Tag: Health maintenance

October 13, 2020October 15, 2020

How Health Care Systems Use Clinical Empathy to Support Patients

by Kelly R. Smith

Surgeon and nurse operating on a patient

Introduction: What is Clinical Empathy?

What is clinical empathy? The Journal of General Internal Medicine¹ defines it this way, “the act of correctly acknowledging the emotional state of another without experiencing that state oneself.” Note that patients desire empathy from providers, and providers want to make it available. As opposed to the layman’s concept of empathy, professional empathy must be purely cognitive, in contrast with sympathy. Otherwise, the professional risks identifying too closely with the patient, endangering the relationship and clouding the judgement needed for proper medical condition diagnosis and treatment.

Of course, this is not to say that the concept of clinical empathy is limited to the relationship between the provider and the patient (although that is the focus of this paper). It affects the entire medical community in one way or another. It applies to all, from the ophthalmologist to the surgeon and everyone in between.

The Role of Social Media

More patients are going online to discuss what they are experiencing. Such as, “Did you have this side effect from your flu shot? Were you warned?” This is having a relatively new influence on the patient/doctor relationship. The question is – how can this situation be managed in the most productive way possible? Empathy skills can be honed by understanding real-life situations and concerns. In order to get a grasp on what kind of relevant concerns are floating around on the internet, data analysis must be . At first glance, due to the sheer magnitude (and “noise”) of the data set, the problem might seem overwhelming.

This is where specialized software comes into the picture. Specifically, data analysis software that has both the statistical and analytical capacity to inspect, clean, transform, and model data in order to derive important information for decision-making purposes.

What sort of patient concerns crop up often in social media? Wait-time is always a big issue that leads to patient frustration. They see a lot of activity in the hospital or clinic, but nobody has a sense of urgency for their care. Another common concern is doctors and staff that are distracted, aloof, and impersonal. It is also quite common for someone online to seek out others that have had their condition and they want advice or confirmation that their treatment protocol will result in a high level of efficacy. Conversely, some patients reach out to share without being asked. This can be considered empathy in its own right.

Providers have noticed an uptick in this type of social media use during the COVID-19 pandemic. Group norms play a large part in this; while spending more time indoors and online researchers have found that individuals gravitate towards similar age groups, lifestyles, and socioeconomic groups that are similar to their own.

In many cases, the provider realistically can’t spend a great deal of time with one individual, or the volume of information is so large that the patient does not absorb it all. The patient may decide to fill in the gaps, and discover other points of view, via the internet. Social media used properly is a benefit to the medical community.²

Improving Clinical Empathy and Setting a Standard

The first step is to reach a consensus among the group of providers involved. Next is to define the current dynamic. and define specific methods to achieve the level of improvement needed. Some things to consider are:

Is there a current system of training for the group to ensure that a standard level of knowledge and application exists.
Is emphasis being adequately put on communication skills? There are many times when the provider must deliver negative news to the patient. Empathetic skills are extremely important in these situations.
Are providers experiencing “burnout” due to stress, administrative duties, long hours, etc.? This will have an adverse effect on providing empathetic care.

The Importance of Clinical Empathy

The importance of empathy in the provider/patient relationship cannot be overstated. In many cases, a patient who harbors the perception that the provider is not caring or involved will not present sufficient information for a proper diagnosis to be made. Empathy creates a communication bridge between the provider and the patient.

An end-game consequence is fewer situations where a patient does not feel like he or she received the expected level of care. More successful case outcomes translate into greater provider satisfaction and fewer issues with burnout.

What Are Some Relevant Barriers to Achieving Clinical Empathy

Lack of emotional intelligence, being unaware that one isn’t being perceived as empathetic.
Younger providers during training can seek to emulate more established colleagues who themselves are not empathetic.
Trying to balance the need to be objective and the need to show empathy and falling on the left side of the scale. This can be especially problematic when delivering bad news.
When a provider is experiencing burnout or has simply become jaded due to the long time spent on the job; enthusiasm to help others can get lost over time.

Empathy Gaps

Empathy gaps occur when the patient has seen his provider but comes away unsatisfied, feeling misunderstood. This can occur when:

They feel misunderstood or that the wrong assumptions were made.
They feel that the advice was boilerplate rather than personalized.
They feel that the level of service was substandard. This can be a problem for doctors that accept Medicare and Medicaid and try to book as many patients as possible.
No advise was given for supplements that could help their conditions or interfere with current treatment.

Changing behavior that causes these gaps can be done through MAPS (Motivation Ability Processing). This is formal training that providers go through that touches on areas of concern that have been identified.

Summary

Clinical empathy is not a recent phenomenon but advances in technology present new and powerful tools to identify issues and correct them. A suitable attitude is, “never be satisfied nor complacent.” Empathy has affected the medical community in many ways and is itself being affected by ever-changing conditions. Two of the prominent recent ones are the expanding presence of social media and the COVID-19 pandemic and subsequent lockdown. Ways to alleviate it in order to provide a better experience for the patient and the provider are being explored and implemented.

