Take a Break: Try Virtual Curling

With the Olympics over, and the USA Men’s Curling team taking the gold for the first time ever, you may have watched a lot of curling. Now you can try it at virtual curling.

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Life with chronic Conditions: I can’t afford my Meds

This past week a friend told me how she hadn’t taken her meds for a chronic condition for over a year because she couldn’t afford the co-pay of over $500 a month. A mutual friend, who is in pharmaceuticals, described a variety of ways to obtain medication when you can’t afford it. While a lot of this was in the post Life with Chronic Conditions: Shop Around for the Best Pharmaceutical Prices, she had a direct approach for obtaining free samples and coupons to significantly reduce the price.

• Know what your health insurance covers. Your prescription benefit generally has a different co-pay/deductible than your overall policy. Some insurers wont pay for certain drugs. In short, get as much information in advance as you can.

• When a medication is prescribed, know exactly what it’s for and whether it’s absolutely necessary.

• Discuss price. Is a generic as good as the brand name? Does the provider have samples you can try?

• While a lot of  doctors, clinics and health centers have “no sales reps” policies,  they can call a rep to obtain coupons and/or free samples. Many doctors, hospitals and pharmacies use a system to keep track of pharmacy representatives, so it’s a simple matter of knowing who makes the drug. However, if they don’t, going to the drug website will identify who manufacturers the drug and the provider should follow the Health Professionals links for contact information. Social work departments at hospitals are another source for obtaining coupons to cover co-pays etc. Some condition specific organizations, i.e. the American Parkinson’s Disease Association, will provide coupons to members of local chapters.

• Attend condition specific workshops and conferences. Often times drug reps will be sponsoring the event and will be on hand to discuss the medication as well as provide drug coupons.

• Get to know your pharmacist. Some of them will have special programs or can help arrange a discount.

• Shop around. Consumer reports recommends using Costco as they consistently had the lowest retail prices for the drugs they were checking. You don’t need to be a member to use its pharmacy, though joining can gain you more discounts.

• If you are taking a drug that is frequently prescribed, some pharmacies-places like Walmart-will provide a much lower price than what you can get with your prescription plan.

• Statewide Prescription Assistance and Health Care Programs provide an opportunity for uninsured and under insured individuals to access medications at a significant discount. Some programs require applications and some programs require no application. Click here to see what’s available in your state.

Learn more ways to save by going to Life with Chronic Conditions: Shop Around for the Best Pharmaceutical Prices 

Take a Break: Read the Cherokee Phoenix

On Feb. 21, 1828, The Cherokee Phoenix was the first newspaper published by Native Americans in the United States and the first published in a Native American language. Originally produced in New Echota, capital of the Cherokee Nation (present day Georgia), it is now being published in Tahlequah, OK.  The paper continued until 1834 and was revived in the 20^th century. It is available in both print and Internet version.  Read it today at their website. 

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Journal Watch February 2018

CHRONIC PAIN

Medical cannabis significantly safer for elderly with chronic pain than Opioids: A new study found cannabis therapy is safe and efficacious for elderly patients who are seeking to address cancer symptoms, Parkinson's disease, post-traumatic stress disorder, ulcerative colitis, Crohn's disease, multiple sclerosis, and other medical issues. After six months, more than 18 percent of patients surveyed had stopped using opioid analgesics or had reduced their dosage. The European Journal of Internal Medicine 

Pilot study in Kenya shows link between chronic pain and glutamate consumption: Preliminary research from a small pilot study carried out in Meru, in eastern Kenya, shows a link between chronic pain and consumption of glutamate, a common flavor enhancer found in Western and non-Western diets worldwide. Results demonstrated that when study participants cut monosodium glutamate from their diets, their symptoms improved. Nutrition 

Limited Evidence for Effect of Cranial Electrical Stimulation: Evidence for the effectiveness of cranial electrical stimulation (CES) is sparse, according to a review published online Feb. 13 in the Annals of Internal Medicine. Researchers reviewed evidence relating to the benefits and harms of CES for adults with chronic painful conditions, depression, anxiety, and insomnia. "Evidence is insufficient that CES has clinically important effects on fibromyalgia, headache, neuromusculoskeletal pain, degenerative joint pain, depression, or insomnia; low-strength evidence suggests modest benefit in patients with anxiety and depression," the authors write.

