Report: Electronic health records haven't cut health costs

The conversion to electronic health records isn't producing savings in health-care costs predicted by a 2005 report, and it's had mixed results in improving efficiency and patient care, according to a RAND Corporation report. The company's 2005 predictions helped drive growth in the EHR industry and encourage billions of dollars in subsidies from the federal government to hospitals and doctors to implement such systems, Reed Abelson and Julie Creswell of The New York Times report.

The 2005 report predicted that widespread use of EHRs could save the U.S. health care system at least $81 billion a year. "But evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services," Abelson and Creswell write. Health care costs have risen $800 billion since the 2005 report, according to federal data.

Authors of the new report, published in this month's issue of Health Affairs, said they didn't attach dollar amounts to how much electronic record keeping has helped or hurt efforts to reduce costs. "But the firm's acknowledgement that its earlier analysis was overly optimistic adds to a chorus of concern about the cost of the new systems and the haste with which they have been adopted," Abelson and Creswell report.

There are several factors why the switch has not created significant savings, report authors said. Those factors include use of commercial record systems, slow rates of system adoption, and the fact that electronic records "do not address the fact that doctors and hospitals reap the benefits of high volumes of care," Abelson and Creswell report. (Read more)

The conversion to electronic health records isn't producing savings in health-care costs predicted by a 2005 report, and it's had mixed results in improving efficiency and patient care, according to a RAND Corporation report. The company's 2005 predictions helped drive growth in the EHR industry and encourage billions of dollars in subsidies from the federal government to hospitals and doctors to implement such systems, Reed Abelson and Julie Creswell of The New York Times report.

The 2005 report predicted that widespread use of EHRs could save the U.S. health care system at least $81 billion a year. "But evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services," Abelson and Creswell write. Health care costs have risen $800 billion since the 2005 report, according to federal data.

Authors of the new report, published in this month's issue of Health Affairs, said they didn't attach dollar amounts to how much electronic record keeping has helped or hurt efforts to reduce costs. "But the firm's acknowledgement that its earlier analysis was overly optimistic adds to a chorus of concern about the cost of the new systems and the haste with which they have been adopted," Abelson and Creswell report.

There are several factors why the switch has not created significant savings, report authors said. Those factors include use of commercial record systems, slow rates of system adoption, and the fact that electronic records "do not address the fact that doctors and hospitals reap the benefits of high volumes of care," Abelson and Creswell report. (Read more)

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Prevent Back Pain and Other Common Problems by Sitting Correctly

By Dr. Mercola

From smart phones to computers to iPads, our beloved electronic devices are crippling our posture and contributing to weight gain, back pain, and joint problems like carpal tunnel syndrome.

Fortunately, there are a few strategies and exercises – such as changing your position often and “reorganizing” your torso – that can address a lot of these potential problems and help keep you more fit and properly aligned.

As miserable as back pain is, that may be the least of your worries if you spend a significant portion of your time on your duff. Sitting may actually cut years off your life. Lack of exercise is sitting’s evil accomplice. The more you sit, the less your body wants to move.

According to a study in the British Medical Journal,¹ reducing the average time you spend sitting to less than three hours per day could increase your life expectancy by two years, which is a significant decrease from the 4.5 to 5 hours per day the average American now spends on a chair or sofa.

An analysis of 18 studies showed that people who sat for the longest periods of time were twice as likely to have diabetes or heart disease, compared to those who sat the least.² Sitting has actually joined smoking and obesity as an important risk factor for chronic disease.

The Price You Pay for a Sedentary Lifestyle

A number of studies have investigated the health ramifications of a sedentary lifestyle. The research linking too much sitting with increased risks of disease and premature death is quite noteworthy:

1. Men who were sedentary for more than 23 hours a week had a 64 percent greater risk of dying from heart disease than those who were sedentary less than 11 hours a week, according to a 2010 study in Medicine & Science in Sports & Exercise.³
2. A study of more than 17,000 Canadians found that the mortality risk from all causes was 1.54 times higher among people who spent most of their day sitting, compared to those who sat infrequently.⁴
3. According to an Australian study, sitting time is a predictor of weight gain among women, even after controlling for calories consumed and leisurely physical activity, such as exercise.⁵
4. People who use a computer for at least 11 hours per week or watch TV for more than 21 hours per week are more likely to be obese than those who use a computer or watch TV for more than 5 hours per week.⁶
5. Your risk of metabolic syndrome rises in a dose-dependent manner depending on your "screen time" (the amount of time you spend watching TV or using a computer). Physical activity has only a minimal impact on the relationship between screen time and metabolic syndrome.⁷

Going to the Gym May NOT Be Enough

Interestingly, research has also suggested a regular fitness regimen might be insufficient to counteract the effects of excessively sedentary habits during the remaining hours of the day, due to the adverse metabolic impact of sitting. Especially if the fitness regimen is focused around equipment that puts you back in a seated position like a recumbent bike or rowing machine. A 2009 study⁸ highlighted much of the contemporary evidence linking sitting with biomarkers of poor metabolic health, showing how total sitting time correlates with an increased risk of type 2 diabetes, heart disease and other prevalent chronic health problems.

According to the authors:

"Even if people meet the current recommendation of 30 minutes of physical activity on most days each week, there may be significant adverse metabolic and health effects from prolonged sitting – the activity that dominates most people's remaining 'non-exercise' waking hours."

In other words, even if you're fairly physically active, riding your bike to work or hitting the gym four or five days a week, you may still succumb to the effects of too much sitting if the majority of your day is spent behind a desk or on the couch. Researchers have dubbed this phenomenon the "active couch potato effect."

According to a New York Times article,⁹ after just an hour of sitting, the production of enzymes that burn fat in your body declines by as much as 90 percent. Extended sitting slows your body’s metabolism of glucose and decreases your HDL, which is the type of lipid you want MORE of, instead of less. This explains why those who sit habitually for extended periods of time have higher risk for type 2 diabetes and cardiovascular problems.

The Key To Sitting Successfully: Stand Up

The basic remedy is to get up and do a few simple exercises – but you have to do this frequently if you spend a lot of your life in a chair. Most back, neck, and other muscle pains are related to imbalanced absorption of force throughout your body, created by working in unnatural positions for extended periods. When you teach your body to establish and repeat correct positioning, the pain often goes away. You must correct your foot, pelvis, torso, shoulder and neck positions as these are all required for good posture and balance. When these core areas are positioned improperly, you will likely develop pain first in those areas, with other areas soon to follow. As the center of your body changes its structure to adapt to the demands you ask it to do most frequently, the extremities will follow..

For example, a great deal of carpal tunnel issues do not result solely from improper wrist position, but from forward rotation of the shoulder. The forward rotation of the shoulder is directly connected to the position of your lower back, and pelvis. As the shoulder changes position all of the muscles and nerves below the shoulder are adversely affected. The result is symptoms within the wrist that cannot be fixed at the wrist.

A basic remedy is to simply get up! But additionally, there are certain exercises you can perform to further reduce the adverse impact of sitting.

In the interview above, Kelly Starrett, popular mobility expert and physical therapist with Crossfit, shares some excellent tips for maintaining good posture while working for extended periods in a chair.¹⁰ The key is to change positions often – at least every 20 to 30 minutes – and maintain proper torso alignment, regardless of what position you’re in. Starrett recommends standing up often and doing some specific realignment exercises, which are actually quick and easy.

Sitting, especially while doing computer work or texting, tends to result in leaning forward with your head, neck, shoulders and upper back. The key is to teach your body to support itself in a more neutral position, without overcorrecting.

Realigning Your Body in Five Easy Steps

Starrett recommends a five-step series of body “reorganizations” or realignments, done in the following sequence:

1. Stand up with your with feet pointing straight forward or slightly inward.
2. In the interview Kelly recommends that we realign the pelvis by simply squeezing your butt tightly, we would like to add that this will be more effective for the majority of people if also told to internally rotate their feet 10-15 degrees (big toes slightly towards each other), roll feet to the outside of the arch and then try to pull the back of the legs together without the heels moving. This will allow the thigh and butt muscles to work together; the squeeze alone is otherwise less effective.
3. Create some tension in your core by slightly tightening your abdominals (this is not an extreme tightening – just to 20 percent of your max)
4. Correct your shoulder position by externally rotating (think of unscrewing) your shoulders and arms (rolling your shoulders back), which brings your shoulder blades closer together, your chest up and forward, and your thumbs pointing away from your body
5. While keeping your shoulders externally rotated, turn your hands back to neutral, so that your thumbs are now facing forward

These basic alignments can be applied no matter what position you’re in – whether you’re standing, sitting, kneeling, or anything in between. In the video, Starrett demonstrates exactly how to perform these simple corrections, making it much easier to visualize. If you practice these exercises regularly, you’ll be preventing many of the problems that commonly arise.

In case you’re wondering if you can just substitute a balance ball for your chair, there is little evidence for any benefit. Studies show minimal, if any, postural improvement, and one study even showed “spinal shrinkage” from using these balls as a chair.¹¹The apparatus you sit on is far less important than the positions in which you teach your body to sit.

However, the ergonomic revolution has led to the birth of some interesting desks and workstations that offer the option of standing up to work. Some workstations even have a treadmill underneath for walking. Sales of the “TredDesk” have reportedly grown tenfold since its introduction in 2008. There are a number of companies putting a lot of money into research and development in this area, and I suspect to see many more of these designs coming down the pike.

Foundation Training Exercises:

Foundation Training is another way to compensate for long hours spend sitting. Foundation training exercises are powerful simple structural movements that help strengthen and realign your body posture. This program was developed by Chiropractor Eric Goodman as a way to address his personal chronic back pain, and have been a great answer to the increasing physical challenges of modern society. As a starting point, Dr. Goodman suggests making the following adjustments to your body when sitting. These recommendations are not meant to replace the way you sit constantly, but to give you useful alternative positions to use. It is recommended that you try them often, as your body is likely in need:

1. Backrests tend to promote excessive rounding of the spine and push us into what's called an anterior head carriage. Sit upright on the front edge of a chair and practice the next 2 tips. At least 2/3 of your thigh should be off of the chair, and your knees should be no more than 6 inches apart while practicing.
2. When sitting, try to keep your chin behind your chest bone. When your chin is too far forward, you will inadvertently teach your hip flexors to remain abnormally short and you set yourself up for increased compression and degeneration.
3. An easy way to learn to lengthen your hip flexors without hyperextending your spine is to slowly increase the distance between your rib cage and pelvis while keeping your chin pulled in and down towards your throat. This is demonstrated in the last 5 minutes of the TED Talk listed above.

For more information on Foundation Training, please refer to my earlier article and interview with Dr. Goodman, as well as watching the videos below in which Dr. Goodman demonstrates two of his favorite exercises:..

Yet another type of exercise called Egoscue can also be helpful in mitigating the damage from excess sitting

Take Breaks from Sitting to Ground Yourself to the Earth

Another downside to sitting is the lack of contact with the Earth, since most of us are sitting indoors. Have you noticed how much better you feel when you walk barefoot on the Earth, whether it’s dirt or sand or grass?

Science has finally solved this mystery!

For most of our evolutionary history, humans have had continuous contact with the Earth, but this is certainly not the case today. We are separated from it by a barrier of asphalt, wood, rugs, plastics, and especially shoes. Living in direct contact with the Earthgrounds your body, producing beneficial electrophysiological changes that help protect you from potentially disruptive electromagnetic fields. Some of the EMFs closest to our bodies are those generated by the electronic devices that have practically become a modern appendage – like smart phones and iPads.

Your immune system functions optimally when your body has an adequate supply of electrons, which are easily and naturally obtained by barefoot/bare skin contact with the Earth. Research indicates Earth’s electrons are the ultimate antioxidants, acting aspowerful anti-inflammatories.

Chronic inflammation leads to a multitude of health problems. Therefore, reducing inflammation will help mitigate the negative effects of excessive sitting. Earthing (grounding) decreases the effect of the potentially disruptive electromagnetic fields that are emitted by those electronic devices we’ve come to depend on.