References

Jodi Halpern MD, PhD. What is Clinical Empathy? Journal of General Internal Medicine. https://onlinelibrary.wiley.com/doi/full/10.1046/j.1525-1497.2003.21017.x
Katherine Chretein and Terry Kind, Social Media and Clinical Care, Circulation, https://www.ahajournals.org/doi/10.1161/circulationaha.112.128017

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Kelly R. Smith is an Air Force veteran and was a commercial carpenter for 20 years before returning to night school at the University of Houston where he earned a Bachelor’s Degree in Computer Science. After working at NASA for a few years, he went on to develop software for the transportation, financial, and energy-trading industries. He has been writing, in one capacity or another, since he could hold a pencil. As a freelance writer now, he specializes in producing articles and blog content for a variety of clients. His personal blog is at I Can Fix Up My Home Blog where he muses on many different topics.

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September 13, 2020September 25, 2020

Who Needs a Flu Vaccine Shot and When

by Kelly R. Smith

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This article was updated on 09/25/20.

As of this writing, flu shots have become available for the expected flu season which we will experience roughly between October and May. Anyone can catch the flu (influenza) but at a higher risk are:

Infants and young children.
People 65 years of age and over.
Pregnant women.
People with pre-existing health conditions or a weakened immune system.

Why Get Your Flu Shot Early

This year is different. Everybody and their brother are more cognizant of health issues and transmittable illnesses. The COVID-19 pandemic, with it’s associated fashion statement of face masks, already has everybody woke to virus culture. In light of that, it’s not a stretch to assume that more immunization naysayers will be queuing up for an influenza shot.

I got mine today at my local Kroger, where I get my blood pressure medication prescription filled. It’s free with my health insurance. Out of curiosity I asked the needle-wielder if he expected a run on vaccine stores due to the public’s heightened health awareness. He said yes; that is the prevalent sentiment in his circle of comrade shot-givers. There are only so many doses made available seasonally, and when they’re gone, they’re gone. If you snooze, you lose.

So, avoid the lines and the shortages. Get your shot now. If you can remember the gasoline shortage lines when that bumbling fool Jimmy Carter was president, that is a good analogy of what we might be looking at with flu shots.

Double Trouble This Season

This flu season contains a double-whammy; the flu plus the Coronavirus pandemic. Getting them both at once will be a very bad scenario, especially for anyone over 65 or that has an underlying condition.

“No one knows for sure how most people will react to simultaneous infection with these two viruses,” says Michael B. Grosso, MD, medical director of Huntington Hospital in Huntington, New York. “However, we have extensive experience with children and adults experiencing co-infection with two or more respiratory viruses. As you might guess, people get sicker, take longer to recover and require hospitalization more often when co-infection happens. It’s unlikely to be different with COVID-19 and flu.”

How the Flu Vaccine Works

In the old days, when the flu happened, it just happened. The Spanish Flu was devastating. It lasted from 1918 until 1920 and claimed approximately 500 million souls. A previous flu pandemic during 1889-1890 killed ~1 million people worldwide.

Today we know a bit more about it. We know it will happen every year. We have a good idea of where it will start and from this knowledge we (the CDC) has a good guess of which strains to prepare immunizations for. It’s still a crap-shoot, but it’s better than nothing. The shot I got today is targeted for old codgers in my age group.

The one I received was Fluzone High-Dose Quadrivalent. It has four times the antigen, (the part of the vaccine that helps your body build up protection against flu viruses), than Fluzone Quadrivalent and other standard-dose inactivated flu vaccines. Both are quadrivalent vaccines. The higher dose of antigen in the vaccine is intended to give older people a better immune response, and therefore, better protection against flu. What’s not to love?

Vaccines are Good for You and Your Neighbors

I feel compelled to express my feelings on this subject. Over the past decade or so, there has arisen a segment of the population that is entirely anti-vaccination. OK, I get it. In rare circumstances vaccinations can cause issues. But face it, life is, at best, a crap-shoot, my friend. Play the odds.

You don’t want your kid to face the 1 in 1,000,000,000 chance of autism? So no shot for smallpox or polio? OK. Let’s make that happen. We thought those diseases were eradicated in North America but without Trump’s wall, they are being imported.

So get your flu vaccine shot and get it while the doses are still available. There is a predicted demand that will work against you if you hesitate. Go bold, get poked, and don’t look back.

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Photo of Kelly R. Smith Kelly R. Smith is an Air Force veteran and was a commercial carpenter for 20 years before returning to night school at the University of Houston where he earned a Bachelor’s Degree in Computer Science. After working at NASA for a few years, he went on to develop software for the transportation, financial, and energy-trading industries. He has been writing, in one capacity or another, since he could hold a pencil. As a freelance writer now, he specializes in producing articles and blog content for a variety of clients. His personal blog is at I Can Fix Up My Home Blog where he muses on many different topics.

August 3, 2020February 7, 2021

10 Habits Result in a Slow Metabolism

Small Changes to Your Diet and Lifestyle Will Put Your Weight Loss in High Gear

by Kelly R. Smith

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This article was updated on 02/07/21.