COMPLEMENTARY & ALTERNATIVE MEDICINE

Stress-Reducing Techniques Can Reduce Seizure Frequency in Patients With Refractory Epilepsy: Learning techniques to help manage stress may help people with epilepsy reduce how often they have seizures, according to a study published in Neurology. 

Therapeutic Horseback Riding Can Help alleviate PTSD: For military veterans, therapeutic horseback riding (THR) may be a clinically effective intervention for relieving symptoms of post-traumatic stress disorder (PTSD), according to a study published online Jan. 19 in Military Medical Research.

FDA ACTION

• Approved the first blood test to evaluate mild traumatic brain injury (mTBI) in adults

• Approved apalutamide (Erleada) for the treatment of patients with non-metastatic, castration-resistant prostate cancer.

• Expands approval of Imfinzi to reduce the risk of non small cell lung cancer progressing

• Expands treatment window for use of clot retrieval devices in certain stroke patients

• Approved marketing of clinical decision support software for altering providers of a potential stroke in patients

PREVENTION

Poor fitness linked to weaker brain fiber, higher dementia riskScientists have more evidence that exercise improves brain health and could be a lifesaving ingredient that prevents Alzheimer's disease. A new study from UT Southwestern's O'Donnell Brain Institute suggests that the lower the fitness level, the faster the deterioration of vital nerve fibers in the brain. This deterioration results in cognitive decline, including memory issues characteristic of dementia patients. "This research supports the hypothesis that improving people's fitness may improve their brain health and slow down the aging process," Journal of Alzheimer's Disease

Climb stairs to lower blood pressure and strengthen leg muscles: A new study demonstrates that stair climbing not only lowers blood pressure but also builds leg strength, especially in postmenopausal women with estrogen deficiencies who are more susceptible to vascular and muscle problems. The study involved Korean postmenopausal women who trained four days a week, climbing 192 steps two to five times a day. North American Menopause Society 

Running helps brain stave off effects of chronic stress: The study finds that running mitigates the negative impacts chronic stress has on the hippocampus, the part of the brain responsible for learning and memory. Neurobiology of Learning and Memory

Can ultraviolet light fight the spread of influenza? Overhead far-UVC light, a type of ultraviolet light that is harmless to humans, effectively killed airborne flu virus, researchers have found. The lighting may offer a new weapon against the spread of flu virus in public spaces. Scientific Reports 

Rotating Night Shift Increases Odds of Type 2 Diabetes: Rotating shift work, which includes night shifts is associated with increased odds of type 2 diabetes, according to a study published online Feb. 12 in Diabetes Care.

  

NUTRITION/SUPPLEMENTS/VITAMINS

Drinking hot tea associated with a 5-fold increased risk for esophageal cancer for some: Consuming hot tea at high temperatures is associated with an increased risk for esophageal cancer in those who also drink alcohol and smoke cigarettes, a new study finds. American College of Physicians

Eating Slower Tied to Lower Obesity Risk inType 2 Diabetes: Slower eating also found to be associated with reduced BMI, waist circumference. Eating speed can affect changes in obesity, body mass index (BMI), and waist circumference in patients with type 2 diabetes, according to a study published online Feb. 12 in BMJ Open.

 Vitamin D3 could help heal or prevent cardiovascular damage: A new study conducted suggests that a little more sunlight might help restore damage to your cardiovascular system. The study shows that Vitamin D3 -- which is made by the body naturally when skin is exposed to the sun -- can significantly restore the damage to the cardiovascular system caused by several diseases, including hypertension, diabetes and atherosclerosis. Vitamin D3 supplements are also available over-the-counter.

Very Low-Calorie Diet Prompts Brief Heart Function Drop: Very low-calorie diets (VLCD) can cause transient deterioration in heart function, according to a study presented at the European Society of Cardiology's joint EuroCMR/SMCR meeting. "The metabolic improvements with a very low-calorie diet, such as a reduction in liver fat and reversal of diabetes, would be expected to improve heart function. Instead, heart function got worse in the first week before starting to improve.” 

