WebMD Feature

By Suz Redfearn

It’s true—they do make it hard to get the money you’re entitled to. Here’s how to get them to pay up.

Health insurance companies like to keep secrets. And they like to save money. Example: You have surgery, and weeks later you get a bill for using an out-of-network anesthesiologist. Ridiculous, right? You didn’t choose who put you under, so you shouldn’t have to pay extra. But your insurer sent the bill anyway, hoping you wouldn’t notice.

Fighting back against this kind of trickery—and winning—is a lot easier than you think, says Kevin Flynn, president of Healthcare Advocates, a Philadelphia-based firm that helps patients wrangle with their health plans. We checked with Flynn and other insurance-industry insiders, lawyers, doctors, and regulators to uncover nine little-known ways to get the health coverage you deserve—for less.

Don’t pay if you don’t have a say.

When you purposely see an out-of-network doctor, your plan usually makes it clear that it’ll cost you. But when you have surgery, the hospital chooses the anesthesiologist. If you get that annoying “out-of-network” bill, Flynn says, draft a strongly worded letter stating you had no say about the anesthesiologist—in-network or otherwise—and, therefore, won’t pay any additional fees. “If you don’t have direct control, you are not liable,” Flynn says, adding that this tack is likely to work every time, but few consumers know about it.

You may be eligible for more coverage.

Depending on your state, you could be eligible for more benefits than your plan is telling you about. Take Maryland, for instance. Health plans operating there must pay for expensive infertility coverage. But one state over, in Virginia, they don’t. It’s unlikely that your plan is trumpeting info about state-mandated coverage, though. It’s up to you to get the scoop. One good place to check is Families USA (www.familiesusa.org), a consumer group that keeps tabs on state rules, suggests Kevin Lembo, Connecticut’s official health care advocate for consumers. Another option: Contact your state’s insurance commissioner (http://www.naic.org/state_web_map.htm).

To get tested, talk up your symptoms.

Your insurer doesn’t want to pay for a colonoscopy if it’s not necessary. But if your best friend is diagnosed with colon cancer and you want the $675 test to put your mind at ease, here’s how to get one covered: Mention to your doctor that you’ve had some blood in your stool and a lot of gas lately—or simply that your bowel habits have changed. Your plan has to pay for the test if you have gastro complaints, health experts say. (Only 21 states require insurers to cover colonoscopies for general screening.)

Stall first, answer questions later.

When Wendy Decenzo became pregnant with twins, she wasn’t worried about health insurance. Her husband, Chris, had made sure to get a health plan that covered pregnancy well before they started trying. But when Wendy began going for prenatal visits, coverage was denied. Their plan, Blue Cross of California, wouldn’t say why. Instead, the insurer asked the Decenzos to sign release forms allowing the plan to view their medical histories, which the law says are private.

Chris believes the company was looking for any info that the Decenzos may have accidentally omitted when they applied for coverage. If an omission were found, the couple might have been denied coverage. “It seemed like a fishing expedition in order to deny us,” Chris says. So they refused to sign, and three months later the plan started paying for the prenatal appointments, even going back and paying for earlier visits that hadn’t been covered. Flynn says lots of insurers try this trick, but since their review process usually lasts only 60 to 90 days, they often drop the inquiry after that. Sometimes, procrastination pays.

Letters are your best bet.

It may seem a bit inconvenient, but the old-fashioned letter is by far the best way to communicate with your health plan. “Don’t do anything over the phone. It takes forever and when you’re done there’s no record of it, so it didn’t happen,” says Rhonda Orin, a Washington, D.C.–based attorney and author of Making Them Pay: How to Get the Most From Health Insurance and Managed Care.

Letters almost always get a response, adds Lembo, the Connecticut health care advocate. Some plans will answer e-mail, but many won’t. And to whom, exactly, should you address your mail? Experts recommend following your plan’s appeal process for letters and sending copies to your state insurance commissioner. Also, keep copies of every letter you’ve sent your plan and everything they’ve sent back. That way, when your insurer says, “We never said we’d cover that,” you can say, “I have it right here in writing.”

Doctors can be good weapons.

You just got four massage sessions, under doctor’s orders, for lower-back pain—but your insurer refuses to pay for them? Ask your doctor for help. He can tell the insurer he’s going to complain to the state board that regulates health plans.

“Health plans may not fear you, but they do respect the board,” says James Moss, a retired Kentucky surgeon. He intervened on a patient’s behalf and, by pressuring the board, helped the patient win coverage. Another option: Say you’ll call your congressman and/or state Medicare office to lodge a formal complaint, Moss says.

Caveat: Don’t actually contact your state board yourself if a claim is denied. Janice Weiss, a Jupiter, Florida–based attorney who fights health plans for consumers, says some of her clients who went this route ended up hurting their cases when the state agency ruled their claims invalid; that left them little recourse with their insurance companies. Instead, while working your plan’s appeals process, just suggest you may take the matter to your state.

A little research can go a long way.

If you want a special CT scan or MRI, your doc probably won’t authorize it unless it’s an absolute must. Persuade her with expert info from the American College of Radiology’s Appropriateness Criteria, says Anne Roberts, executive vice chair of the department of radiology at the University of California, San Diego. Used primarily by doctors but open to the public, it’s an up-to-date list of the types of imaging that are right for various conditions. Arming yourself with the info doesn’t guarantee coverage, but it’s a proactive step in the right direction.

There are ways to get drugs cheaper.

Doctors are often wowed by the latest and greatest drugs, which tend to be the most expensive. Make sure these newer, high-end meds are what you need before you leave the doctor’s office. Sometimes your insurance plan won’t pay for them at all; other times it’ll charge higher co-pays. In many cases, drugs have generic versions that are just as effective but cheaper than the newer ones. Always ask your doc (or the pharmacist) for generics. And if you really need a medicine that doesn’t have a generic version, order it by mail. Many plans have a less-expensive mail-order pharmacy option. Another prescription trick for people who have chronic conditions like allergies: Ask your doc to write you a prescription for two or three months’ worth of medication instead of one. Goodbye, extra co-pays.

