The drag queens of the conservative right

(I apologize in advance to my drag queen friends for putting them in the same sentence as the conservative extremists -- I merely do this to make a point) 

Who among us can forget the 1980s? I would guess that most of my readers were conscious adults during that glorious decade. Having come to this country as a young teen in the late '70s, I enjoyed the '80s as my time of initiation into the American culture. It was then that I became aware of such iconic symbols as the Brady Bunch, The Doors, and... drag queens. Yes, drag queens. As the struggle for gay equality permeated our collective consciousness, I began to notice a plethora of drag queens in the press's coverage of gay pride events. And a lot of very tough women in leather jackets on motorcycles. Just like most people in that era, I was not aware of any gay people in my immediate circle, so I had to assume that these flamboyant and memorable images were representative of the gay community at large. 

Well, my views grew up. As I learned more, I realized that the lovely drag queens and the charming biker lesbians were but the tip of the gay iceberg, images that in those days had sure shock value and sold news. The vast majority of the gay community, as it turned out, was virtually indistinguishable from heterosexuals. And for this reason, they were not newsworthy. 

I find the attention-grabbing efforts of the conservative extremists at hijacking our national healthcare discussion akin to the coverage of gay pride during the '80s: just the drag queens (though not nearly as charming and genuine) and no average gay people. Does Sarah Palin really represent the entire Republican party? Don't tell me that the hatred spewed hourly by the likes of Rush, Glenn and Bill does not make an average Republican cringe! Where are the voices of reason?

Another group that amazed and surprised my immigrant sensibilities in the 1980s was The Moral Majority. I remember finally someone coming out with the slogan "Moral Majority is neither". Today we have the extreme right purporting to represent the Republican majority and fiscal conservatism. In fact, they do neither. This emperor has no clothes.      

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The drag queens of the conservative right

(I apologize in advance to my drag queen friends for putting them in the same sentence as the conservative extremists -- I merely do this to make a point) 

Who among us can forget the 1980s? I would guess that most of my readers were conscious adults during that glorious decade. Having come to this country as a young teen in the late '70s, I enjoyed the '80s as my time of initiation into the American culture. It was then that I became aware of such iconic symbols as the Brady Bunch, The Doors, and... drag queens. Yes, drag queens. As the struggle for gay equality permeated our collective consciousness, I began to notice a plethora of drag queens in the press's coverage of gay pride events. And a lot of very tough women in leather jackets on motorcycles. Just like most people in that era, I was not aware of any gay people in my immediate circle, so I had to assume that these flamboyant and memorable images were representative of the gay community at large. 

Well, my views grew up. As I learned more, I realized that the lovely drag queens and the charming biker lesbians were but the tip of the gay iceberg, images that in those days had sure shock value and sold news. The vast majority of the gay community, as it turned out, was virtually indistinguishable from heterosexuals. And for this reason, they were not newsworthy. 

I find the attention-grabbing efforts of the conservative extremists at hijacking our national healthcare discussion akin to the coverage of gay pride during the '80s: just the drag queens (though not nearly as charming and genuine) and no average gay people. Does Sarah Palin really represent the entire Republican party? Don't tell me that the hatred spewed hourly by the likes of Rush, Glenn and Bill does not make an average Republican cringe! Where are the voices of reason?

Another group that amazed and surprised my immigrant sensibilities in the 1980s was The Moral Majority. I remember finally someone coming out with the slogan "Moral Majority is neither". Today we have the extreme right purporting to represent the Republican majority and fiscal conservatism. In fact, they do neither. This emperor has no clothes.      

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Absence-of-evidence based medicine

The term evidence-based medicine has made it into our colloquial language over the last decade. David Sackett, considered one of the founding fathers of the movement, defined it as

... the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research." (Sackett D, 1996)

The reality is that only about 5% of all medical practice recommendations have good quality evidence behind them, and perhaps another quarter have some evidence. The rest of medicine is practiced by "the seat of the pants" approach, or "the 15 years of experience" method. Clearly, this is not wrong when there is absence of evidence.

It is a fallacy, however, to confuse this absence of evidence with the evidence of absence of an association or an effect. What I mean by this is that in the former no one has bothered to generate the evidence, whereas in the latter there is evidence that does not support an association between the exposure and outcome. The latter is in fact evidence, while the former is absence of any evidence.

The distinction may be subtle, but is worth making. Take some of our environmental policies, for example. There are 80,000 potentially toxic chemicals on the market, including household cleaners, pesticides, etc., of which only 200 have been evaluated for toxicity by the government agencies. Does this represent the evidence of absence of any harm to human health? Of course not! This is a clear case of absence of evidence -- we have not deemed it fit to put resources into investigating the association between exposures to these chemicals and health. So to say that these chemicals are harmless would be a fallacy in the absence of a concerted effort to study them in the context of public's health.

Similarly, because our adverse drug reactions reporting system has traditionally been voluntary, the absence of reporting does not equal the absence of adverse events. Again, a classic situation of absence of evidence and NOT evidence of absence of these events.

So, given what I have just said, it is in fact difficult to practice evidence-based medicine or evidence-based public health. Unfortunately, even the evidence that exists is slow to wend its way into practice. As the RAND researchers demonstrated several years ago, the median penetration of evidence into practice is on the order of 50%, which is no better than a coin toss! So, we can certainly do better than that. When there is evidence. But, let's not be fooled: most of the time what we end up practicing is absence-of-evidence based medicine. Question your doctors closely to distinguish between the two, as this distinction is the key to rational decision making.

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Absence-of-evidence based medicine

The term evidence-based medicine has made it into our colloquial language over the last decade. David Sackett, considered one of the founding fathers of the movement, defined it as

... the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research." (Sackett D, 1996)

The reality is that only about 5% of all medical practice recommendations have good quality evidence behind them, and perhaps another quarter have some evidence. The rest of medicine is practiced by "the seat of the pants" approach, or "the 15 years of experience" method. Clearly, this is not wrong when there is absence of evidence.

It is a fallacy, however, to confuse this absence of evidence with the evidence of absence of an association or an effect. What I mean by this is that in the former no one has bothered to generate the evidence, whereas in the latter there is evidence that does not support an association between the exposure and outcome. The latter is in fact evidence, while the former is absence of any evidence.

The distinction may be subtle, but is worth making. Take some of our environmental policies, for example. There are 80,000 potentially toxic chemicals on the market, including household cleaners, pesticides, etc., of which only 200 have been evaluated for toxicity by the government agencies. Does this represent the evidence of absence of any harm to human health? Of course not! This is a clear case of absence of evidence -- we have not deemed it fit to put resources into investigating the association between exposures to these chemicals and health. So to say that these chemicals are harmless would be a fallacy in the absence of a concerted effort to study them in the context of public's health.

Similarly, because our adverse drug reactions reporting system has traditionally been voluntary, the absence of reporting does not equal the absence of adverse events. Again, a classic situation of absence of evidence and NOT evidence of absence of these events.

So, given what I have just said, it is in fact difficult to practice evidence-based medicine or evidence-based public health. Unfortunately, even the evidence that exists is slow to wend its way into practice. As the RAND researchers demonstrated several years ago, the median penetration of evidence into practice is on the order of 50%, which is no better than a coin toss! So, we can certainly do better than that. When there is evidence. But, let's not be fooled: most of the time what we end up practicing is absence-of-evidence based medicine. Question your doctors closely to distinguish between the two, as this distinction is the key to rational decision making.

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What kind of people guaranteed by the compulsory health insurance with public funding?

What kind of people guaranteed by the compulsory health insurance with public funding?

