Wednesday, October 18, 2017

Half of US medical care delivered by ERs

I admit it--even though I have a Medicare HMO, I have gone to the ER when in pain--they can do tests right on site--if you go to the doctor, it can take days for the appt and then they farm you to imaging centers and labs--more days.

Yes, the ER is the most expensive care you can get. But it's available, and they have to treat at least your presenting complaint (and usually not beyond that).

Researchers at the University of Maryland have now done a study that shows half of medical care is done in ERs.

The researchers say the study shows how important ERs are. (And little known--hospital budgets depend on payment in ERs by people with insurance.)

Examining several large national databases, the researchers found that there were 130 million ER visits in 2010--compared with 101 million outpatient visits and 39 million inpatient encounters.

Over the next 10 yrs, emergency care visits increased 44%. Outpatient (doc's office) visits accounted for 38% and inpatient 15% in that time,

Most likely to use the ER:

--African Americans (54% of the time)
--Patients with "other" insurance (often meaning no insurance)
--More people in the south than northeast
--Medicare and Medicaid holders

In other words, vulnerable populations.

Use of the ER is often criticized--since many times, the reasons are not emergencies. But some experts say this trend is covering for weaknesses in inpatient and outpatient handling and lack of prevention.

Emergency room use is not likely to be reduced any time soon, the researchers said. But--they add--we need to connect ERs to care in other sectors. Not sure what that means.


Tuesday, October 17, 2017

Food-borne illness on my mind

Three nights ago, we ordered Mexican takeout. I did not exactly get the throwups, but I was a gas balloon, the burps, pain, etc...Miserable all night.  My daughter also felt crummy.

Today, I am baking chicken breasts and am reminded that I recently read you do not have to rinse them off (salmonella) before roasting, because the heat will kill the bad stuff. Rinsed anyhow.

So today--you get another post on food-borne illness.

--First, babies and the elderly (me, I guess) are most at risk.

--Some foods can be left out if they are cooked properly.

--But other foods--starch-based--can get more contaminated if cooked and then reheated.

From Bernard Camins, MD, assoc professor of infectious diseases at the University of Alabama Birmingham, says the main bacteria in foods are salmonella, E.coli, shigella, listeria, and campylobachter. Most are found in foods, but listeria comes from the soil.

These can cause diarrhea, sometimes bloody. And of course, vomiting.

Bacteria that makes you sick reproduces and creates toxins that in turn make you miserable.

Mayo and icing can harbor staph.

Cookie dough contains eggs, which can cause salmonella.

Reheated starch foods are a risk.  Say pasta that was cooked then reheated to a warm-only state.

Cooked meat is usually OK--although processed meat like hot dogs and salami have been linked to listeria.

If you get sick from eating a food, this usually lasts 24-72 hours. But people sick with other illnesses can get to a serious state.

--Keep food at proper temperatures

--Separate clean and contaminated dishes in the sink

--Keep meat separate--use a different cutting board for veggies, a different knife.

--Wear disposable gloves while cooking

--Wash hands a lot! (My daughter washes the gloves.)

I would say this is making me hungry for lunch, but strangely, I am not that hungry.

Monday, October 16, 2017

Vegan vending

Yes, peanut butter crackers are vegan, but are they delish and healthy?

According to a story by Erin Brodwin in Business Insider, Lamiaa Bounahmidi has started a company called LeCupboard to dispense healthy food out of vending machines.

The dishes range in price from $6 to $13 and come in reusable glass dishes, that can be returned for a $3 refund. So far, the "cupboards" are located in seven places around San Francisco.

The author tried three items...

--First she tapped in any dietary preferences or restrictions on the touchscreen (avoid gluten avoid nuts, etc).

--In 30 seconds the dish comes out along with an ingredient list and nutritional profile.

--An appetizer featuring lemon, seaweed and veggies was delicious, she said. The beets were glazed on a lemon marinade and paired with a veggie that tastes like seaweed. A light serving of black rice in a spicy sauce topped it.

--The main dish she picked was a falafel bowl, inspired by visits to Cairo. She said the falafel might have been heated for more intense flavor, but it was tasty and filling.

--Dessert was called Le Versailles, a plant-based choc mousse sprinkled with sea salt, raspberries and pistachios. Fluffy and rich. She said she could eat this once a week.

Still, the author said she often gets street food--easy and cheap.

I can see this concept being further defined--returning the containers sounds like a pain.

Friday, October 13, 2017

Men have fun with new baby, women do more of the work

A study done at Ohio State showed that three months after the birth of their first child, on days when both parents were at home, the men were most often relaxing while the women did the housework and child care.

Women spend 49 minutes relaxing, but men spent 101 minutes in leisure activities. (Journal of Sex Roles)

The investigators went out of their way--they say--to give men as much credit as possible for work around the house.

Fifty-two couples were surveyed.

On workdays and non-workdays, women did about the same amount. But men doubled their leisure activities on non-workdays.

This disparity, the researchers said, can lead to relationship issues. No kidding.

They also said in some cases, women need to step back and let the father do more housework and childcare--to their own standards, not the women's.

LET them?

Oh, well, best not to be bitter.

I remember once my ex- suited up in overalls, grabbed about six cleaning products, and went to clean the bathroom...When he got done, he looked at me, expectant. I think he wanted me to see how it's done so I could do it...I said, "Cool--when are you doing it again?"

Thursday, October 12, 2017

How to prevent lower back pain

Exercise I did. No, that's not
me, you silly puppy. I wish.
If you are approaching a "certain age," you may be among the 80% of adults who experience lower back pain.

Some yrs ago, I had it...Called the doctor and they said, "Oh, everyone over 50 gets it." They didn't even say to come over. I did some yoga poses for a while and it went away. Now I only get it if I lean over for a long time--changing the cat litter or something.

But there is a spine surgeon at the Atlantic Spine Center--Kaixuan Liu, MD--who says once you have had it once, there is a good chance it will recur. Causes can range from sprains, to age, to sitting, or stress.

Some tips on preventing that:

The impulse is to rest your back, but Liu says that is the worst thing you can do....Exercise is key.

--Walking or running can prevent compacted discs.

--Other aerobic exercise is also good. Lifting, cycling, or swimming. Stay away from high-impact exercise sich as lifting, twisting or bending.

--Aerobic activity means less pain--without drugs.

--Less pain means more active--see where I am going?

--Exercise should be regular and sustainable.

Guess the kitty litter gambit fell into the "lifting" category...Maybe getting up from the desk would help.