An advocate can help you win.

Imagine being turned down for coverage after running up $125,000 in medical bills. That’s what happened to the parents of a daughter with anorexia just before they sought help from Kevin Flynn, of Healthcare Advocates. For $400, he took over the fight with their insurer and—after a year’s worth of combat—won.

Flynn is a patient advocate, part of a growing industry that makes its money from helping you. Some advo-cates help you interact with your doctor, while others specialize in insurance disputes. Most of all, firms like Flynn’s keep the letters going out on your behalf, saving you time, energy, and headaches. “The insurers know that advocates know the laws, the regulations—things a regular consumer might not know. That makes them nervous,” Flynn says.

Advocates can even get policies changed. One of Flynn’s clients, who had rectal cancer, was having trouble getting his insurance plan to pay for a new radiation therapy. The insurer claimed the treatment wasn’t ready for prime time, but Flynn found six studies showing its usefulness for the disease, got the coverage—and got the insurer to rewrite its policy.

To find an advocate, contact the Patient Advocate Foundation, says Laura Weil, interim director of Sarah Lawrence College’s Health Advocacy Program. Another helpful resource is the Society for Healthcare Consumer Advocacy. Also try checking with the medical association for a particular condition, like the Multiple Myeloma Association or the National Association of Anorexia Nervosa and Associated Disorders; many of these groups keep lists of advocates.

Because prevention is the most powerful cure!

Not surprisingly, our animals’ health is beginning to mirror our own. Today we’re seeing many of the epidemics that have plagued humans, such as obesity, diabetes and chronic inflammation, and even cancer, manifest at epidemic levels in our pets. If you take a good look around, you’ll find that people really do look like their pets. More accurately, they tend to have similar characteristics, and unfortunately, that includes similar health problems.

Some professionals claim this is caused by the emotional burden that pets absorb from the family environment; the animals manifest similar symptoms as the people. This emotional influence does, in fact, play a larger role than most of us think. But the majority of symptoms are a result of similar eating habits – a heavily processed diet. Research shows that the high glycemic (raises blood sugar dramatically) state of processed food promotes inflammation throughout the body. This inflammation is too small to diagnose but it does increase the incidence of chronic inflammation.

Processed foods, like low quality pet kibbles, tend to be higher in glycemic index than whole foods, and the addition of low cost grain or other starch sources are mostly to blame. These higher glycemic diets have also been linked to insulin resistance, which also increases the risk of obesity.

Obesity and cancer affect a huge number of canines these days, and our felines seem to be suffering from diabetes and obesity in epic proportions. Recent genetic research shows that a greater free radical load on the body caused, in large part, by poor quality food, adversely affects gene function. One of the gene systems pinpointed is directly involved in the production of hormones (prostaglandins) that contribute to inflammation and tumor formation.

What’s the significance of this? It provides a direct scientific link between processed, high glycemic index foods, and diseases like cancer, chronic inflammation, and obesity.

For our animals, these risks increase as they get older. Just like us, our furry companions can tolerate metabolic strains imposed by diet, environment and/or emotion when they are young. But as we age, our ability to produce internal antioxidants to protect us from these strains declines.

Supplements to consider

Fortunately, there are things we can do to block these nasty metabolic influences, starting with supplementation. Here’s what you should consider:

Antioxidants — Research shows that uncontrolled free radicals accelerate genes beyond their normal activity. This causes us to age faster. For our companion animals, this is an even greater problem since they already have a faster rate of aging then we do. Antioxidant supplementation literally helps protect us from the unnatural influence our food and environment deliver. Supplementing our animal companion’s food with a basic multivitamin/mineral formula that contains a healthy concentration of bioavailable, active forms of antioxidants and mineral and vitamin cofactors, is the key to better health and improved quality of life. Recommended is lipoic acid, specifically in the form of palladium lipoic complexes, which can help to neutralize the free radicals within your pet’s body that are thought to influence the aging and disease processes and convert them into energy.

Grapeseed proanthocyanidins and boswellic acid (from the herb boswelia serrata) – These contain protective and anti-inflammatory effects as well. However, many who administer these herbs, or other nutrient-based therapies such as glucosamine or chondroitin sulfate for joint problems, experience limited results due to a failure to address the animal’s primary needs. This involves more basic daily nutritional requirements such as active essential fat, vitamin and mineral nutrients.

Manganese, copper, sulfur, vitamin C, and vitamin E – Our bodies and those of our companion animals are complex, requiring multiples of nutrients in tandem. Cartilage regeneration, for example, depends on much more than just glucosamine. Canned and dry kibble foods are fortified with many of these essentials, including vitamins, minerals and essential fatty acids like linoleic acid. However, the gut’s ability to absorb them in this form may be limited. Vitamins degrade rapidly in these environments and the integrity and activity of essential fatty acids cannot be protected even if they are added back to the denatured food.

Choosing the right supplement for therapy or prevention

Our pets’ digestive system is shorter than ours; it runs faster than our own. Liquid forms, or properly manufactured powdered forms which do not contain binders, are absorbed more efficiently. If you are using tablets, make sure your animal chews them thoroughly. Additionally, these nutrients must be provided in the correct proportionsfor the specialized metabolism of your canine or feline companion. Human supplements are designed for our own metabolic needs and are not best suited to treat and maintain our pet’s health. Instead, use products formulated especially for animals.

Remember, prevention is extremey important. A correctly proportioned vitamin supplement is the most powerful health support you can offer your loyal friend.

by Franco Cavaleri

For many pet owners, significantly cold weather is now in full swing. This means it’s time to give special attention to your pets, both inside and out.

