeling good?” but shift toward asking “Am I taking part in existence?” He stated that each of us is irreplaceable and unique. What really counts for psychological and existential well-being is having something to live for, which requires being open and flexible to the ever-changing meaning of the moment.
Additional Reading
Life Purpose from the University of Minnesota’s Taking Charge of Your Health
Why am I finding it so difficult to write about purpose? It’s a catch all term with any number of definitions-what is it that makes you want to get up in the morning; what it is that makes one want to succeed; goals; reason for being; what matters. According to Dan Pink, the author of "A Whole New Mind," Purpose is the yearning to do what we do in the service of something larger than ourselves. Maybe that last definition is the one that makes the most sense. So for this post, that’s the definition of purpose that I’m thinking of.
How does purpose relate to chronic disease? Many people, both caregivers and those living with an illness, have told me that the best thing that ever happened to them was the diagnosis. In a sea of fear, pain, anxiety and unknown, defining their purpose is what saved them. While some started support groups, raised money or become active in finding a cure for their condition, others made major changes in how they live, and interact with people and the world around them. Most engaged in activities that helped others.
But what if you are so compromised you aren’t able to do much for yourself, let alone someone else?
A few weeks ago, I read an interesting article “Finding Meaning in a Shrinking World.” The author Kathryn Britton is a coach working with professionals to increase well-being, energy and meaning. She was visiting an 87 year old friend in a nursing home and wondered what she could tell her friend about finding meaning in her current state. Attending the Meaning Conference, she wondered about giving meaning to life when you are no longer able to serve others or contribute with your life’s passion. As a result of the conference, she came up with the following list:
• Other people find meaning in life by serving you, so your needs enhance their lives.
• Younger people — your children, grandchildren, others who serve you – also learn by watching you. If you accept your shrinking world cheerfully, you may be making it easier for them to do so when their time comes.
• There is a time in life for doing and giving, and another time for receiving. Without someone to receive, nobody can give.
• Think about what would not have been if you had not existed. The existence of those things gives witness to your existence.
• Meaning doesn’t have to come from what you do. Meaning can come from the way you are. The time for doing is past. The time for being is now. One speaker, Z. Bellin, studied how people express meaning, and whether it is more dependent on doing or being. He said our understanding of meaning tends to be over-focused on accomplishment. There are many ways to experience meaning — by coping with difficulties and through interactions with others. Meaningful experiences remind us of our aliveness in relation to the world.
Alexander Batthyany, from the University of Vienna, was a keynote speaker. He said, “Up to the last moment we can choose what will be our harvest and what will remain of us.” He suggests we ask not only “Am I getting what I want? Am I feeling good?” but shift toward asking “Am I taking part in existence?” He stated that each of us is irreplaceable and unique. What really counts for psychological and existential well-being is having something to live for, which requires being open and flexible to the ever-changing meaning of the moment.
Additional Reading
Life Purpose from the University of Minnesota’s Taking Charge of Your Health
Friday, September 3, 2010
Got Drugs? Turn in Your Unused or Expired Medication on Sept. 25
On September 25, 2010, the US Department of Justice Drug Enforcement Administration’s Office of Diversion Control will coordinate a collaborative effort with state and local law enforcement agencies to remove potentially dangerous controlled substances from our nation’s medicine cabinets. Collection activities will take place from 10:00 a.m. through 2:00 p.m. at sites established throughout the country. The National Take-Back Day provides an opportunity for the public to surrender expired, unwanted, or unused pharmaceutical controlled substances and other medications for destruction. These drugs are a potential source of supply for illegal use and an unacceptable risk to public health and safety.
This one-day effort is intended to bring national focus to the issue of increasing pharmaceutical controlled substance abuse.
. The program is anonymous.
. Prescription and over the counter solid dosage medications, i.e. tablets and capsules accepted.
. Intra-venous solutions, injectables, and needles will not be accepted.
Illicit substances such as marijuana or methamphetamine are not a part of this initiative.
To learn more about the program and the collection station nearest you by going to http://www.deadiversion.usdoj.gov/takeback/
This one-day effort is intended to bring national focus to the issue of increasing pharmaceutical controlled substance abuse.
. The program is anonymous.
. Prescription and over the counter solid dosage medications, i.e. tablets and capsules accepted.
. Intra-venous solutions, injectables, and needles will not be accepted.
Illicit substances such as marijuana or methamphetamine are not a part of this initiative.
To learn more about the program and the collection station nearest you by going to http://www.deadiversion.usdoj.gov/takeback/
Wednesday, September 1, 2010
Take a Break: It’s Back to School
Celebrate the first day of September, and the start of the school year, by taking advantage of free “open courses” available from many of the major universities and colleges ( Tufts, John Hopkins, Yale ) Education-Portal includes a list of some of the best Open Courses available on-line
Not quite the same as Open Course, University of California Television provides a wide array of seminars, lectures etc. on various topics. Launched in January 2000, University of California Television (UCTV) is a non-commercial channel featuring 24/7 programming from throughout the University of California, the nation's premier research university made up of ten campuses, three national labs and affiliated institutions.
UCTV embraces the core missions of the University of California -- teaching, research, and public service -- through quality, in-depth television that brings to life the tremendous range of knowledge, culture and dialogue generated on UC's diverse campuses. Through its powerful reach on satellite, cable and the web, UCTV transports this knowledge far beyond the campus borders and into the homes and lives of millions of viewers around the globe.
Not quite the same as Open Course, University of California Television provides a wide array of seminars, lectures etc. on various topics. Launched in January 2000, University of California Television (UCTV) is a non-commercial channel featuring 24/7 programming from throughout the University of California, the nation's premier research university made up of ten campuses, three national labs and affiliated institutions.
UCTV embraces the core missions of the University of California -- teaching, research, and public service -- through quality, in-depth television that brings to life the tremendous range of knowledge, culture and dialogue generated on UC's diverse campuses. Through its powerful reach on satellite, cable and the web, UCTV transports this knowledge far beyond the campus borders and into the homes and lives of millions of viewers around the globe.
Subscribe to:
Posts (Atom)