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Archive for February, 2008

The Top 10 Immune Busters

Posted on: February 15th, 2008 by info No Comments

Strengthen your immune system by kicking these defense-impairing habits. Follow this advice, and your body will thank you. 

1. Stop Smoking
Smoking, and breathing in secondhand smoke, are terrible for your entire body. Cigarette smoke contains more than 4,000 chemical compounds. Of these, at least 43 are known carcinogens.
 
Here are just some of the ways it wreaks havoc: Smoking causes heart disease, lung and esophageal cancer, and chronic lung disease. It contributes to cancer of the bladder, pancreas, and kidneys. Women who smoke during pregnancy are more likely to have problems, including babies with low birth weights, which is a leading cause of infant death.
 
In fact, smoking kills more than two times as many people as AIDS, alcohol abuse, motor vehicle accidents, homicides, drugs, and suicide combined. One out of every five deaths in America is smoking-related. On average, smokers die nearly 7 years earlier than nonsmokers!
 
Secondhand smoke is almost as deadly. Each year, because of exposure to tobacco smoke, an estimated 3,000 nonsmoking Americans die of lung cancer and 300,000 children suffer from lower respiratory tract infections. Secondhand smoke can trigger an asthma attack and aggravate symptoms in people with allergies. In addition, tobacco smoke has been shown to make asthma worse in preschool children and may even cause it.

2. Dodge Those PCBs
It takes just one exposure of less than one-millionth of a gram for immunotoxic contaminants such as polychlorinated biphenyls (PCBs), mercury, certain pesticides, and dioxin-like substances to disrupt the immune function of innocent wildlife. Since these chemicals can stay in the environment for decades, vulnerable wildlife species have no escape from their devastation. Moreover, not only do these toxins become more concentrated as they move their way up the food chain, they can also cause life-threatening autoimmune reactions–the immune system’s inability to tell the difference between the body’s own tissues and foreign invaders.
 
So, what does this have to do with your immune system? A lot. Evidence suggests that some of these same chemicals may be putting us at risk. A few examples: In Aberdeen, N.C.–home of the Aberdeen pesticides dump–scientists found that young adults were two times more likely than nonresidents to have shingles, a painful condition caused by a herpes virus. In another study, researchers found that chlordane, a termite-killing substance, caused weaker immune responses in people who had been exposed.
 
So what can you do? Reduce your exposure as much as possible to unnecessary toxins. Stay away from cigarette smoke, excess alcohol, and illicit drugs. Buy organic produce when possible. Rinse your fruits and vegetables thoroughly to remove pesticides. Switch to natural gardening methods and stay indoors or go away when your neighbors are using pesticides. Choose cleansers, paper goods, and other products that are made with less toxic materials. Read food labels vigilantly and avoid products that contain unnecessary chemicals.

3. Avoid Sleep Deprivation
Sleep deprivation has a powerfully detrimental effect on your immune system. The perfect example is college students who get sick after pulling all-nighters cramming for exams.
 
If you’re tired when you wake up in the morning, you’re not getting enough sleep, or maybe not enough quality sleep. Either way, your immunity is probably compromised. Poor sleep is associated with lower immune system function and reduced numbers of killer cells that fight germs. Killer cells are also the part of the immune system that combats cells that divide too rapidly, as they do in cancer. Lower their numbers and you may be at greater risk for illness.
 
Studies have shown that chronic sleep deprivation also contributes to heart disease, gastrointestinal problems, and other medical illnesses. One study on the effects of sleep deprivation showed that a group of men restricted to 4 to 6 hours of sleep per night experienced changes in hormone function and carbohydrate metabolism that mimic aging changes; the lack of sleep was making them older faster.
 
4. Release Yourself from the Stress Trap
No doubt about it, stress is an Immune Buster. The loss of a job, the death of a spouse, the breakup of a marriage–these are all examples of situations that can trigger a vigorous stress response in the body.
 
There is compelling scientific evidence that chronic stress causes a measurable decline in the immune system’s ability to fight disease. Severe and chronic stress have a direct impact on the immune system that can cause disease or change the course of a preexisting disease. For example, studies have indicated that higher levels of stress hormones lead to more rapid cancer progression.
 
Other research has shown that people who are stressed are more prone to developing cardiovascular disease. Studies show that women with cardiovascular disease who are better able to manage their stress live longer and remain healthier than women with cardiovascular disease who undergo a lot of stress and don’t know how to manage it.
 
Periods of extreme stress can result in lower natural killer cell count, sluggish “killer T” cells, and diminished macrophage activity that can amplify the immune response. In fact, widows and widowers are much more likely to get sick during the first year following the death of their spouse than their peers who have not experienced a major loss.
 
5. Adopt an Optimistic Outlook
Even subtle shades of sadness can weaken your immune system. Here’s why:
 
Studies show that pessimists who look at a half-glass of water and think that it’s half-empty don’t live as long as optimists, who see the same glass as half-full. When pessimists put a more positive spin on the calamities in their lives, they have less stress and better health. One reason for this could be that optimists take better care of themselves. It could also be due to less stress-related damage to your immune system, such as killer cells that suddenly become pacifists. In one study, cancer patients who completed a special course designed to make them more optimistic had stronger immune systems than those who maintained their woesome ways.
 