Plant Based Milks: The nutritional differences and health benefits among various plant-based alternative milks are discussed in a review published in the January issue of the Journal of Food Science and Technology. Nutritionally, soy milk is the best alternative for replacing cow's milk. Almond milk also has a balanced nutrient profile and was found to have a better flavor than soy milk, but it has a lower nutrient density and total number of calories compared to cow's milk. Those who consume almond milk should take care to get appropriate quantities of various essential nutrients from other dietary sources. Rice milk and coconut milk cannot act as ideal alternatives to cow's milk due to limited nutrient diversity.

Omega 3 Fatty Acids Not Found to Up Risk of Heart Disease: Supplementation with omega-3 fatty acids is not associated with fatal or nonfatal coronary heart disease or major vascular events, according to a review published online Jan. 31 in JAMA Cardiology. This meta-analysis "provides no support for current recommendations for the use of such supplements in people with a history of coronary heart disease.”

TREATMENT

Deep Brain Stimulation Shows Promise for Treating Alzheimer’s Disease: Deep brain stimulation (DBS) of frontal lobe networks show promise for treating Alzheimer’s disease. Journal of Alzheimer’s Disease. 

Low-Intensity Electrical Brain Stimulation Improves Memory: Low-intensity electrical stimulation applied to a specific area can improve verbal short-term memory, according to a study published in Brain. “The most exciting finding of this research is that our memory for language information can be improved by directly stimulating this underexplored brain area.”

Medications to Treat Cardiovascular Risk Factors Do Not Impact Erectile Function: A study into the effects of cholesterol-lowering statins and blood-pressure lowering candesartan/HCTZ concludes that these medications do not negatively affect erectile function (ED). .“Previous research suggests that cardiovascular risk factors such as high blood pressure and cholesterol increase the risk of ED, but there has been little research examining whether modifying these risk factors can impact its development.” Canadian Journal of Cardiology 

NICE Recommends Use of Paracetamol to Relievea Sore Throat Rather Than Antibiotics: The National Institute for Health and Care Excellence (NICE) has published guidance recommending that patients with a sore throat, including pharyngitis and tonsillitis, should not be prescribed antibiotics. Instead doctors should help people to manage their symptoms with pain relief, such as paracetamol or ibuprofen. Evidence reviewed by NICE found most people will get better without antibiotics, usually experiencing symptoms for up to a week. 

Opioid cessation may be more successful when depression is treated: Opioid cessation in non-cancer pain may be more successful when depression is treated to remission, a new study shows. Science Daily

Greater Weight Loss With RYGB in Obese With T2DM at Three Years: For obese adults with type 2 diabetes, Roux-en-Y gastric bypass (RYGB) surgery is associated with greater weight loss, lower hemoglobin A1c (HbA1c), and reduced cardiovascular risk compared with intensive medical diabetes and weight management (IMWM), according to a study published online Feb. 6 in Diabetes Care. 

Drug that treats psoriasis also reduces aortic vascular inflammation: An antibody used to treat the skin disease psoriasis is also effective at reducing aortic inflammation, a key marker of future risk of major cardiovascular events. Researchers led a randomized, double-blind, placebo-controlled study and found patients who took the drug ustekinumab had a 19 percent improvement in aortic inflammation, as measured and confirmed by imaging, when compared to the placebo group. American Academy of Dermatology Annual Meeting in San Diego .

Risk Fracture Risk with Long term use of Inhaled Corticosteroids: Long-term, high-dose use of inhaled corticosteroids (ICSs) is associated with a modest increase in the risk of hip and upper extremity fractures in patients with chronic obstructive pulmonary disease (COPD), according to a study published in the February issue of CHEST.

OTHER

TBI Is Associated With Increased Dementia Risk for Decades After Injury:Traumatic brain injury (TBI) increases the risk of a dementia diagnosis for more than 30 years after a trauma, though the risk of dementia decreases over time, according to a study of164,334 individuals with TBI and matched control participants who did not have TBI. PLOS Medicine.

