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How to Avoid Getting Sick When Everyone Around You Already Is

It happens every year. The holidays approach, the weather cools, and just as the season really begin to get busy, you begin to feel sick. We all know the feeling: fatigue, headache, sore throat, low energy. Why does the winter seem to be married to illness?

The answer, according to Dr. Anthony Lyon with the Ash Center in New York, is a combination of overtiring our bodies at the exact time we ask them to battle the cold weather. And when you add the element of enclosure—more people are cooped up together in the winter months, germs spreading as the heat blasts—well, it’s a sure recipe for sickness.

So how can you protect yourself when everyone at the office is catching the flu? The trick isn’t to avoid the ill, but to focus on priming your body to fight off any pending sickness that may be sneezed your way.

In addition to eating well (come on, leafy greens!) and avid hand-washing, Dr. Lyon offers tips for staying well, even when you seem to be the only one.

Breathe better. Lyon suggests you battle exhaustion—a leading cause of illness—by improving the way you breathe. Lyon notes that improper breathing can impact the 5 main reasons why you feel tired: sleep disruption; overwhelming stress or anxiety; gastrointestinal upset and suboptimal digestion; immune system dysregulation; and chronic neck and low back pain.

So how can you breathe better?

“When asked to take a deep breath, most people bow out their chest, lift their shoulders to their ears and breathe in a  very vertical manner,” says Lyon. “This is the style we have adopted after years of reacting to challenging situations, including physical or emotional trauma. But, by breathing like this, you are actually perpetuating a sense of fear and unrest by sending a signal to your brain that you are in ‘flight or fight’ mode. Instead, expand your abdomen when you inhale and make it look like a pregnant belly, which engages your diaphragm, and dissipates turmoil by telling your vagus nerve that all is fine and it is okay to rest, relax and digest.” Lyon explains that when you can rest, relax and digest, you give your body the best chance to restore and recover, and protect itself from germy invaders.

flu-cold-sneeze

Move your muscles. Lyon promotes movement as a surefire way to stay healthy. And while any physical activity is great for keeping your systems moving, Lyon says that weight training to build stronger muscles can help ward off winter illness. “We are only starting to learn all of the health benefits that strong muscle confers, including its role as an endocrine gland,” says Lyon. “Muscles secrete proteins, hormones and other vitally important messenger molecules that send signals to direct essential activities elsewhere. Keep your muscle happy so your immune system will be primed and ready to go.”

Adjust your bedtime. We all know catching enough zzzs can help us feel rested and give our body ample time to fight potential illness. But Lyon stresses it’s not just how much you sleep (aim for 7-8 hours), but when. Lyon recommends falling asleep by 10pm at the latest. “By going to bed at a decent hour, your sleep will be physiologic – which means it is congruent with your body’s normal functioning. Right around 10pm is when certain organs need to start the housekeeping work to prepare you for the next day, including your brain, which needs to detoxify from the day you just had. When you stay up late, the housekeeping cannot be completed, leaving you fatigued the next day.” If you have a ton of tasks on your to-do list, Lyon says you’ll be better off turning in at a decent time and waking up early.

By: Zoe Eisenberg          November 16, 2016          @ZoEisenberg

 

source: www.care2.com
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When Patients Manage Doctors

People with multiple chronic illnesses often must take charge of managing their own care

By SUMATHI REDDY    Aug. 10, 2015 

One in four Americans lives with more than one chronic illness; three out of four among those 65 and older.

Managing those people’s health care is often difficult. Integrated health systems, such as Kaiser Permanente and Mayo Clinic, aim to ensure that treatment for one condition doesn’t interfere with care the patient is receiving for other diseases. Often, however, the responsibility of coordinating treatments falls on the patients themselves.

“Conflicts between medications, and doctors that don’t talk to one another, is a big and common problem,” said John Piette, director of the Center for Managing Chronic Disease at the University of Michigan School of Public Health. “People have difficulty managing both symptoms and side effects of multiple medications,” he added.

The Department of Health and Human Services (HHS) in July issued a free curriculum for training health-care professionals and others in how to care for patients with multiple chronic conditions. The curriculum includes strategies to help patients keep track of their own care by involving caregivers, for example. For patients who have a hard time taking numerous daily medications, doctors should tell them which drugs are most important, the curriculum recommends.