Public funds by compulsory health insurance in a group of persons defined in the Law of Health Insurance. Public funds by the compulsory health insurance covering individuals, territorial sickness funds to be included in the insured by compulsory health insurance net, together with a valid identity document and must submit documentation to show that health insurance compulsory, prohibit public funds:

* Those who accepted the law of the Republic of Lithuania set the type of pension or compensation for social assistance - these people at the local hospital to be included in the fund is guaranteed by the compulsory health insurance is not required because the netting data on territorial sickness funds information data schema to the State Social Insurance Fund Board;
* Working age people who have homes listed from the exchange of labor as a willing and able to perform a specific job - the job ieškančiojo certificate;
* Unemployment necessary working age people with state laws of social pension insurance for old state social insurance pension - the State Social Insurance Fund Council issued a statement about the state social pension insurance for the state social insurance old-age pension;
* Women with the procedures established by law granted maternity leave and employment for women during pregnancy, 70 days (after the expiration of 28 weeks of gestation or more) before birth and 56 days after birth - from the health care institution issued a certificate of registration of pregnant women pregnant netting ;
* One of the parents (adoptive parents), grew at children under 8 years old, is also one of the parents (adoptive parents), growing two or more small children and child / children's birth certificates;
* People under 18 years - these people at the local hospital to be included in the funds guaranteed by the compulsory health insurance netting is not required;
* Republic of Lithuania in general education, vocational, higher education and further full-time student and student - student / student certificate of citizenship of the Republic of Lithuania and citizens from these countries and people without citizenship residing permanently in Lithuania, the state EU countries are enrolled in school full time - students Certificate and Higher School Certificate, which states that the person is studying in high school full time, which indicates the study period;
* State support for individuals who receive social benefits - the city (district) municipalities of the Ministry of Social Affairs issued a statement of social benefits;
* One of the parents (adoptive parents), guardian or trustee, the nursing home level of disability (disabled children), or the person who declared unfit for work (before 1 July 2005 to June - Group I invalid) until 24 years , or a person recognized as unfit for work (before 1 July 2005 to June - Group I disability) before 26 years of disease caused by 24 years, or the special needs of people who constantly care (until July 1, 2005 until June -- Full Handicap):
1. one parent at home caring for a disabled child - the child's birth certificate and certificate of disability;
2 one parent caring for a person declared unfit for work for 24 years, or those who declared unfit for work until 26 years from disease caused by 24 years - caring for people with disabilities birth certificate and a certificate stating that the person is declared unfit for work up to 24 years old or under 26 years of disease caused by 24 years;
3 single parent caring for people who continually special needs care - caring for the birth certificate and proof of the need for constant care;
4 wali (guardian), caring for disabled children - caring for children with disabilities certificate, the district (city) Municipal Council (Mayor) decision on the child's guardian (guardian) award;
5 carers, nursing homes people found unfit for work for 24 years, or those who declared unfit for work until 26 years from disease caused by 24 years - the court ruling giving custody and neveiksniam people under the umbrella of personal disability certificate stating that the person is declared unfit for work up until 24 years or 26 years of disease caused by 24 years;
6 carers caring for people who continually special needs care - a decision the court gave custody of documents neveiksniam people and certification needs constant care;
7 trustee, nursing homes people found unfit for work for 24 years, or those who declared unfit for work until 26 years from disease caused by 24 years - a court decision to provide limited welfare veiksniam person or court order to welfare of people who because of their health status can not apply themselves of their rights and perform tasks and disability certificate stating that the person is declared unfit for work up to 24 years old or under 26 years of disease caused by 24 years;
8 carers, caring for people who continually special needs care - a court decision to provide limited welfare veiksniam person or court order for the welfare of people because of their health status can not independently exercise the right and duty, and a certification document the need for continued treatment constantly;
* People, according to the law to recognize people with disabilities - disabilities license;
* People who suffer from dangerous diseases to the public, which includes the Ministry of Health list - private health care institution that issued the certificate of illness / disease;
* Resistance (Resistance) participants - soldiers, volunteers, participants in the struggle for independence; former ghetto and former fascist minors forced to places of detention prisoners, rehabilitation of political prisoners and those who identified with them, refugees and people those who identified with them and those affected by the 1991 January 13 th, or other events to maintain independence and statehood of Lithuania - Lithuanian Genocide and Resistance Research Center released a statement about someone following membership (or one of them) groups;
* People who have contributed to the Chernobyl nuclear power plant accident reconstruction;
* The people in accordance with the laws of war in Afghanistan is a recognized legal status of participants, - the local territorial military office issued a statement about someone following membership (or one of them) groups;
* Before you reach retirement age and who is not insured income of the couple the President - Presidential term of office;
* State-recognized religious communities of priests, clergy training school students and out of the convent novitiate formation vienuolinę immigrants - the people at the local hospital to be included in the fund is guaranteed by the compulsory health insurance is not required because the netting data on territorial sickness funds information data schema Bishop Lithuania 'Conference;
* Accompanied children under the age of foreigners - minors who represented parties must produce evidence of representation;
* Additional and temporary protection in the Republic of Lithuania received by foreigners:
1. those who identified the body of a disease or condition, including the Ministry of Health, approved list - private health care institution issued a certificate stating that the person who found a disease or condition of the body and for temporary residence in Lithuania;
Single parent with 2 small children - kids / children's identity documents, a statement from the country-side or other authorized agencies and members of the family's temporary residence in the Republic of Lithuania;
3 women during pregnancy, 70 days before delivery and 56 days after birth - from the health care institution issued a certificate of registration of pregnant women pregnant women and netting for temporary residence in Lithuania;
4 people who reach the age of the Republic of Lithuania, the retirement age legislation - live temporarily in the Republic of Lithuania;
5 people under 18 years old - live temporarily in Lithuania.

Republic of Lithuania and temporary protection for people who are given temporary residence in Lithuania should be the entry "40 Art UTPĮ. 1 9 P. UTPĮ 40 or Art. 1 10 p.", which states that people who were given the protection of the Republic of Lithuania.

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New 'CMIO' stories

The long-awaited second issue of CMIO is out, and now it's going to a regular, bimonthly publishing schedule. I tell you this because I have two feature stories in this issue, including the cover story on health information exchange.

I also wrote a feature on "meaningful use" of health IT. That, of course, is the standard for qualifying for federal EHR subsidies starting in 2011.

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Resource-constrained medical situations: What would a grown-up do?

Today the Institute of Medicine has released their "Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations". This report was specifically commissioned by Nicole Lurie, MD, MSPH, the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services. The committee was charged with the following:
1). Identify and describe key elements to include in standards of care protocols to develop a framework for care in crisis situations.
2). Review roles and responsibilities as well as ways of integrating public opinion in the guidance.
3). Incorporate ethical principles into the guidance.

The committee admits that, due to an "accelerated time frame", they might not have examined the totality of evidence or included all relevant stakeholders. This begs the question of why the time line was so aggressive, given that we have been expecting an avian flu pandemic for years. Is this yet another failure of the previous administration or just the usual government inefficiency? I give Nicole Lurie credit for jumping into this morass with much needed alacrity.

Nevertheless, their conclusions are sobering (and not unlike what I have written in my previous posts on the matter). They state

... the committee recognizes that although some federal, state, municipality, territorial, and health-sector agencies and institutions have made considerable progress in developing protocols, many states have only just begun to address this urgent need. [emphasis mine]

Additionally, the IOM committee concludes that

... there is an urgent and clear need for a single national guidance for states for crisis events and is not specific to certain event. [emphasis mine]

The committee then goes on to define what they call "crisis standard of care", which is "the level of health and medical care capable of being delivered during a catastrophic event". The change in the level of care is to be declared by the state government. They then go on to develop ethical drivers for crisis standards, emphasizing fairness, equitability, community and provider education and communication, and the rule of law. Finally, the report makes specific recommendations for the states for the development of these standards of care.