Bottom line: the more you can walk or stand barefoot upon the Earth, the healthier you will be. Whenever possible, take a moment to venture outside and plant your feet in the wet grass!

We are designed to move well, sit well and play well within our environment. It is up to us to teach our body to do these things as it is designed to. We can only deprive our body of what it requires for so long before it begins to rebel against us physically.

About Dr Kevin Lau

Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.

By Dr. Mercola

From smart phones to computers to iPads, our beloved electronic devices are crippling our posture and contributing to weight gain, back pain, and joint problems like carpal tunnel syndrome.

Fortunately, there are a few strategies and exercises – such as changing your position often and “reorganizing” your torso – that can address a lot of these potential problems and help keep you more fit and properly aligned.

As miserable as back pain is, that may be the least of your worries if you spend a significant portion of your time on your duff. Sitting may actually cut years off your life. Lack of exercise is sitting’s evil accomplice. The more you sit, the less your body wants to move.

According to a study in the British Medical Journal,¹ reducing the average time you spend sitting to less than three hours per day could increase your life expectancy by two years, which is a significant decrease from the 4.5 to 5 hours per day the average American now spends on a chair or sofa.

An analysis of 18 studies showed that people who sat for the longest periods of time were twice as likely to have diabetes or heart disease, compared to those who sat the least.² Sitting has actually joined smoking and obesity as an important risk factor for chronic disease.

The Price You Pay for a Sedentary Lifestyle

A number of studies have investigated the health ramifications of a sedentary lifestyle. The research linking too much sitting with increased risks of disease and premature death is quite noteworthy:

1. Men who were sedentary for more than 23 hours a week had a 64 percent greater risk of dying from heart disease than those who were sedentary less than 11 hours a week, according to a 2010 study in Medicine & Science in Sports & Exercise.³
2. A study of more than 17,000 Canadians found that the mortality risk from all causes was 1.54 times higher among people who spent most of their day sitting, compared to those who sat infrequently.⁴
3. According to an Australian study, sitting time is a predictor of weight gain among women, even after controlling for calories consumed and leisurely physical activity, such as exercise.⁵
4. People who use a computer for at least 11 hours per week or watch TV for more than 21 hours per week are more likely to be obese than those who use a computer or watch TV for more than 5 hours per week.⁶
5. Your risk of metabolic syndrome rises in a dose-dependent manner depending on your "screen time" (the amount of time you spend watching TV or using a computer). Physical activity has only a minimal impact on the relationship between screen time and metabolic syndrome.⁷

Going to the Gym May NOT Be Enough

Interestingly, research has also suggested a regular fitness regimen might be insufficient to counteract the effects of excessively sedentary habits during the remaining hours of the day, due to the adverse metabolic impact of sitting. Especially if the fitness regimen is focused around equipment that puts you back in a seated position like a recumbent bike or rowing machine. A 2009 study⁸ highlighted much of the contemporary evidence linking sitting with biomarkers of poor metabolic health, showing how total sitting time correlates with an increased risk of type 2 diabetes, heart disease and other prevalent chronic health problems.

According to the authors:

"Even if people meet the current recommendation of 30 minutes of physical activity on most days each week, there may be significant adverse metabolic and health effects from prolonged sitting – the activity that dominates most people's remaining 'non-exercise' waking hours."

In other words, even if you're fairly physically active, riding your bike to work or hitting the gym four or five days a week, you may still succumb to the effects of too much sitting if the majority of your day is spent behind a desk or on the couch. Researchers have dubbed this phenomenon the "active couch potato effect."

According to a New York Times article,⁹ after just an hour of sitting, the production of enzymes that burn fat in your body declines by as much as 90 percent. Extended sitting slows your body’s metabolism of glucose and decreases your HDL, which is the type of lipid you want MORE of, instead of less. This explains why those who sit habitually for extended periods of time have higher risk for type 2 diabetes and cardiovascular problems.

The Key To Sitting Successfully: Stand Up

The basic remedy is to get up and do a few simple exercises – but you have to do this frequently if you spend a lot of your life in a chair. Most back, neck, and other muscle pains are related to imbalanced absorption of force throughout your body, created by working in unnatural positions for extended periods. When you teach your body to establish and repeat correct positioning, the pain often goes away. You must correct your foot, pelvis, torso, shoulder and neck positions as these are all required for good posture and balance. When these core areas are positioned improperly, you will likely develop pain first in those areas, with other areas soon to follow. As the center of your body changes its structure to adapt to the demands you ask it to do most frequently, the extremities will follow..

For example, a great deal of carpal tunnel issues do not result solely from improper wrist position, but from forward rotation of the shoulder. The forward rotation of the shoulder is directly connected to the position of your lower back, and pelvis. As the shoulder changes position all of the muscles and nerves below the shoulder are adversely affected. The result is symptoms within the wrist that cannot be fixed at the wrist.

A basic remedy is to simply get up! But additionally, there are certain exercises you can perform to further reduce the adverse impact of sitting.

In the interview above, Kelly Starrett, popular mobility expert and physical therapist with Crossfit, shares some excellent tips for maintaining good posture while working for extended periods in a chair.¹⁰ The key is to change positions often – at least every 20 to 30 minutes – and maintain proper torso alignment, regardless of what position you’re in. Starrett recommends standing up often and doing some specific realignment exercises, which are actually quick and easy.

Sitting, especially while doing computer work or texting, tends to result in leaning forward with your head, neck, shoulders and upper back. The key is to teach your body to support itself in a more neutral position, without overcorrecting.

Realigning Your Body in Five Easy Steps

Starrett recommends a five-step series of body “reorganizations” or realignments, done in the following sequence:

1. Stand up with your with feet pointing straight forward or slightly inward.
2. In the interview Kelly recommends that we realign the pelvis by simply squeezing your butt tightly, we would like to add that this will be more effective for the majority of people if also told to internally rotate their feet 10-15 degrees (big toes slightly towards each other), roll feet to the outside of the arch and then try to pull the back of the legs together without the heels moving. This will allow the thigh and butt muscles to work together; the squeeze alone is otherwise less effective.
3. Create some tension in your core by slightly tightening your abdominals (this is not an extreme tightening – just to 20 percent of your max)
4. Correct your shoulder position by externally rotating (think of unscrewing) your shoulders and arms (rolling your shoulders back), which brings your shoulder blades closer together, your chest up and forward, and your thumbs pointing away from your body
5. While keeping your shoulders externally rotated, turn your hands back to neutral, so that your thumbs are now facing forward

These basic alignments can be applied no matter what position you’re in – whether you’re standing, sitting, kneeling, or anything in between. In the video, Starrett demonstrates exactly how to perform these simple corrections, making it much easier to visualize. If you practice these exercises regularly, you’ll be preventing many of the problems that commonly arise.

In case you’re wondering if you can just substitute a balance ball for your chair, there is little evidence for any benefit. Studies show minimal, if any, postural improvement, and one study even showed “spinal shrinkage” from using these balls as a chair.¹¹The apparatus you sit on is far less important than the positions in which you teach your body to sit.

However, the ergonomic revolution has led to the birth of some interesting desks and workstations that offer the option of standing up to work. Some workstations even have a treadmill underneath for walking. Sales of the “TredDesk” have reportedly grown tenfold since its introduction in 2008. There are a number of companies putting a lot of money into research and development in this area, and I suspect to see many more of these designs coming down the pike.

Foundation Training Exercises:

Foundation Training is another way to compensate for long hours spend sitting. Foundation training exercises are powerful simple structural movements that help strengthen and realign your body posture. This program was developed by Chiropractor Eric Goodman as a way to address his personal chronic back pain, and have been a great answer to the increasing physical challenges of modern society. As a starting point, Dr. Goodman suggests making the following adjustments to your body when sitting. These recommendations are not meant to replace the way you sit constantly, but to give you useful alternative positions to use. It is recommended that you try them often, as your body is likely in need:

1. Backrests tend to promote excessive rounding of the spine and push us into what's called an anterior head carriage. Sit upright on the front edge of a chair and practice the next 2 tips. At least 2/3 of your thigh should be off of the chair, and your knees should be no more than 6 inches apart while practicing.
2. When sitting, try to keep your chin behind your chest bone. When your chin is too far forward, you will inadvertently teach your hip flexors to remain abnormally short and you set yourself up for increased compression and degeneration.
3. An easy way to learn to lengthen your hip flexors without hyperextending your spine is to slowly increase the distance between your rib cage and pelvis while keeping your chin pulled in and down towards your throat. This is demonstrated in the last 5 minutes of the TED Talk listed above.

For more information on Foundation Training, please refer to my earlier article and interview with Dr. Goodman, as well as watching the videos below in which Dr. Goodman demonstrates two of his favorite exercises:..

Yet another type of exercise called Egoscue can also be helpful in mitigating the damage from excess sitting

Take Breaks from Sitting to Ground Yourself to the Earth

Another downside to sitting is the lack of contact with the Earth, since most of us are sitting indoors. Have you noticed how much better you feel when you walk barefoot on the Earth, whether it’s dirt or sand or grass?

Science has finally solved this mystery!

For most of our evolutionary history, humans have had continuous contact with the Earth, but this is certainly not the case today. We are separated from it by a barrier of asphalt, wood, rugs, plastics, and especially shoes. Living in direct contact with the Earthgrounds your body, producing beneficial electrophysiological changes that help protect you from potentially disruptive electromagnetic fields. Some of the EMFs closest to our bodies are those generated by the electronic devices that have practically become a modern appendage – like smart phones and iPads.

Your immune system functions optimally when your body has an adequate supply of electrons, which are easily and naturally obtained by barefoot/bare skin contact with the Earth. Research indicates Earth’s electrons are the ultimate antioxidants, acting aspowerful anti-inflammatories.

Chronic inflammation leads to a multitude of health problems. Therefore, reducing inflammation will help mitigate the negative effects of excessive sitting. Earthing (grounding) decreases the effect of the potentially disruptive electromagnetic fields that are emitted by those electronic devices we’ve come to depend on.

Bottom line: the more you can walk or stand barefoot upon the Earth, the healthier you will be. Whenever possible, take a moment to venture outside and plant your feet in the wet grass!

We are designed to move well, sit well and play well within our environment. It is up to us to teach our body to do these things as it is designed to. We can only deprive our body of what it requires for so long before it begins to rebel against us physically.

About Dr Kevin Lau

Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.

Read More

FDA could require tamper-resistant painkillers; without such action, prescription-drug abuse problem would worsen

UPDATE, Jan. 14 : Laura Ungar of The Courier-Journal reports, "Addicts by the scores used to get a quick and easy high from snorting or shooting up the powerful narcotic OxyContin — until manufacturer Purdue Pharma developed a new version that’s harder to abuse. But with the company’s patent on its original drug set to expire in April, activists, lawmakers and doctors are worried that cheaper, easily crushable generic versions will flood Kentucky and worsen the state’s already-devastating prescription drug abuse problem."

The Food and Drug Administration will force generic manufacturers of powerful pain pills to switch to a tamper-resistant composition if it finds evidence the composition curbs prescription drug abuse and addiction, Alan Rappeport of The Financial Times reports. Public-health advocates worry that if generic versions of opiate pills are not made tamper-resistant, the prescription drug abuse epidemic may worsen.

If the agency finds tamper-resistance significantly deter abuse, it has legal authority to require generic drug makers to switch their opiate formulas. Just as manufacturers of some pain pills began switching formulas to make the pills harder to crush, easily crushable, generic forms of OxyContin and Opana were released. Purdue Pharma and Endo Pharmaceuticals, which make Opana, have hoped to extend patent life of their drugs by pushing the FDA to prevent generic makers from using old versions of their drugs. Generic makers argue this will keep patients from buying cheaper drugs.