Cold weather creates its own set of stress for all animals, but your pet needs your undivided attention now more than at almost any time of the year. Here are some winterizing tips for optimizing your animal’s comfort and well-being.

When the temperatures reach sub-zero, it’s time to give the outdoor cat and dog a break and invite them in, even if it’s in the garage. By “inside,” that doesn’t mean letting dogs and cats in and out of a warm house from night to day. Creating an abrupt temperature contrast can increase the risk of some infectious diseases. Consider housing them in the shelter of a well-built doghouse or bringing them into a tool shed or garage.

When you take your inside pooch out for “bathroom break,” stay out with them. If you’re cold enough to go inside, it probably is too cold for the pet to stay out much longer as well. When you bring a pet in, wipe its paws and underside, making certain there are no ice balls clinging between the toes or on the sole of the foot. They can cause frostbite to an animal that is left outside for a significant time in sub-zero temperatures.

If you opt not to bring the dog inside, make certain its shelter is clean, dry and well insulated with straw, wood shavings or a blanket. Animals drag a lot of moisture onto their bedding from every trip outside in snow. Plan on changing the bedding as frequently as necessary or simply placing it in the dryer for a warm-up. Equally critical, position the opening, which should have a door flap, away from the direction in which snow and wind usually comes.

Outdoor cats will seek warmth and sometimes this includes near or on a car engine. This means that if they don’t move when you go out to start the engine the next time, they can be seriously injured or killed. Before starting the engine, rap on the hood a couple of times to chase them off from beneath the hood.

Pets that move about on sidewalks, driveways or streets run the risk of picking up rock salt, ice and other chemicals in their foot pads. Each time they are brought in, make certain to wipe all four feet thoroughly. There is a tendency for them to lick the salt off their feet, which can cause an inflammation of the digestive tract.

Keep an eye on your pet’s outside water. If it is not heated, it will need to be changed several times daily when temperatures dip far below freezing. Ice is not a substitute for clean water. Pet stores sell heated bowls, which can prevent water freezing.

For short-coated animals, you might want to put them in a protective sweater before taking them outside. They will become chilled quickly after leaving a 72-degree house and walking onto single-digit-temperature turf. Also realize, sweaters are not a substitute for shelter. They can get wet and actually remove more heat from an animal than they conserve.

Be particularly careful when escorting elderly, arthritic pets outside. They will become stiff and tender quickly and may find it difficult to move about in the snow or ice. Keep them tethered tightly to your side if the route to the yard is icy. A bad slip can cause a ruptured disc, broken leg or other major injury.

If you live near a pond or lake, don’t allow your pets to run loose without some thought on your part. They may head for thin ice and fall through if they are not familiar with icy ponds. It is very difficult for a pet to escape these situations and equally challenging for you to reach the site safely.

Nutrition is a particularly important concern. Outdoor pets require more calories in the winter to generate energy to ward off the cold. As a result, add 10 to 15 percent more to its daily diet to allow it to meet those needs. Another way to meet cold weather calorie requirements is by adding some fats to their regular ration. Be careful though, fats can lead to diarrhea and dehydration if too much is added. And make sure they’re getting their supplements, for increased energy as well as overall health!

“The begining of a new calendar year is a great time to change your life and improve your health,” says AMARC President and CEO, Al Sanchez, Jr. “The future is filled with uncertainties, but each of us has the ability to control our  behaviors and our health.”

Research indicates that keeping New Year’s Resolutions is easier for some than others.  While certain individuals can simply make a decision to change and then do it, about 70% of people are not able to change or maintain resolutions that they make.  The research on long term health behavior change is rather complex, but much of the research can be synthesized down to a few basic principles. What follows are some strategies that have been proven effective in assisting people to make lifestyle related changes.  If you are serious about improving yourself, the following guidelines will help with any behavior.

Where to Start?

Most people have a general idea of what they would like to change when they decide to set a New Year’s resolution.  Others are a little less sure of where to begin, and still others go overboard trying to change everything all at once.  Trying to exercise daily while making significant changes in your diet, quitting smoking and altering your sleep patterns may be a bit too stressful to change and maintain over the long run.  Although healthy changes -like practicing relaxation exercises and quitting smoking - can compliment each other, it is sometimes better to initially concentrate on one behavior at a time.  Once you achieve success in one area you can always move on to the next.

1. Identify and set behavioral objectives

Clearly defined written goals are the tools which make resolutions achievable. To be successful, resolutions must be desirable, specific, measurable, and realistic.  The toughest thing about making a lifestyle change is the ultimate realization that the behavior will have to be maintained.  Begin by making sure that the resolution is something you really want and is well thought out.  You must think about this as a lifetime change. Be honest with yourself.  If you do not enjoy running, don’t tell yourself that you will go out and jog every day.  Why would you do that to yourself?

It is not unusual for people to make unrealistic demands on themselves.  When someone is trying to cure a serious addiction such as tobacco or alcohol, we hope that the individual will be able to quit for good.  When focusing on other behaviors, it is important to be careful with absolutes.  I once had a friend who ate chocolate on a daily basis tell me that her resolution was to never eat chocolate again.  Why?  Obviously she enjoyed chocolate.  She was setting herself up for failure.  Wouldn’t if be more reasonable to suggest that she only allow herself to eat two small pieces a week? One of the reasons most diets fail is because people go to extremes.  They go on and off diets, losing weight and then gaining back in a vicious cycle.  If you want to eat healthy, you have to see yourself eating that way for the rest of your life.

Another reason people fail at New Year’s Resolutions is that their resolutions are intentionally or unintentionally vague, e.g.,  “I will be healthier this year,” or “I get in shape.” Be certain to focus on goals that identify specific behaviors.  Saying that you will lose 10 pounds of fat is not a behavior.  Losing weight is an outcome of behaviors such as exercising aerobically four days a week, or reducing your daily calorie intake by 500 calories a day.