Now, it is obvious that there is plenty of room for paranoia, similar to what we have witnessed recently in conjunction with our healthcare reform discussions, to hijack this very important topic. If that is the way we choose to handle the matter, the results are potentially disastrous. Instead, the press really need to step up to the plate and present a rational and nuanced discussion of the realities of the choices in the setting of a crisis. The lazy and insidious metaphors of fascism, socialism, communism, Hitler, Stalin, McCarthy, etc., accomplish nothing other than to promote chaos (we have to ask ourselves what the advantages of chaos may be for those who are working so hard to promote it).

The fundamental question is "What is the role of the government in a crisis situation?" I am certainly not a civics scholar, but it seems reasonable to expect the government to act in the best interest of all citizenry, to be a unifying force where there needs to be a concerted response, and to promote fairness and equity within some ethically accepted standards. In a potential mass casualty like H1N1 pandemic, the resource constraints are real. Instead of saying an outright "no" to any plans, be they from Washington, the states, or the healthcare institutions, let's engage in a logical public dialogue. Like grown-ups. As I've said before, we won't all agree, but we should all have our polite and considered say. That is, after all, what Democracy is all about!

 

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Resource-constrained medical situations: What would a grown-up do?

Today the Institute of Medicine has released their "Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations". This report was specifically commissioned by Nicole Lurie, MD, MSPH, the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services. The committee was charged with the following:
1). Identify and describe key elements to include in standards of care protocols to develop a framework for care in crisis situations.
2). Review roles and responsibilities as well as ways of integrating public opinion in the guidance.
3). Incorporate ethical principles into the guidance.

The committee admits that, due to an "accelerated time frame", they might not have examined the totality of evidence or included all relevant stakeholders. This begs the question of why the time line was so aggressive, given that we have been expecting an avian flu pandemic for years. Is this yet another failure of the previous administration or just the usual government inefficiency? I give Nicole Lurie credit for jumping into this morass with much needed alacrity.

Nevertheless, their conclusions are sobering (and not unlike what I have written in my previous posts on the matter). They state

... the committee recognizes that although some federal, state, municipality, territorial, and health-sector agencies and institutions have made considerable progress in developing protocols, many states have only just begun to address this urgent need. [emphasis mine]

Additionally, the IOM committee concludes that

... there is an urgent and clear need for a single national guidance for states for crisis events and is not specific to certain event. [emphasis mine]

The committee then goes on to define what they call "crisis standard of care", which is "the level of health and medical care capable of being delivered during a catastrophic event". The change in the level of care is to be declared by the state government. They then go on to develop ethical drivers for crisis standards, emphasizing fairness, equitability, community and provider education and communication, and the rule of law. Finally, the report makes specific recommendations for the states for the development of these standards of care.

Now, it is obvious that there is plenty of room for paranoia, similar to what we have witnessed recently in conjunction with our healthcare reform discussions, to hijack this very important topic. If that is the way we choose to handle the matter, the results are potentially disastrous. Instead, the press really need to step up to the plate and present a rational and nuanced discussion of the realities of the choices in the setting of a crisis. The lazy and insidious metaphors of fascism, socialism, communism, Hitler, Stalin, McCarthy, etc., accomplish nothing other than to promote chaos (we have to ask ourselves what the advantages of chaos may be for those who are working so hard to promote it).

The fundamental question is "What is the role of the government in a crisis situation?" I am certainly not a civics scholar, but it seems reasonable to expect the government to act in the best interest of all citizenry, to be a unifying force where there needs to be a concerted response, and to promote fairness and equity within some ethically accepted standards. In a potential mass casualty like H1N1 pandemic, the resource constraints are real. Instead of saying an outright "no" to any plans, be they from Washington, the states, or the healthcare institutions, let's engage in a logical public dialogue. Like grown-ups. As I've said before, we won't all agree, but we should all have our polite and considered say. That is, after all, what Democracy is all about!

 

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Compilation: H1N1 and ICU prioritization plans resources

Here are some approaches that have been suggested for how to prioritize limited ICU resources in a case of a mass casualty/pandemic situation. Some of the key points are:
1. Need to codify these protocols prior to the actual event, so as to maximize efficiency and minimize chaos
2. It is desirable to get community buy-in
3. Broad adoption is also needed to avoid litigation downstream

Here are some resources:
1. The Canadian protocol
2. American College of Chest Physicians disaster preparedness presentation
3. Recent joint MA DPH and HSPH statement on altered standards during a pandemic
4. Critical care during epidemics
5. Allocation of vents in a public health disaster (from NYC DPH)
6. SCCM podcast from Dr. Randy Wax
7. Chest Journal supplement: Definitive care for the critically ill during a disaster
8. Canadian Pandemic Resources for Critical Care
9. NYS DOH draft document on ventilator allocation (hat tip to Scott Hensley)

And here are a few posts on this blog that have discussed some of the issues:
1. Imagination and H1N1 preparedness
2. A narrowing window of opportunity
3. H1N1: Why we are unprepared
4. H1N1 predictions demystified
5. Notes from a pandemic

This is by no means an exhaustive list, but just some stuff I could come up with off the top of my head. Please, feel free to suggest other relevant resources in your comments.

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What’s missing in Health ICT? It’s the “C”!

Last Friday, I had an opportunity to spend part of the afternoon with Dr. Don Detmer (right) during his visit to Microsoft Research. If the name isn’t familiar, Dr. Detmer is a surgeon and the immediate past president of AMIA, the American Medical Informatics Association. He is also Professor of Medical Education at the University of Virginia. You can learn more about his distinguished career here.

As fellow clinicians and champions for greater use of ICT (Information Communications Technology) in health and healthcare, Don and I hit it off immediately. We also agreed that the missing piece in the use of ICT in clinical medicine today isn’t so much the “I” but rather the “C”. In fact, when Don talks about CT he doesn’t mean those big pieces of imaging equipment that scan your body; he’s talking about Communication and Collaboration technologies for clinical workflow.

You see, we’ve gotten pretty good at capturing data and storing it electronically. Where things still break down is in how we use that data and share it to improve care quality and patient safety and avoid the inherent costs associated with not doing so. How is all that data helping us if we don’t have equally powerful tools to make sense of it all and more importantly, to communicate what we learn across the care team and to our patients? Furthermore, how does all this electronic information we are capturing contribute to clinical research and scientific discovery?

Let me refer to something going on in my own family to illustrate the point. Two weeks ago, my elderly Aunt who seldom has headaches said she was having, “the worst headache of her life”. When it persisted after administration of the usual remedies and she also began to experience visual symptoms, I could only recommend that she immediately consult her physician or go to the ER. It was after hours and her personal physician wasn’t available so she went to the ER. The doctors there wereimage sufficiently concerned that they ordered a CT scan of her head (not the one pictured above). My Aunt was told that the CT appeared to be normal, but might not show acute thrombotic changes or very small hemorrhages. They also recommended a consultation with an ophthalmologist the next day. The eye doctor didn’t find anything wrong with her eyes, but proclaimed there was definitely something going wrong in her head. My Aunt said that her eye docotr ordered lots of blood work and told her to follow up with her personal physician. More than a week later, she’s still waiting for someone to tell her what is going on in her head. It seems her family doctor is waiting to receive information from the ER, imaging center, and laboratory. In other words, the data is available, it’s just not being communicated. Clinical workflow is broken because the community physicians caring for my Aunt don’t have the communication and collaboration infrastructure to work seamlessly as a care team.

