To contact us Click HERE
I guess I'm going to share just a little bit more because now I'm just all sorts of curious and the thinking juices are definitely flowing...I read that even though it is impractical to install to APS pushbuttons along with the speakers on a corner with two separate poles it is recommended for there to be a verbal message saying it was okay to cross the cross walk. Apparently it would say whatever street it was that someone who is visually impaired was trying to cross and then say walk sign is on to cross, (that specific crosswalk).
This also makes me think more about my last post too because even though someone who is visually impaired can hear the bird chirping how do they know exactly what street they are on unless they've crossed the same one tons of times before. It's amazing to me how much you can open yourself up to in the world when you don't even realize stuff like this everyday.
When any of you read this I'd be interested to know what sounds you've come across when crossing a crosswalk if any sounds at all??
27 Haziran 2012 Çarşamba
Let's Focus on the Up Side...
To contact us Click HERE
For this blog I wanted to write about the up side of things we are getting RIGHT in the world of human factors. I didn't want to find anything negative or something could improve on, because, let's face it....the world is always changing and adapting. Slowly, but surely. I've recently been apartment hunting a little for when I get married in August. During my search I have almost always come across a little wheel chair sign at the bottom of the website I was looking at townhouses on. For a while I couldn't figure out what it meant. Then I took a drive to one of the town homes I had looked at online and I realized that most apartment complexes or even town home community make special areas for the handicap to live. For instance these particular town homes I was looking at were all multi level and when I drove around I saw some one level homes.
It dawned on me later that that particular row was for the handicap, because they were all one level, they had special parking so that those residents didn't have to go so far to get into their home.
It impressed me, and maybe it's only something small. However, I love that they do this because they are able to have all kinds of residents and don't have to turn away residents who wouldn't be able to live in a multi level home.
It dawned on me later that that particular row was for the handicap, because they were all one level, they had special parking so that those residents didn't have to go so far to get into their home.
It impressed me, and maybe it's only something small. However, I love that they do this because they are able to have all kinds of residents and don't have to turn away residents who wouldn't be able to live in a multi level home.
Designing Isn't Just for Adults..
To contact us Click HERE
I think that our field kind of has some negative views sometimes. People don't really know what we do or understand what we do. They think that we simply "fluff pillows and pick paint chips."
However, we know that this isn't the case. We know that we do much more than this. People don't understand that we are going to school to make their lives better and more comfortable. We know stuff that could make a difference in the way that they live.
It never ceases to amaze me the amount of knowledge I learn everyday about our field of choice. When I gave my presentation last week it amazed me the certain things we could do to even improve a newborns room by putting in sound systems. Or even when Marcene did the presentation on health care environments and she talked about how they were painting their machines bright colors or making them look like something cool and not a big scary MRI machine. It's amazing how even just those small touches can improve the way a child might behave and not be scared to go to the doctor.
There is all sorts of knowledge out there for us to learn how to design and it's not just for adults and elderly. It's very useful for children too.
However, we know that this isn't the case. We know that we do much more than this. People don't understand that we are going to school to make their lives better and more comfortable. We know stuff that could make a difference in the way that they live.
It never ceases to amaze me the amount of knowledge I learn everyday about our field of choice. When I gave my presentation last week it amazed me the certain things we could do to even improve a newborns room by putting in sound systems. Or even when Marcene did the presentation on health care environments and she talked about how they were painting their machines bright colors or making them look like something cool and not a big scary MRI machine. It's amazing how even just those small touches can improve the way a child might behave and not be scared to go to the doctor.
There is all sorts of knowledge out there for us to learn how to design and it's not just for adults and elderly. It's very useful for children too.
25 Haziran 2012 Pazartesi
Westminster Dog Show Disallows Shelter Pet Message
To contact us Click HERE
The exclusive Westminster Kennel Club (WKC) Dog Show has banned the meremention of shelter dogs at its event.
They have dropped Pedigree, a long term dog food sponsor, because theydidn't like Pedigree's ad campaign which encouraged people to adopt shelterpets. David Frei, a spokesperson for the show is reported as saying:
“Our show is a celebration of dogs. We’re not promoting purebreds at theexpense of non-purebreds. We celebrate all dogs. When we’re seeing puppiesbehind bars, it takes away from that. Not just because it’s sad, but it’s notour message.”
Really? Pedigree, though often marketing to pure breeds, hence thename Pedigree, does not feel compromised in also addressing the plight ofshelter pets. Shelters, do not feel their message is undermined by ministeringto the needs of homeless pure breeds -often about 25% of their residents -and Ibelieve a message that advocates the humane treatment, appreciation and respectfor all dogs is one that truly celebrates dogs.