In writing about successful achievers, Dennis Waitely has said, “Winners in life have clearly defined, constantly referred to game plans and purposes.  They know where they are going every day, every month, every year. Objectives range all the way from lifetime goals to daily priorities.  The reason most people never reach their goals is that they don’t define them, learn about them or even seriously consider them as believable or achievable.  In other words they never really set them.”

An additional reason for behavior change failure is that individuals fail to set short and intermediate objectives in addition to their long-term goals.  It is difficult to stay focused on a long-term goal with out weekly and daily benchmarks.  Weight control programs are a good example.  Indulgent lifestyles may be responsible for a weight gain of 15 pounds over ten years.  Unfortunately, people tend to look for quick fixes.  They are not content with waiting and working through an additional 10 years of prudence to return to a significantly lower body fat percentage.  Measurable short-term behavioral objectives will provide the reinforcement for continued motivation and attention to the intended behavior.  Using weight loss as an example, rather than obsessing about daily trips to the weight scale, one should focus on the daily behaviors that will lead to the desired outcomes.
 

2. Explore the behavior and formulate a strategic plan

To increase the likelihood of success with a resolution, it is important to formulate a detailed plan.  Entrepreneurs and CEOs have explicit business plans to guide their operations.  Financial planners advocate the need for a well-researched fiscal plan for our future.  A construction crew can not build a building without a plan.  Why should we view health behavior changes any differently?  Poorly planned behavior changes result in failure.  To effectively plan a successful resolution one has to do their homework.
 
Baseline

In examining an existing behavior, it is important to note when and how often the target behavior occurs.  If we have a baseline measurement of the behavior, it also becomes easier to set realistic objectives.  Examples include how often and when a person uses tobacco, or eats high calorie snacks, or displays outbursts of anger.
 

Triggers

If we know when a behavior occurs then we can begin to identify possible motivations and antecedents (triggers).  For example, is this a behavior that is related to certain stressful situations, or other emotional triggers?  Is one accustomed to lighting up a cigarette when they have a cup of coffee or a glass of beer? What need (e.g., relaxation, emotional relief, socialization) does your current behavior fill and how will you fill the void in the future?  If the motivations and antecedents are known then we can plan for alternative coping mechanisms.
 

Learn from your past

Understanding your behavioral history can also provide clues to winning resolutions.  If you have tried to change this behavior in the past, but have not been successful, what went wrong?  Why will it be different this time?  In the case of tobacco addictions, one may need to attempt to quit a number of times (three to four times for most people) before they finally become successful.  The point is, every time you try, you learn something new about yourself and the behavior which can be applied to the next attempt.
 

Plan for stress management

Two of the most common explanations for health resolution failure are poor time management and/or increased levels of stress.  Behavioral changes are difficult enough without the added demands of trying to balance work, relationships, family demands and life in general.  When things get tough, people often revert back to old behavior patterns.  Knowing this ahead of time allows one to prepare and plan for such occurrences as they arise.
 

Research success

Not only should you explore elements of your behavior, but it would also be helpful to see what you can learn from research on your specific behavior.  A wealth of information is now available the best practices for a number of difficult behavioral changes.  Stay away from unhealthy regimens and avoid experimenting on yourself when valid and reliable information is available.  The internet offers access to a world of health information never before available to so many people.  Unfortunately, as with most sources, not all information found there can be considered reliable or valid, so spend time looking at multiple sources and tap into the knowledge of others who might know better.
 

Get expert help

There is also nothing wrong with seeking help from qualified experts in your area.  A certified health education specialist can assist you in putting together a generic plan for any health behavior.  Other professionals offer advise in their area of specialization such as a certified personal trainer for exercise programs, and a registered dietitian for nutritional improvement.  Make sure to ask questions about a professional’s qualifications (for example - how long have you been doing this? how much experience so you have with my particular need?) and don’t hesitate to ask for scientific references to support the advice you are given.
 

3. Develop a support system for your resolution

Tell everyone about your intended behavior change.  Research indicates that one of the qualities of those who are successful at making changes is that they have excellent support systems.  Many of those who make resolutions never tell others about them.  Consciously, or subconsciously, they think, “If I fail, no one will view me as a failure if they don’t know I was trying to change.” Communicating your resolution and intentions increases your accountability to the behavior.  From the very beginning it is important to share your objectives and goals with those around you so that you can enlist their support.

It is very difficult to remain smoke free when smoking friends keep offering you cigarettes, or to practice good communication skills with a partner that doesn’t want to put in any effort, or to control your eating when your family insists on eating large quantities of unhealthy foods in front of you.  As part of the plan described above, include strategies to initiate involvement of others in your efforts.  In an ideal situation, you may be able to lure a buddy into joining your behavior change with you.  Having someone to work out with or quit chewing tobacco can give a big boost to success.  Whether it is a spouse, boyfriend/girlfriend, roommate, co-worker, or just an acquaintance, knowing that you are accountable to someone other than yourself will help to keep you on track.
 

4. Program for success and maintenance

Harry Truman once said, “A pessimist is one who makes difficulties of his opportunities, and an optimist is one who makes opportunities of his difficulties.” With any endeavor as important as a lifestyle change, it is vital to have the proper mental attitude.  The first recommendation is to expect success.  Winners model the behavior they are working toward and have the mindset that their goals are within reach.  This can be enhanced through both positive self-talk and visualization.  One must visualize themselves already having achieved their new lifestyle. Have an image of who you want to become and then act as if you are already that person.  You must see yourself as a non-smoker, as a physically fit - active person, as an emotionally happy individual.  To see yourself in any other light invites self-doubt and contradictions.