The FDA said it will take a "flexible" approach to determining the effectiveness of tamper-resistant drugs because abusers are constantly finding new ways to avoid deterrents. (Read more)

UPDATE, Jan. 14 : Laura Ungar of The Courier-Journal reports, "Addicts by the scores used to get a quick and easy high from snorting or shooting up the powerful narcotic OxyContin — until manufacturer Purdue Pharma developed a new version that’s harder to abuse. But with the company’s patent on its original drug set to expire in April, activists, lawmakers and doctors are worried that cheaper, easily crushable generic versions will flood Kentucky and worsen the state’s already-devastating prescription drug abuse problem."

The Food and Drug Administration will force generic manufacturers of powerful pain pills to switch to a tamper-resistant composition if it finds evidence the composition curbs prescription drug abuse and addiction, Alan Rappeport of The Financial Times reports. Public-health advocates worry that if generic versions of opiate pills are not made tamper-resistant, the prescription drug abuse epidemic may worsen.

If the agency finds tamper-resistance significantly deter abuse, it has legal authority to require generic drug makers to switch their opiate formulas. Just as manufacturers of some pain pills began switching formulas to make the pills harder to crush, easily crushable, generic forms of OxyContin and Opana were released. Purdue Pharma and Endo Pharmaceuticals, which make Opana, have hoped to extend patent life of their drugs by pushing the FDA to prevent generic makers from using old versions of their drugs. Generic makers argue this will keep patients from buying cheaper drugs.

The FDA said it will take a "flexible" approach to determining the effectiveness of tamper-resistant drugs because abusers are constantly finding new ways to avoid deterrents. (Read more)

Read More

Pike court will keep lawsuit county and attorney general filed against Purdue Pharma over damage done by its OxyContin

A state court will hear the Kentucky attorney general's 2007 lawsuit against OxyContin manufacturer Purdue Pharma, against the wishes of the company. The U.S. Court of Appeals for the 2nd Circuit affirmed a lower court's order returning the suit to Kentucky from New York's Southern District, where Purdue wanted the case heard. The suit was filed in Pike Circuit Court, in Kentucky's easternmost county.

"After years of delay tactics, Purdue will now answer to a Kentucky court and a Kentucky jury," Attorney General Jack Conway said. Purdue Pharma spokeswoman Libby Holman said the company is disappointed by the decision, but now it is "fully prepared to vigorously defend this action on its merits, and we expect to prevail."

Then-AG Greg Stumbo and Pike County sued Purdue Pharma in October 2007, alleging that the company's "aggressive and deceptive marketing campaign saddled taxpayers with millions of dollars in social, health care and other costs," Laura Ungar of The Courier-Journal in Louisville reports. The suit also alleges the company misled health-care providers, consumers and the government about the highly addictive nature of OxyContin. The suit is largely based on admissions of guilt made by the company and several top-ranking company officials in a May 2007 Virginia federal court settlement. Purdue Pharma, its president, chief legal counsel and former medical director pleaded guilty to misleading doctors, regulators and patients about OxyContin during that case.

The nation's prescription-drug epidemic apparently began in the region, largely because of the introduction and high rate of prescription of OxyContin. Kentucky has nearly 1,000 overdose deaths a year. Conway's office said the suit against Purdue Pharma seeks reimbursement for drug-abuse programs, law-enforcement actions and prescription payments through Medicaid and the Kentucky Pharmaceutical Alliance Program. (Read more)

A state court will hear the Kentucky attorney general's 2007 lawsuit against OxyContin manufacturer Purdue Pharma, against the wishes of the company. The U.S. Court of Appeals for the 2nd Circuit affirmed a lower court's order returning the suit to Kentucky from New York's Southern District, where Purdue wanted the case heard. The suit was filed in Pike Circuit Court, in Kentucky's easternmost county.

"After years of delay tactics, Purdue will now answer to a Kentucky court and a Kentucky jury," Attorney General Jack Conway said. Purdue Pharma spokeswoman Libby Holman said the company is disappointed by the decision, but now it is "fully prepared to vigorously defend this action on its merits, and we expect to prevail."

Then-AG Greg Stumbo and Pike County sued Purdue Pharma in October 2007, alleging that the company's "aggressive and deceptive marketing campaign saddled taxpayers with millions of dollars in social, health care and other costs," Laura Ungar of The Courier-Journal in Louisville reports. The suit also alleges the company misled health-care providers, consumers and the government about the highly addictive nature of OxyContin. The suit is largely based on admissions of guilt made by the company and several top-ranking company officials in a May 2007 Virginia federal court settlement. Purdue Pharma, its president, chief legal counsel and former medical director pleaded guilty to misleading doctors, regulators and patients about OxyContin during that case.

The nation's prescription-drug epidemic apparently began in the region, largely because of the introduction and high rate of prescription of OxyContin. Kentucky has nearly 1,000 overdose deaths a year. Conway's office said the suit against Purdue Pharma seeks reimbursement for drug-abuse programs, law-enforcement actions and prescription payments through Medicaid and the Kentucky Pharmaceutical Alliance Program. (Read more)

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Rep. Westrom, bolstered by increasing public support, thinks third time may be the charm to pass a statewide smoking ban law

A coalition of health groups say they will give state Rep. Susan Westrom, D-Lexington, the most public support ever for a bill to ban smoking in Kentucky restaurants and workplaces, a bill she's tried to get passed twice, Jacqueline Pitts of CN2 reports. The coalition, which includes Smoke-Free Kentucky and the American Lung Association, revealed plans yesterday for a two-week ad campaign about the benefits of a statewide smoking ban law.

So far, 24 states have approved smoking bans, and more than 30 Kentucky cities and counties have passed similar local bans. Westrom said that Gov. Steve Beshear, who once said bans should be left to localities to decide, is more supportive of a statewide ban now. A 2012 Foundation for a Healthy Kentucky poll shows that 59 percent of Kentucky adults are in favor of a statewide ban. Westrom said she wants to work with new legislators to get their support for the bill. (Read more)

A coalition of health groups say they will give state Rep. Susan Westrom, D-Lexington, the most public support ever for a bill to ban smoking in Kentucky restaurants and workplaces, a bill she's tried to get passed twice, Jacqueline Pitts of CN2 reports. The coalition, which includes Smoke-Free Kentucky and the American Lung Association, revealed plans yesterday for a two-week ad campaign about the benefits of a statewide smoking ban law.

So far, 24 states have approved smoking bans, and more than 30 Kentucky cities and counties have passed similar local bans. Westrom said that Gov. Steve Beshear, who once said bans should be left to localities to decide, is more supportive of a statewide ban now. A 2012 Foundation for a Healthy Kentucky poll shows that 59 percent of Kentucky adults are in favor of a statewide ban. Westrom said she wants to work with new legislators to get their support for the bill. (Read more)

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Evolving insights into FIP virulence

Terada Y, Shiozaki Y, Shimoda H, et al. Feline infectious peritonitis virus with a large deletion in the 5'-terminal region of the spike gene retains its virulence for cats. The Journal of general virology. 2012; 93: 1930-4. 

The acquisition of macrophage tropism appears to be an essential step in the transformation of feline enteric corona virus (FECV) to feline infectious peritonitis virus (FIPV).This is a transformation from a largely non-pathogenic and localized enterocyte pathogen to a highly virulent and systemic monocyte/macrophage pathogen. Therefore, determining the critical genetic mutation(s) leading a change in tropism is required for understanding the pathogenic phenomena of feline coronavirus (FCoV) infections. Although various viral proteins such as 3c and 7b have been considered to be involved in the transformation, the spike (S) protein may also play a role in a switch toward macrophage tropism and enhanced virulence. 

In coronaviruses, the S protein functions in cell entry and is responsible for receptor attachment and membrane fusion. While the receptor-binding site is located in the N-terminal part of the protein, fusion is mediated by its membrane proximal part. Surprisingly, previous studies have suggested virulence mutation(s) in the S protein occur in the membrane-proximal domain of the protein and not in the N-terminal region. 

In the present study, a type I FCoV strain, C3663, was found to have a large deletion of 735 bp within the gene encoding for the S protein, resulting in an estimated 245 amino acid loss in the N-terminal region of the protein. FIP developed in three out of four cats that were infected with strain C3663, suggesting that the 5’-terminal region of the S gene is not essential for pathogenic transformation. If the S protein is indeed involved in the transformation and development of FIP, then this result is consistent with the localization of the determinant for macrophage tropism lying in the domain responsible for membrane fusion suggesting a role for fusion function rather than for receptor binding. [GO]

See also: Rottier PJ, Nakamura K, Schellen P, Volders H and Haijema BJ. Acquisition of macrophage tropism during the pathogenesis of feline infectious peritonitis is determined by mutations in the feline coronavirus spike protein. J Virol. 2005; 79: 14122-30. 

Related blog articles:
Understanding FIP virulence (October 2012)
Development of new therapies for FIP (March 2012)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
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Terada Y, Shiozaki Y, Shimoda H, et al. Feline infectious peritonitis virus with a large deletion in the 5'-terminal region of the spike gene retains its virulence for cats. The Journal of general virology. 2012; 93: 1930-4. 

The acquisition of macrophage tropism appears to be an essential step in the transformation of feline enteric corona virus (FECV) to feline infectious peritonitis virus (FIPV).This is a transformation from a largely non-pathogenic and localized enterocyte pathogen to a highly virulent and systemic monocyte/macrophage pathogen. Therefore, determining the critical genetic mutation(s) leading a change in tropism is required for understanding the pathogenic phenomena of feline coronavirus (FCoV) infections. Although various viral proteins such as 3c and 7b have been considered to be involved in the transformation, the spike (S) protein may also play a role in a switch toward macrophage tropism and enhanced virulence. 

In coronaviruses, the S protein functions in cell entry and is responsible for receptor attachment and membrane fusion. While the receptor-binding site is located in the N-terminal part of the protein, fusion is mediated by its membrane proximal part. Surprisingly, previous studies have suggested virulence mutation(s) in the S protein occur in the membrane-proximal domain of the protein and not in the N-terminal region. 

In the present study, a type I FCoV strain, C3663, was found to have a large deletion of 735 bp within the gene encoding for the S protein, resulting in an estimated 245 amino acid loss in the N-terminal region of the protein. FIP developed in three out of four cats that were infected with strain C3663, suggesting that the 5’-terminal region of the S gene is not essential for pathogenic transformation. If the S protein is indeed involved in the transformation and development of FIP, then this result is consistent with the localization of the determinant for macrophage tropism lying in the domain responsible for membrane fusion suggesting a role for fusion function rather than for receptor binding. [GO]

See also: Rottier PJ, Nakamura K, Schellen P, Volders H and Haijema BJ. Acquisition of macrophage tropism during the pathogenesis of feline infectious peritonitis is determined by mutations in the feline coronavirus spike protein. J Virol. 2005; 79: 14122-30. 

Related blog articles:
Understanding FIP virulence (October 2012)
Development of new therapies for FIP (March 2012)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

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Coalition of health groups launches two-week ad campaign to drum up support for a statewide smoking ban

A geographically targeted newspaper and online advertising campaign calling for "a comprehensive, statewide smoke-free law" is hitting Kentucky media outlets this week, as the legislature convenes, and next week. The campaign was launched by Smoke-Free Kentucky Coalition, the Campaign for Tobacco-Free Kids and the Robert Wood Johnson Foundation. The newspaper ad can viewed here.

Twenty-nine percent of Kentucky adults are smokers, giving the state the highest smoking rate in the U.S., and ranks very high in youth smoking, according to the Centers for Disease Control. Kentucky also has the nation's highest lung cancer death rates, 87 percent of which are caused by smoking, according to the National Cancer Institute. The state also "lags behind other states in enacting a comprehensive, statewide smoke-free law that covers all indoor workplaces, including bars and restaurants," a press release about the ad campaign says. Twenty-four states have smoking bans. A fall poll for the Foundation for a Healthy Kentucky showed that 59 percent of Kentucky adults support a smoking ban in workplaces, restaurants and bars. For a story on the poll, click here.