In fact, I get sad when watching the fancy breeds in the dog show andimagine them living in puppy mills, and wonder, how many of these less thanfortunate members of this exclusive club will end up in my shelters sad, sick,and homeless.
Now that takes some of the enjoyment out of it for me.
 |
| courtesy spcaLA |
The exclusive Westminster Kennel Club (WKC) Dog Show has banned the meremention of shelter dogs at its event.
They have dropped Pedigree, a long term dog food sponsor, because theydidn't like Pedigree's ad campaign which encouraged people to adopt shelterpets. David Frei, a spokesperson for the show is reported as saying:
“Our show is a celebration of dogs. We’re not promoting purebreds at theexpense of non-purebreds. We celebrate all dogs. When we’re seeing puppiesbehind bars, it takes away from that. Not just because it’s sad, but it’s notour message.”
Really? Pedigree, though often marketing to pure breeds, hence thename Pedigree, does not feel compromised in also addressing the plight ofshelter pets. Shelters, do not feel their message is undermined by ministeringto the needs of homeless pure breeds -often about 25% of their residents -and Ibelieve a message that advocates the humane treatment, appreciation and respectfor all dogs is one that truly celebrates dogs.
In fact, I get sad when watching the fancy breeds in the dog show andimagine them living in puppy mills, and wonder, how many of these less thanfortunate members of this exclusive club will end up in my shelters sad, sick,and homeless.
Now that takes some of the enjoyment out of it for me.
Obama to Decide Whether to Expand Military's Animal Cruelty Policy
To contact us Click HERE
The Department of Defense is asking President Obama for permission to expand the military's current animal cruelty policy to include abandonment and to also apply to personal pets rather than just those owned by the military. The constant relocation and reassignment of military families has resulted in many pets simply being left behind, abandoned, and unattended. Stars and Stripes is reporting that the problem is so great in places like Hawaii and Germany that local shelters are reluctant to adopt pets to Americans and/or military families at all.
The military is further concerned that the problem will worsen as United Airlines, the airline contracted to transport military personnel, refuses to permit certain breeds of dogs, such as American Staffordshire Terriers, on their planes, and will not waive this restriction for the Defense Department.
While I fully support holding those who choose to have a pet responsible for caring for that pet and accountable to the authorities for not doing so, I would also suggest that the military drop United Airlines and contract with another carrier so those with "banned" family dogs can travel without the additional heartbreak of the loss of a pet or the expense of funding their own flights on another airline. It seems an unnecessary stressor for those who would otherwise not abandon their pet.
In fact, if all pet lovers chose, in sympathy, to fly with different airlines - maybe we would see an attitude change from United.
The president is expected to decide this spring.
The Department of Defense is asking President Obama for permission to expand the military's current animal cruelty policy to include abandonment and to also apply to personal pets rather than just those owned by the military. The constant relocation and reassignment of military families has resulted in many pets simply being left behind, abandoned, and unattended. Stars and Stripes is reporting that the problem is so great in places like Hawaii and Germany that local shelters are reluctant to adopt pets to Americans and/or military families at all.The military is further concerned that the problem will worsen as United Airlines, the airline contracted to transport military personnel, refuses to permit certain breeds of dogs, such as American Staffordshire Terriers, on their planes, and will not waive this restriction for the Defense Department.
While I fully support holding those who choose to have a pet responsible for caring for that pet and accountable to the authorities for not doing so, I would also suggest that the military drop United Airlines and contract with another carrier so those with "banned" family dogs can travel without the additional heartbreak of the loss of a pet or the expense of funding their own flights on another airline. It seems an unnecessary stressor for those who would otherwise not abandon their pet.
In fact, if all pet lovers chose, in sympathy, to fly with different airlines - maybe we would see an attitude change from United.
The president is expected to decide this spring.
"Something's Happening Here - What It Is Ain't Exactly Clear..."
To contact us Click HERE
I wasn’t going to write about this – but – it has beenbothering me. Last week, the aspca (NOTa national umbrella organization) subsidized adoptions across the country for acouple of days. The subsidy allowed some shelters to give away pets, or tocharge 10 or 20 dollars for the pet. So whyhas this been nagging at me?
I began to wonder why they are really doing this. Promoting adoptions is the obvious answer butis it the correct one? You and I will never know – but here is what I think.The aspca has been and is under fire for fundraising in everyone’s neighborhoodand amassing approximately 188,024,402 million dollars in New Yorkto the detriment of all the other spcas and the animals they serve. They getaway with it because consumers believe that they are the “national office” and thatevery spca in the country is a chapter which receives funding from them. Not true. Each spca is a separate and independent legalentity and it could affect the aspca’s ability to raise funds if they disclosedthat. In fact, out of that near 185,000,000million dollars, they grant out fewerthan 6 million but spend over 25 million on fundraising.