The above is but one small example that reinforces the point on which Dr. Detmer and I so vehemently agree. It’s not so much about the “I”, it’s about the paucity of CT in clinical practice. And, I don’t mean computed tomography!

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Health Reform—neither brain surgery nor rocket science

An op-ed piece, No Country for Old Men, filed today on The Health Care Blog by health industry consultant and futurist, Jeff Goldsmith, provides a brilliant review and excellent analysis of our past sins and possible future under health reform. Perhaps most telling is the frightening scenario he paints of doctors, especially primary care physicians, leaving the profession.

In a recent HealthBlog post that was also picked up by ABC News I provided some of my own thoughts on why "affordable" and "health insurance" shouldn't be used in the same sentence. It's really all about cost. Unless we figure out a way to substantially reduce the cost of just about everything related to healthcare (which like food is something that every one of us must consume) we are doomed to failure. But where to cut?

A lot of folks immediately point to greedy doctors. Yes, there areimage some of those, but if medical practice was so lucrative why a predicted shortage of physicians? A new MGMA survey of physician incomes ranged from a low of around $150,000 for primary care to $650,000 for neurosurgery. I don't know about you, but I want the doctor drilling into my head to be well paid. $650K doesn't seem like all that much for someone who trained for more than a dozen years and sacrificed all of his or her 20's and early 30's learning a trade. Likewise, $150K seems inadequate for people making life and death decisions after a minimum of 8 years of very expensive, post graduate education. Heck, they don’t even come close to qualifying as “needlessly wealthy” which has been defined by some people as those earning more than $250K per year.

I do know one thing. These days even the "needlessly wealthy" are having trouble saving for retirement, paying for college, and funding their future healthcare needs. To the idea of a public healthcare plan that would let me retire before I become eligible for Medicare and also be affordable, I’d say “sign me up”! The problem is, the math just doesn't figure without passing along much of the burden to someone else. And I just don't know who that someone else is going to be.

Our present health system doesn’t “scale” for lots of reasons; access and cost among them. Technology can help. If a unit of health service can be delivered by telephone, e-mail, web visit, home test, home monitoring, retail medical clinic, or visiting nurse as a less costly or more efficient alternative to traditional office or hospital services, we should encourage it. Organizations like Group Health, Kaiser, UPMC, Geisinger, and Mayo are already paving the way. The health industry is ripe for disruptive innovation. What’s needed are the appropriately aligned incentives that will move us in that direction.

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Please take care in selecting an EMR for your practice

Bill Crounse 2007 05 As reported by HDM on-line, the Office of the National Coordinator for Health Information Technology has published additional information on a $598 million grant program to fund the creation of about 70 Health Information Technology Regional Extension Centers. The centers will help hospitals and physicians select, acquire and use electronic health records systems.

No doubt some serious education and hand-holding will be needed as more physicians and hospitals take the plunge into electronic medical record systems and “meaningful use”. If taking the plunge is anything like what I saw and heard during a visit to my own doctor last week, doing your EMR homework before you buy is an important step if you hope to swim rather than sink.

My doctor belongs to a very large, multi-specialty group practice. Like most large clinic systems in America this group practice, which also operates a hospital, has been using electronic records for some time. Even though the multi-specialty clinic drives most of organization’s business, they decided to purchase a health information system that is better known for running hospitals than outpatient medical centers. As long as I’ve known my doctor, he’s been complaining about the EMR system he is forced to use in the clinic.

And it’s not just my doctor who does the complaining. On my visit last week, the first thing his assistant did while checking me in was to verbally assault the blankity-blank computer system. She clicked furiously on the screen multiple times waiting for the system to respond. Just entering my vitals seamed to require clicking through endless screens. It took a ridiculous amount of keyboard work. “I hate this system”, she said. “It is always slow, especially when we are busy. And several times a day, it just goes down”.

She eventually got through all the screens and entered my data,image although I noticed that she took down my chief complaint and medication list on a sheet of paper perhaps to enter that information into the computer later. My doctor came into the room, asked me a few questions, and did a cursory exam. Mainly I was there to get some prescriptions renewed. My doctor also decided to order a few lab tests on me while I was there. On my last office visit, he had ordered lab work on the computer. This time he used a sheet paper. Before I even had a chance to say something about this he blurted out, “I suppose you noticed that I’m back to ordering lab work on paper. We tied CPOE (computerized physician order entry) but it just took too long! The clinic docs revolted, so now we are back to doing it the old fashioned way.”

Of course, I could have predicted all of this. There are much better solutions on the market for ambulatory patient care than what my doctor is being forced to use . There are far more intuitive and responsive EMR solutions. There are also solutions that are more accommodating to clinical workflow and mobile scenarios using Tablet PCs and other wireless devices. But my doctor’s group practice spent millions of dollars on what they have, and I’m quite certain they won’t be trashing it anytime soon.

So, let this be a warning. Do your homework. Select a system for your practice with the research and care you would put into making any large, really important purchase for your home or business. Don’t delegate this to your staff. It is your responsibility. You, your staff and your practice will be greatly impacted by the decisions you make. So maybe, just maybe……. a visit to one of those government funded “extension centers” would be a good idea before you take the plunge.

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Get Your Sleep

The gap between the amount of sleep we get and the amount of sleep we need seems to be widening. When we are infants, we somehow managed to get the 16 hours of sleep our bodies required for development, and as we got older, first as restive teenagers and young adults with more important things to do after the sun goes down than to spend it dreaming, even though our bodies ask for 9 hours, and then later on in life where getting sleep is now viewed as a challenge, even though we have a slower social life and require slightly more sleep than when we were younger to feel rested. Over half of all older adults report frequent and even chronic inability to sleep. Insomnia and sleep apnea are much more pronounced in older populations, and the devastating effects of both are felt more by this group and their ability to recover from sleep debt much slower and less complete.

Lacking in adequate sleep is not just an inconvenience or minor irritant, it can also be the sign of a serious health problem, or the cause of one if left unchecked. If our bodies do not get enough rest, several of our body’s systems can become imbalances, and the immediate effects of sleep deprivation on motor skill ability and reaction times can take an otherwise safe and sane individual and turn them into a 2 ton loaded gun if put behind the wheel of an automobile in that state. Approximately 2000 people are killed every year in sleep related car accidents, and numerous other work related injuries and health problems can be associated with lack of sleep as well.

Without the ability to rest and reset all of its switches, the body will soon begin to shut down, efficiency is lost, and mental alertness can eventually come to a halt. The average adult male needs approximately 7-10 hours of sleep each and every day for optimal performance. While this is usually easily accommodated, certain sleeping disorders as well as a stressful lifestyle, and other factors such as alcoholism or drug abuse can interrupt sleeping patterns or interfere with the proper chemical reactions that take place in the brain to allow healthy rest. Certain medications can also interfere with sleep and either produce drowsiness or insomnia when taken. Diet can also play a factor. Getting your nightly rest is crucial to your health and safe physical and mental activity.

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Nature VS Nurture & Drug Addiction

It is becoming harder and harder not to recognize the part that heredity plays in the role of alcoholic propensity. Studies clearly have shown time and time again that the child of an alcoholic parent is 3 to 4 times as likely to have problems later on in life with alcohol abuse, and that the younger a person takes their first drink, the higher this risk is than in children of non alcoholics who start drinking even earlier in life. The fact that heredity play a major role in the propensity to abuse alcohol or other drugs not a reason to exclude the fact that there are other factors also, that play a role in the development of the disease and the behaviors undertaken by the person with these risks.