HHS has taken other steps to address the needs of patients with multiple chronic conditions since launching an initiative in 2010 to study the issue. The Centers for Medicare and Medicaid Services, an agency within HHS, began this year reimbursing health-care providers for time spent coordinating the care of those patients outside of regular office visits.

The department also seeks to ensure that people with multiple chronic conditions are included in clinical trials. “That’s important because we want to make sure that when drugs come on to the market that they are truly safe and effective for patients with multiple chronic conditions,” said Dr. Anand Parekh, HHS deputy assistant secretary for health.

For many patients, multiple chronic conditions, such as obesity and diabetes, are related, or what is called concordant. Other patients have completely separate conditions, such as epilepsy and cardiovascular disease, which are known as discordant.

doctor patient
‘Conflicts between medications, and doctors
that don’t talk to one another, is a big and common problem,’
says John Piette, director of the Center for Managing Chronic Disease
at the University of Michigan School of Public Health.

Electronic health records can help doctors keep track of the varied care patients might be receiving, especially when they see multiple specialists at the same hospital or medical center. Patients shouldn’t necessarily rely on this, however, said Dr. Piette, who is also a senior scientist in the Veterans Health Administration. Ultimately, it is the patient who has to be “a proactive consumer of health care and in charge of managing their multiple conditions,” he said.

Sometimes different specialists give a patient conflicting advice. In this case, patients should write down as much information as possible when talking to each doctor and let them know about the apparent conflict, Dr. Piette said. Patients could also encourage the doctors to talk to each other if needed, he said.

Victor Montori, professor of medicine at the Mayo Clinic in Rochester, Minn., talks about the “work of being a patient,” which involves more than keeping up with one’s medications. Patients must also educate themselves about the health care they need, said Dr. Montori, who is also lead investigator of the clinic’s Knowledge and Evaluation Research Unit, which seeks ways to adapt care for individual patient’s needs.

Doctors who prescribe medications should be responsible for taking into account the patient’s various illnesses, Dr. Montori said. If clinicians don’t have the expertise to understand potential drug interactions, they should seek advice from a pharmacist, who is trained to deal with problems that arise when patients take many drugs, he said.

Dr. Michael Munger, a family physician in Overland Park, Kan., says he sees himself as a quarterback, coordinating care for his patients with multiple chronic conditions. That means ‘getting the patient to the right care at the right time and making sure the information – past medicines, medical history – is available,’ he says.

Dr. Montori recommends patients build their own version of a medical record by keeping a complete and updated list of medicines handy and bringing it to all doctors’ visits. And if the demands of being a patient become overwhelming, talk to the doctor, he said. For example, as a diabetes doctor, Dr. Montori might ask patients to check their blood sugar several times a day. When this is difficult for a patient to do, some checks can be eliminated in cases when they are less critical, he said.

He also recommends that patients who aren’t in an integrated health system seek out a “quarterback” to keep an eye on the big picture and help coordinate their care. Usually this is a primary care doctor or an internist, or in some cases the specialist who the patient sees the most. For a cancer patient, for example, the oncologist will often take on that responsibility. Family members can also help by keeping track of treatments for multiple illnesses.

Michael Munger, a family physician in Overland Park, Kan., said he regularly coordinates care for his patients, most of whom have multiple chronic conditions.

That part of the job, he said, means “getting the patient to the right care at the right time and making sure the information—past medicines, medical history—is available.”

Dr. Munger says he always starts visits by going over a patient’s medication list. “Most of my patients have it tucked in their purse or their wallet,” he said. “I have them pull that out so we can review it and make sure it’s current.”


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Why you shouldn’t go to work sick

By Dr. Jennifer Shu, Special to CNN     Tue September 24, 2013

The average adult gets a cold about two or three times a year, with each one lasting up to a week, or sometimes longer.

Editor’s note: Dr. Jennifer Shu, CNNHealth’s Living Well expert doctor, is a practicing pediatrician and mother of two.

