Friday, October 17, 2008

wellness weekly

Vitamin D: Two things about this amazing vitamin. One is that pediatricians have come out with a statement on increasing the recommended daily intake of Vitamin D, not only because more seems to be better, but because what we have been consuming may not be adequate. The recommendation was 200 IU a day beginning at two months of age, but now it is 400 IU a day at an even younger age. If you are a parent, please discuss this with your child’s pediatrician or physician before making any changes. For adults, Walter Willett has been recommending, as have others, up to 1000 or more IUs a day. I was going to mention something about Vitamin D this week before the AAP recommendation was released, so that was a nice segue. I had begun consuming additional vitamin D over a year ago. I added one 400 IU and had 400 in both my calcium and multivitamin. I just bought another bottle of each and was dosing them out when I checked the labels, just to be sure and good thing I did, the multivitamin now has MORE vitamin D (800 iu), more than I feel comfortable consuming. So I have a bottle of Vitamin D if anyone needs it J.

Cancer Prevention (for women): When reading an article regarding a health awareness survey, I took note of the study author’s suggestion that people in public health should help to get this message out. So here it is. Endometrial cancer is also associated with lifestyle factors and is significantly correlated to weight. Endometrial cancer is the most common gynecologic cancer and few women understand that excess weight can increase the risk for it. Additionally, obese persons with endometrial cancer have a higher risk of death from the cancer. The good news is that there is a cure for this cancer, through surgery, as long as it is caught in time. (prevention would be the best case scenario of course). Two signs for the disease were noted in the article by A. Harding and they are bleeding after menopause or and possibly between menstrual cycles. The study was a survey of professional women and asked if they thought obesity increased the risk of breast, colon and or endometrial cancer and the lowest response was the endometrial. The sample isn’t representative of the general public because the respondents had at least a 4 year degree. This means that it is likely that less people know of the risks than more.

Selective Fear: I was in the office complex gym one evening this week. (weight training !) Two guys were also there and one of them I had seen before and had spoken to several times in the gym. I had also seen this man smoking around our complex. It is odd that I see him working out and taking his walks as he obviously wants to maintain his health, but that is the way it is. Anyway, we were all working out and one guy was sweaty and was cleaning off the equipment with a bottle of stuff that looked like Windex. My smoker friend said he wasn’t so sure about using that stuff as it might cause CANCER! Well, of course I said something……….. And isn’t it just the way we are! We worry about things that have yet to be proven to be harmful when continuing to do all the things that science has pretty much confirmed will kill or debilitate us.

Vigilance: There is a place for my kind of rigidity after all. A study released this week builds on some other studies regarding people who have lost an important amount of weight and maintained that loss. It is vigilance. The successful persons exercise almost an hour a day and do not overeat. They are conscious of calories in and out and they have fewer TVs then heavy people. Well. Oh and their exercise is of the high intensity variety which in the USA Today article was described as jogging, aerobics, and cycling. More proof that it is a lifestyle not a DIET. And yes I am talking to you, person who will not be named here…

STENTS; Stents are the little, ok teeny tiny tubes, if you will, that are used to prop open arteries that have become clogged. We have talked about this a few times, recalling, they have drug eluting stents and plain metal stents and studies compete to prove one safer than the other as it is a multi million or billion dollar industry…….. OK good. Now there is another study about the number of stents. Apparently, not all surgeons or cardiologists complete the gold standard stress tests or artery volume scans (?) before placing stents. A company that sells a technology that can determine if an artery is actually clogged supported a study regarding the use of less stents. The persons with fewer stents had better outcomes over time than those with multiple ones. I>E they were still alive. So , are the results valid even though the study was funded by the medical device company? I don’t know, but it seems to me less would be better than more.

MCR and Home IV Infusion: I got a new perspective when I read an article in the WSJ this morning about the fact that Medicare does not cover the full cost of home IV infusion, for example, for antibiotics. I know this from my days as a hospital social worker. I also know, as the article states, that hospitals often have indigent funds that they use to pay for the home therapy. The therapy can be very expensive but not as expensive as a hospital bed. Hospitals can save money if a person is discharged on home IV meds and it used to be my job to try to make that happen. The WSJ article didn’t say that Medicare usually pays a prearranged fee for a condition and if the person needs more service than the money covers, too bad. Hospitals are also in a bind to free up beds, in certain departments anyway. AND, some diseases are worth more money than others. SORRY< but this is true. What I didn’t wrap my mind around before are two things that I should have. One is that it is a good idea to get the hell out of the hospital as fast as you can because of those ever increasing and now talked about GER MS. But most importantly, don’t most people WANT to go home?! (ok, in my case, a lot of the people did NOT want to leave the hospital, but they had oh so many other issues as to not make them the average person.) Ok, so now I know, pushing to get patients out of the hospital isn’t poor patient care after all.

OK, remember vigilance and diligence. You are worth the effort, EVERY day.

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