So, they throw pocket change at this adoption promotion,publicize the hell out of it and generate more smoke for the mirrors.
But was it a good event that helped animals? In Californiathey worked mostly with government pounds where adopters are not screened andall one needs is the fee to take home an animal. At no charge or even with anominal charge many animals very likely went to hoarders, backyard sellers, and other entitiesthat had only plans to resell the pets at a huge mark up. How many sales werean impulse grab where the pet was returned or simply turned out? It is easy to empty ashelter but not so easy to have the adoption stick and actually find the pet ahome. It is neither a success nor even an adoption if the pet is not kept. Doyou think the aspca is tracking that or is even concerned about that? I don't know, but if so, the event business model would have been different. Of course there are those of us who would cherish a pet for life that we found on the street or received at no cost. I am not talking about us.
I think that my disquietude comes from the fear that manyof these animals might be in awful places as a result of the aspca’s publicrelations effort to appear to be funding animals in areas in which they solicitdonations and provide nothing in return.
They could be throwing couch cushion change to seem to besomething they are not, while perhaps tossing pets to the very real wolves.
Please donate locally.
I wasn’t going to write about this – but – it has beenbothering me. Last week, the aspca (NOTa national umbrella organization) subsidized adoptions across the country for acouple of days. The subsidy allowed some shelters to give away pets, or tocharge 10 or 20 dollars for the pet. So whyhas this been nagging at me?
 |
| Courtesy spcaL |
So, they throw pocket change at this adoption promotion,publicize the hell out of it and generate more smoke for the mirrors.
But was it a good event that helped animals? In Californiathey worked mostly with government pounds where adopters are not screened andall one needs is the fee to take home an animal. At no charge or even with anominal charge many animals very likely went to hoarders, backyard sellers, and other entitiesthat had only plans to resell the pets at a huge mark up. How many sales werean impulse grab where the pet was returned or simply turned out? It is easy to empty ashelter but not so easy to have the adoption stick and actually find the pet ahome. It is neither a success nor even an adoption if the pet is not kept. Doyou think the aspca is tracking that or is even concerned about that? I don't know, but if so, the event business model would have been different. Of course there are those of us who would cherish a pet for life that we found on the street or received at no cost. I am not talking about us.
I think that my disquietude comes from the fear that manyof these animals might be in awful places as a result of the aspca’s publicrelations effort to appear to be funding animals in areas in which they solicitdonations and provide nothing in return.
They could be throwing couch cushion change to seem to besomething they are not, while perhaps tossing pets to the very real wolves.
Please donate locally.
Stop the Cruel and Bullying "Sport"of Hounding California's Bears and Bobcats
To contact us Click HERE
Senate Bill 1221 will stop the cruel and bullying pastime of “hounding” bears and bobcats.
"Hounding" is a hunting practice where dogs are first sprayed with a bear attractant and fitted with high‐tech radio collars, that permit the hunters to hunt remotely. The dogs can chase the bear or bobcats for miles until they are treed or exhausted, at which time the tip-switch on the collars alerts the hunters, who, arrive and shoot a weary animal at point blank range. Essentially, the hounds take all the risks while the "sport" hunter lounges around in the park waiting for the signal to exert him or herself enough to shoot a trapped, immobilized animal.
Notwithstanding the terrifying ordeal suffered by the target animal, the hounds don't fare much better. They are not treated as pets but as working animals. They get injured running, hit by cars, and are often wounded or killed by the target animal or any other wildlife (such as deer) that they may encounter. There are reports of shelters receiving these dogs dehydrated, skinny and injured after they are no longer any use to the "sportsman".
I respectfully submit that this form of hunting is neither sport nor sportsman like. As comedian Paul Rodriguez said: "In a sport both sides should know they are in the game".
Not only do the animals not know they are playing - the bullies are cheating.
It is time to end this practice in California. Please contact your representatives http://www.leginfo.ca.gov/yourleg.html and urge them to pass SB 1221.
Thank you.
Senate Bill 1221 will stop the cruel and bullying pastime of “hounding” bears and bobcats.
 |
| Courtesy Google Images |
 |
| Courtesy Google Images |
I respectfully submit that this form of hunting is neither sport nor sportsman like. As comedian Paul Rodriguez said: "In a sport both sides should know they are in the game".
Not only do the animals not know they are playing - the bullies are cheating.
It is time to end this practice in California. Please contact your representatives http://www.leginfo.ca.gov/yourleg.html and urge them to pass SB 1221.