There are actually three roles in a person’s life that contribute to the successful management or susceptibility to falling prey to addiction:

Lifestyle and social choices- A person who never takes their first drink will not have to deal with the physical addiction of the disease. If a person is not exposed to alcohol, or chooses not to expose their body to it, then disaster is preemptively avoided. In homes where drinking is the common thing to do this can be much harder and thus the second influencing factor on addictive behavior, environment.

Children who grow up around binge drinking, drunkenness, or otherwise irresponsible alcohol or other drug use, whether in the familial or social environment are more likely to consume alcohol or other drugs than those in drug and alcohol free environments. There are exceptions to this rule, but a permissive atmosphere, or an environment where alcohol education is insufficient but supply of alcohol apparent tends to favor alcohol abuse more readily than other environments without such factors.

A family history of alcoholism is a sure sign that a person may be at higher risk of falling into alcoholic patterns. If your parents are/were alcoholic, the chances of you developing alcoholism are 3-400% higher than in non alcoholic families, and 200% higher if alcoholism was present in the previous generation. These numbers are astronomical, and though heredity cannot be controlled, hedging your chances of avoiding trouble for your kids by providing good lifestyle choices as well as a healthy atmosphere are controllable. We can’t just sit back and blame it all on nature. As parents it is our job to nurture our children.

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Food Allergy or Food Intolerance

Knowing the difference between food allergies and food intolerances can be the difference between a minor inconvenience and a fatal condition.

Some people are more sensitive to certain foods such as lactose, and can produce gas and other side effects when ingested. Food intolerances are usually not life threatening and easily manages by limiting or trying eliminate the suspect food from your diet. Mild intolerances can sometimes be managed with over the counter remedies that will diminish the sensitivity of your body to the food while still allowing you to enjoy them in moderate amounts.

Food allergies on the other hand are a much more serious matter. If a person is allergic to certain foods, such as nuts and happen to ingest them, the immediate intervention of medical attention can be necessary. The negative effects can be immediate and life threatening. Food allergies can produce serious side effects such as rashes and hives or even produce internal swelling that can cut off air passages and even cause death.

It is often common practice for people to refer to foods that they have any adverse reaction to as being foods that they are allergic to. While this might be accepted as a matter of speech, the reality of the two conditions puts them worlds apart. If allergies are not given medical attention from the offset of symptoms, the results can be far more disastrous than bad gas or the flu like symptoms produced by food intolerance.

Allergies are usually discovered by either exposure and reaction to the item or through testing for specific allergens in a lab setting. The best situation to be in is to find out through communication with your health care provider and not by having an adverse reaction to any given allergen.

If you have known allergies, one of the best things that you can do is invest in a medical bracelet with you known allergies listed on in the case of accidental ingestion. They are inexpensive, there use is widely accepted and known, and if you are unable to communicate by speaking can save your life. If you were to ingest peanuts at a restaurant unknowingly, and you had an allergic reaction and was unable to explain your condition to those around you, a medical bracelet would allow those around to summon medical attention with information that could save your life.

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What To Do About Hair Loss Due To Psoriasis

Psoriasis is not simply dry scalp as some people think. Psoriasis is an immunity affecting condition that can produce symptoms in several regions of the body. It can produce scaling, discoloration, burning and itching, and hair loss. The hair loss generally associated with psoriasis is usually temporary, but in severe cases, the damage to the skin is so pronounced, that hair follicle damage is irreversible, and hair will not grow back. Management of the condition is the best method to minimize hair loss for psoriasis patients, with the most common remedies used being diet and symptomatic treatment, as well as a focus on not exacerbating the condition.

The red patches of skin cause by psoriasis are often linked to adverse reaction to medication, gastric abnormalities, stress, or an abundance or toxins in the body. The most common place for seeing the effects of psoriasis is on the head, though anyplace on the body is susceptible. Of the 50%+ that report scalp infection, treatment with medicated shampoo, usually containing salicylic acid are prescribed to control inflammation and itching.

Other anti itch ointments and even medications are used to further reduce selling and discomfort. No known medical cure is known for Psoriasis, though many of the symptoms associated with the disease are treatable.

Psoriasis seems to be agitated by a high acid diet, so the consumption of fish, vegetables and other foods with a high alkaline content are best eaten and fatty and other highly acidic foods such as chicken are best to be avoided. Other foods that are problematic are foods that are prone to promotion of toxicity, such as processed grains and starches. Eating whole grains and nutrient rich fruits and vegetables instead is good advice to follow.

In relation to hair loss and psoriasis, the best thing you can do is not to increase damage to the affected areas. Do not pull of scabs, or scratch reddened areas. This might promote the dislocation of hair, and if the follicle damage is extreme enough, that hair might be lost forever. Make sure to keep your hair moist through the use of oils or hair creams, and make sure to apply medication the area as prescribed to speed up the healing process.

As most hair loss due to psoriasis is temporary, the majority of sufferers will regain lost hair if care is taken and proper caution observed. Diet and proper medical follow through are your best friend when it comes to keeping your hair while experiencing psoriasis attacks.

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Easy Childhood Obesity Fighting Strategies

If you are an adult over 30, the next time you take your children to the playground take a good hard look at the weight condition of the general youth population. Chances are, you will see several children at one time that are clinically overweight amongst them, and being in a place of activity, you are seeing the ones with at least some form of physical activity.

The fact is that the growth of obesity in children has become an increasing problem over the last 30 years in the West, and now in the East, due to a variety of environmental, social behavioral, and even economic variables. While the rate of obesity in children may be skyrocketing and seem like an inevitable fact, simply implementing a few of the following suggestions could save your child from a lifelong problem with obesity or unwanted weight gain that started in childhood.

1. Assign some of the physical responsibilities of the household to your children. Parents are not simply employed maidservants for their children. Aside from the character building and lesson in responsible behavior, the physical energy created by mowing the lawn can increase cardiovascular activity for 30-45 minutes, and even simple chores such as taking out the trash can help maintain muscle activity that YouTube just is simply unable to provide.
2. Put your money where your sports are. Simply finding a stick in the schoolyard can lead to hours of war or pirate play for some children, while others are drawn more toward organized and structured activity environments. Simply providing the tools, and toys, needed to play organized sports can spring into an avid interest and participation in a sport that they love.
3. Don’t leave yourself out, make it a family event. Take mountain bike rides in the mountains with your kids, or simply hikes along the beach. Your children will be much more interested in activities that provide a spirit or teamwork and companionship. Do not make it competitive, but enjoyable.
4. Take active vacations. Don’t just fly across the country to sleep in a hotel, or hide at home and watch television for two weeks. Get the family together and go do something. Go camping, take a walking tour, or simply hit a local water park. Make it fun, and make it physical.
5. Make sure to encourage, and not discourage. Self worth and image were one of the highest indicating factors found to affect chances of success in fighting obesity in already overweight children. Not only that, the population of persons found to have the lowest self image when overweight was the under 25 and female grouping.

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Don’t Wait For Baldness To Occur In Order To Gain Control of Hair Loss

Often the loss of hair can be controlled, or even stopped in its tracks and reversed, if it is caught early enough. With recent technological advances in hair care, especially in the area of male pattern baldness, the ability to slow down the rate of hair loss, stop it, and even re-grow hair is a medical fact. Feeling that your only options are hair pieces, spray products or surgery are a thing of the past. Hormonal and medicated creams and lotions, as well as ingested medication are now available on the market that can bring back a healthy head of hair with early detection.