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It’s no secret that our metabolisms slow down as we age. For most of us that means packing on the pounds. If you want to reverse that course of action, it’s not too late to begin. There’s no need to wait to make a New Years resolution. Just work on this list of bad habits that slow metabolism.

Do you skip breakfast? Unless you are practicing intermittent fasting, you shouldn’t. When you sleep, your metabolism slows. A hearty breakfast will kick it back into gear. While you are at it, try to include foods that contain probiotics, like yogurt with active cultures, to keep your gut in balance. Regularity is a good thing!
Or, are you eating the wrong things for breakfast? Donuts may be your convenient comfort food, but they aren’t doing you any nutritional favors. What you really need is fiber and protein. I usually go for my homemade bread; it has whole wheat and quinoa for protein and plenty of fiber, what with the steel-cut oats and wheat bran.
Are you sitting too much? An excess of butt-time triggers your energy-conservation mode. Working from home during the COVID-19 pandemic only makes things worse. I work from home but I’m made aware when I’ve been at the keyboard too long by my Garmin 235 watch. It has a move bar that activates after sitting too long. A stroll around the block is enough to make it go away… until the next time. The National Health Service from the UK says, “Sitting for long periods is thought to slow the metabolism, which affects the body’s ability to regulate blood sugar, blood pressure, and break down body fat.”
Are you doing enough strength training? Resistance-based exercise keeps your heart rate, and thereby your metabolism, higher after you finish. The American Council on Exercise says, “Whether you lift weights, use resistance bands or use your own body weight for resistance, resistance creates microtears in the muscle tissue. As your body repairs these tears, muscle tissue grows and requires more calories to stay alive.” Cardio activities like running do this as well, just not for as long. Ideally, you should do both cardio and weights.

Are you eating enough protein? If not, you aren’t going to be able to build or even maintain muscle mass. As noted above, muscle mass is essential in keeping the motor that is your metabolism humming along. If you are a vegan you will need to be more creative to satisfy your protein needs. My oatmeal flax seed bread recipe is a good source as are beans and quinoa.
Are you drinking enough water? Most of us don’t. A study by The Journal of Clinical Endocrinology & Metabolism found that, “Drinking 500 ml of water increased metabolic rate by 30%. The increase occurred within 10 min and reached a maximum after 30–40 min. The total thermogenic response was about 100 kJ.” So drink up.
Are you stressed out? If you are then you’re producing the hormone cortisol. The effects? An increased appetite, less desire to exercise, an attraction to comfort foods, and reduced quality of sleep.
Are you getting enough dairy products in your diet? Milk, cheese, yogurt, and supplements are critical; research links dietary calcium intake to improved regulation of energy metabolism. The National Institute of Health, citing a Spanish study, concluded that, “Our results show that consuming dairy products is associated with a better metabolic profile in the Spanish population.”
Are you sleeping cool? As it turns out, snoozing in a room that’s about a cool 66ºF increases the level of brown fat. This fat is responsible for burning calories to generate heat. So chill out already.
Are you eating too much fast food? If you are, you are consuming a lot of high-fat content which takes more time to digest than leaner content. This, in turn, can slow down metabolism and stress compounds the problem.

So there you have it. These 10 bad habits result in a slow metabolism. The good news is that it’s easy to form new habits. So get on with it already.

References

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August 1, 2020February 6, 2021

Introduction to Intermittent Fasting

A Beginner’s Guide to Weight Loss, Cellular Cleansing, and Detox

by Kelly R. Smith

Empty plate symbolizes intermittent fasting for weight loss

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This article was updated on 01/09/21.

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Fasting, or abstaining from eating for a period of time, has always had a place in human history. Sometimes it’s for religious reasons. Matthew 6:16-18 does not tell us that we have to fast. However, He expects that we will. He said, “when you fast…” So, just an expectation. But in a broader scope, most people today explore intermittent fasting for weight loss and a method of liver detox. As a bonus, there are other health benefits that we will go into. There’s inspiration on many levels.

Intermittent Fasting Methods

The 16/8 method. This is the most popular method primarily because it is the easiest to do. With most of us spending an inordinate amount of time at home and away from fast food distractions because of the COVID-19 pandemic anyway, it’s easy. This method entails eating your first meal of the day at noon (lunch), and the last one around 8 PM (dinner). Do this every day. Water, coffee, and unsweetened tea are fine during your fast.
The 5:2 method. Your week looks like this — you eat normally except on Tuesday and Friday where women eat just 500 calories and men just 600 calories. You might have heard it called called the Fast Diet; it was popularized by British journalist Michael Mosley. Dietitians recommend these foods.
The eat, stop, eat method. This is just like the 5:2 except that you fast completely on Tuesday and Friday. For example begin fasting after dinner on Monday and go until dinner on Tuesday. You might find this one difficult to stick with this form of diet faithfully but if you resolve to make it a habit it will get easier.
The alternate day method. Eat normally one day, fast the next. Repeat. Over and over. In some interpretations, some few calories are allowed on fasting days.
The warrior diet. Every day you get to eat a large dinner but only small amounts of raw fruits and vegetables during the day.
Spontaneous meal skipping. Here you get to eat normally but skip breakfast one day per week and dinner another day. When you do eat breakfast, try my homemade bread recipe. It’s loaded with good things.