Thank you.
Rihanna's Dog Got "Minxed"
To contact us Click HERE
The latest trend in manicures and pedicures is the minx manicure. It is a process where pictures and patterns are painted onto fingernails and toenails thereby instantly transforming ordinary fingers and toes into works of art.
It was only a matter of time before this new art form appeared on a pet. In this case it was Rihanna's dog. She posted a photo of her dog with the caption "Bitch got minx."
The product is said to be toxic, odorless, chemical free and perfectly safe for natural nails. However, before you try something like this on your pet, use common sense. When in doubt, ask a veterinarian - is this safe for pets? Procedures and materials deemed safe for people may still have adverse effect on animals.
If it's safe - make sure it's something your pet tolerates and is comfortable doing. If your dog needs a sedative to do it, it most likely should not be done.
Need I say- don't even think about this for a cat!
 |
| Courtesy Instagram |
It was only a matter of time before this new art form appeared on a pet. In this case it was Rihanna's dog. She posted a photo of her dog with the caption "Bitch got minx."
The product is said to be toxic, odorless, chemical free and perfectly safe for natural nails. However, before you try something like this on your pet, use common sense. When in doubt, ask a veterinarian - is this safe for pets? Procedures and materials deemed safe for people may still have adverse effect on animals.
If it's safe - make sure it's something your pet tolerates and is comfortable doing. If your dog needs a sedative to do it, it most likely should not be done.
Need I say- don't even think about this for a cat!
24 Haziran 2012 Pazar
New Hyperglycemia Management Guidelines
To contact us Click HERE
After doing much reading and trying tofollow what is said in the document released April 19, 2012 as thenew hyperglycemia management guidelines, I am beginning to understandwhat is being said. The guidelines were published in DiabetesCare by the American Diabetes Association (ADA) and inDiabetologia by the European Association for the Study ofDiabetes (EASD).
The last guidelines on management ofhyperglycemia were published about five years ago and recentdevelopments have now been incorporated into the new guidelines. Theclaim is made that there is growing complexity and some controversyin contemporary glycemic management for persons with type 2 diabetes– you think? What I do not understand is the thinking that oralmedication is the route to follow by adding medication aftermedication to solve the problem.
According the experts, the answer hasto follow the ACCORD rules and this is what pulled the study down. Medication on top of medication just does not work, but our diabetesexperts think this is the only way and Big Pharma has them convincedthat this is the route to go. This violates other statements andbasically means things will be business as usual.
Oh, yes, the guidelines are full ofplatitudes to make us think that the new guidelines are patientoriented, but when the president of ADA's medicine and science statesthat the ADA set the HbA1c goal at 7% in general, but with someindividualization, this means little or no change. At least otherbloggers are thinking that little will change and that doctors willcontinue to push oral medication after oral medication until it istoo late for insulin to prevent complications.
When the president for medicine andscience of the American Diabetes Association, Vivian Fonseca, MD, ofTulane University in New Orleans criticizes a study, you know thatthe ADA has something to protect in the new guidelines. This is one ofmedication combinations – in fact the medication combinationpromoted in the chart so highly prized by the ADA.
I agree with Tom Ross when he states. “What's new in these guidelines, apparently, is the emphasis onfiguring out which drug combination is right for different kinds ofpatients, on the basis of many different factors which can limit theefficacy or safety of particular drugs in particular individuals. Idon't think this is the revolution in thinking about diabetes carethat I would have liked to see.”
Everything about the new guidelinesseems prefaced on getting patients on medications and as soon aspossible. There seems no room for patients that want to managediabetes with diet and exercise; and there are many doing just thatand succeeding.
The other point that really upsets me –if they are really advocating individuals and allowing individualchoices, why is insulin listed last? This is just a continuation ofthe mantra of making this the medication of last resort whencomplications have already made themselves known. I really need towonder if people that desire to move to insulin will be allowed thechoice, or will the doctors want to keep piling oral medications onand generating more and more severe side effects. The side effectsof insulin are minor in comparison to some of the oral diabetesmedications. What are these so-called experts thinking? They mustbe followers of the insulin myths.
After doing much reading and trying tofollow what is said in the document released April 19, 2012 as thenew hyperglycemia management guidelines, I am beginning to understandwhat is being said. The guidelines were published in DiabetesCare by the American Diabetes Association (ADA) and inDiabetologia by the European Association for the Study ofDiabetes (EASD).
The last guidelines on management ofhyperglycemia were published about five years ago and recentdevelopments have now been incorporated into the new guidelines. Theclaim is made that there is growing complexity and some controversyin contemporary glycemic management for persons with type 2 diabetes– you think? What I do not understand is the thinking that oralmedication is the route to follow by adding medication aftermedication to solve the problem.