Tobacco-Free Kids communications manager Catherine Butsch said the ad is running in the Lexington Herald-Leader, the Messenger-Inquirer of Owensboro, the Daily Independent of Ashland, the Commonwealth Journal of Somerset, the Kentucky New Era of Hopkinsville, the Glasgow Daily Times, the Paducah Sun, the Paducah-based West Kentucky News, the Sentinel-Echo of London, the Lebanon Enterprise, the Jessamine Journal, the Tompkinsville News, the Carlisle Weekly of Bardwell, the Fulton Leader, the Marshall County Tribune Courier, and the Kentucky Gazette, a government-oriented twice-monthly in Frankfort. The online ad will run on websites of the Herald-Leader, Business Lexington, The Lane Report and CN2, a cable news service. The campaign will cost $93,000, Butsch said.

A geographically targeted newspaper and online advertising campaign calling for "a comprehensive, statewide smoke-free law" is hitting Kentucky media outlets this week, as the legislature convenes, and next week. The campaign was launched by Smoke-Free Kentucky Coalition, the Campaign for Tobacco-Free Kids and the Robert Wood Johnson Foundation. The newspaper ad can viewed here.

Twenty-nine percent of Kentucky adults are smokers, giving the state the highest smoking rate in the U.S., and ranks very high in youth smoking, according to the Centers for Disease Control. Kentucky also has the nation's highest lung cancer death rates, 87 percent of which are caused by smoking, according to the National Cancer Institute. The state also "lags behind other states in enacting a comprehensive, statewide smoke-free law that covers all indoor workplaces, including bars and restaurants," a press release about the ad campaign says. Twenty-four states have smoking bans. A fall poll for the Foundation for a Healthy Kentucky showed that 59 percent of Kentucky adults support a smoking ban in workplaces, restaurants and bars. For a story on the poll, click here.

Tobacco-Free Kids communications manager Catherine Butsch said the ad is running in the Lexington Herald-Leader, the Messenger-Inquirer of Owensboro, the Daily Independent of Ashland, the Commonwealth Journal of Somerset, the Kentucky New Era of Hopkinsville, the Glasgow Daily Times, the Paducah Sun, the Paducah-based West Kentucky News, the Sentinel-Echo of London, the Lebanon Enterprise, the Jessamine Journal, the Tompkinsville News, the Carlisle Weekly of Bardwell, the Fulton Leader, the Marshall County Tribune Courier, and the Kentucky Gazette, a government-oriented twice-monthly in Frankfort. The online ad will run on websites of the Herald-Leader, Business Lexington, The Lane Report and CN2, a cable news service. The campaign will cost $93,000, Butsch said.

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Republicans moving to gain a say over Beshear's decisions about insurance exchange, Medicaid expansion; Democrat dismissive

Kentucky Senate Health and Welfare Committee Chair Julie Denton, R-Louisville, left, said yesterday that she would file legislation that would block Democratic Gov. Steve Beshear from setting up a health-insurance exchange or expanding Medicaid coverage without legislative approval, Joseph Gerth of The Courier-Journal reports. Beshear has already established an exchange under the federal health reform, but hasn't announced whether he will expand Medicaid.

Denton said the exchanges and Medicaid expansion would be too costly for the state and shouldn't be something Beshear can set up unilaterally. But her effort will likely face opposition in the Democrat-controlled House, Gerth writes. Liberal Rep. Tom Burch, D-Louisville, said Denton "should save the ink that it would take to print the bills," and House Democrats would not receive the bill favorably. Burch has been in the legislature longer than any other current member.

State health-insurance exchanges will allow the uninsured to buy insurance from private companies and perhaps get government subsidies to help pay for it. If Medicaid were expanded in Kentucky, hundreds of thousands of more people would be covered, with the fedreal government paying all the extra cost in 2014-16, decreasing to 90 percent by 2020. Gerth reports that Senate Republicans said they will make it a priority "to rein in Beshear on Medicaid," which they fear would be unsustainable if it were expanded. Denton said requiring legislative approval of these parts of "Obamacare" would give Kentucky citizens a greater voice in the process. (Read more)

Kentucky Senate Health and Welfare Committee Chair Julie Denton, R-Louisville, left, said yesterday that she would file legislation that would block Democratic Gov. Steve Beshear from setting up a health-insurance exchange or expanding Medicaid coverage without legislative approval, Joseph Gerth of The Courier-Journal reports. Beshear has already established an exchange under the federal health reform, but hasn't announced whether he will expand Medicaid.

Denton said the exchanges and Medicaid expansion would be too costly for the state and shouldn't be something Beshear can set up unilaterally. But her effort will likely face opposition in the Democrat-controlled House, Gerth writes. Liberal Rep. Tom Burch, D-Louisville, said Denton "should save the ink that it would take to print the bills," and House Democrats would not receive the bill favorably. Burch has been in the legislature longer than any other current member.

State health-insurance exchanges will allow the uninsured to buy insurance from private companies and perhaps get government subsidies to help pay for it. If Medicaid were expanded in Kentucky, hundreds of thousands of more people would be covered, with the fedreal government paying all the extra cost in 2014-16, decreasing to 90 percent by 2020. Gerth reports that Senate Republicans said they will make it a priority "to rein in Beshear on Medicaid," which they fear would be unsustainable if it were expanded. Denton said requiring legislative approval of these parts of "Obamacare" would give Kentucky citizens a greater voice in the process. (Read more)

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Evaluating disinfection methods for viruses and bacteria

Tuladhar E, Hazeleger WC, Koopmans M, Zwietering MH, Beumer RR and Duizer E. Residual viral and bacterial contamination of surfaces after cleaning and disinfection. Applied and environmental microbiology. 2012; 78: 7769-75.
 
Cleaning and disinfection are important facets of animal care and critical for multi-cat settings, such as veterinary clinics, breeding catteries, and shelters. These investigators examined the ability of various methods to disinfect surfaces of a multitude of viruses (e.g., norovirus, rotavirus, and others) and bacteria (e.g., Staphylococcus, Salmonella, and others) that vary in environmental stability. A single wipe with water, liquid soap, or free chlorine solution led to reduction in contamination but not total elimination of the pathogens. A second wipe with chlorine solution led to significantly more reduction in contamination. However, a single wipe with liquid soap followed by a single wipe with chlorine solution reduced contaminant levels significantly for most pathogens tested. [MK]

See also: Murphy CP, Reid-Smith RJ, Weese JS and McEwen SA. Evaluation of specific infection control practices used by companion animal veterinarians in community Veterinary practices in southern Ontario. Zoonoses Public Health. 2010; 57: 429-38.

Related blog articles:
Disease control in animal shelters (May 2011)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

Tuladhar E, Hazeleger WC, Koopmans M, Zwietering MH, Beumer RR and Duizer E. Residual viral and bacterial contamination of surfaces after cleaning and disinfection. Applied and environmental microbiology. 2012; 78: 7769-75.
 
Cleaning and disinfection are important facets of animal care and critical for multi-cat settings, such as veterinary clinics, breeding catteries, and shelters. These investigators examined the ability of various methods to disinfect surfaces of a multitude of viruses (e.g., norovirus, rotavirus, and others) and bacteria (e.g., Staphylococcus, Salmonella, and others) that vary in environmental stability. A single wipe with water, liquid soap, or free chlorine solution led to reduction in contamination but not total elimination of the pathogens. A second wipe with chlorine solution led to significantly more reduction in contamination. However, a single wipe with liquid soap followed by a single wipe with chlorine solution reduced contaminant levels significantly for most pathogens tested. [MK]

See also: Murphy CP, Reid-Smith RJ, Weese JS and McEwen SA. Evaluation of specific infection control practices used by companion animal veterinarians in community Veterinary practices in southern Ontario. Zoonoses Public Health. 2010; 57: 429-38.

Related blog articles:
Disease control in animal shelters (May 2011)

More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

Read More

Increased Risk Of Stroke for Thyroid and Diabetes Patients!

Increased Risk Of Stroke for Thyroid and Diabetes Patients!

Attention: If you or someone you know is stricken with diabetes along with low thyroid, known as hypothyroidism, then you MUST read this article.  Your life may already be hanging on by a thread, a thread that your doctor doesn’t even know may be unraveling quickly.

Research has shown that diabetic patients are commonly found to have concurrent thyroid disorders.

In comparison to the normal population, diabetics have over 30% more hypothyroid disease, an 11% increase in postpartum diabetes and studies have shown that diabetics have over 5 times the incidence of sub-clinical hypothyroid disease compared with the normal population!

An autoimmune disease known as Hashimoto’s Thyroiditis accounts for between 70%-80% of all hypothyroid disease cases in American adults.  It is the most common cause of hypothyroid in the adult population. In people with hypothyroidism caused by autoimmune disease it has been found that they have, as a group, multiple other conditions along with the hypothyroidism.

It is known that patients with one organ-specific autoimmune disease are at risk of developing other autoimmune disorders, and because thyroid disorders are more common in females, it is not surprising that so many female diabetes patients have thyroid disease.

One problem that arises with having these two conditions together is that, due to the diabetic state of glucose dysregulation, glucose is inefficiently transported to the cells and the metabolism of glucose is diminished. This results in an increase of glucose in the blood stream.

As a result, the body will convert the excess sugar to triglycerides to be stored in adipose tissue for use as energy when it may be needed.

Because hypothyroidism decreases the overall rate at which you burn calories (Think of the thyroid as your body's furnace) and low thyroid also slows down hormone production, your triglycerides are more likely to remain in your fat cells because of the lowered energy needs of the body, this is one reason many people with low thyroid have cold hands and / or feet because the byproduct of energy production is heat, so if the bodies “furnace”, is functioning below what is required, one symptom could be those cold hands and feet.

Hypothyroidism may also increase your LDL levels (low density lipoproteins, which are wrongly called our “bad” cholesterol) by increasing the absorption of cholesterol through your liver, preventing it from effectively eliminating excess cholesterol.

So you see, diabetes causes you to make more triglycerides and then hypothyroidism helps you to keep them around, either stored as fat because you don’t utilize them for energy or within the bloodstream.

High triglyceride blood plasma levels are one marker used to show increased risk factor for heart disease, atherosclerosis, metabolic syndrome, transient ischemic attacks (TIA) and stroke. 

In fact two studies found that increased triglycerides were a more reliable marker for future strokes that LDL or that so called “bad cholesterol”.

Prior to these two studies elevated LDL levels were always deemed the prime suspect in the development of stroke.

In the first study that was done, spanning over 4 years, researchers at UCLA collected data on more than 1,000 patients who were admitted to the medical center for TIA’s.

All of the study patients had fasting lipid panels drawn the day following admission to the hospital. After comparing the lipid panels, researchers found that patients with the highest triglyceride levels were 2.7 times more likely to suffer a stroke than those with low triglyceride levels.  

LDL levels, however, showed no correlation to stroke risk.

A 2001 study reported similar results. An Israeli team of scientists’ analyzed more than 11,000 patients, all of whom had coronary heart disease but had never suffered a stroke. 

During an 8-year follow-up period, 487 of those study patients had a TIA or full-blown stroke.

In studying these patients’ findings along with those whom had high triglycerides, researchers determined that diabetics with thyroid conditions who had triglyceride levels of 200 mg/dL or more had a 30% greater risk of having a stroke than patients with normal triglyceride levels.

This information has been around for over 10 years, and if your triglycerides have always been an issue in your blood panels, has your doctor ever explained this to you?

If the doctor does any reading of research at all they should know this connection between Diabetes, Hypothyroidism, Glucose, Triglycerides, Heart Disease and Strokes.

If they don’t acknowledge this and, instead continue to prescribe you statins for your supposed high cholesterol, then maybe it’s time for you to find a doctor that does actively search out the newest, life saving research.

You deserve to have a health care provider that actually provides “health improving care”, not just  “keep you from dying care”. 

Think about the definition of medicine: The prevention, alleviation, or cure of disease.

Knowing that definition would you say that, in your opinion, the doctors you see for your health, have they prevented any of your diseases? Have they cured you of any of these disease conditions?