Fasting Affects Your Hormones and Cells

Once you adopt one of these fasting methods and make it a habit, things start happening under the hood. If your main goal is to lose weight and shed pounds, there’s good news — your hormone levels change making stored body fat more available for fuel. Here are some other changes that improve your health.

Gene functionality. There are changes in the function of your genes that are related to longevity as well as protection against disease.
Human Growth Hormone (HGH) increase. This leads to both fat loss and muscle gain.
Cells undergo repairs. As you fast, cells begin cellular repairs including autophagy, which is when your cells digest and eliminate older and dysfunctional proteins that have built up inside cells.
Insulin levels change. Your insulin sensitivity gets better and your levels of insulin drop off dramatically. This in turn makes your stored body fat more accessible for weight loss.

Intermittent Fasting Promotes Detox

Intermittent fasting supports your healthy immune function. As you might suspect, healthy immune function is at the center of body detox. First of all, it promotes stem cell function and their ability to renew and repair themselves. Lab studies have shown that fasting correlates with fewer unhealthy cells. One study determined that just 3 days of fasting can quite literally regenerate one’s entire immune system! It showed that as the body “eats up” old immune cells, stem cell activity is increased. Just logical when you think of it. The stem cells then begin to create new immune cells which leads to the anti-aging effects of fasting.

Secondly, intermittent fasting has been shown to reduce the autoimmune response. It promotes cell repair during the cellular re-feeding phase. Third, fasting supports the production as well as the repair of white blood cells. White blood cells are especially important in the lymph system. They fight harmful invaders and work to keep the body healthy.

The take-away from all this is that if you are looking for a way to lose weight while generally improving your health, intermittent fasting is worth looking into. As with anything else, it is always a good idea to run it past your doctor. And when you do eat try to stick to organic food that has undergone minimal food processing if any at all.

References:

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July 27, 2020July 29, 2020

10 Signs of Nutrient Deficiency

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Many of us eat fast food or whatever is at hand because of the fast-paced lives we live. You might say to yourself, “I take a multivitamin; I’m good.” That is not always true. Supplements, at least high-quality ones, are not bad in themselves despite what some say. Some manufacturers are indeed mountebanks but not all. Additionally, not getting enough fiber can mean a short-circuiting on nutrient absorption. Living in the Coronavirus lock-down surely doesn’t help. If you have any of these signs of nutrient deficiency, it’s prudent to turn things around. Here are some signs.

Signals From Your Body Regarding Nutrient Uptake

You are developing a pale, sallow complexion. The problem may be iron deficiency. This makes for smaller red blood cells. Not only does it mean you produce fewer of them but they are filled with less hemoglobin. Hence, your skin looks less red. The American Society of Hematology says, “Iron is very important in maintaining many body functions, including the production of hemoglobin, the molecule in your blood that carries oxygen. Iron is also necessary to maintain healthy cells, skin, hair, and nails.” The solution? Boost your intake of dark leafy greens, grass-fed beef, lentils, and fortified cereals and breads.
You have stubborn acne. In the past this has been blamed on certain foods like chocolate and one of our favorites, commercial or homemade pizza. We now understand it a bit better. The lack of enough omega-3 fatty acids may be the culprit; they have strong anti-inflammatory properties. So if you are lacking, it can present as acne. The solution? Pick up some fish oil capsules and eat more salmon.
You Have Brittle Nails. If your fingernails have been breaking easily and often, it might be due to a lack of biotin, also known as vitamin B7, which nourishes your nail’s growth plates. The solution? Supplements are a good way to go. I take what is called on the bottle Super B-Complex, which contains 1,000 mcg which is equal to 3,333% of daily value. This is not an issue because it’s a water-soluble vitamin. Also, eat more eat more eggs, cheese, nuts, seeds, fish, organ meats, and vegetables such as cauliflower and sweet potatoes.
Your skin is parched and dry. You can blame this one on an omega-3 fatty acid deficiency. In this case, they help nourish your skin’s lipid barrier. This is the layer of oils that act as a gatekeeper to keep harmful germs and toxins out and essential moisture in. This deficiency can also manifest in more wrinkles and visible aging due to skin dehydration, ladies.