Severe and lingering symptoms occur in some after treatment for Lyme disease: In a study of 61 people treated for the bacteria that causes Lyme disease, researchers conclude that fatigue, pain, insomnia and depression do indeed persist over long periods of time for some people, despite largely normal physical exams and clinical laboratory testing. Frontiers in Medicine 

Multiple chronic diseases leave patients with adversely high costs: Current strategies for treating patients with several chronic diseases are putting an unnecessary financial burden on countries' health systems and individuals, a global study has found. Experts say that the current clinical practice of tackling each disease in isolation may lead to the prescription of unnecessary medicines, resulting in patient expenses that are disproportionate to the number of conditions they have. BMJ Global Health

Hands over knife for pill cutting: Using your hands may be best for splitting an aspirin tablet, according to a study published online Jan. 24 in the Journal of Pharmacy Practice and Research.

Take a Break: Make Kissing Lips for Valentines Day

                                                  Happy Valentine’s Day! 

                          Trying making “kissing lips” for your favorite valentine.

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Life with Chronic conditions: Finding Peace in Wild Things

I found myself reading Wendell Berry’s poem “The Peace of Wild Things” over and over again this week.

When despair for the world grows in me 

and I wake in the night at the least sound

 in fear of what my life and my children's lives may be, 

I go and lie down where the wood drake 

rests in his beauty on the water, and the great heron feeds.

 I come into the peace of wild things 

who do not tax their lives with forethought 

of grief. I come into the presence of still water. 

And I feel above me the day-blind stars 

waiting with their light. For a time 

I rest in the grace of the world, and am free.

The line that resonated the most was “I come into the peace of wild things 

who do not tax their lives with forethought of grief.” We spend an inordinate amount of time worrying over things we can’t control, may never happen or if they do happen, aren’t nearly as bad as we fear.

Given its deep winter here in Vermont, while I go for walks with my dog, I spend more time looking out the window watching the birds as they flit in and around the feeder, or the squirrels chasing one another , making tracks in the snow. The deer are forever coming to check and see if they missed an apple, even if it’s high in the tree. This is a far more peaceful and calming pursuit than watching television, reading a newspaper or trolling the Internet. Definitely recommend it.

Take a Break: Graffiti a Masterpiece

A mustache on the Mona Lisa and different colors for Mondrain’s paintings  are just some of the ways to “graffiti” art masterpieces. Download a famous painting  and make it your own by changing colors, adding new designs, turning them into cartoons (just what is the Mona Lisa thinking) or whatever strikes your fancy. You can even color a few ones, cut them up and create a whole new different type of masterpiece.

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Life with Chronic conditions: Learning to be resilient

The link between disease, violence and trauma has been well established. This past week, there has been quite a bit of discussion from NPR’s article What do Asthma, Heart Disease and Cancer Have in Common? Maybe Childhood Trauma.

The good news is that in spite of what you might have experienced in your life, you can learn to be resilient-the ability to maintain a stable equilibrium regardless of the twist and turns life presents.

Developing resilience-things to consider

• Change what you can change recognizing that you are not your circumstances. You control your own fate by how you respond.

• Accept that the only constant in life is change.

• Recognize that events are not traumatic until we label them as such. The death of a close friend can be devastating. However, viewing it as having significant meaning-such as it helping to bring about a more effective treatment for a disease; you developed friendships that wouldn’t have happened otherwise-will be far more helpful than considering it a traumatizing experience that “I’ll never get over.” Unfortunately, social media, particularly Facebook is a wash in catch phrases to support the trauma aspects and not the “final gifts” perspective.

• Make connections and build social support networks. Identify who you can reach out to when you’re dealing with stressful experiences.

• Recognize how you respond to stress: What situations have you found to be most difficult? How did you deal with them? What worked? What didn’t? What has made you more hopeful about the future?

• Develop a source of spiritual and religious support.

• Develop a positive image of the future. Understand your purpose

• Have solid goals and a desire to achieve them

• Be empathetic and compassionate but don’t bow to peer pressure

• Stay flexible: Recognize that strong emotions are okay but also recognize you will need to let them go in order function. Take breaks when dealing with stressful situations in order to rest and recharge yourself. Ask for help if you need it.

• Do not identify as a victim but rather as thriver.

• Take care of yourself, practice self-compassion, relaxation.

 Try an on line free programs to help with building resilience- 27 Resilience Activities and Worksheets for Students and Adults

Take a Break: Try 8 Brocades

   This is one of my favorite Qigong practices. If you are feeling stressed, a good way to relax. Just do what you can do.