Other research supports the idea that having a negative outlook when under stress can make you and your immune system miss out. A 1998 study at UCLA found that law students who began their first semester optimistic about the experience had more helper T cells midsemester, which can amplify the immune response, and more powerful natural killer cells. The reason? They experienced events such as their grueling first year as less stressful than did their more pessimistic classmates. Researchers say that this establishes the possibility that a person’s outlook and mood when stressed might affect responses to common immune challenges such as exposure to cold viruses.

6. Avoid Sedentary Lifestyles
One in four American women doesn’t exercise at all, making sedentary lifestyles even more common in women than in men. Sedentary ways have a tremendous impact on health. The benefits of exercise are so great that choosing not to exercise is like throwing away a winning lottery ticket. Millions of Americans suffer from illnesses that can be prevented or treated through exercise, including 50 million people with high blood pressure, 13.5 million with coronary heart disease, and 8 million with type 2 diabetes.
 
Studies show the dangers of a sedentary life. One study compared inactive people with those who walked briskly almost every day. Researchers found that those who didn’t walk took twice as many sick days in 4 months as those who walked.
 
Over time, you should work up to the standard recommendation of five times a week for at least 30 minutes. Experts say that it takes a half-hour of aerobic exercise to sweep white blood cells, key immune system components that are stuck on the blood vessel walls, back into circulation.
 
Moderate exercise is the key. If your exercise is too intense, it can actually suppress your immune system, which is why marathon runners often get colds after a race. What defines overexertion depends on your fitness level. Consult with your doctor to determine yours before starting an exercise program.
 
7. Avoid Social Isolation
The cost of social isolation may be higher than we think. Studies show that the fewer human connections we have at home, at work, and in the community, the more likely we are to get sick, flood our brains with anxiety-causing chemicals, and die prematurely.
 
One study in Sweden showed that those who frequented cultural events such as concerts, museum exhibits, and even ball games tended to live longer than their stay-at-home peers. The key factors could be increased social contact and reduced stress. Other studies have found that people who are isolated may live only half as long as those who have a lot of human contact. Love seems to be an immune system nutrient.
 
The good news is that these same studies also show that the more human connections we have, the more likely we are to live longer and healthier. Connectedness is the unacknowledged key to emotional and physical health. The more ties you have, the more likely you are to stay well in the first place. Researchers who monitored 276 people between the ages of 18 and 55 found that those who had six or more connections were four times better at fighting off the viruses that cause colds.
 
8. Junk the Junk Food
Combined with sedentary lives, a poor diet is estimated to kill between 310,000 and 580,000 Americans each year.   So, how bad is junk food for your immune system?
 
Experts have known for some time that when a person is malnourished, her immune system is weakened. When you restore the person to normal nutrition, her immune system improves, which is no surprise. But what they’re just learning is that when you continue to improve nutrition beyond mere adequacy, the immune system continues to improve, even in healthy people.
 
One thing that a lot of junk food has in common is excess fat. Fats, especially polyunsaturated fats, tend to suppress the immune system. Cut your total fat intake to no more than 25% of daily calories.
 
Another bad component of junk food is excess sugar. Sugar inhibits phagocytosis, the process by which viruses and bacteria are engulfed and then literally chewed up by white blood cells.

9. Arm Yourself Against Too Many Antibiotics
The cost of antibiotic resistance is high, both literally and from a health perspective. Literally, while it costs only $12,000 to treat a patient who has tuberculosis that responds to antibiotics, the cost soars to $180,000 for a patient with a multidrug-resistant strain.
 
From a health perspective, the cost of antibiotic resistance is an increase in the seriousness of disease. For example, treating a person with tuberculosis caused by a strain that is killed by antibiotics is highly effective. In contrast, between 40 and 60% of people who get antibiotic-resistant tuberculosis die.
 
The cost of misuse of antibiotics can be a weakened immune system. Researchers found that certain patients taking antibiotics had reduced levels of cytokines, the hormone messengers of the immune system. When your immune system is suppressed, you’re more likely to develop resistant bacteria or to become sick in the future.
 
Here are steps to take to use antibiotics properly:
•  Take antibiotics only for bacterial infections.
•  Take antibiotics the right way. If you are prescribed an antibiotic, it’s crucial that you take the entire course.
•  Don’t use antibiotics to try to prevent infection.
•  Don’t save or share antibiotics.
•  Avoid antibacterial hand soaps and lotions.

10. Use Laughter to Beat Stress
Researchers have found that the positive emotions associated with laughter decrease stress hormones and increase certain immune cells while activating others. In one study conducted at Loma Linda University School of Medicine in California, 10 healthy men who watched a funny video for an hour had significant increases in one particular hormone of the immune system that activates other components of the immune system.
 
So how can you add a little humor to your life? Simply find reasons to laugh. Rent a funny video; read a book of jokes. Have lunch with a friend known for her sense of humor. Lightening up can really light up your immune system.