 I bet the your answers to those 2 questions is a profound “No!”.  In fact, when you have your blood chemistry tested and a blood chemistry result comes back on your test that is out of range the doctor probably tells you "We'll watch it.", not giving any explanation or a limited explanation at best about what they are watching and waiting for.

Well let me clue you in, this “watch and wait” is really a code for “We need for your health to become worse because, in reality, you aren’t sick enough for the type of care that we provide.”   

That's Not Health Care, That's Sick Care!

This is why you continue to deteriorate as the years go by because no one is trying hard enough for you! They aren't getting to the root cause of your problems.

You need a health provider who is willing to investigate your health in order to find what the cause of all these problems you are saddled with. A health-rejuvenating clinician that doesn’t blame your "Bad Luck" for what you are going through.

Saying a person with your health is just unlucky is a cop-out. It is a lazy doctor’s excuse to be incompetent. It's their way of dealing with their inadequate and falsely labeled “health care” treatment.

The best that you get from the medical doctor is an attempt to alleviate your symptoms, but even then they are ignoring this huge elephant in the room that I just went over with you, which is:  

Triglycerides, Not Cholesterol, Is How You Assess The Risk Factor Of A Future Stroke In Those Patients With Both Hypothyroid Disease And Diabetes!

You are invaluable to your family, friends and loved ones, don’t you think you are deserving of a doctor who’s life mission it is to contribute to his patients allowing them the opportunity to achieve the most optimal health imaginable?

A doctor who will look at your health as a whole so that you are afforded the very best care by using his knowledge of the human body and all it's systems to find the common cause of your multiple health system issues! That doctor would then need to know what to do for you so that you are no longer burdened with that always present fear that comes with the uncertainty of not knowing when the next “health crisis” shoe will drop causing you to become even more ill.

To live is to be able to enjoy your life as it was meant to be, it's not just going through the motions of the day unable to do the things that you love because of your poor health. Isn't it time to stop beating your head against the wall and change the direction of your life? Well then you are going to have to find someone that knows how to look at hypothyroidism and diabetes from a functional perspective.

Has your doctor even tested you for an autoimmune thyroid? If not, how does that doctor know what in the world is really going on in your body?

The doctor you entrust your health, and ultimately your life with needs to look beyond the labels of hypothyroidism and/ or diabetes so that they are able to do some real, health improving detective work to find the root cause(s) of your specific issue(s).

Do you get blood work results that are out of range and yet your doctor doesn’t seem to concerned with those pathological findings, telling you that we’ll just watch those results and see how they are on the next follow-up and when that time comes the doctor does the same thing again?  Worse yet, does your doctor not even acknowledge the negative results and instead tells you that your blood work is fine, making up some lame excuse like it’s ok for your age and weight?

If that's the case it is imperative that you find someone who understands the interaction between Hypothyroidism, Diabetes and the rest of your body's systems.

The combination of these two diseases in one individual is a deadly serious problem that cannot be swept under the rug and ignored, you must find a doctor that fully understands the gravity of this situation and will give it the attention it deserves by analyzing all the facts from a functional medical perspective.

Fortunately, I have spent many countless hours on these specific disease processes. I have the background, knowledge and desire it takes to get to the root of your problems so that you don’t become a statistic of an ever increasingly cold and incompetent health care system.

Patients often times are forced to blindly travel down the path of poor health as it meanders along due to a doctor that is either far too busy, too lazy or just too damn stubborn to stay up to date with the most current scientific research.

Chronic health conditions such as these are given the most inadequate of care in our current health care system and a huge reason is the health insurance companies. You see, they are the controller of the money and they dictate what care a patient will receive; many times a doctor is unable to exercise their full clinical skills due to the fact that they wouldn't be reimbursed by the insurance company as well as they dare not go against what has been set as the "Standard Of Care" for a particular health condition even though that Care is generic in that it is based on the diagnosed condition and not based upon an individual patient's uniqueness.

Unfortunately our health care system for the chronically ill patient is broken and patient care is no longer based on the individual but instead, it is has become an assembly line of “cookie cutter” treatment protocols that do not deviate much from patient to patient within the same diagnosis.

If you have been in the medical system for any length of time, you know this to be the case.

You are expected to wait, sometimes hours after your appointment time to see the doctor, then, when you finally get into your exam room, the doctor asks you a few questions, may or may not order blood work and then write you a couple of prescriptions for Synthroid^®to cover the hypothyroid and Metformin^® for your diabetes.

They can’t take the time to explain why your blood work is the way it is, nor will they have an answer as to why you continue to feel as you did before beginning your thyroid replacement hormones and the diabetes support medications.

Don’t you think you deserve better than what you have been getting in regards to your healthcare?  

Isn’t your life as important as anyone else’s?

Shouldn’t the doctor you employ to recover your lost health make it his fundamental duty to do all that is within his God given talent and power so that you no longer continue on the downward spiral of decreasing health in which you find yourself now?

If you are finally sick and tired of being sick and tired and you want to find someone that cares as much about your health as you do, then call my office at 281-812-8101 and set up a free, no obligation Health Recovery Workshop so you may see for yourself that there is hope and you are not destined to live a life of misery.

My door is open for those that want to take responsibility for their own health and stop relying on some profit driven, corporate health insurance company with their doctors that feed into this international profit driven machine at the expense of their patients’ health and many times the patient pays the ultimate cost by losing that same health and life that they and entrusted with the doctor to protect, nurture and improve.

If you have any questions or just want to sit down and talk about the possible solutions to your health issues, then please give my office a call at: 281-812-8101.

If you want to learn more please go to my website at:

http://LifeChangingCareHouston.com

http://FixMyThyroidNow.com 
http://FixMyDiabetesNow.com

In Health,

Dr. Walter K. Crooks DM (P), DC, CCCN

Increased Risk Of Stroke for Thyroid and Diabetes Patients!

Attention: If you or someone you know is stricken with diabetes along with low thyroid, known as hypothyroidism, then you MUST read this article.  Your life may already be hanging on by a thread, a thread that your doctor doesn’t even know may be unraveling quickly.

Research has shown that diabetic patients are commonly found to have concurrent thyroid disorders.

In comparison to the normal population, diabetics have over 30% more hypothyroid disease, an 11% increase in postpartum diabetes and studies have shown that diabetics have over 5 times the incidence of sub-clinical hypothyroid disease compared with the normal population!

An autoimmune disease known as Hashimoto’s Thyroiditis accounts for between 70%-80% of all hypothyroid disease cases in American adults.  It is the most common cause of hypothyroid in the adult population. In people with hypothyroidism caused by autoimmune disease it has been found that they have, as a group, multiple other conditions along with the hypothyroidism.

It is known that patients with one organ-specific autoimmune disease are at risk of developing other autoimmune disorders, and because thyroid disorders are more common in females, it is not surprising that so many female diabetes patients have thyroid disease.

One problem that arises with having these two conditions together is that, due to the diabetic state of glucose dysregulation, glucose is inefficiently transported to the cells and the metabolism of glucose is diminished. This results in an increase of glucose in the blood stream.

As a result, the body will convert the excess sugar to triglycerides to be stored in adipose tissue for use as energy when it may be needed.

Because hypothyroidism decreases the overall rate at which you burn calories (Think of the thyroid as your body's furnace) and low thyroid also slows down hormone production, your triglycerides are more likely to remain in your fat cells because of the lowered energy needs of the body, this is one reason many people with low thyroid have cold hands and / or feet because the byproduct of energy production is heat, so if the bodies “furnace”, is functioning below what is required, one symptom could be those cold hands and feet.

Hypothyroidism may also increase your LDL levels (low density lipoproteins, which are wrongly called our “bad” cholesterol) by increasing the absorption of cholesterol through your liver, preventing it from effectively eliminating excess cholesterol.

So you see, diabetes causes you to make more triglycerides and then hypothyroidism helps you to keep them around, either stored as fat because you don’t utilize them for energy or within the bloodstream.

High triglyceride blood plasma levels are one marker used to show increased risk factor for heart disease, atherosclerosis, metabolic syndrome, transient ischemic attacks (TIA) and stroke. 

In fact two studies found that increased triglycerides were a more reliable marker for future strokes that LDL or that so called “bad cholesterol”.

Prior to these two studies elevated LDL levels were always deemed the prime suspect in the development of stroke.

In the first study that was done, spanning over 4 years, researchers at UCLA collected data on more than 1,000 patients who were admitted to the medical center for TIA’s.

All of the study patients had fasting lipid panels drawn the day following admission to the hospital. After comparing the lipid panels, researchers found that patients with the highest triglyceride levels were 2.7 times more likely to suffer a stroke than those with low triglyceride levels.  

LDL levels, however, showed no correlation to stroke risk.

A 2001 study reported similar results. An Israeli team of scientists’ analyzed more than 11,000 patients, all of whom had coronary heart disease but had never suffered a stroke. 

During an 8-year follow-up period, 487 of those study patients had a TIA or full-blown stroke.

In studying these patients’ findings along with those whom had high triglycerides, researchers determined that diabetics with thyroid conditions who had triglyceride levels of 200 mg/dL or more had a 30% greater risk of having a stroke than patients with normal triglyceride levels.

This information has been around for over 10 years, and if your triglycerides have always been an issue in your blood panels, has your doctor ever explained this to you?

If the doctor does any reading of research at all they should know this connection between Diabetes, Hypothyroidism, Glucose, Triglycerides, Heart Disease and Strokes.

If they don’t acknowledge this and, instead continue to prescribe you statins for your supposed high cholesterol, then maybe it’s time for you to find a doctor that does actively search out the newest, life saving research.

You deserve to have a health care provider that actually provides “health improving care”, not just  “keep you from dying care”. 

Think about the definition of medicine: The prevention, alleviation, or cure of disease.

Knowing that definition would you say that, in your opinion, the doctors you see for your health, have they prevented any of your diseases? Have they cured you of any of these disease conditions?

 I bet the your answers to those 2 questions is a profound “No!”.  In fact, when you have your blood chemistry tested and a blood chemistry result comes back on your test that is out of range the doctor probably tells you "We'll watch it.", not giving any explanation or a limited explanation at best about what they are watching and waiting for.

Well let me clue you in, this “watch and wait” is really a code for “We need for your health to become worse because, in reality, you aren’t sick enough for the type of care that we provide.”   

That's Not Health Care, That's Sick Care!

This is why you continue to deteriorate as the years go by because no one is trying hard enough for you! They aren't getting to the root cause of your problems.

You need a health provider who is willing to investigate your health in order to find what the cause of all these problems you are saddled with. A health-rejuvenating clinician that doesn’t blame your "Bad Luck" for what you are going through.

Saying a person with your health is just unlucky is a cop-out. It is a lazy doctor’s excuse to be incompetent. It's their way of dealing with their inadequate and falsely labeled “health care” treatment.

The best that you get from the medical doctor is an attempt to alleviate your symptoms, but even then they are ignoring this huge elephant in the room that I just went over with you, which is:  

Triglycerides, Not Cholesterol, Is How You Assess The Risk Factor Of A Future Stroke In Those Patients With Both Hypothyroid Disease And Diabetes!

You are invaluable to your family, friends and loved ones, don’t you think you are deserving of a doctor who’s life mission it is to contribute to his patients allowing them the opportunity to achieve the most optimal health imaginable?

A doctor who will look at your health as a whole so that you are afforded the very best care by using his knowledge of the human body and all it's systems to find the common cause of your multiple health system issues! That doctor would then need to know what to do for you so that you are no longer burdened with that always present fear that comes with the uncertainty of not knowing when the next “health crisis” shoe will drop causing you to become even more ill.

To live is to be able to enjoy your life as it was meant to be, it's not just going through the motions of the day unable to do the things that you love because of your poor health. Isn't it time to stop beating your head against the wall and change the direction of your life? Well then you are going to have to find someone that knows how to look at hypothyroidism and diabetes from a functional perspective.