Lips that are sore and cracked. This can be the result of an iron deficiency and/or a riboflavin (vitamin B2) deficiency. The National Institutes of Health says, “The signs and symptoms of riboflavin deficiency (also known as ariboflavinosis) include skin disorders, hyperemia (excess blood) and edema of the mouth and throat, angular stomatitis (lesions at the corners of the mouth), cheilosis (swollen, cracked lips), hair loss, reproductive problems, sore throat, itchy and red eyes, and degeneration of the liver and nervous system.” Suffice to say I don’t want this one. The solution? Once again, a B-Complex vitamin should do the trick.
You have a wound that resists healing. If you are reading this, you know as an individual how long it takes your body to deal with cuts and scrapes. If it seems to be taking too long, you might have an iron deficiency. As a rule, shoot for 20 to 30 grams of protein at each meal and 10 to 15 grams of protein with each snack. Mind you, this is harder to do if you are a vegan but it’s not impossible. Peanut butter and other legumes are good. Carnivores are less likely to have this issue. Protein drinks are also readily available. I’m partial to favorites like this beef Stroganoff recipe that I make from time to time.
Are you experiencing bleeding gums? Usually this signifies that one is a bit derelict in flossing and brushing. But if this is not you, a vitamin K deficiency might be at the root (so to speak; pardon the pun) of your problem. It has a big role in role in helping blood clot, or coagulate. The solution? Look for vitamin K1 (phylloquinone) mainly in leafy greens and cruciferous vegetables. Vitamin K2 (menaquinone) is actually bacteria produced your gut. It is also available in fermented foods, cheese, natto, meat, dairy, and eggs, according to the National Institutes of Health.
Your hair is thinning. Your hair can be a mirror of what you eat. Protein and vitamin C deficiencies have been known to cause thinning or brittle hair as well as hair that falls out easily. Vitamin C assists you in making collagen, one of the building blocks of healthy hair and healthy hair follicles. Protein supplies amino acids destined for collagen (and other protein) synthesis.
Your nails are misshapen or discolored. If your iron levels are low, this can result in whitened or ridged nails. A vitamin B12 deficiency can make your nails turn brownish. A lack of biotin increases your risk of fungal infections that, in turn, can manifest as ridging and discoloration.
Premature graying of the hair. Going gray early can be caused by many things — genetics, some say worry, and the jury is still out on getting a fright. But we are concerned here with nutrition. The mineral copper helps you create melanin which is one pigment, among others, that imparts color to your hair. If you have low copper levels, or an underlying medical issue which stops you from metabolizing copper you ingest properly, this can turn your hair gray. Which I must say, I find downright fetching on most women although they likely disagree.

The bottom line here is that each sign of nutrient deficiency is linked to primary vitamins and minerals, but in reality, they’re all a “soup” in which all have a role. The best course of action is a well-rounded diet accompanied by high-quality nutritional supplements. As a caveat, if you can’t clear something up in short order, consult with your primary care physician.

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June 29, 2020July 31, 2020

Growing Mint: An Herb Garden Staple

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Chocolate mint in the garden next to tomato plant

Mint is a perennial herb with very fragrant, toothed leaves and tiny purple, pink, or white flowers. It has a fruity, aromatic taste and offers many health benefits. There are many varieties so you have a wide range to select from. One thing is certain — mint, grown organically, is an herb garden and kitchen staple, much as basil is.

The Many Varieties of Mint

The number of mint flavors can be a bit overwhelming; I like to keep at least two of them growing. An odd thing is the way you can identify it other than the smell. If you look close, the stem is actually square. The oddities of nature, yes? Anyway, pick your favorites from this list:

Chocolate. Yes, it really does look and taste like the real thing. My favorite additive to go into my dark-roast coffee grounds in the morning. None of those artificial chemical flavors for me.
Apple/Pineapple.
Spearmint. Was this your favorite chewing gum flavor as a kid?
Pennyroyal.
Citrus Mint. Just the thing for iced tea on a summer afternoon.
Corsican. This is one of the strongest tasting of mints and it is also the smallest; growing tight-knit it makes a good ground cover in semi-shady areas. Unlike most mints it can be difficult to grow. It likes to be well-watered. It makes a good companion plant for things like chives and tomatoes.
Peppermint. For adding a bit of candy flavor without all the sugar.
Banana.
Orange. Also good in tea and cold brew coffee.

Planting and Care of Mint

First, consider that mint spreads rapidly. This means growing it in a container or enclosed within some kind of root barricade to rein in the horizontal runners and underground rhizomes.
Mint likes light soil with good drainage; its native habitat is along stream banks.
Most varieties prefer some shade; check the exact requirements of your favorite variety/s.
It likes a thin layer of compost or organic fertilizer every few months.
Keep the area covered with a layer of hardwood mulch to retain moisture. Do NOT use any colored mulch. Those color chemicals and dyes are not your friends, especially if you intend to consume the leaves.
Other than watering, a light top-dressing with compost, some mulch, and occasional organic fertilizer, these are easy plants to grow.
Prune them back regularly. the smaller, younger leaves are the most flavorful… but, where you let them flower, the butterflies will thank you!

Nutritional Benefits

Aids in digestion.
Eases dizziness and nausea.
Helps with nasal congestion.
Boosts dental health.
Improves blood circulation.
Boosts immunity. That’s not a bad thing during the CORVID-19 pandemic.

By now you can see why growing mint in your garden or containers is a good idea. It’s healthy, tasty, nutritious, and importantly to many of us, easy to grow.