According the experts, the answer hasto follow the ACCORD rules and this is what pulled the study down. Medication on top of medication just does not work, but our diabetesexperts think this is the only way and Big Pharma has them convincedthat this is the route to go. This violates other statements andbasically means things will be business as usual.
Oh, yes, the guidelines are full ofplatitudes to make us think that the new guidelines are patientoriented, but when the president of ADA's medicine and science statesthat the ADA set the HbA1c goal at 7% in general, but with someindividualization, this means little or no change. At least otherbloggers are thinking that little will change and that doctors willcontinue to push oral medication after oral medication until it istoo late for insulin to prevent complications.
When the president for medicine andscience of the American Diabetes Association, Vivian Fonseca, MD, ofTulane University in New Orleans criticizes a study, you know thatthe ADA has something to protect in the new guidelines. This is one ofmedication combinations – in fact the medication combinationpromoted in the chart so highly prized by the ADA.
I agree with Tom Ross when he states. “What's new in these guidelines, apparently, is the emphasis onfiguring out which drug combination is right for different kinds ofpatients, on the basis of many different factors which can limit theefficacy or safety of particular drugs in particular individuals. Idon't think this is the revolution in thinking about diabetes carethat I would have liked to see.”
Everything about the new guidelinesseems prefaced on getting patients on medications and as soon aspossible. There seems no room for patients that want to managediabetes with diet and exercise; and there are many doing just thatand succeeding.
The other point that really upsets me –if they are really advocating individuals and allowing individualchoices, why is insulin listed last? This is just a continuation ofthe mantra of making this the medication of last resort whencomplications have already made themselves known. I really need towonder if people that desire to move to insulin will be allowed thechoice, or will the doctors want to keep piling oral medications onand generating more and more severe side effects. The side effectsof insulin are minor in comparison to some of the oral diabetesmedications. What are these so-called experts thinking? They mustbe followers of the insulin myths.
Making the Most Out of Your Doctor Appointments
To contact us Click HERE
Okay, I do miss some of my doctorappointments. Why does this happen? To be honest, I am not sure ifit is my subconscious kicking in and telling me to ignore it orwhether I am having memory problems. I do know that when theweather is bad, I will not travel the thirty plus miles one way, andI know that one got canceled (I actually called) because of the priceof gas and trying to stretch the budget.
My appointments have become too routineand my lab results have been very consistent (boring comes to mind). What puzzles me even more is how difficult it is to schedule severaldoctor appointments in one day. In nine years of trying to do this,I have only succeeded getting two doctor's appointments in one dayonce – repeat one time. I thought I had done it three other times,but one doctor always had to reschedule for some legitimate reason. I do not like this, but things do mess with doctors schedules thatcannot be prevented.
I am discussing this because of a blogin diabetesselfmanagement.com that brings up some excellent pointersthat we should follow to get the most out of our doctor appointments. It is written for diabetes appointments, but I am covering alldoctor appointments. Read the blog and see how you compare and ifyou are planning for a successful healthcare visit. I will covereach point as well to show how I compare. First, I must state that Ihave no problems with keeping my diabetes appointments. It is myother doctors I have my problems in forgetting my appointments.
1. Make time for it (the appointment). As a retired person, Iseldom have any conflicts for my time – unless it is during thewinter months and the weather is bad. As suggested I do turn off mycell phone and if I forget, most offices have reminders to do justthat. I have heard people talking on their cell phones during officevisits and I can understand doctors becoming very annoyed by this.2. Plan ahead. Since we cannot remember everything to ask thedoctor, I do make a list of questions that I need covered. Then aday or two before the appointment I try to prioritize them in orderof their importance to me. I print them out so that if time runsout, I can hand it to the doctor and most of the time I will receivesomething in the mail with answers, or some doctors will call andgive me the answer. Always record any activity out of the usual,like job changes, travel, or other changes. For me this is not aproblem, but I do make mention of applicable health problems thatconcern me. I have them written down and also have blank paper torecord instructions. I do repeat what I have written to make sure Ihave understood what the doctor has said.3. Bring your meter and logbook. Although many people willnot let their doctor have access to their meter, I think I get muchmore out of my appointments as the doctor does download my meter andreviews the readings and a couple of graphs with me. I always havemy logbook for food and insulin injections if it is needed.4. Facing the scale. Get over it, the number is what it isand you can only remove heavy clothing like a heavy winter coat. Iknow this is the procedure for most of my office visits, so I have aninterest, but I do not obsess about it. I do get a few wry comments,but I just say it is what it is and the topic usually is dropped. Idid have one doctor ask if I would consider bariatric procedure. Myinstantaneous no response stopped him cold. He did ask why and Icarefully told him why explaining several of the things I would notbe told and the problems this could cause for me. He commented Imust have researched this and I hauled out a printout and he lookedat it and when he saw the source, handed it back. He said that hehad read it and agreed with it, but that the hospital was pushing alldoctors to try to see what could be done. He did say he would notbring it up again with me, if I could hold my current weight orreduce it, as he was looking at my weight chart and said I have beenup and down but that I was under what my highest had been. I toldhim to look for possible alternatives, but to forget people thatinsisted on the ADA way. He agreed and said I did not need thecalories or carbohydrates.5. Discuss your medicines. This is important and is somethingdoctors are mostly requiring. Although the blog suggests a list orthe bottles, I normally use the list method, but I do have twodoctors that are now demanding the bottles before giving out any newprescriptions or renewals. They are not requiring this at everyappointment, only when something is to be renewed. Some usee-prescribing and a few still are not. This blog does what should bedone but few blogs do. It tells you to list all over-the-counter orherbal products
Many people insist they do not have totell their doctor what supplements or other non-prescriptionmedications they are taking. I will say I record everything, evenprescriptions that are for short periods and I have not taken forsome time since the last appointment. I do list the period that they weretaken.