There are many reasons for hair loss and several variables in a person’s life that could be a contributor. Hereditary considerations, environmental factors such as workplace chemical exposure, or even personal medications could be affecting your hairline, producing showing areas of scalp where hair used to be. Catching hair loss before it completely takes hold can often alarm you to needed changes in lifestyle that could be taken, such as protective equipment, medication changes, or even more serious hormonal issues that with the help of medical attention could be corrected, and thus eliminating your hair loss problem.

If the reason for your hair loss is not environmental, but in fact hormonal, or otherwise medical, often a combination of an oral medication, paired with a topical solution for the scalp has shown to produce the best results when trying to halt, or re-grow hair. Changes in diet and otherwise indulging in a healthy lifestyle, including exercise and stress reduction have also been shown to have influence on treatment progress and successful hair re-growth.

Seeking the advice of your doctor early can also have the added benefit of not ever having to make up for lost ground. If you are able to catch the problem and have it arrested or even reversed as early as possible, then the frustration of having to regain hair that has already fallen out can be lessened, and the chances of saving more hair from being lost to begin with can be increased. To be proactive now, getting into a medication and application routine as soon as possible, could save you from the incredible trouble and high expense of having to take more drastic measures in the future.

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Is hair transplant surgery really the right answer?

Both men and women have been dealing with thinning hair and even baldness with whatever technology was available at the time. Whether the treatments were dietary in nature, purely applied cosmetic, or even surgical correction, each generation has done their best to outdo the previous in terms of safety, effectiveness, and natural aesthetics. today’s hair transplant surgery techniques fit the bill of all three to a tee.

The best thing about hair transplant surgery as opposed to other types of hair replacement or cosmetic procedure is that you can continue to hold your head up in self confidence knowing that the hair that is growing on your head is truly yours.

In previous years, most men, and even women, were given only a handful of extremely limited choices when it came to hair replacement. “Hair plug” surgery, which left a person’s with a full head of hair, but also looked like it was “planted” like a golf course track were about as technologically advanced as it got. Other choices were to take medications or herbal supplements, or the worst of the worst, you bought a can of “hair paint” off the TV at 2 AM and sprayed your hair on in the morning just to feel like an idiot by afternoon.

It is a good thing that medical science keeps getting better, because in the last 10-15 years, a new procedure, called Follicular hair transplant surgery, has now given those with male pattern baldness or other hair loss the ability to get natural hair transplant surgery, using their own hair, and leaving behind a natural, thick head of hair that looks like it belonged there all along.

Follicular hair transplant surgery is far better than hair butchery as the surgeon can take as few as 1-2 hairs from the back of the head, where the thickest hair resides, and transplant them to areas of concern. This ability to transplant so few hairs at a time allow for a natural pattern of removal and replanting to take place, instead of the unnatural looking “plug harvests” that seemed to be the result of previous methods.

With these surgeries becoming more commonplace, and as the cost for treatment comes down due to perfection of the technology, the need to try to hide under a rug or scrub and rub chemicals on your scalp at night can be replaced with the self confidence and great look provided by your own head of hair.

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Causes Of Hair Loss In Women & How It Happens

Female pattern baldness, or alopecia, is not as common as the male oriented pattern baldness in men, but affects more women than commonly thought. The causes for women to lose their hair or to experience noticeable thinning are as many and as varied as the reasons for male baldness. Reaction to medication, physical damage, and heredity are just a few. If you experience hair loss and are not sure what the reason is, seek the advice of a medical professional as soon as possible to make sure that it is not just a sign of a more serious medical condition.

Most female thinning and baldness is caused by hereditary factors, and usually follows the pattern of top of the hairline thinning, with the possibility of total frontal baldness with an eventual thinning, though rarely fully balding back of the head. Hereditary female pattern baldness, though the most common form of female hair loss, is also the least likely to react to treatment by medication, either OTC or prescribed. This condition is produced by testosterone and other hormonal changes which can lead to the conversion of DHT which in turn destroys hair follicles beyond the point of restoration. Lack of vitamins in the system, advanced age, and thyroid or other hormone related disorders are likely to increase your risks for hair loss also.

Most hair restoration medications, unfortunately work only for men, and medication can actually be more of a precursor to female hair loss than it is to be an effective treatment. Steroids, blood thinners, and contraceptives, including those administered for hormone replacement due to menopause can increase the chances of experiencing female pattern baldness. Some hair loss due to medication is temporary, and even major re-growth can take place once the suspect medication is removed from the system. There are women who completely go bald due to chemotherapy and other high potency drug cocktails, but once treatment is ceased, the hair is able to return.

If hair loss is permanent, usually the only option left is hair transplant surgery, Thanks to advances in hair restoration technology this is now widely available and is capable of producing extremely natural looking results. Before deciding on restorative surgery, make sure to rule out the existence of other complications that might be able to be corrected, allowing your hair to re-grow. Hair replacement, like any other surgical option, should be thoroughly discussed with a medical professional and all risks and benefits weighed.

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Why Running Might Be The Best All Around Fitness Activity

When people think of exercise, very few would overlook running as a definite possibility. Running is a great fat burner. You can burn off a can of soda in one mile, and a granola bar on the way back, and still maintain cardiovascular benefits for up to two hours after you stop running. Another reason running is a great choice, especially for first time exercises, is there is not expensive equipment to buy and to keep it fresh and never boring, all you have to do is change directions. Running has actually been shown to improve self esteem levels, strengthen bones, increase stamina, and give the heart and lungs one of the best workouts of any exercise. The cardiovascular workout provided by running is the very thing the doctor ordered to keep your risk of heart disease and stroke, which happens to be one of the biggest killers worldwide.

You do not have to start off running marathons to get the health benefits from running either. Many people start off by not even running at all, but simply walking. Walking can burn calories also, and is easier on the knees and other joints in older, inexperienced, or out of shape individuals. Both the speed and the distance traveled during your run can be increased gradually to increase both performance and metabolic benefit.

There is no reason to injure yourself while enjoying running. Make sure to stretch out properly before each run and do not take on more than you can chew. Making sure that the pulse and breathing remain elevated for 20-30 minutes a day can cut your risk for heart disease in half, so feeling like you need to enter the New York Marathon, or complete a 3 minute mile in order to get benefit is not needed. Also make sure to drink plenty of water. Dehydration is the runner’s enemy, and leg and side cramps, chronic soreness in the limbs, or even passing out can all be consequences for depriving you body of much needed water when running.

Running can be experienced by all ages and athletic ability. The advantages of running or even walking far outweigh the cost of most people’s excuses not to. So tighten those laces, stretch those legs, and head out on an adventure to wherever you wish, as all directions lead to better health.

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What’s The Difference Between Organic And Natural?

Many people think that there is no difference between organic and natural food. But this is not true. Organic food refers to food items that are produced, manufactured and handled using certified organic means, such as defined by the USDA under its Organic Food Products Act. Natural food refers to food items that are not altered chemically or synthesized in any form. They are derived from plants and animals. A natural food item is not necessarily organic, and vice versa.

Why do some people prefer natural food while others prefer organic food? Those who believe that synthesizing foods results in loss of nutrients, demand natural foods. Organic food fans want their food to be free of chemical fertilizers, pesticides and preservatives.

Basic differences in organic foods and natural foods are the following:

Stringent standards for organic food production, handling and processing exist throughout the world. Stringent standards do not exist for natural foods.

A manufacturer is required to follow specified rules and regulations before he can use the organic label. Natural food labels are used freely by manufacturers due to a lack of adequate guidelines.

The demand for organic foods is greater than the demand for natural foods.