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March 5, 2020

8 Immune-System Strategies for Cold and Flu Season

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It just doesn’t seem fair; just when we are feeling upbeat and optimistic as we look forward to spring, songbirds, and short britches, the cold and flu season arrives. Just like clockwork many of us are coughing, enduring stuffy noses, sneezing, and worse. And to add insult to injury, this year we have to deal with the coronavirus (COVID-19). For any of these afflictions, these 8 immune-system strategies will help to avoid sickness and make life a wee bit more manageable while on the mend if you succumb.

Get a Flu Shot. OK, you should have gotten it some time ago but there is still time if what you’ve got is the common cold. When your immune system is already compromised the flu might see you as an easy target.
Cut Back on the Alcohol. Too much can leave you susceptible to dehydration and poor sleep which are the two immunity-boosters you need the most. Being a bit tipsy can also lead to unhealthy food choices, sleeping less than you need to, and a higher chance of skipping workouts, all of which will have a negative effect on your immune system.
Get Enough Sleep. This can’t be stressed enough. Not getting enough sleep can lower the immune response. Your body has to have the correct amount of restorative time that it needs to fight off germs of all types. Quality deep sleep is the key factor but it all counts. See the image below. This was my sleep history last night as recorded by my Garmin 235 watch. First, I didn’t get enough rack-time and my deep sleep wasn’t optimized. I still have work to do. Hey, I’m dealing with it.

Sleep pattern screenshot recorded with a Garmin 235 watch

Heft that Water Bottle. Hydrate, Hydrate, Hydrate. Copious hydration keeps energy levels up and also allows your body to scoot toxins and other waste materials out of your system at a faster rate. This fine-tunes your immune system’s ability to fight infection. Remember that many fruits and vegetables contain both water and electrolytes.
Include Probiotics in Your Diet. A surprising proportion of your immune system is actually in your gastrointestinal tract. The cells lining your gut have a responsibility for producing antibodies which fight off bacteria and viruses. Foods such as yogurt with live cultures, kimchi, kombucha, and sauerkraut are your friends. Supplements are also effective for this and overall health to keep everything in balance.
Keep Your Hands Away from Your Mouth, Nose, and Eyes. You probably touch your face more than you think you do. Even though you might wash your hands often, germs can still build up on your hands shortly after. The CDC tells us that germs can easily enter the body via the eyes, nose, and mouth.
Get Enough Exercise. Stick to your workout schedule. It improves the way your immune system combats germs and disease, making it more efficient at fighting subsequent infection, the National Institutes of Health points out.
Finally, Wash Your Hands Frequently. This one should be common sense but many people neglect it to their detriment. When it is not convenient, use a hand sanitizer. Keep a squirt pump bottle in one of your car cup-holders. Ladies, put one in your purse. Studies have shown that some of the most germ-laden surfaces are grocery store carts and restaurant salt shakers and menus. How often have you seen these items wiped down with sanitizer? That’s right. Never.

Adhering to these 8 immune-System strategies for cold and flu season may not guarantee that you won’t get sick but it will certainly shift the odds in your favor. And remember, you are not only protecting yourself, you aren’t spreading anything to others.

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March 3, 2020May 4, 2021

History of U.S. Medical Insurance

Baylor University’s Initial Concept for Care Eventually Led to an Economic Behemoth

by Kelly R. Smith

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This article was updated on 05/04/21.

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Today we are surrounded by so many high-tech medical apparatuses and procedures that we take them for granted. For example, I recently had laparoscopic inguinal (groin) hernia surgery. No scalpel slashing, just 3 punctures. All the work was done microscopically and I was on my feet within 3 hours. Now, that’s good customer service.

But it wasn’t always that way. More than 90% of commonly accepted medicine did not even exist in the 1950s. One of the consequences is that people, average people, not just the monied upper-crust, are living longer. A greater understanding of things like controlling high blood pressure adds years and quality of life.

The Cost of Modern Medicine

It should come as no surprise that all this progress comes with a cost. In fact, it has been rising faster than any other expenditure when looked at on a national level. Flash back if you will to 1930–we spent $2.8 billion on health care. That equates to 3.5% of the gross domestic product (GDP) or only $23 per person.

In 2015 that rose to $3 trillion. That’s $9,536 per person or 15% of GDP. During the 1980s medical expenditures rose by 117%. Of that, 43% can be attributed to inflation. 10% can be attributed to the rise in population and longer life expectancy. 23% was due to new technology, medicines, and treatment innovations. The remaining 24% is due to another instance of inflation that resides totally within the medical community. This last number tells us that there is a lack of oversight and cost transparency. There is no financial propping up as with the banking, agricultural, and auto-building industries.

The Transformation of Hospitals

It was only in the 1850s that the medical community realized that diseases were caused by microorganisms. This became known as the germ theory of disease and it was indeed revolutionary. It led to research that was to begin to focus on preventative rather than just curative treatment. Rabies was banished from human population in 1885. Diphtheria and whooping cough were brought under control. When milk began to be pasteurized the death rate of children went from 125.1/thousand to 15.8/thousand in 1925.

In 1873 hospitals, of which there were only 149 in the country, were more like hospices; the poor and and deathly-ill went there to die; those institutions were little more than petri dishes, not at all sanitary. But that changed because of the changes brought about by germ theory.