Keeping this positive mindset isn’t always easy.  With difficult changes one must expect the occasional setback.  Setbacks should be anticipated and planned for.  Some set New Year’s Resolutions with an all-or-nothing attitude.  At the first sign of difficulty they assume that they will never succeed and back out of their behavior change.  Examples include the ex-smoker who lights up a cigarette, or the problem drinker who takes that first drink, or the dieter who sinks their teeth into a hot fudge sundae and then decides that they shouldn’t even bother to try anymore.  The important thing is to think of setbacks as just that, a temporary setback and not a failure.  So what if you screw-up.  You’re human, it happens.  Get right back in there, learn from your mistakes and move on.
Reward Yourself

One of the ways to stay positive in light of difficulties is to continually reward any achievements.  Rewards and incentives reinforce behaviors and proper attitudes.  Ultimately, rewards must be intrinsically focused.  We assume that success is its own reward, however new behaviors are uncomfortable, so it is helpful to add external stimulus, so that one can feel good in the face of discomfort.  As an example, beginning an exercise program can be painful and time consuming, with few quick results.  An effective exercise prescription would involve activity that is not viewed as total drudgery.  In this situation, you have to have something to look forward to.  Something has to be done to make you feel good about your workout, so try and couple your exercise with a pleasurable activity (or make your workout a pleasurable activity!).  Whether it is a well-deserved massage, hot tub, or an enjoyable healthy meal, the behavior needs reinforcement so you can feel good about your effort.

Some people choose to punish themselves when they don’t meet objectives, e.g., I didn’t go to the gym today, so I won’t allow myself to watch my favorite TV show.  I personally feel that people tend to beat themselves up enough and that you don’t need to punish yourself.  What you are trying to do is feel good about your new behavior, not feel worse.  Focus on rewarding the positives.  Advertise your success and celebrate achievements with your support system.
 

Provide a Visual Record

Another way to keep yourself motivated is to keep a visual record of your success.  This can be as simple as a calendar with stars on it, or a chart of progress toward some intermediate goal.  Many individuals choose to keep track of their daily achievements or setbacks in a journal.  The journal becomes a means of documenting what is working and what requires modification.  Writing about daily accomplishments or setbacks also encourages further accountability to the behavior.  If you know that you are going to write about your efforts, then you are more likely to follow through.

So, in closing, remember…..

Adopting a new healthier lifestyle can be challenging, but also very rewarding.  I hope this article has given you some ideas on how to increase the chance of becoming successful.  If you are still undecided about trying to make a healthy New Year’s Resolution consider this: While during our lifetime advances in medical sciences will add about 2 years to your life, changes in your personal behavior (lifestyle) can add 15+ years.  Isn’t it about time to make some changes?
 

Have a happy and healthy New Year with your new lifestyle!

How you can turn your secret life into a healthier, open relationship

After 15 pleasant years with the same person, Marcia David started seeing someone else. As several months of two-timing passed, she came clean: She told her doctor she’d been seeing a naturopathic physician on the side.

It’s not that her doctor was mad. Just disappointed, really — or at least, that’s what she surmised from the awkward silence that followed her admission. But after years of being treated with a high dosage of medication for a chronic intestinal problem, the 59-year-old wanted to explore some alternative, natural options to ease her pain.

Like David, many people are seeking natural approaches to health care, but just aren’t comfortable telling their traditional family doctor about it.

Thirty-six percent of adults are using some form of complementary or alternative medicine, according to a 2004 survey from the National Center for Complementary and Alternative Medicine. Many doctors of both conventional and alternative persuasions say they’ve seen a rise in patients who are interested in both forms of medicine.

Some patients hide their newfound approach to health care from their usual doctor, and some just don’t feel it’s necessary to come clean, but keeping that secret can be harmful, doctors warn. Some alternative medicines may produce adverse effects when combined with over-the-counter medications, prescription drugs or other conventional medical approaches.

“What ends up happening is the patients are going to go and do these things anyway, and they’re going to do these without medical direction,” says Dr. Mimi Guarneri, medical director for Scripps Center for Integrative Medicine in San Diego.

East meets West

Nationwide, several programs are cropping up that marry western and alternative approaches to health care, such as Scripps and Bastyr Center for Natural Health in Seattle, and doctors are growing more used to seeing patients who try multiple disciplines.

“Every week, I get patients who are coming in for the first time,” says Dr. Jane Guiltinan, a naturopathic physician and clinical professor at Bastyr University in Seattle. “Some of them are nervous. They like their (primary) doctor, and they don’t want to lose their doctor, and they don’t want to make their doctor angry at them.”

For Stephanie Quilao, the apprehension about seeing a naturopathic doctor wasn’t just about disappointing her regular physician — she knew her family wouldn’t approve. She’d been raised in a traditional medical family: Her grandfather was a surgeon, her mom’s a nurse and among her cousins are three M.D.s, a handful of nurses and several medical technicians.

“I just did it covertly for a while,” says Quilao, who lives in Foster City, Calif., and is in her late 30s.

Quilao held out for a year before revealing her secret to her family. But some patients don’t last that long — even the most careful cheaters often get caught.

The jig is up

One of Dr. George Grossberg’s longtime patients, an older man he’d been treating for depression, came in complaining of a disturbing development: he’d recently noticed blood in his urine. He reluctantly agreed to a cystoscopy (an unpleasant procedure that involves inserting a thin probe through the urethra and up to the bladder) after a series of tests failed to reveal the problem.

On a hunch, Grossberg asked if the patient had started taking any new medications. He said no, just aspirin — but then his wife produced a giant bottle of ginkgo biloba from her bag.

“I said ‘Whoa! Before you have this very unpleasant procedure, stop taking this,’” said Grossberg, the director of the division of geriatric psychiatry at Saint Louis University. He explained to the man and his wife that aspirin is a mild blood thinner, and when taken with ginkgo, the interaction of the two can cause bleeding. The patient stopped taking the herbal supplement, and within two weeks, the bleeding had stopped.