6. Take off your shoes and socks. For appointments with yourdiabetes doctor and your podiatrist this is a must. You may not haveboth, but you should consider this. Yes, it is a requirement foryour podiatrist, but may not be for your diabetes doctor orendocrinologist if they know you see a podiatrist regularly. Eitherway, you should consider this as being important for the health ofyour feet. Even my neurologist surprises me once in a while whenchecking my neuropathy.
Especially for your podiatrist beprepared to discuss any foot-related concerns you may have. If youhave problems with trimming your toenails or finding shoes that fit,and you don't have a podiatrist, ask for a referral to one.
7. Discuss your goals. Always be prepared for this,especially for your diabetes and have questions at the ready for yourdoctor as to how best achieve these. Be prepared as some doctors areonly interesting in the A1c readings and you may need to ask somespecific questions to convince the doctor you are serious. With allcandor, if your doctor is unwilling to listen and discuss your goals,consider the need to find another doctor that will work with you toachieve goals for both of you.8. Bring your calendar. Always bring your appointment book,or calendar (digital or paper) with you to schedule future visits. Make sure that you allow sufficient time between lab tests and yourappointment to prevent conflicts or obtaining lab results. Alwaysask for a copy of lab results to assist you in tracking your ownhealth. 9. Get the most from your minutes. This may seem difficult asthe 10 to 15 minutes go by fast. Accept that the doctor may feel asrushed as you and you may have more questions than he has time toanswer. I admit this is often the case for me. So I prioritize myquestions to get the most important ones answered first. I amfortunate that a few of my doctors realize that I have a list andthey do ask that I put my name, address, and telephone number on it. I always do this and they generally take the list of questions andanswer them after hours or mail me the answers. One doctor does useemail to answer them. I have had one doctor then call if he has ano-show to answer questions. Another doctor does answer thequestions and gives me my sheet with his answers at the nextappointment. This has let me know that I should be detailed in myquestions and a couple of the doctors have thanked me for doing this.
Not every appointment will go asplanned, so the better you have prepared yourself, the easier it canbe for both of you. Although this seldom happens, I did have oneappointment terminated as the doctor was called away on an emergency. I did hear him instruct his nurse to get my list of questions andgive me my copy of the lab report as he hustled off. The nurse didsay that it way one of his family in the emergency room, but that wasall she said. Two days later, he called to ask if I understood thelab reports and if I had paper and pen available. He answered myquestions after saying it was his wife that had been in a vehicleaccident.
This was totally appreciated andexplained why he had rushed off and I was very appreciative of histime in answering my questions. In the appointments since, nofurther mention was made of what happened and things were normal forthe appointments. This is just one more reason to have a list ofquestions ready with your information included. I have found outover time that most doctors will appreciate the questions printed outin case they are short of time and the good ones will evaluate thequestions and respond to the important ones. Depending on the numberof questions, some do mail back the answers.
Okay, I do miss some of my doctorappointments. Why does this happen? To be honest, I am not sure ifit is my subconscious kicking in and telling me to ignore it orwhether I am having memory problems. I do know that when theweather is bad, I will not travel the thirty plus miles one way, andI know that one got canceled (I actually called) because of the priceof gas and trying to stretch the budget.