By 100 years later the number of hospitals had increased to over 7,000 and their role had morphed into medical research and clinical medicine. Exciting times. But… they cost a lot to operate and the number of patients could not be reliably estimated. The solution? Late in the 1920s hospital insurance was introduced in Dallas, Texas to stabilize cash flow. For a premium of $6 per year Baylor University Hospital would provide 21 days of care to subscribers.

Soon other hospitals adopted this model and formed confederations so that patients could choose a treatment facility. This was the business model for Blue Cross which launched in California in 1932. These were rudimentary insurance plans; they did not include co-pays or deductions, just fixed premiums meant to stabilize cash flow. One consequence is that patients gravitated toward hospital stays (expensive) rather than outpatient treatments (cheaper).

This insurance was paid directly to the hospital and not to the individual. This eliminated any opportunity to “shop around.” Since the money was not coming itemized out of the patient’s pocket, why should he or she care what the price tag was?

The Government Fails to Regulate Medical Insurance

During the mid to late 30s Blue Cross was spreading rapidly. The states moved to try to regulate them to the same standards as other types of “insurance.” But the American Medical Association and the American Hospital Association lobbied to be exempt, claiming an exception due to operating on a non-profit basis. The IRS agreed and ruled that they were also exempt from federal taxation. Blue Cross and other insurance companies emerging in the field operated on a cost-plus basis. Now there was zero incentive to control costs an strive for efficiency.

Hospitals began to compete not on price but by wooing doctor referrals. Doctors were being paid “reasonable and customary” charges. If Dr. C began charging a bit more, Dr. A and Dr. B would follow suit and the standard of “reasonable and customary” inched up. No oversight.

The Modern Medical Insurance Paradigm

When World War II drew us in, two things happened. One, the labor market got tighter since more workers enlisted in the military. Two, price and wage controls were implemented. In order to attract the best employees, companies began offering employer-paid health insurance as a fringe benefit which the IRS recognized as a business expense.

The National Labor Relations Board imposed collective bargaining on health insurance plans so unions began to demand more and more, driving prices up. But a consequence was that the patient became further distanced from the medical system and they lost many choices; one must take what is offered.

In 1965 the government waded into the medical market with Medicaid and Medicare. Initially, hospitals and doctors resisted but when they began to reap the dividends they quickly changed their tune. Now state governments largely controlled the purse strings of most major hospitals and thus could influence policy.

More recently a major factor in driving up medical costs is litigation. Medical malpractice suits have exploded. Cases have increased by a 1:300 ratio in the years from 1969 to 1990 alone. A special class of lawyers have even emerged to take advantage of this low-hanging fruit; these are your ambulance-chasers and your class-action law firms where actual plaintiffs make pennies while the lawyers walk away with the bulk of the settlements.

This short history of American medical insurance should serve to put things into perspective as we have a national debate over how it really should be handled. Should we stay on our present course or model our system on Britain or Canada? Should we believe in a socialist “free for all” system as Bernie Sanders advocates? (Hint: there’s no such thing as free.) Should we adopt an Obamacare model complete with a Jacobin death panel? This will continue to be an evolving national debate.

A Fundamental Guide to Long Runs

A Weekly Slow, Long Anaerobic Run is a Key Building Block to Your Training Program

by Kelly R. Smith

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Many runners, especially newbies, are of the mindset that running long is a workout done solely for preparing for a half marathon, full marathon, or an ultramarathon. In actuality, there’s quite a bit more to the story. They are an important part of a properly balanced training program for runners of all stripes. It is just one aspect of the 10 habits of highly-successful runners. By the way, the same logic applies to walkers as well; just adapt the concepts as needed. Aerobics is aerobics.

Weekly long distance runs also supply key benefits for athletes that are preparing for a 5K, 10K, or any distance. It also keeps the body from plateauing for individuals intent on burning calories for a weight loss program.

In short (pun not intended), longer distance, slower workouts are just one more factor in a comprehensive workout program. Your easy and recovery runs should make up the bulk of your program in order to avoid injury. Although the term has fallen by the wayside, we used to call this LSD (Long, Slow Distance).

Round out your weekly routine by adding in some interval workouts, fartlek, tempo runs, and sporadic pick-ups to activate your fast-twitch muscle fibers for developing speed. Adding in some hill training will boost leg strength and teaches your legs to handle lactic acid build-up.

Whatever type of workout you have planned for the day it’s important to stick to your workout warm-up routine. It might not seem necessary for a slow long run but in fact, it is. And after all, there is something to be said for conforming to habit to keep you honest. The importance of rituals in our everyday lives keeps us balanced.

Olympian mom 'trains' with her daughter and it's hilarious 😂 https://t.co/AOHjuMmdI9 pic.twitter.com/P0e9BXIxQn
— Good Morning America (@GMA) July 16, 2021

Long Distance Running Stimulates Physiological Adaptations

Running Times (sadly, a now-defunct magazine) coach and columnist Greg McMillan rightly pointed out that there are 3 distinct physiological adaptations that distance training provides us with.