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Obesity Linked to Increased Cancer Risk

Posted on: February 13th, 2008 by info No Comments

By Steven Reinberg
HealthDay

Weight management, exercise and proper nutrition are key to reducing your risk of cancer. And the earlier in life you adopt these practices, the better off you’ll be, a recent study suggests.

Factors such as birth weight, childbearing, breast-feeding, and adult height and weight also influence cancer risk, according to the report released by the American Institute for Cancer Research and the Britain-based World Cancer Research Fund. Understanding how these factors affect cancer risk, and how to put this information to use to prevent the disease, offer promising new directions for cancer research, the study authors said.

“We need to think about cancer as the product of many long-term influences, not as something that ‘just happens,’ ” Dr. Walter J. Willett said in a prepared statement. Willett, a professor of epidemiology and nutrition at the Harvard School of Public Health, was one of 21 authors of the report Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective.

“Examining the causes of cancer this way, across the entire lifetime, is called the life course approach,” he added.

The report, an analysis by scientists from around the world of more than 7,000 studies, offers 10 recommendations to help prevent cancer. They include staying lean, getting at least 30 minutes of exercise daily, limiting your intake of red meat and alcohol, informed supplementation and avoiding processed meats.

“These findings are right on,” said Colleen Doyle, director of nutrition and physical activity at the American Cancer Society. “They are consistent with our own nutrition and physical activity guidelines. They clearly put the emphasis where the emphasis needs to be, and that’s on controlling your weight.”

“This is a good-news report,” added Karen Collins, a nutrition adviser at the American Institute for Cancer Research. “If we are watching our weight, working regular physical activity into our daily life and eating a healthy balance of foods, we could prevent a third of cancers,” she said. “Extra weight is not dead weight,” she said. “It’s an active metabolic tissue that produces substances that promote the development of cancer.”

“People should take this message to be empowering,” Collins said.

The analysis of the studies found a definite link between excess fat and cancers of the esophagus, pancreas, colon and rectum, endometrium, kidney as well as breast cancer in postmenopausal women.

The risk from excess weight begins at birth, according to the report. The reason for the link between birth weight and breast cancer has to do with body fat. Excess body fat influences the body’s hormones, and these changes can make it more likely for cells to undergo the kind of abnormal growth that leads to cancer, the researchers said.

In addition, overweight girls can start menstruating at an earlier age. So, over their lifetime, they will have more menstrual cycles. This extended exposure to estrogen is associated with increased risk for premenopausal breast cancer, the report found.

Not smoking is the most important thing one can do to reduce the risk of cancer, Doyle said. But, she added, “there are estimates that obesity will overtake smoking as the leading preventable cause of death.

“It’s great to see another report that emphasizes being active, watching your weight and eating a healthy diet are not only going to help you reduce your risk of cancer but heart disease and diabetes as well,” Doyle said.

The report also found that breast-feeding can lower a mother’s risk for developing breast cancer. In addition, breast-fed infants have a lower risk of becoming overweight or obese, and this means a lower risk of developing cancer.

“The evidence is uniformly strong on breast-feeding, and the fact that it offers cancer protection to both mothers and their children is why we made breast-feeding one of our 10 Recommendations to Prevent Cancer,” Willett said.

In addition, tall people seem to have a higher risk of colorectal and postmenopausal breast cancer, according to the report.

“We found that tallness is also probably linked to increased risk for ovarian, pancreatic and premenopausal cancer as well,” Willett said. Although the association between height and cancer is convincing, tall people are not destined to get cancer, he added.

Willett noted that being at increased risk is not a guarantee that you are going to develop cancer. “Risk isn’t fate,” he said. “The evidence clearly shows that risk can be changed.”

“We wanted to point these emerging links out, because we now believe them to be more important than the scientific community, much less the public, has yet realized,” Willett added. “Whether or not we get cancer has to do with our genes and with the choices we make everyday. Our cancer risk is also influenced by our whole accumulated life experience, from conception onwards.

“Body weight and composition is a big factor,” one expert said.

“This report really reinforces the connection between being overweight or obese and the increased risk of many, if not all, cancers,” said Carolyn Lammersfeld, the national director of nutrition at Cancer Treatment Centers of America. “The majority of Americans are not aware of that connection. They are more concerned with pesticides and environmental contaminants, but obesity is a much greater risk factor,” she said.

But risks can be minimized, she added. “If you don’t have cancer, it’s never too late to try to do what you can to lower your risk,” Lammersfeld said. “In addition, cancer survivors should follow the diet and weight recommendations to prevent a return of cancer.”

The report said that people should not depend solely on dietary supplements to try to offset cancer risk — something Lammersfeld agreed with. “You can’t simply fix a crappy diet with supplements,” she said. “You need a balanced diet and specific supplements to augment your food intake, as well as atenuate the effects of the foods themselves. Also, daily exercise and a positive mental state are integral.”

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Nine Secrets Health Insurers Do Not Want You to Know

Posted on: February 12th, 2008 by info No Comments

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.

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