(CNN) – The average adult gets a cold about two or three times a year, with each one lasting up to a week, or sometimes longer.

Staying home from work every time you are sick could add up to a lot of missed days. In fact, it has been reported that up to 40% of lost time from work is due to the common cold, totaling about 23 million missed days per year.

Even though it can be tempting to go to work while you’re sick, here are some reasons why you are better off staying home:

You’ll get other people sick

Germs can spread from direct contact with a sick person or his or her secretions (such as from handshakes or touching shared objects like doorknobs). Some viruses can live on the skin or other surfaces for at least a few hours and continue to infect others.

In addition, viruses can spray a few feet following a cough or sneeze. Especially in the earliest part of illness, when you are most contagious, stay home if you work in close quarters with other people or if you handle food.

It’s also important not to go to work if you work with young children, the elderly or people with weak immune systems. The relatively minor illness you experience may cause more severe symptoms in these groups of people.


You’ll be less productive

It is hard to know the exact financial and physical toll that an illness takes on an individual or employer. Sure, you’ll be more productive than if you stayed home and didn’t do any work at all, but you may not be as sharp or efficient when suffering from a cold.

It may take longer to recover

Pushing yourself and working too much in the early stages of illness may actually prolong your recovery time. Studies have shown that lack of sleep can weaken your immune system and make you more susceptible to colds.

Conversely, getting enough sleep can boost infection-fighting cells and antibodies so you can get well faster. Do yourself a favor and stay home and rest.

Ideally, we would all be able to rest and recuperate during a cold. If that’s not possible, see if you can work from home so at least you won’t spread your germs.

If you must go to work, try to keep your distance from others, wash or sanitize your hands often, and cover coughs and sneezes with a sleeve or elbow. You can also cover with a tissue but be sure to throw it away immediately and then wash your hands.

Disinfect touched objects such as phones, doorknobs, and computer keyboards, and consider avoiding sharing items such as pens.

source: cnn


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The Spoon Theory

by Christine Miserandino

My best friend and I were in the diner, talking. As usual, it was very late and we were eating French fries with gravy. Like normal girls our age, we spent a lot of time in the diner while in college, and most of the time we spent talking about boys, music or trivial things, that seemed very important at the time. We never got serious about anything in particular and spent most of our time laughing.

As I went to take some of my medicine with a snack as I usually did, she watched me with an awkward kind of stare, instead of continuing the conversation. She then asked me out of the blue what it felt like to have Lupus and be sick. I was shocked not only because she asked the random question, but also because I assumed she knew all there was to know about Lupus. She came to doctors with me, she saw me walk with a cane, and throw up in the bathroom. She had seen me cry in pain, what else was there to know?

I started to ramble on about pills, and aches and pains, but she kept pursuing, and didn’t seem satisfied with my answers. I was a little surprised as being my roommate in college and friend for years; I thought she already knew the medical definition of Lupus. Then she looked at me with a face every sick person knows well, the face of pure curiosity about something no one healthy can truly understand. She asked what it felt like, not physically, but what it felt like to be me, to be sick.

As I tried to gain my composure, I glanced around the table for help or guidance, or at least stall for time to think. I was trying to find the right words. How do I answer a question I never was able to answer for myself? How do I explain every detail of every day being effected, and give the emotions a sick person goes through with clarity. I could have given up, cracked a joke like I usually do, and changed the subject, but I remember thinking if I don’t try to explain this, how could I ever expect her to understand. If I can’t explain this to my best friend, how could I explain my world to anyone else? I had to at least try.

At that moment, the spoon theory was born. I quickly grabbed every spoon on the table; hell I grabbed spoons off of the other tables. I looked at her in the eyes and said “Here you go, you have Lupus”. She looked at me slightly confused, as anyone would when they are being handed a bouquet of spoons. The cold metal spoons clanked in my hands, as I grouped them together and shoved them into her hands.

I explained that the difference in being sick and being healthy is having to make choices or to consciously think about things when the rest of the world doesn’t have to. The healthy have the luxury of a life without choices, a gift most people take for granted.