Has your doctor even tested you for an autoimmune thyroid? If not, how does that doctor know what in the world is really going on in your body?

The doctor you entrust your health, and ultimately your life with needs to look beyond the labels of hypothyroidism and/ or diabetes so that they are able to do some real, health improving detective work to find the root cause(s) of your specific issue(s).

Do you get blood work results that are out of range and yet your doctor doesn’t seem to concerned with those pathological findings, telling you that we’ll just watch those results and see how they are on the next follow-up and when that time comes the doctor does the same thing again?  Worse yet, does your doctor not even acknowledge the negative results and instead tells you that your blood work is fine, making up some lame excuse like it’s ok for your age and weight?

If that's the case it is imperative that you find someone who understands the interaction between Hypothyroidism, Diabetes and the rest of your body's systems.

The combination of these two diseases in one individual is a deadly serious problem that cannot be swept under the rug and ignored, you must find a doctor that fully understands the gravity of this situation and will give it the attention it deserves by analyzing all the facts from a functional medical perspective.

Fortunately, I have spent many countless hours on these specific disease processes. I have the background, knowledge and desire it takes to get to the root of your problems so that you don’t become a statistic of an ever increasingly cold and incompetent health care system.

Patients often times are forced to blindly travel down the path of poor health as it meanders along due to a doctor that is either far too busy, too lazy or just too damn stubborn to stay up to date with the most current scientific research.

Chronic health conditions such as these are given the most inadequate of care in our current health care system and a huge reason is the health insurance companies. You see, they are the controller of the money and they dictate what care a patient will receive; many times a doctor is unable to exercise their full clinical skills due to the fact that they wouldn't be reimbursed by the insurance company as well as they dare not go against what has been set as the "Standard Of Care" for a particular health condition even though that Care is generic in that it is based on the diagnosed condition and not based upon an individual patient's uniqueness.

Unfortunately our health care system for the chronically ill patient is broken and patient care is no longer based on the individual but instead, it is has become an assembly line of “cookie cutter” treatment protocols that do not deviate much from patient to patient within the same diagnosis.

If you have been in the medical system for any length of time, you know this to be the case.

You are expected to wait, sometimes hours after your appointment time to see the doctor, then, when you finally get into your exam room, the doctor asks you a few questions, may or may not order blood work and then write you a couple of prescriptions for Synthroid^®to cover the hypothyroid and Metformin^® for your diabetes.

They can’t take the time to explain why your blood work is the way it is, nor will they have an answer as to why you continue to feel as you did before beginning your thyroid replacement hormones and the diabetes support medications.

Don’t you think you deserve better than what you have been getting in regards to your healthcare?  

Isn’t your life as important as anyone else’s?

Shouldn’t the doctor you employ to recover your lost health make it his fundamental duty to do all that is within his God given talent and power so that you no longer continue on the downward spiral of decreasing health in which you find yourself now?

If you are finally sick and tired of being sick and tired and you want to find someone that cares as much about your health as you do, then call my office at 281-812-8101 and set up a free, no obligation Health Recovery Workshop so you may see for yourself that there is hope and you are not destined to live a life of misery.

My door is open for those that want to take responsibility for their own health and stop relying on some profit driven, corporate health insurance company with their doctors that feed into this international profit driven machine at the expense of their patients’ health and many times the patient pays the ultimate cost by losing that same health and life that they and entrusted with the doctor to protect, nurture and improve.

If you have any questions or just want to sit down and talk about the possible solutions to your health issues, then please give my office a call at: 281-812-8101.

If you want to learn more please go to my website at:

http://LifeChangingCareHouston.com

http://FixMyThyroidNow.com 
http://FixMyDiabetesNow.com

In Health,

Dr. Walter K. Crooks DM (P), DC, CCCN

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3 in 5 Kentucky adults favor a statewide smoking ban, according to an independent poll that may have oversampled smokers

By Al Cross
Kentucky Health News

Kentuckians now favor a statewide smoking ban by a margin of 3 to 2, according to the latest Kentucky Health Issues Poll conducted last fall for the Foundation for a Healthy Kentucky. Interestingly, 38 percent of the Kentucky adults polled said they were smokers, much more than the 29 percent found by a year-long federal survey. Among those identified as smokers, 37 percent favored such a law, while it was favored by 68 percent of former smokers and 75 percent of those who said they had never smoked.

Overall, 59 percent of those polled said they supported a state law that would prohibit smoking in most public places, including workplaces, public buildings, offices, restaurants and bars, while 38 percent said they opposed it and 4 percent said they had no opinion. The figures showed a 5-point shift toward support since the last poll, in 2011. The gain was among smokers and former smokers.

Support for the law was higher among registered voters than non-voters, perhaps a consideration for legislators considering the proposal. Among voters, 62 percent favored it while 36 percent opposed it. Only 50 percent of nonvoters supported it. Support was slightly higher among Republicans (64 percent) than among Democrats (59 percent; only 44 percent of independents, who comprise about 7 percent of Kentucky voters, said they supported it. The poll also found that support for the law increases as age and income increase.

As for the apparent oversampling of smokers, pollster Eric Rademacher said self-reporting of such habits is known to vary according to time, and the differences in his poll and the federal survey "are likely due to the different time frames in which they were conducted and the different methodology employed by each study." He added, "For example, a person who regularly smokes might openly disclose that information at one point in the year. However, at another point in the year, that same person might be directly exposed to news or advertising that paints smoking in a negative light from a societal perspective. Hearing that information could make the person more reluctant to discuss their smoking behavior with researchers soon after they have seen or heard it.”

Rademacher is co-director of the Institute for Policy Research at the University of Cincinnati, which did the poll for the foundation and the Health Foundation of Greater Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone from Sept. 20 to Oct. 14. This included 1,360 landline interviews and 320 interviews with cell phone users. In 19 of 20 cases, each statewide figure will be accurate to plus or minus 2.5 percentage points. Smaller samples, such as those of smokers and non-smokers, have larger margins of error. There are other sources of variation inherent in public opinion studies, such as non-response, question wording, or context effects that can introduce error or bias. For a copy of the poll's full questionnaire and guidance to interviewers, click here. For more information, go to www.healthy-ky.org
or www.healthfoundation.org/kentucky-health-issues-poll.

The Foundation for a Healthy Kentucky noted the health implications that a smoke-free law would address: "Secondhand smoke poses serious health risks. Smoke-free environments are the only way to fully protect nonsmokers from these hazards. To reduce these risks, many Kentucky communities have adopted smoke-free policies. On Jan. 1, 2013, Hopkinsville became the 22nd municipality in Kentucky to implement a comprehensive smoke-free ordinance or regulation," bringing to 34 percent the share of Kentuckians who live in jurisdictions covered by comprehensive smoke-free ordinances or health-department regulations. For a list of the communities and percentages, and those with bans that are less than comprehensive, from the Kentucky Center for Smoke-Free Policy, click here.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

By Al Cross
Kentucky Health News

Kentuckians now favor a statewide smoking ban by a margin of 3 to 2, according to the latest Kentucky Health Issues Poll conducted last fall for the Foundation for a Healthy Kentucky. Interestingly, 38 percent of the Kentucky adults polled said they were smokers, much more than the 29 percent found by a year-long federal survey. Among those identified as smokers, 37 percent favored such a law, while it was favored by 68 percent of former smokers and 75 percent of those who said they had never smoked.

Overall, 59 percent of those polled said they supported a state law that would prohibit smoking in most public places, including workplaces, public buildings, offices, restaurants and bars, while 38 percent said they opposed it and 4 percent said they had no opinion. The figures showed a 5-point shift toward support since the last poll, in 2011. The gain was among smokers and former smokers.

Support for the law was higher among registered voters than non-voters, perhaps a consideration for legislators considering the proposal. Among voters, 62 percent favored it while 36 percent opposed it. Only 50 percent of nonvoters supported it. Support was slightly higher among Republicans (64 percent) than among Democrats (59 percent; only 44 percent of independents, who comprise about 7 percent of Kentucky voters, said they supported it. The poll also found that support for the law increases as age and income increase.

As for the apparent oversampling of smokers, pollster Eric Rademacher said self-reporting of such habits is known to vary according to time, and the differences in his poll and the federal survey "are likely due to the different time frames in which they were conducted and the different methodology employed by each study." He added, "For example, a person who regularly smokes might openly disclose that information at one point in the year. However, at another point in the year, that same person might be directly exposed to news or advertising that paints smoking in a negative light from a societal perspective. Hearing that information could make the person more reluctant to discuss their smoking behavior with researchers soon after they have seen or heard it.”

Rademacher is co-director of the Institute for Policy Research at the University of Cincinnati, which did the poll for the foundation and the Health Foundation of Greater Cincinnati. A random sample of 1,680 adults from throughout Kentucky was interviewed by telephone from Sept. 20 to Oct. 14. This included 1,360 landline interviews and 320 interviews with cell phone users. In 19 of 20 cases, each statewide figure will be accurate to plus or minus 2.5 percentage points. Smaller samples, such as those of smokers and non-smokers, have larger margins of error. There are other sources of variation inherent in public opinion studies, such as non-response, question wording, or context effects that can introduce error or bias. For a copy of the poll's full questionnaire and guidance to interviewers, click here. For more information, go to www.healthy-ky.org
or www.healthfoundation.org/kentucky-health-issues-poll.

The Foundation for a Healthy Kentucky noted the health implications that a smoke-free law would address: "Secondhand smoke poses serious health risks. Smoke-free environments are the only way to fully protect nonsmokers from these hazards. To reduce these risks, many Kentucky communities have adopted smoke-free policies. On Jan. 1, 2013, Hopkinsville became the 22nd municipality in Kentucky to implement a comprehensive smoke-free ordinance or regulation," bringing to 34 percent the share of Kentuckians who live in jurisdictions covered by comprehensive smoke-free ordinances or health-department regulations. For a list of the communities and percentages, and those with bans that are less than comprehensive, from the Kentucky Center for Smoke-Free Policy, click here.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

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Legislature likely to tweak, clarify and limit last year's 'pill mill bill'

State lawmakers could narrow the focus of last year's "pill mill bill" during the legislative session that begins tomorrow, to concentrate on adults with long-term prescriptions for frequently abused painkillers, John Cheves of the Lexington Herald-Leader reported yesterday. Doctors, hospitals and patients have complained that HB 1 in its current from "restricts too many drugs in too many clinical settings, needlessly complicating medical care in an effort to shut down storefront pain clinics that recklessly hand out prescriptions," Cheves writes.

Under the law, people with long-term prescriptions for controlled substances must submit to urine drug testing to determine if they are actually taking the drug rather than selling it, and if other unprescribed drugs are in their systems. Some patients complained they were being charges hundreds of dollars for urine tests because their insurance companies denied coverage of such testing. One couple was charged more than $900 for tests to get prescriptions for insomnia and anti-anxiety medication.

The new rules, being drafted by the Kentucky Board of Medical Licensure, would reduce the mandate for drug screening to pain medicine prescriptions of 90 days or more. Other medications would not require testing unless the doctor thinks it's necessary. The new rules will say that other types of testing which would be cheaper, including hair, could be used. The board is also restricting its focus to powerful painkillers, including hydrocodone and oxycodone.

The new regulations are subject to approval by the legislature, which could write its own restrictions into law, but the consensus appears to be that the law needs tweaking, not major changes. for example, House Speaker Greg Stumbo said it should be changed to clarify that hospitals don't have to run a new background check on a patient every time they give another dose of a controlled substance during his stay. (Read more)

State lawmakers could narrow the focus of last year's "pill mill bill" during the legislative session that begins tomorrow, to concentrate on adults with long-term prescriptions for frequently abused painkillers, John Cheves of the Lexington Herald-Leader reported yesterday. Doctors, hospitals and patients have complained that HB 1 in its current from "restricts too many drugs in too many clinical settings, needlessly complicating medical care in an effort to shut down storefront pain clinics that recklessly hand out prescriptions," Cheves writes.