New capillary growth. What are capillaries? These are the smallest of blood vessels; the more you have, the more oxygen-delivery your body is efficiently capable of. The end result is that they enhance your ability to do work. Capillaries are also key during the process of dissipating heat as they direct more blood close to your skin.
Musculoskeletal strengthening. As Arnold the Terminator would say, “I’ll pump you up!” Similar to the way lifting weights strengthens particular target muscles, when you add stress to your legs it promotes ligament, tendon, and muscle strengthening. To maintain and build bone density be sure to get enough calcium and vitamin D in your diet. As far as supplements go, a CoQ10 dietary supplement is highly encouraged for the many benefits for runners, especially us, ahem, older ones. See the graphic below.
Enzyme changes. Running long distances encourages an increase in the number of enzymes in the legs.
Improved mental functioning. Studies have shown that aerobic exercise such as running improves memory and brain cell functioning.

Increase Your Running Distance Slowly but Surely

The majority of wise runners do their weekly long runs when they can allocate the time for both the run and the requisite recovery; usually, this means the weekend. I’m comfortable with my long run on Saturday and my recovery run on Sunday. Just this morning I did my long run followed by a mile cool-down walk. I never used to do the cool-down but it really helps to give your heart rate a wee bit of time to come down. It really does take this long when the temperature is in the mid-to-upper 90s. Just look at a marathon training schedule and you will see that two things stick out. First, the run distance increases adhering to the traditional 10 percent rule.

Secondly, the 10 percent build-up happens every other week in most plans; a good distance on the alternate week is generally about 10 miles for a good maintenance-distance run if you are training for a marathon. It goes without saying is that this rule becomes even more important as one gravitates to longer and more intense endurance events. The second caveat of the 10 percent rule is to limit your total weekly mileage increase to 10 percent.

Make the Long Run a Social Event

There are good reasons for making your long run a social event. And, not because “misery loves company.” Rather, because accomplishment loves company. This is one of the best benefits of running clubs. It is certainly much easier to roll out of bed in the sleepy pre-dawn hours when you know your comrades are waiting for you to start laying down the miles. In fact, distance training and comradeship are the foundation of many long-lasting friendships.

As an example, organizations like USA Fit have made a cottage industry of it, and some would say, have taken the concept too far (strongly encouraged to buy merch, etc.) They’re everywhere; in Texas alone there are at least 20 clubs.

These kinds of organizations seem to be largely responsible for the growing phenomenon of marathon walkers (sometimes called turtles). Not that there is anything wrong with that as long as the race organizers let walkers start at least a couple of hours before the gun for the runners goes off.

Hopefully, this guide to long runs has encouraged you to to insert them into your training regimen. Your heart will thank you, your bathroom scale will thank you, and of course it goes a long way towards managing insomnia.

About the Author:

Photo of Kelly R. Smith Kelly R. Smith is an Air Force veteran and was a commercial carpenter for 20 years before returning to night school at the University of Houston where he earned a Bachelor’s Degree in Computer Science. After working at NASA for a few years, he went on to develop software for the transportation, financial, and energy-trading industries. He has been writing, in one capacity or another, since he could hold a pencil. As a freelance writer now, he specializes in producing articles and blog content for a variety of clients. His personal blog is at Considered Opinions Blog where he muses on many different topics.

where he muses on many different topics.

February 14, 2020October 29, 2020

Body Weight, Fat Percentage, and BMI

by Kelly R. Smith

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This article was updated on 10/29/20.

Here we are. Last January is in the rear view mirror; the new one is fast arriving. Was weight loss one of your New Year’s resolutions? How’s that working out? Weight loss is kind of a nebulous term. What most people really want is fat loss, not to be confused with lean muscle mass loss.

When a person goes on a diet and introduces weight training, the number on the scale starts to lose its meaning and those pounds reflected are not a good way to judge progress. Your “body weight” may not change much but your percentage of body fat does. Why? Because muscle weighs about 15-20% more than fat so the same “weight” of muscle occupies less real estate than fat. The way your clothes fit give a better indication of your progress than the scale does. Of course, if you do not introduce weight training the scale becomes more of a better indicator. This is also true if you take up running.

BMI is the Best Body Fat Guideline

To maintain optimal health it is important to reach and maintain a certain percentage of body fat. There are many components to your weight such as bone density, level of hydration (water), and organs. BMI or Body Mass Index is a method of estimating a person’s body fat percentage based on their weight and height measurement which it assigns a reference number to. It is easy to calculate. Try it below.

It is helpful to continue to weigh yourself on the scale but to get a real grasp on your “weight”, keep referring to the BMI calculator for an assessment of what you really want to know. The longer you are overweight the more chance you have of high blood pressure, stroke, heart problems, and type 2 diabetes. Don’t relapse into your old fat-inducing bad habits.

The relationship between body weight, fat percentage, and BMI is often misunderstood, partly due to commercial marketing and partly due to societal expectations and social media. But now that you know, go fight the good fight and get the results you desire.

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