There is no evidence to prove that organic food is healthier than non-organic food, but people who prefer organic food feel it is safer than conventional food because chemicals are not used in its production. Other people prefer natural food because they believe that excessive processing of food disturbs their health benefits.

Both organic foods and natural foods are priced higher than non-organic food items.
The shelf life of organic food is more than that of natural food. It can be stored for a longer duration.

Organic food is sold in almost every super market. There are special stores that sell organic food. Organic food can be purchased online as well. Natural food is available in many stores that also sell organic food. Some special stores sell natural food. Many stores selling health food items also sell natural food products.

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Why Exercise Brings You No Results

Most people rush into an exercise routine knowing very little, if anything about the muscle groups that they are working, the exercises that they are performing, or what goal each individual exercise is intended to produce. Many times people start running, swimming, or lifting weights without first learning to recognize progress when they see it. Sometimes there is benefit that is never seen, so the person stops thinking the activity a failure, or they are doing the activity wrong, and fail to recognize this as the reason for lack of results.

Sometimes this lack of information is not only the cause of failure by dropping out, but is also one of the main reasons for workout related injury. If a person does not understand the mechanics of an exercise technique, the ability to properly assess and avoid injury, increasing the likelihood of getting hurt.

Your spinal region, and anywhere there are connections between body parts are highest at risk for improper use and injury. If stresses that should be applied to muscle mass is instead applied to the joints and back, not only are you likely to hurt yourself, but if you do happen to avoid injury, the energy you spent stressing these areas is wasted instead of establishing progress toward your exercise goals, such as building muscle or losing weight.

Sometimes people simply know how much of a certain exercise is needed before it takes hold and becomes effective. The thing I hate to see the most is a new person to the gym, running from machine to machine, spending a few minutes in a bulls run, just to leave as quickly as they came, never allowing their body to warm up, and not allowing enough energy to be consistently spent on one activity to produce any results whatsoever.

When you decide on a specific form of exercise, whether it be aerobic activity for cardiovascular improvement & weight loss, or a weight training program to increase muscle mass or strength, it is encouraged to speak with someone who also is experienced in the same method. This can be a friend or a gym partner, but if possible, a personal trainer would be the best solution as they would not only be able to tell you of their experiences, but evaluate your own situation and help you create a personal program that helps you to achieve your workout goals.

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Premature Ejaculation Exercises for A Healthy Cure

Many people are being bombarded with ads every day promoting drugs for the treatment of a most common men’s health issue, premature ejaculation. With sexual issues not being at the top of their “talk about” list, few men are aware of the fact that as much as up to 75% of the male population experiences the condition of premature ejaculation at one point or another. Controlling sexual performance is not always a matter of a dysfunctional body, but failure of the owner to understand what his body is doing at any given time, making it almost impossible to control its performance. With a little knowledge under their belt, most men will be able to prevent premature ejaculation with the help of sexual exercise, physical manipulation techniques that can be performed during coitus, allowing ultimate control over male orgasm and ejaculation.

Most men are able to notice the sensation of an orgasm building up in their body, and if they can physically pull their penis out in time, prior to climax, then simply cutting off the flow of pre ejaculate by gently squeezing 1/2 to one inch below the head for approximately 15 seconds, or until the sensation of a rising climax subsides, then they can continue sexual activity. Remember to always use a condom even if a tested partner, as the pre ejaculate that is released prior to male orgasm can still lead to pregnancy.

Another popular method for cutting off the flow of semen, diminishing the chances of premature ejaculation is to gently hold and pull down on the scrotum when the man begins to experience early climax. The timing and duration of this technique is the same as squeezing below the head of the penis, but is less likely to produce painful sensations and can even involve partner participation. In either method, the man should immediately pull out before his body is overwhelmed with climatic sensation, and sexual protection should always be worn, which far from impeding sexual ability, can contribute to stamina due to a slight reduction in sensitivity as well as gently compressing the penis during sexual encounters.

With these two simple erectile manipulation techniques, the need to resort to the looking into the use of medication or surgery to cure your premature ejaculation might just be held at bay. Getting to know how your body works and how you can take advantage of that can often be the best solution.

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Women Aren’t The Only Ones That Get Yeast Infections

Few men know that they also can get yeast infections. Yeast infections as a condition are not gender specific. The cause for yeast infections, an out of balance Candida Alb cans fungus level in the body, can affect either men or women, and when out of balance, can produce negative symptomatic consequences in the genitals and esophagi canal.

Anti-Inflammatory medications can sometimes not only be the therapy prescribed to bring your Candida Alb cans level back into balance, medications that you are already taking can be the source of the balance disruption, causing male yeast infections in the first place.

Sexual transmission with a partner who also has a yeast infection is another method of commuting this bacterial malady. To protect yourself from sexual transmission, open communication with sexual partners about the possibility of sexually transmitted diseases and infections, as well as the use of barrier protection, such as condoms have been known to reduce infections.

A man with a yeast infection will most likely experience some similar symptoms as those of women, such as genital itching, discomfort, or even discharge. If any of these symptoms occur, immediate medical attention should be sought in order to rule out more serious medical conditions before seeking over the counter remedies.

Other symptoms might not lead the man to think of yeast infections at all when experienced. Severe stomach cramps, uncontrollable or increased passing of gas, and other abdominal discomforts would not signify a genital bacterial infection by first glance. Erectile dysfunction on the other hand may be thought of at first as a sign of serious medical or chronic ailment but might actually be a bacterial infection that can be treated with antibiotics.

The treatment for men with yeast infections are the same as they are for women, however the application methods do vary. Male yeast infection OTC treatments can be found for both men and women. Be sure to read the ingredients and follow the instructions carefully.

Wearing loose fitting clothing around the midsection and avoiding scratching the area as well as following your prescribed treatment schedule can aid recovery from a male yeast infection greatly.

Due to the lower incident of genital discharge during yeast infection for men than women, more men are diagnosed with having a yeast infection at a doctor as opposed to self examination. If you are a man and you are experiencing any of the above symptoms, reluctant as you may be, you should contact you physician and schedule an examination as soon as possible.

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Get Your Mojo Back Safely & Naturally

There are a wide variety of both pharmaceutical, chemical, and natural herbal forms of sexual impotence and erectile dysfunction treatments on the market today. While the shear amount of choices might seem daunting, if you keep a clear distinction between your choice of using either synthetic or natural substances as your method of increasing sexual stamina and ability, then it is a lot easier to sort through the offer to find what is right for you.

Viagra, and other erectile dysfunction medications are being sold in every pharmacy and are marketed through every media channel known to man. Thankfully, due to certain medical marketing notification rules, it is easy to notice the 10-15 second disclaimer about the possible serious side effects of taking these potent synthetic cocktails. When one studies the history of these medications, one can find that their initial use was not even to treat sexual conditions at all, but where heart medications. By increasing the level of nitric oxide in the system, stimulating blood flow and swelling the penis with a gratuitous supply of blood.

There is an argument of contention within the medical community if the drugs that are synthetically manufactured for the use in erectile dysfunction treatment have any positive effect on the libido at all. There is no such contention on the issue of the associated risks of using the drugs, and these side effects have been well documented.

Viagra has been known to cause blurred vision, or even the ability for people to see colors, has a verified history of headaches, can lower blood pressure to seriously low levels in a very fast time, and even cause heart attacks. While herbal treatment of erectile dysfunction does carry with it some minor side effects, and as with any other substance ingested as a medical remedy, these effects should be known before taking them. Ephedrine, Horny goat weed, and other herbal remedies have been known to raise the pulse, breathing rate, and even lower blood pressure. The saving grace of using herbal remedies is that with much lower concentration of active ingredients that with pharmaceuticals, you do not have to begin at such a large dose, diminishing the chances of complications and unwanted side effects.