“Unfortunately, a lot of doctors don’t ask about those types of things,” says Grossberg. “Patients don’t consider these alternative remedies to be medicines because, after all, they’re available without prescriptions.”

For cancer patients, combining chemotherapy with some common herbal remedies can cause some potentially dangerous side effects, warn doctors. St. John’s wort, an herb used to treat mild to moderate depression, can decrease the efficacy of chemo, whereas something as seemingly innocuous as grapefruit juice can intensify the toxicity of the drugs.

For some, the pressure of leading a double life is too much. One of Grossberg’s patients thought it was time to come clean.

All of a sudden, she’d started having terrible headaches, nausea and heart palpitations, and in an effort to end the pain, the truth came spilling out.

“She ’fessed up to me, that in addition to the medication I was giving her (a low-dose antidepressant), she was taking a modest dose of St. John’s wort,” Grossberg says.

An open relationship

Alternative and conventional approaches to health care can coexist and even thrive in an open relationship, health experts say. But honesty is key.

“You need to have a physician you can communicate with,” Guarneri says.

Tell your doctor what supplements or procedures you’re interested in trying, and ask if it the medication would be a good fit for you. Better yet, have your naturopathic and conventional doctors consult with each other about the best plan for you. And if your doctor doesn’t bring up the subject, it’s up to you to describe the herbal treatments you’re taking. Go into any such conversations with an informed approach, and if your doctor immediately recommends you stop using the supplement or procedure, be sure to ask why to ensure he has validated reasons for doing so, not simply that he is not open to the possiblities.

For the once two-timing David, a combination of conventional and naturopathic medicine now works best. The Seattle-area resident sees Guiltinan now as her primary physician, but for concerns about eyes and ears she still sees an M.D.

“I think it’s balanced well for me now,” David says, “because I know how to use both sides.”

By Melissa Dahl
Health writer
MSNBC
© 2007 MSNBC Interactive

Want to feel better, have more energy and perhaps even live longer? Look no further than old-fashioned exercise.

The merits of exercise — from preventing chronic health conditions to boosting confidence and self-esteem — are hard to ignore. And the benefits are yours for the taking, regardless of age, sex or physical ability. Need more convincing? Check out seven specific ways exercise can improve your life.

1. Exercise improves your mood.
Need to blow off some steam after a stressful day? A workout at the gym or a brisk 30-minute walk can help you calm down.

Exercise stimulates various brain chemicals, which may leave you feeling happier and more relaxed than you were before you worked out. You’ll also look better and feel better when you exercise regularly, which can boost your confidence and improve your self-esteem. Exercise even reduces feelings of depression and anxiety.

2. Exercise combats chronic diseases.
Worried about heart disease? Hoping to prevent osteoporosis? Regular exercise might be the ticket.

Regular exercise can help you prevent — or manage — high blood pressure. Your cholesterol will benefit, too. Regular exercise boosts high-density lipoprotein (HDL), or “good,” cholesterol while decreasing low-density lipoprotein (LDL), or “bad,” cholesterol. This one-two punch keeps your blood flowing smoothly by lowering the buildup of plaques in your arteries.

And there’s more. Regular exercise can help you prevent type 2 diabetes, osteoporosis and certain types of cancer.

3. Exercise helps you manage your weight.
Want to drop those excess pounds? Trade some couch time for walking or other physical activities.

This one’s a no-brainer. When you exercise, you burn calories. The more intensely you exercise, the more calories you burn — and the easier it is to keep your weight under control. You don’t even need to set aside major chunks of time for working out. Take the stairs instead of the elevator. Walk during your lunch break. Do jumping jacks during commercials. Better yet, turn off the TV and take a brisk walk. Dedicated workouts are great, but activity you accumulate throughout the day helps you burn calories, too.

4. Exercise strengthens your heart and lungs.
Winded by grocery shopping or household chores? Don’t throw in the towel. Regular exercise can leave you breathing easier.

Exercise delivers oxygen and nutrients to your tissues. In fact, regular exercise helps your entire cardiovascular system — the circulation of blood through your heart and blood vessels — work more efficiently. Big deal? You bet! When your heart and lungs work more efficiently, you’ll have more energy to do the things you enjoy.

5. Exercise promotes better sleep.
Struggling to fall asleep? Or stay asleep? It might help to boost your physical activity during the day.

A good night’s sleep can improve your concentration, productivity and mood. And, you guessed it, exercise is sometimes the key to better sleep. Regular exercise can help you fall asleep faster and deepen your sleep. The timing is up to you — but if you’re having trouble sleeping, you might want to try late afternoon workouts. The natural dip in body temperature five to six hours after you exercise might help you fall asleep.

6. Exercise can put the spark back into your sex life.
Are you too tired to have sex? Or feeling too out of shape to enjoy physical intimacy? Exercise to the rescue.

Regular exercise can leave you feeling energized and looking better, which may have a positive effect on your sex life. But there’s more to it than that. Exercise improves your circulation, which can lead to more satisfying sex. And men who exercise regularly are less likely to have problems with erectile dysfunction than are men who don’t exercise, especially as they get older.

7. Exercise can be — gasp — fun!
Wondering what to do on a Saturday afternoon? Looking for an activity that suits the entire family? Get physical!

Exercise doesn’t have to be drudgery. Take a ballroom dancing class. Check out a local climbing wall or hiking trail. Push your kids on the swings or climb with them on the jungle gym. Plan a neighborhood kickball or touch football game. Find an activity you enjoy, and go for it. If you get bored, try something new. If you’re moving, it counts!

Are you convinced? Good. Start reaping the benefits of physical activity today!

Deepak Chopra shares his wisdom and thoughts on a mind/body/spirit approach to aging

Q: How can I reverse my body aging?