My appointments have become too routineand my lab results have been very consistent (boring comes to mind). What puzzles me even more is how difficult it is to schedule severaldoctor appointments in one day. In nine years of trying to do this,I have only succeeded getting two doctor's appointments in one dayonce – repeat one time. I thought I had done it three other times,but one doctor always had to reschedule for some legitimate reason. I do not like this, but things do mess with doctors schedules thatcannot be prevented.
I am discussing this because of a blogin diabetesselfmanagement.com that brings up some excellent pointersthat we should follow to get the most out of our doctor appointments. It is written for diabetes appointments, but I am covering alldoctor appointments. Read the blog and see how you compare and ifyou are planning for a successful healthcare visit. I will covereach point as well to show how I compare. First, I must state that Ihave no problems with keeping my diabetes appointments. It is myother doctors I have my problems in forgetting my appointments.
1. Make time for it (the appointment). As a retired person, Iseldom have any conflicts for my time – unless it is during thewinter months and the weather is bad. As suggested I do turn off mycell phone and if I forget, most offices have reminders to do justthat. I have heard people talking on their cell phones during officevisits and I can understand doctors becoming very annoyed by this.2. Plan ahead. Since we cannot remember everything to ask thedoctor, I do make a list of questions that I need covered. Then aday or two before the appointment I try to prioritize them in orderof their importance to me. I print them out so that if time runsout, I can hand it to the doctor and most of the time I will receivesomething in the mail with answers, or some doctors will call andgive me the answer. Always record any activity out of the usual,like job changes, travel, or other changes. For me this is not aproblem, but I do make mention of applicable health problems thatconcern me. I have them written down and also have blank paper torecord instructions. I do repeat what I have written to make sure Ihave understood what the doctor has said.3. Bring your meter and logbook. Although many people willnot let their doctor have access to their meter, I think I get muchmore out of my appointments as the doctor does download my meter andreviews the readings and a couple of graphs with me. I always havemy logbook for food and insulin injections if it is needed.4. Facing the scale. Get over it, the number is what it isand you can only remove heavy clothing like a heavy winter coat. Iknow this is the procedure for most of my office visits, so I have aninterest, but I do not obsess about it. I do get a few wry comments,but I just say it is what it is and the topic usually is dropped. Idid have one doctor ask if I would consider bariatric procedure. Myinstantaneous no response stopped him cold. He did ask why and Icarefully told him why explaining several of the things I would notbe told and the problems this could cause for me. He commented Imust have researched this and I hauled out a printout and he lookedat it and when he saw the source, handed it back. He said that hehad read it and agreed with it, but that the hospital was pushing alldoctors to try to see what could be done. He did say he would notbring it up again with me, if I could hold my current weight orreduce it, as he was looking at my weight chart and said I have beenup and down but that I was under what my highest had been. I toldhim to look for possible alternatives, but to forget people thatinsisted on the ADA way. He agreed and said I did not need thecalories or carbohydrates.5. Discuss your medicines. This is important and is somethingdoctors are mostly requiring. Although the blog suggests a list orthe bottles, I normally use the list method, but I do have twodoctors that are now demanding the bottles before giving out any newprescriptions or renewals. They are not requiring this at everyappointment, only when something is to be renewed. Some usee-prescribing and a few still are not. This blog does what should bedone but few blogs do. It tells you to list all over-the-counter orherbal products
Many people insist they do not have totell their doctor what supplements or other non-prescriptionmedications they are taking. I will say I record everything, evenprescriptions that are for short periods and I have not taken forsome time since the last appointment. I do list the period that they weretaken.
6. Take off your shoes and socks. For appointments with yourdiabetes doctor and your podiatrist this is a must. You may not haveboth, but you should consider this. Yes, it is a requirement foryour podiatrist, but may not be for your diabetes doctor orendocrinologist if they know you see a podiatrist regularly. Eitherway, you should consider this as being important for the health ofyour feet. Even my neurologist surprises me once in a while whenchecking my neuropathy.
Especially for your podiatrist beprepared to discuss any foot-related concerns you may have. If youhave problems with trimming your toenails or finding shoes that fit,and you don't have a podiatrist, ask for a referral to one.