Most people start the day with unlimited amount of possibilities, and energy to do whatever they desire, especially young people. For the most part, they do not need to worry about the effects of their actions. So for my explanation, I used spoons to convey this point. I wanted something for her to actually hold, for me to then take away, since most people who get sick feel a “loss” of a life they once knew. If I was in control of taking away the spoons, then she would know what it feels like to have someone or something else, in this case Lupus, being in control.

She grabbed the spoons with excitement. She didn’t understand what I was doing, but she is always up for a good time, so I guess she thought I was cracking a joke of some kind like I usually do when talking about touchy topics. Little did she know how serious I would become?

I asked her to count her spoons. She asked why, and I explained that when you are healthy you expect to have a never-ending supply of “spoons”. But when you have to now plan your day, you need to know exactly how many “spoons” you are starting with. It doesn’t guarantee that you might not lose some along the way, but at least it helps to know where you are starting. She counted out 12 spoons. She laughed and said she wanted more. I said no, and I knew right away that this little game would work, when she looked disappointed, and we hadn’t even started yet. I’ve wanted more “spoons” for years and haven’t found a way yet to get more, why should she? I also told her to always be conscious of how many she had, and not to drop them because she can never forget she has Lupus.

I asked her to list off the tasks of her day, including the most simple. As, she rattled off daily chores, or just fun things to do; I explained how each one would cost her a spoon. When she jumped right into getting ready for work as her first task of the morning, I cut her off and took away a spoon. I practically jumped down her throat. I said ” No! You don’t just get up. You have to crack open your eyes, and then realize you are late. You didn’t sleep well the night before. You have to crawl out of bed, and then you have to make your self something to eat before you can do anything else, because if you don’t, you can’t take your medicine, and if you don’t take your medicine you might as well give up all your spoons for today and tomorrow too.” I quickly took away a spoon and she realized she hasn’t even gotten dressed yet. Showering cost her spoon, just for washing her hair and shaving her legs. Reaching high and low that early in the morning could actually cost more than one spoon, but I figured I would give her a break; I didn’t want to scare her right away. Getting dressed was worth another spoon. I stopped her and broke down every task to show her how every little detail needs to be thought about. You cannot simply just throw clothes on when you are sick. I explained that I have to see what clothes I can physically put on, if my hands hurt that day buttons are out of the question. If I have bruises that day, I need to wear long sleeves, and if I have a fever I need a sweater to stay warm and so on. If my hair is falling out I need to spend more time to look presentable, and then you need to factor in another 5 minutes for feeling badly that it took you 2 hours to do all this.

pain


I think she was starting to understand when she theoretically didn’t even get to work, and she was left with 6 spoons. I then explained to her that she needed to choose the rest of her day wisely, since when your “spoons” are gone, they are gone. Sometimes you can borrow against tomorrow’s “spoons”, but just think how hard tomorrow will be with less “spoons”. I also needed to explain that a person who is sick always lives with the looming thought that tomorrow may be the day that a cold comes, or an infection, or any number of things that could be very dangerous. So you do not want to run low on “spoons”, because you never know when you truly will need them. I didn’t want to depress her, but I needed to be realistic, and unfortunately being prepared for the worst is part of a real day for me.

We went through the rest of the day, and she slowly learned that skipping lunch would cost her a spoon, as well as standing on a train, or even typing at her computer too long. She was forced to make choices and think about things differently. Hypothetically, she had to choose not to run errands, so that she could eat dinner that night.

When we got to the end of her pretend day, she said she was hungry. I summarized that she had to eat dinner but she only had one spoon left. If she cooked, she wouldn’t have enough energy to clean the pots. If she went out for dinner, she might be too tired to drive home safely. Then I also explained, that I didn’t even bother to add into this game, that she was so nauseous, that cooking was probably out of the question anyway. So she decided to make soup, it was easy. I then said it is only 7pm, you have the rest of the night but maybe end up with one spoon, so you can do something fun, or clean your apartment, or do chores, but you can’t do it all.

I rarely see her emotional, so when I saw her upset I knew maybe I was getting through to her. I didn’t want my friend to be upset, but at the same time I was happy to think finally maybe someone understood me a little bit. She had tears in her eyes and asked quietly “Christine, How do you do it? Do you really do this everyday?” I explained that some days were worse then others; some days I have more spoons then most. But I can never make it go away and I can’t forget about it, I always have to think about it. I handed her a spoon I had been holding in reserve. I said simply, “I have learned to live life with an extra spoon in my pocket, in reserve. You need to always be prepared.”