A: There are three types of aging – chronological age (which is your age according to your date of birth), biological age (which is measured by looking at certain bio markers), and psychological age (which is dependent on your attitude.)

It is now known that psychological age correlates more closely to biological age than chronological age. If you have the attitude that you get better as you grow older in every way – physically, emotionally, spiritually and socially, then you will age in a much more graceful manner.

The well known biological markers of aging include: blood pressure, bone density, body temperature regulation, basal metabolic rate, immune function, sugar tolerance, muscle mass, muscle strength, skin hickness (amount of wrinkles) immune function, and sex hormone levels. If you want to slow down or even reverse these bio markers of aging, then practice one or more of the following:

1. Change your perception of time. Don’t be in a hurry.
2. Get restful sleep.
3. Eat fresh, nutritious food.
4. Take at least two multivitamins with minerals, as well as other valuable supplements, every day.
5. Practice a mind-body technique such as yoga or tai chi.
6. Exercise regularly.
7. Don’t put toxins in your life - including toxic food, toxic emotions, toxic relationships, and avoid toxic environments.
8. Have a flexible attitude to minor hassles.
9. Look at so-called problems as opportunities.
10. Nurture loving relationships.
11. Always have an attitude of curiosity, learning, and wonder and spend time with children.

If you take a multivitamin every morning and perhaps a supplement or two because you care about your health, does it make sense to do the same with your dog or cat? Stephanie Pendleton of Emerald Isle, North Carolina, would say yes.

Pendleton caught on to pet supplements a few years ago when she noticed that her 13-year-old cat, Sierra, wasn’t up to her usual antics.

“She was having a hard time jumping up on the counter, and she wasn’t playing as much as she used to,” Pendleton says. “Finally, she just spent less time up there, I think, because it was painful for her.”

Pendleton researched Sierra’s problem online, and learned about the joint supplements glucosamine and chondroitin. She asked her veterinarian, and they agreed to give the cat a product that combines both joint supplements.

“Sierra is jumping all over the place again,” Pendleton says.

Now, Pendleton is a believer in pet supplements. She gives Sierra and her other cat, 2-year-old Serenity, a multivitamin, probiotics to help their immune systems and essential fatty acids for skin and coat health. Sierra gets seven pills, Serenity four.

Demand for supplements is on the rise. The pet supplement market has grown about 15 percent annually since 2000 and is now a $1.3 billion business, according to the National Animal Supplement Council. Simmons Market Research Bureau says approximately 17 percent of pet owners give their cats and dogs some type of supplement.

A pet supplement is a product that is intended to complement the diet and help support and maintain a normal biological function. Products range from multivitamins for overall health to targeted formulas that claim to alleviate joint problems as well as ones to address degenerative diseases or canine cognitive dysfunction.

Dr. Tim Montague, a veterinarian at Eads Animal Hospital in Eads, Tennessee, started using supplements in 1992. He was wary at first because he didn’t learn about them in veterinary school, and there weren’t many on the market. But when an old professor of his recommended a joint supplement for one of Montague’s patients, he took notice. Montague’s golden retriever Ayla had an arthritic shoulder, so he also tried a joint supplement on her.

“She could barely make it up and down the stairs, but within a week after the supplement she was running and catching Frisbees in the yard,” Montague says. “That sold me on that product.” He said his patients have had good success with joint supplements and he prescribes them all the time.

The FDA urges pet owners to talk to their veterinarians, as well as other pet owners, before giving supplements to their animals, something Montague agrees with.

“People need to be careful about starting any kind of regimen,” he says. “I’ve seen animals harmed by people getting the wrong information over the Internet.”

Dr. John Bauer, professor of clinical nutrition at Texas A&M University’s College of Veterinary Medicine, offers four factors to consider when evaluating supplements:

1. Product quality -  How much of the functional, active ingredient is in the product? Responsible manufacturers will have 800 numbers on the package to call with technical questions about the ingredients, and your veterinarian should know what specific questions to ask.

2. Efficacy - Is there any scientific basis to support the use of this supplement? If information about product testing isn’t available on the company’s Web site or elsewhere, call the company for details about the studies that have been performed.

3. Tolerance - Check the list of ingredients carefully before giving a supplement to your pet. For example, a supplement might include lactose, which some cats and dogs can’t tolerate. It’s a good idea to consult your veterinarian first to discuss how the supplements may react with any medications the pet is taking.

4. Safety - A product’s safety should be proven. For example, the company might state in its literature that it was tested in high doses on mice and found to be safe, or the number of adverse events reported might be few to none

By Joan Shim

November 9, 2007

Natural Products Association Responds to Misinformed and Misleading Articles in New York Times, Reader’s Digest
Association Counters Negative Conclusions and Substantiates Safe and Effective Use of Supplements

Recent articles in both the Reader’s Digest and New York Times unfairly and inaccurately depicted dietary supplements as either unregulated or unsafe. The Natural Products Association contacted both publications to set the record straight.

In an article titled “the Vitamin Hoax — 10 Not to Take,” the November issue of Reader’s Digest took aim at the use of supplements as part of living a healthy lifestyle. The Natural Products Association’s executive director and CEO, David Seckman, in a letter to Reader’s Digest corrected many of the errors and underlying assumptions in the article.

“While the story was full of inaccuracies, the cover was especially troubling because it may lead people who are safely and beneficially taking vitamins to stop, actually putting their health at greater risk,” Seckman said. “Proper nutrition continues to be a huge health challenge for America, with one of every four Americans (over 75 million, including children), not getting the recommended daily allowance of nutrition in their daily diets. Likewise, only 23 percent of Americans get the recommended five servings of fruits and vegetables per day that they need. Sure, we all wish we could eat pyramid-perfect diets, but the reality is far different, and that’s where nutritional supplements play a very important role.”