Under the law, people with long-term prescriptions for controlled substances must submit to urine drug testing to determine if they are actually taking the drug rather than selling it, and if other unprescribed drugs are in their systems. Some patients complained they were being charges hundreds of dollars for urine tests because their insurance companies denied coverage of such testing. One couple was charged more than $900 for tests to get prescriptions for insomnia and anti-anxiety medication.

The new rules, being drafted by the Kentucky Board of Medical Licensure, would reduce the mandate for drug screening to pain medicine prescriptions of 90 days or more. Other medications would not require testing unless the doctor thinks it's necessary. The new rules will say that other types of testing which would be cheaper, including hair, could be used. The board is also restricting its focus to powerful painkillers, including hydrocodone and oxycodone.

The new regulations are subject to approval by the legislature, which could write its own restrictions into law, but the consensus appears to be that the law needs tweaking, not major changes. for example, House Speaker Greg Stumbo said it should be changed to clarify that hospitals don't have to run a new background check on a patient every time they give another dose of a controlled substance during his stay. (Read more)

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Health agencies in Rockcastle, Jackson, Clay, Harlan to lose 14 employees, some environmental and food-safety inspections

In the latest example of Medicaid changes' impact on local health departments, environmental and food-safety inspections will be reduced by layoffs in four counties served by the Cumberland Valley District Health Department, Nola Sizemore of the Harlan Daily Enterprise reports. Health departments in Harlan, Rockcastle, Clay and Jackson counties will lose a total of 14 employees later this month. (Enterprise photo: Harlan County Health Department)

Health Department Interim Director Lynett Renner told Sizemore said the layoffs, along with furlough days, are a result of decreased funding and the "advent of managed care organizations" in November 2011. The agency has almost $1 million in outstanding accounts because payments from those organizations have been slow to come in. "Also, one of the things that affected the health departments tremendously is we’re the only provider in the state required to pay a Medicaid match, which means for every service we provide for a client who has Medicaid, we have to pay the state back 20 percent and that recently increased to 28 percent," Renner said.

Renner told Sizemore that environmental services and restaurant health inspections would be most affected, adding that public health is often taken for granted by the local community. "So much is done behind the scenes to ensure the health and safety of every citizens," she told Sizemore. "My fear is they're reducing the ability of the public health infrastructure to be able to maintain that level of service that provides protection." (Read more)

In the latest example of Medicaid changes' impact on local health departments, environmental and food-safety inspections will be reduced by layoffs in four counties served by the Cumberland Valley District Health Department, Nola Sizemore of the Harlan Daily Enterprise reports. Health departments in Harlan, Rockcastle, Clay and Jackson counties will lose a total of 14 employees later this month. (Enterprise photo: Harlan County Health Department)

Health Department Interim Director Lynett Renner told Sizemore said the layoffs, along with furlough days, are a result of decreased funding and the "advent of managed care organizations" in November 2011. The agency has almost $1 million in outstanding accounts because payments from those organizations have been slow to come in. "Also, one of the things that affected the health departments tremendously is we’re the only provider in the state required to pay a Medicaid match, which means for every service we provide for a client who has Medicaid, we have to pay the state back 20 percent and that recently increased to 28 percent," Renner said.

Renner told Sizemore that environmental services and restaurant health inspections would be most affected, adding that public health is often taken for granted by the local community. "So much is done behind the scenes to ensure the health and safety of every citizens," she told Sizemore. "My fear is they're reducing the ability of the public health infrastructure to be able to maintain that level of service that provides protection." (Read more)

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Danville newspaper examines problems hospitals and doctors have with state's managed-care Medicaid program

All the talk about "Obamacare" may have obscured Kentucky's biggest health-care story, Kendra Peek of The Advocate-Messenger in Danville suggests, in a look at Kentucky's troublesome shift to managed-care Medicaid. "It's the biggest story in the state that's not being told," said Vicki Darnell, president and CEO of Ephraim McDowell Regional Medical Center in Danville, told Peek. Her story is an example of how a smaller newspaper can show the impact of a statwwide policy. (A-M photo)

On Nov. 1, 2011, Medicaid in Kentucky switched to a managed care program, which essentially means management of Medicaid was outsourced to private insurance companies Peek reports. There are three managed care organizations (MCOs) statewide: Coventry Cares of Kentucky, Kentucky Spirit and WellCare of Kentucky.

The time for payments to doctors and hospitals has doubled since MCOs were implemented, McDowell Chief Financial Officer Bill Snapp told Peek. Before, they were getting paid for Medicaid patients' care within 17 to 20 days. Immediately after the switch, he said, it took as long as 70 days. Some private physicians have been forced to make hard financial decisions because of delays, and because MCOs reimburse doctors at "significantly lower rates than private insurers," Peek reports. Some hospitals, physicians and health departments have had to lay off employees, and some doctors are refusing to see Medicaid patients because they can't afford to.

In some cases, patients have had to find doctors or hospitals where the MCO they selected would be accepted, Peek reports. Hospitals cannot legally deny treatment to anyone based on insurance, but having to find hospitals or physicians that accept particular MCOs can become expensive out-of-pocket for patients. Some primary physicians may not be allowed to work at certain facilities, requiring their patients to be shifted to another doctor.

MCOs have been in the news for these issues. Coventry Cares canceled contracts with Appalachian Regional Healthcare, a network of hospitals in Eastern Kentucky, in a move that drew significant backlash. Kentucky Spirit has announced it would end its managed-care contract in July, saying it has concerns about the sustainability of the plan. (Read more)

All the talk about "Obamacare" may have obscured Kentucky's biggest health-care story, Kendra Peek of The Advocate-Messenger in Danville suggests, in a look at Kentucky's troublesome shift to managed-care Medicaid. "It's the biggest story in the state that's not being told," said Vicki Darnell, president and CEO of Ephraim McDowell Regional Medical Center in Danville, told Peek. Her story is an example of how a smaller newspaper can show the impact of a statwwide policy. (A-M photo)

On Nov. 1, 2011, Medicaid in Kentucky switched to a managed care program, which essentially means management of Medicaid was outsourced to private insurance companies Peek reports. There are three managed care organizations (MCOs) statewide: Coventry Cares of Kentucky, Kentucky Spirit and WellCare of Kentucky.

The time for payments to doctors and hospitals has doubled since MCOs were implemented, McDowell Chief Financial Officer Bill Snapp told Peek. Before, they were getting paid for Medicaid patients' care within 17 to 20 days. Immediately after the switch, he said, it took as long as 70 days. Some private physicians have been forced to make hard financial decisions because of delays, and because MCOs reimburse doctors at "significantly lower rates than private insurers," Peek reports. Some hospitals, physicians and health departments have had to lay off employees, and some doctors are refusing to see Medicaid patients because they can't afford to.

In some cases, patients have had to find doctors or hospitals where the MCO they selected would be accepted, Peek reports. Hospitals cannot legally deny treatment to anyone based on insurance, but having to find hospitals or physicians that accept particular MCOs can become expensive out-of-pocket for patients. Some primary physicians may not be allowed to work at certain facilities, requiring their patients to be shifted to another doctor.

MCOs have been in the news for these issues. Coventry Cares canceled contracts with Appalachian Regional Healthcare, a network of hospitals in Eastern Kentucky, in a move that drew significant backlash. Kentucky Spirit has announced it would end its managed-care contract in July, saying it has concerns about the sustainability of the plan. (Read more)

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WORLD RENOWNED HEART SURGEON SPEAKS OUT ON WHAT REALLY CAUSES HEART DISEASE

WORLD RENOWNED HEART SURGEON SPEAKS OUT ON WHAT REALLY CAUSES HEART DISEASE

A MUST READ FOR EVERYBODY!!!

We physicians with all our training, knowledge and authority often acquire a rather large ego that tends to make it difficult to admit we are wrong. So, here it is. I freely admit to being wrong. As a heart surgeon with 25 years experience and having performed over 5,000 open-heart surgeries, today is my day to right the wrong with medical and scientific fact.

I trained for many years with other prominent physicians labeled “opinion makers.” Bombarded with scientific literature, continually attending education seminars, we opinion makers insisted heart disease resulted from the simple fact of elevated blood cholesterol.

The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake. The latter of course we insisted would lower cholesterol and heart disease. Deviations from these recommendations were considered heresy and could quite possibly result in malpractice.

It Is Not Working!
These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated.

The long-established dietary recommendations have created epidemics of obesity and diabetes, the consequences of which dwarf any historical plague in terms of mortality, human suffering and dire economic consequences.

Despite the fact that 25% of the population takes expensive statin medications and despite the fact we have reduced the fat content of our diets, more Americans will die this year of heart disease than ever before.

Statistics from the American Heart Association show that 75 million Americans currently suffer from heart disease, 20 million have diabetes and 57 million have pre-diabetes. These disorders are affecting younger and younger people in greater numbers every year.



 Inflammation Inflammation Inflammation
 
Simply stated, without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped.

Inflammation is not complicated — it is quite simply your body’s natural defense to a foreign invader such as a bacteria, toxin or virus. The cycle of inflammation is perfect in how it protects your body from these bacterial and viral invaders. However, if we chronically expose the body to injury by toxins or foods the human body was never designed to process, a condition occurs called chronic inflammation. Chronic inflammation is just as harmful as acute inflammation is beneficial.

What thoughtful person would willfully expose himself repeatedly to foods or other substances that are known to cause injury to the body? Well, smokers perhaps, but at least they made that choice willfully.

The rest of us have simply followed the recommended mainstream diet that is low in fat and high in polyunsaturated fats and carbohydrates, not knowing we were causing repeated injury to our blood vessels. This repeated injury creates chronic inflammation leading to heart disease, stroke, diabetes and obesity.
Let me repeat that:  

The injury and inflammation in our blood vessels is caused by the low fat diet recommended for years by mainstream medicine.

From Dr. Walter K. Crooks: "What are the biggest culprits of chronic inflammation? Immune reactions to plant proteins such as Gluten (wheat, barley and rye) Casein (dairy) Soy. Also dietary yeast and eggs are known to cause these same reactions in susceptible individuals.

Simple sugars also cause chronic inflammation due to their influence on insulin, which is also inflammatory.  When highly refined foods are consumed they cause a spike in insulin production which caused global body inflammation."

Take a moment to visualize rubbing a stiff brush repeatedly over soft skin until it becomes quite red and nearly bleeding. You kept this up several times a day, every day for five years. If you could tolerate this painful brushing, you would have a bleeding, swollen infected area that became worse with each repeated injury. This is a good way to visualize the inflammatory process that could be going on in your body right now.

Regardless of where the inflammatory process occurs, externally or internally, it is the same. I have peered inside thousands upon thousands of arteries. A diseased artery looks as if someone took a brush and scrubbed repeatedly against its wall. Several times a day, every day, the foods we eat create small injuries compounding into more injuries, causing the body to respond continuously and appropriately with inflammation.

Sweet Rolls Ain't Good For Your Sweetie's Health! 
While we savor the tantalizing taste of a sweet roll, our bodies respond alarmingly as if a foreign invader arrived declaring war. Foods loaded with sugars and simple carbohydrates, or processed with omega-6 oils for long shelf life have been the mainstay of the American diet for six decades. These foods have been slowly poisoning everyone.

How does eating a simple sweet roll create a cascade of inflammation to make you sick?

Imagine spilling syrup on your keyboard and you have a visual of what occurs inside the cell. When we consume simple carbohydrates such as sugar, blood sugar rises rapidly. In response, your pancreas secretes insulin whose primary purpose is to drive sugar into each cell where it is stored for energy. If the cell is full and does not need glucose, it is rejected to avoid extra sugar gumming up the works.

When your full cells reject the extra glucose, blood sugar rises producing more insulin and the glucose converts to stored fat.
What does all this have to do with inflammation? Blood sugar is controlled in a very narrow range. Extra sugar molecules attach to a variety of proteins that in turn injure the blood vessel wall. This repeated injury to the blood vessel wall sets off inflammation. When you spike your blood sugar level several times a day, every day, it is exactly like taking sandpaper to the inside of your delicate blood vessels.