The choice is of course up to you, and the advice of a medical professional should always be sought when looking for choices related to a sexual drive or erectile dysfunctional condition. Once you honestly weigh your options, and see enough commercials about how there might be a slight chance that you next date could end in heart attack or stroke, the option to use an herbal sexual enhancement product might become more and more appealing.

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Sunburn Treatment Tips

Everybody loves the sun. It is the source of life for the entire planet and to bask in its rays can be amazing, and as such, there will probably be a time in your life where you either forgot to apply sunscreen or spend more time out in the sun that your sunscreen would protect you, and you got a sunburn. Although the sun is a major source of vitamin E, getting too much sun is not good for you, and regular overexposure can increase your risk of skin cancer.

One of the consequences of not making sure to protect yourself from the sun is that you now have a UV burn to your skin, and nothing but the passage of time will make it go away, however there a few things that you can do to lessen the discomfort and to promote healing and moisturization of the red and damaged skin cells.

The first thing you should do is clean your skin and gently dry it. Do not rub hard or use abrasive cleaners of any sort. Cool water and a dry towel applied lightly is recommended.

Now that you have the skin clean and dry, apply a sunburn treatment spray or gel to the burned area. This might sting a little, but the .5% lidocaine contained in these products will eventually soothe the burning, prevent itching, as well as treating the burn.

Make sure to reintroduce moisture into the skin using lotion containing aloe Vera or apply the gel contained in the natural aloe Vera. This will make sure that the skin stays hydrated and will promote healing as well as soothing some of the pain. Do not rip and pick at your skin as it peels. The skin underneath is very raw and irritated, and it is best to let your skin scuff off naturally. Within a matter of time it your sunburn will start to progressively become less painful, and signs of redness will disappear. Though usually temporary, sunburn can also carry the permanent risk of increasing your chances of getting skin cancer, which in some cases can be fatal. The sun is a very powerful force, and to be treated with the respect it deserves, and the same can be said for your health. So, next time wear a sunscreen above SPF30 and enjoy the sun without getting toasted.

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Tips for Preventing The Common Cold

Ever since we were young, we have been hearing rumors and wives’ tales about how to cure a cold. Everything from hot tea and whisky to ginger root have been said to hold the secret to ending your distress. Unfortunately, there still is not reliable cure for the common cold. Treating the symptoms is about as all you can do. The only thing better is prevention. The common cold is spread through th air and by physical contact. It is a virus, so the stories about not staying dry in the cold, or wearing too little clothing in winter do not actually have any effect on this minor respiratory infection, though other complications can arise due to overexposure to the elements.

The number one way of passing the cold virus is through contact with another person who has a cold. Short of locking yourself into quarantine, contact with other people is often inevitable. Here are some tips that you can follow to help reduce the chances of you leaving your social meetings with an unwanted virus guest.

Contrary to popular belief, do not cover your mouth with your hand if you cough, and inform your friends to avoid the same. Putting the body part you use to handle everything in front of a communicable stream of infected body fluid leaving the body is not the wisest thing to do if you wish to control its spread. Instead use a disposable tissue, and do not save them in your pockets after use, but throw them away immediately.

Wash your hands, wash your hands, wash your hands. Cleanliness is the number one way to avoid infection. Not only wash your hands, but make sure to clean anything that a person known to have the cold comes into contact with.

Avoid dirty habits such as smoking, and eat right. Smoking lowers the immune response in the body as well as allowing you to ingest hundreds of toxins at will. Non smokers are less likely to become infected by the cold than smokers, and the chances of other respiratory infections and problems are highest in the smoking population.

Drink water. Flushing your system of impurities on a natural level is best done with good old H2O, and lots of it. Dehydration has negative effects on immune response as well as leaving you with a feeling of lethargy, making infection fighting activity less likely.

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Quick Smoking Quick Tips

Smoking cigarettes is the leading cause of lung disease and contributes to many of the heart disease and cancer deaths annually. The health risks are well known and the benefits of quitting numerous, however, the ability to successfully quit and intellectually evaluating the risks and benefits involved are two separate things. Quitting smoking has been often compare to kicking a heroin habit, except that the success rate of kicking heroin addiction with treatment has a higher rate of success than those quitting the smoking of tobacco. There are common characteristics that seem to follow when a person does succeed in smoking cessation. Following are some specific steps, though seemingly ritual in nature, if strictly adhered to can increase the likelihood of never smoking another cigarette again.

The very first step in quitting any addictive behavior is an honest commitment to quit. If you are going in this half hearted at best, your chances of failure are almost 100%. Once the commitment to quit is made, many people will actually choose a date to quit. In order to prove the seriousness of your commitment, the best date to choose is the same day of your decision, and to make the commitment not to smoke from that minute on a complete resolution of abstinence.

To aid your ability to resist the temptation to smoke, a complete clean up of the home to remove any traces of cigarette or other tobacco use is in order. It is often beneficial to wash all drapery and bedding, especially if you had the habit of smoking indoors, to remove residue odors, as well as to improve the cleanliness of the home. Smoke is a very dirty solid substance.

Do not do this on your own. Let your family and friends in on the fact that you have given up on cigarettes. With the support of those around you, and their willingness not to smoke around you and to give you encouragement, it can give you the extra social support that many who have failed did not have access to.

Understand that there is only one rule to smoking cessation is absolutely must be followed in order for you to be successful. Do not smoke a single cigarette. If craving become extremely difficult then you might want to contact a medical professional to discuss the use of nicotine patches or gum. While these nicotine replacements do still contain the addictive drug nicotine, the absence of other health related risks associated with ingesting smoke and other ingredients in tobacco products make them a safer alternative for you while you wean yourself off of nicotine slowly.

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Stress Relief Tips

Almost every ailment known to mankind is affected in one way or another due to the presence of stress, usually detrimental. While knowing that a high stress level is not good for your general state of health and can make other conditions worsen, knowing ways to effectively reduce stress can often be elusive. we live in a fast moving culture, but if you take few minutes and reflect on the following tips, finding breathing room and lower blood pressure can be simplified greatly.

Proper breathing control. Of course you have heard the saying “take a deep breath.” Getting Oxygen into the lungs in adequate amounts physically reduces stress on the body as well as feeds the mental capability needed to deal with processing efficiency. Thoughts can become clearer and oxygen to the muscles can bring relaxation to the body, allowing you to relax. Learning to control your breathing can also come in handy if you happen to react to stress in a vascular manner. Taking a few deep breaths can make all the difference between an inconvenience and a panic attack.

Emotional issues and conflict continuance is a common stress factor. Unresolved emotional tensions whether in the home or career centered are often causes of high stress, and if not dealt with can lead to more serious mental and physical health issues ranging from increased risk of heart disease to suicide. Keeping healthy social relationships and allowing yourself creative expression are also great stress reducers. Happy people are not heavily affected by stress and happy people are those with healthy mental outlooks and habits.

Create change. Sometimes a simple change of scenery, pattern of behavior, or just a night on the town is needed to get you out of a stressful rut. The day to day drag of never-ending responsibility without a change can lead to minor depression and leave you with a feeling of frustration that is likely to physiologically stressful. Variety is the spice of life, and if we enjoy life, even if stress is still present, it is less likely to grip us than if we are in stupor of dissatisfaction.

While these tips might not seem like the cutting edge of health science, they are proven, effective, and simple to follow. Who needs something else complicated to stress over? Take a walk in the park, or curl up with a good book instead of watching television for a change. It is sometimes the little things that make the biggest difference.

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