In challenging recent claims that antioxidant vitamins increase mortality, Seckman cited the fact that more than 160 million people in North America and Europe take antioxidants. “If a true mortality risk had become apparent in any of these clinical studies, those studies would have been halted,” Seckman said. “They were not. On the contrary, surveys show repeatedly that in general, people who use dietary supplements are healthier than those who don’t.”

Additionally, Daniel Fabricant, Ph.D., vice president of scientific and regulatory affairs for the Natural Products Association, responded to a piece in the New York Times about the suspension of professional baseball player Mike Cameron that contained numerous inaccuracies about oversight and regulation in the natural products industry and fed into the misconception, fueled by athletes caught breaking the rules, that supplements are unregulated and contain banned substances.

“For too long now, the dietary supplement industry has been the convenient scapegoat, No. 1 on the excuse list of a number of professional athletes who get caught taking banned substances, to the extent it is blatant,” said Fabricant. “Mr. Cameron’s confession is the latest, but follows a similar refrain: blame ‘tainted supplements’ in the abstract, but withhold the specific name of the product, manufacturer, label, or where the supplement was purchased. The bottom line here is that dietary supplements are regulated by the federal government and they are not permitted to contain banned substances, period.”

Fabricant also had strong words regarding a Cornell University nutrition professor quoted in the article who claimed supplements were “unregulated” and contamination was common.

“That is not only absurd, it is especially astonishing coming from an academic who should know better,” said Fabricant, and went on to cite specific examples.

Editor’s Note: Since both letters are submitted to be published, the Natural Products Association cannot print them in their entirety pending notification by the publications. Updates will be posted on the NPA website when they are available to view and members will be notified. In the meantime, to get the facts about dietary supplements, including scientific citations and regulatory authority, go to www.NaturalProductsAssoc.org/supplementfacts.

A federal jury acquitted a prominent Reno doctor on Thursday of charges he trafficked in a human growth hormone.

Dr. James Forsythe, 69, said the charges had robbed him of his practice and he was eager to return to his work.

His attorneys said that while he was the target of an undercover sting operation in 2004 he twice prescribed the drug to a Food and Drug Administration agent to treat a legitimate health condition.

“I’m ecstatic,” attorney Kevin Mirch said. “I’m glad we persuaded the jury that the doctor is innocent.”

Federal prosecutors argued that Forsythe - with a patient list that includes top casino executives and Nevada first lady Dawn Gibbons - sold the drugs illegally for anti-aging purposes, falsifying the diagnosis of a growth hormone deficiency to cover his tracks.

The 12-member jury deliberated for about two hours in U.S. District Court in Reno Wednesday afternoon and returned its verdict at midmorning on Thursday after hearing closing arguments and listening again to secret tape recordings the undercover agent made of Forsythe, who is married to former Nevada Republican Party Chairwoman Earlene Forsythe.

Senior Judge Howard McKibben on Tuesday dismissed one of two counts the Justice Department brought against Forsythe, saying there was no evidence he introduced the drugs into interstate commerce from Israel without required approval.

The remaining charge accused him of distributing Bio-Tropin as an unapproved anti-aging treatment. If convicted, he would had faced up to five years in prison and a $250,000 fine.

Mirch said FDA agents launched the investigation based on the mistaken understanding the drug had not been approved by the federal agency.

Mirch said when they learned it was simply a new name for a previously approved growth hormone, prosecutors changed their strategy to argue that the drug could be prescribed for adults only in special circumstances, including treatment of hormone deficiency and AIDs wasting.

Mirch said the agency exerted “too much power” in a rush to indict Forsythe in 2005.

“He is a good man,” Mirch said. “He has lived since 2004 with absolutely the most horrible cloud over his head, his family’s head and his colleagues’ heads.

“They wanted to get him. They wanted to embarrass the people on this (patient) list and they did. They should have apologized and let this man who is 69 years old attend to his patients like he has for 40 years.”

Assistant U.S. Attorney James Keller said Forsythe didn’t do many of the tests experts said are necessary to determine whether someone suffers from a hormone deficiency.

“This case is not about whether the defendant is a good doctor or whether he practices good medicine,” Keller said.

“You are simply here to determine whether he followed the law and whether he distributed the drug for unauthorized purposes,” he said.

Keller brushed out of the courtroom on Thursday, ignoring a reporter’s request for comment.

On the tape recording, the undercover agent tells Forsythe a man he knows from the gym referred him to Forsythe. He said he had searched on the Internet and been reading about human growth hormones.

Forsythe responded, “So you’re mainly interested in HGH for energy purposes, getting back into shape?” He then told the agent they provide such treatment at his clinic.

Keller said the doctor made a reference to a book entitled “Feel Good with HGH” and handed out a pamphlet “Healthy Aging, Passport to a Better Life.”

“Doesn’t it show he’s doing it for anti-aging purposes?” Keller asked the jury. “He prescribed it for anti-aging, lack of energy - those things for which we want to make us feel younger.”

“There were no questions about the pituitary gland or trauma to the head,” Keller said, which experts testified can cause such a condition.

“Doesn’t that seem like a cover?” Keller asked. He also questioned why Forsythe didn’t write the agent a prescription to take to a pharmacy.

“Why distribute it out of his office? What’s being hidden here?” he said.

Mirch said the government used snippets of the tape out of context “to somehow state that Dr. Forsythe does not have the capacity to tell if someone has a growth hormone deficiency.”

“The government tried to tell you if Dr. Forsythe didn’t do what they consider proper tests, that is a crime. It is not,” he said. “He can prescribe it and give it to that patient if he believes that (diagnosis). It is an allowed use.”

Mirch said the defense team was able to determine that the agent once suffered a stroke, which he compared to head trauma, something the agent had kept from the FDA and Justice Department prosecutors.

“You don’t let an unqualified sick person make the decision to indict a doctor who has a sterling reputation for years and years and years,” he said.