Its hard, the hardest thing I ever had to learn is to slow down, and not do everything. I fight this to this day. I hate feeling left out, having to choose to stay home, or to not get things done that I want to. I wanted her to feel that frustration. I wanted her to understand, that everything everyone else does comes so easy, but for me it is one hundred little jobs in one. I need to think about the weather, my temperature that day, and the whole day’s plans before I can attack any one given thing. When other people can simply do things, I have to attack it and make a plan like I am strategizing a war. It is in that lifestyle, the difference between being sick and healthy. It is the beautiful ability to not think and just do. I miss that freedom. I miss never having to count “spoons”.

After we were emotional and talked about this for a little while longer, I sensed she was sad. Maybe she finally understood. Maybe she realized that she never could truly and honestly say she understands. But at least now she might not complain so much when I can’t go out for dinner some nights, or when I never seem to make it to her house and she always has to drive to mine. I gave her a hug when we walked out of the diner. I had the one spoon in my hand and I said “Don’t worry. I see this as a blessing. I have been forced to think about everything I do. Do you know how many spoons people waste everyday? I don’t have room for wasted time, or wasted “spoons” and I chose to spend this time with you.”

Ever since this night, I have used the spoon theory to explain my life to many people. In fact, my family and friends refer to spoons all the time. It has been a code word for what I can and cannot do. Once people understand the spoon theory they seem to understand me better, but I also think they live their life a little differently too. I think it isn’t just good for understanding Lupus, but anyone dealing with any disability or illness. Hopefully, they don’t take so much for granted or their life in general. I give a piece of myself, in every sense of the word when I do anything. It has become an inside joke. I have become famous for saying to people jokingly that they should feel special when I spend time with them, because they have one of my “spoons”.

Christine Miserandino 

 


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Preventive health care for unhealthy could save billions

‘Focus on illness treatment has made illness and disease a growth industry,’ says study author

The Canadian Press    Jun 19, 2013 

Billions of dollars could be saved in Canada’s health-care system with the introduction of preventive programs that focus on those individuals in poor health, says a study by the School of Public Policy at the University of Calgary.

“Canadian medicare with its focus on illness treatment has made illness and disease a growth industry,” lead author Herb Emery told reporters Wednesday.

“It’s one of the fastest growing parts of our public system…. Where we see retraction in education and other areas, we’re seeing continual five per cent growth per year in treating illness and we can’t keep up with demand.”

The report evaluates the costs and benefits of an alternative approach by examining the preventive health-care program run by Pure North S’Energy Foundation, a not-for-profit organization that pays for and provides personalized, preventative health-care services.

It includes lifestyle counselling, dietary supplements and dental services for Albertans from groups of people who tend to be in poor health.

The report found the annual health-care bill for a Canadian in poor health is more than $10,000 higher than for someone in good health.

The Pure North program achieved positive health outcomes at a cost of $2,300 per participant — far less than treating people once they become sick.


Health care costs unstable

“People in poor health tend to use more health care,” Emery said. “The minority of the population, 20 per cent, is generating 80 per cent of the costs and these are generally people who are in poor health.”

Individuals who are healthy tend to stay in good health, and those in poor health tend to stay that way, said Emery.

“What we’re really talking about is chronic conditions … diabetes, cardiovascular disease and cancer. If we can intervene sooner, we can change lifestyles, we can change health. We can potentially restore the fiscal sustainability of the health care.”

Emery said about 250,000 Albertans describe themselves as being in poor health. If even 45 per cent of that number showed an improvement, it would cut the number of their days in hospital by 25 per cent. He said that would save the system $500 million a year.

Emery said if that was expanded across Canada, the savings would be “in the billions.”

“I think the interest in making people healthier and avoiding chronic diseases is Canada-wide. Everyone agrees that if you can figure out how, it has a higher return for the medicare system. The piece that is missing out there is how do you make people healthier?”