While you may not be able to see it, rest assured it is there. I saw it in over 5,000 surgical patients spanning 25 years who all shared one common denominator — inflammation in their arteries.
Let’s get back to the sweet roll. That innocent looking goody not only contains sugars, it is baked in one of many omega-6 oils such as soybean. Chips and fries are soaked in soybean oil; processed foods are manufactured with omega-6 oils for longer shelf life. While omega-6’s are essential -they are part of every cell membrane controlling what goes in and out of the cell – they must be in the correct balance with omega-3’s.

If the balance shifts by consuming excessive omega-6, the cell membrane produces chemicals called cytokines that directly cause inflammation.

Today’s mainstream American diet has produced an extreme imbalance of these two fats. The ratio of imbalance ranges from 15:1 to as high as 30:1 in favor of omega-6. That’s a tremendous amount of cytokines causing inflammation. In today’s food environment, a 3:1 ratio would be optimal and healthy.

To make matters worse, the excess weight you are carrying from eating these foods creates overloaded fat cells that pour out large quantities of pro-inflammatory chemicals that add to the injury caused by having high blood sugar. The process that began with a sweet roll turns into a vicious cycle over time that creates heart disease, high blood pressure, diabetes and finally, Alzheimer’s disease, as the inflammatory process continues unabated.
Processed Foods Will Kill You
There is no escaping the fact that the more we consume prepared and processed foods, the more we trip the inflammation switch little by little each day. The human body cannot process, nor was it designed to consume, foods packed with sugars and soaked in omega-6 oils.

There is but one answer to quieting inflammation, and that is returning to foods closer to their natural state. To build muscle, eat more protein. Choose carbohydrates that are very complex such as colorful fruits and vegetables. Cut down on or eliminate inflammation- causing omega-6 fats like corn and soybean oil and the processed foods that are made from them.

One tablespoon of corn oil contains 7,280 mg of omega-6; soybean contains 6,940 mg. Instead, use olive oil or butter from grass-fed beef (Don't consume butter if you are reactive to dairy- Dr. Crooks).
Saturated Fats Are Your Friends
Animal fats contain less than 20% omega-6 and are much less likely to cause inflammation than the supposedly healthy oils labeled polyunsaturated. Forget the “science” that has been drummed into your head for decades. The science that saturated fat alone causes heart disease is non-existent. The science that saturated fat raises blood cholesterol is also very weak. Since we now know that cholesterol is not the cause of heart disease, the concern about saturated fat is even more absurd today.

The cholesterol theory led to the no-fat, low-fat recommendations that in turn created the very foods now causing an epidemic of inflammation. Mainstream medicine made a terrible mistake when it advised people to avoid saturated fat in favor of foods high in omega-6 fats. We now have an epidemic of arterial inflammation leading to heart disease and other silent killers.

What you can do is choose whole foods your grandmother served and not those your mom turned to as grocery store aisles filled with manufactured foods. By eliminating inflammatory foods and adding essential nutrients from fresh unprocessed food, you will reverse years of damage in your arteries and throughout your body from consuming the typical American diet.
Dr. Dwight Lundell's Bio:
He is the past Chief of Staff and Chief of Surgery at Banner Heart Hospital , Mesa , AZ. His private practice, Cardiac Care Center was in Mesa, AZ. Recently Dr. Lundell left surgery to focus on the nutritional treatment of heart disease. He is the founder of Healthy Humans Foundation that promotes human health with a focus on helping large corporations promote wellness.

WORLD RENOWNED HEART SURGEON SPEAKS OUT ON WHAT REALLY CAUSES HEART DISEASE

A MUST READ FOR EVERYBODY!!!

We physicians with all our training, knowledge and authority often acquire a rather large ego that tends to make it difficult to admit we are wrong. So, here it is. I freely admit to being wrong. As a heart surgeon with 25 years experience and having performed over 5,000 open-heart surgeries, today is my day to right the wrong with medical and scientific fact.

I trained for many years with other prominent physicians labeled “opinion makers.” Bombarded with scientific literature, continually attending education seminars, we opinion makers insisted heart disease resulted from the simple fact of elevated blood cholesterol.

The only accepted therapy was prescribing medications to lower cholesterol and a diet that severely restricted fat intake. The latter of course we insisted would lower cholesterol and heart disease. Deviations from these recommendations were considered heresy and could quite possibly result in malpractice.

It Is Not Working!
These recommendations are no longer scientifically or morally defensible. The discovery a few years ago that inflammation in the artery wall is the real cause of heart disease is slowly leading to a paradigm shift in how heart disease and other chronic ailments will be treated.

The long-established dietary recommendations have created epidemics of obesity and diabetes, the consequences of which dwarf any historical plague in terms of mortality, human suffering and dire economic consequences.

Despite the fact that 25% of the population takes expensive statin medications and despite the fact we have reduced the fat content of our diets, more Americans will die this year of heart disease than ever before.

Statistics from the American Heart Association show that 75 million Americans currently suffer from heart disease, 20 million have diabetes and 57 million have pre-diabetes. These disorders are affecting younger and younger people in greater numbers every year.



 Inflammation Inflammation Inflammation
 
Simply stated, without inflammation being present in the body, there is no way that cholesterol would accumulate in the wall of the blood vessel and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body as nature intended. It is inflammation that causes cholesterol to become trapped.

Inflammation is not complicated — it is quite simply your body’s natural defense to a foreign invader such as a bacteria, toxin or virus. The cycle of inflammation is perfect in how it protects your body from these bacterial and viral invaders. However, if we chronically expose the body to injury by toxins or foods the human body was never designed to process, a condition occurs called chronic inflammation. Chronic inflammation is just as harmful as acute inflammation is beneficial.

What thoughtful person would willfully expose himself repeatedly to foods or other substances that are known to cause injury to the body? Well, smokers perhaps, but at least they made that choice willfully.

The rest of us have simply followed the recommended mainstream diet that is low in fat and high in polyunsaturated fats and carbohydrates, not knowing we were causing repeated injury to our blood vessels. This repeated injury creates chronic inflammation leading to heart disease, stroke, diabetes and obesity.
Let me repeat that:  

The injury and inflammation in our blood vessels is caused by the low fat diet recommended for years by mainstream medicine.

From Dr. Walter K. Crooks: "What are the biggest culprits of chronic inflammation? Immune reactions to plant proteins such as Gluten (wheat, barley and rye) Casein (dairy) Soy. Also dietary yeast and eggs are known to cause these same reactions in susceptible individuals.

Simple sugars also cause chronic inflammation due to their influence on insulin, which is also inflammatory.  When highly refined foods are consumed they cause a spike in insulin production which caused global body inflammation."

Take a moment to visualize rubbing a stiff brush repeatedly over soft skin until it becomes quite red and nearly bleeding. You kept this up several times a day, every day for five years. If you could tolerate this painful brushing, you would have a bleeding, swollen infected area that became worse with each repeated injury. This is a good way to visualize the inflammatory process that could be going on in your body right now.

Regardless of where the inflammatory process occurs, externally or internally, it is the same. I have peered inside thousands upon thousands of arteries. A diseased artery looks as if someone took a brush and scrubbed repeatedly against its wall. Several times a day, every day, the foods we eat create small injuries compounding into more injuries, causing the body to respond continuously and appropriately with inflammation.

Sweet Rolls Ain't Good For Your Sweetie's Health! 
While we savor the tantalizing taste of a sweet roll, our bodies respond alarmingly as if a foreign invader arrived declaring war. Foods loaded with sugars and simple carbohydrates, or processed with omega-6 oils for long shelf life have been the mainstay of the American diet for six decades. These foods have been slowly poisoning everyone.

How does eating a simple sweet roll create a cascade of inflammation to make you sick?

Imagine spilling syrup on your keyboard and you have a visual of what occurs inside the cell. When we consume simple carbohydrates such as sugar, blood sugar rises rapidly. In response, your pancreas secretes insulin whose primary purpose is to drive sugar into each cell where it is stored for energy. If the cell is full and does not need glucose, it is rejected to avoid extra sugar gumming up the works.

When your full cells reject the extra glucose, blood sugar rises producing more insulin and the glucose converts to stored fat.
What does all this have to do with inflammation? Blood sugar is controlled in a very narrow range. Extra sugar molecules attach to a variety of proteins that in turn injure the blood vessel wall. This repeated injury to the blood vessel wall sets off inflammation. When you spike your blood sugar level several times a day, every day, it is exactly like taking sandpaper to the inside of your delicate blood vessels.

While you may not be able to see it, rest assured it is there. I saw it in over 5,000 surgical patients spanning 25 years who all shared one common denominator — inflammation in their arteries.
Let’s get back to the sweet roll. That innocent looking goody not only contains sugars, it is baked in one of many omega-6 oils such as soybean. Chips and fries are soaked in soybean oil; processed foods are manufactured with omega-6 oils for longer shelf life. While omega-6’s are essential -they are part of every cell membrane controlling what goes in and out of the cell – they must be in the correct balance with omega-3’s.

If the balance shifts by consuming excessive omega-6, the cell membrane produces chemicals called cytokines that directly cause inflammation.

Today’s mainstream American diet has produced an extreme imbalance of these two fats. The ratio of imbalance ranges from 15:1 to as high as 30:1 in favor of omega-6. That’s a tremendous amount of cytokines causing inflammation. In today’s food environment, a 3:1 ratio would be optimal and healthy.

To make matters worse, the excess weight you are carrying from eating these foods creates overloaded fat cells that pour out large quantities of pro-inflammatory chemicals that add to the injury caused by having high blood sugar. The process that began with a sweet roll turns into a vicious cycle over time that creates heart disease, high blood pressure, diabetes and finally, Alzheimer’s disease, as the inflammatory process continues unabated.
Processed Foods Will Kill You
There is no escaping the fact that the more we consume prepared and processed foods, the more we trip the inflammation switch little by little each day. The human body cannot process, nor was it designed to consume, foods packed with sugars and soaked in omega-6 oils.

There is but one answer to quieting inflammation, and that is returning to foods closer to their natural state. To build muscle, eat more protein. Choose carbohydrates that are very complex such as colorful fruits and vegetables. Cut down on or eliminate inflammation- causing omega-6 fats like corn and soybean oil and the processed foods that are made from them.

One tablespoon of corn oil contains 7,280 mg of omega-6; soybean contains 6,940 mg. Instead, use olive oil or butter from grass-fed beef (Don't consume butter if you are reactive to dairy- Dr. Crooks).
Saturated Fats Are Your Friends
Animal fats contain less than 20% omega-6 and are much less likely to cause inflammation than the supposedly healthy oils labeled polyunsaturated. Forget the “science” that has been drummed into your head for decades. The science that saturated fat alone causes heart disease is non-existent. The science that saturated fat raises blood cholesterol is also very weak. Since we now know that cholesterol is not the cause of heart disease, the concern about saturated fat is even more absurd today.

The cholesterol theory led to the no-fat, low-fat recommendations that in turn created the very foods now causing an epidemic of inflammation. Mainstream medicine made a terrible mistake when it advised people to avoid saturated fat in favor of foods high in omega-6 fats. We now have an epidemic of arterial inflammation leading to heart disease and other silent killers.

What you can do is choose whole foods your grandmother served and not those your mom turned to as grocery store aisles filled with manufactured foods. By eliminating inflammatory foods and adding essential nutrients from fresh unprocessed food, you will reverse years of damage in your arteries and throughout your body from consuming the typical American diet.
Dr. Dwight Lundell's Bio:
He is the past Chief of Staff and Chief of Surgery at Banner Heart Hospital , Mesa , AZ. His private practice, Cardiac Care Center was in Mesa, AZ. Recently Dr. Lundell left surgery to focus on the nutritional treatment of heart disease. He is the founder of Healthy Humans Foundation that promotes human health with a focus on helping large corporations promote wellness.

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