7. Discuss your goals. Always be prepared for this,especially for your diabetes and have questions at the ready for yourdoctor as to how best achieve these. Be prepared as some doctors areonly interesting in the A1c readings and you may need to ask somespecific questions to convince the doctor you are serious. With allcandor, if your doctor is unwilling to listen and discuss your goals,consider the need to find another doctor that will work with you toachieve goals for both of you.8. Bring your calendar. Always bring your appointment book,or calendar (digital or paper) with you to schedule future visits. Make sure that you allow sufficient time between lab tests and yourappointment to prevent conflicts or obtaining lab results. Alwaysask for a copy of lab results to assist you in tracking your ownhealth. 9. Get the most from your minutes. This may seem difficult asthe 10 to 15 minutes go by fast. Accept that the doctor may feel asrushed as you and you may have more questions than he has time toanswer. I admit this is often the case for me. So I prioritize myquestions to get the most important ones answered first. I amfortunate that a few of my doctors realize that I have a list andthey do ask that I put my name, address, and telephone number on it. I always do this and they generally take the list of questions andanswer them after hours or mail me the answers. One doctor does useemail to answer them. I have had one doctor then call if he has ano-show to answer questions. Another doctor does answer thequestions and gives me my sheet with his answers at the nextappointment. This has let me know that I should be detailed in myquestions and a couple of the doctors have thanked me for doing this.
Not every appointment will go asplanned, so the better you have prepared yourself, the easier it canbe for both of you. Although this seldom happens, I did have oneappointment terminated as the doctor was called away on an emergency. I did hear him instruct his nurse to get my list of questions andgive me my copy of the lab report as he hustled off. The nurse didsay that it way one of his family in the emergency room, but that wasall she said. Two days later, he called to ask if I understood thelab reports and if I had paper and pen available. He answered myquestions after saying it was his wife that had been in a vehicleaccident.
This was totally appreciated andexplained why he had rushed off and I was very appreciative of histime in answering my questions. In the appointments since, nofurther mention was made of what happened and things were normal forthe appointments. This is just one more reason to have a list ofquestions ready with your information included. I have found outover time that most doctors will appreciate the questions printed outin case they are short of time and the good ones will evaluate thequestions and respond to the important ones. Depending on the numberof questions, some do mail back the answers.
Three Quarters of Sunscreens Not Safe
To contact us Click HERE
Even with the FDA regulations andresearch on sunscreens, can we trust the products? Studies for themarket of sunscreens for 2012 indicate that only one quarter of theproducts on the market is safe. Another area will also bescrutinized over the next year. Some are already making theiraccusations but at this time, there seems to be only speculations andno scientific proof. If proven, then everyone will know for sure.
This speculation has to do withnano-sized particles of zinc oxide in sunscreens. This will beresearched over this summer and hopefully we will have an answerbefore next summer. So for now everyone is promoting theirheadlines, but when you get to the reading, they do say “may”cause cancer. There also is concern about titanium dioxide.
Yes, there are people on both sides ofany issue and here we have the Environmental Working Group on oneside, and some, but not all dermatologists on the other side. Bothsides do agree that people should use sunscreens. The disagreementis about which works best, how often to apply, and safety ofchemicals used in the product. The FDA has now come forward toeliminate some of the ambiguous terms manufacturers have been using. The words waterproof, sweatproof, and sunblock are now not allowed,but you may see "water-resistant," "sweat-resistant,"and just plain "sunscreen". I wish this would be enforced,as there is still much of this on local shelves. I have looked andreported this to store managers, but it is not taken off the shelves. The FDA does need to enforce what they mandate.
The good outcome of FDA finally issuingsome rules is that now they can be revised to make sunscreens moreeffective. EWG has been a leader in getting manufacturers to improveproducts and for the last three years there has been improvements;however, there is more to be accomplished when three quarters of thesunscreens on the market still are of poor quality and do not meetthe needs of people or often are not even meeting standards. Untilsome heavy fines are levied against manufacturers for mislabeling andfalse advertising, we will probably continue to see inferior productson store shelves. Some heavy fines should also be levied againststore chains and other outlets that bring out what remains from prioryears inventory for sale.
Read about sunscreens here is thisMedscape article and here for the WebMD discussion. Although I can'trecommend it, for those that need to be positive about what they arepurchasing, check out EWG's website here.
Even with the FDA regulations andresearch on sunscreens, can we trust the products? Studies for themarket of sunscreens for 2012 indicate that only one quarter of theproducts on the market is safe. Another area will also bescrutinized over the next year. Some are already making theiraccusations but at this time, there seems to be only speculations andno scientific proof. If proven, then everyone will know for sure.
This speculation has to do withnano-sized particles of zinc oxide in sunscreens. This will beresearched over this summer and hopefully we will have an answerbefore next summer. So for now everyone is promoting theirheadlines, but when you get to the reading, they do say “may”cause cancer. There also is concern about titanium dioxide.
Yes, there are people on both sides ofany issue and here we have the Environmental Working Group on oneside, and some, but not all dermatologists on the other side. Bothsides do agree that people should use sunscreens. The disagreementis about which works best, how often to apply, and safety ofchemicals used in the product. The FDA has now come forward toeliminate some of the ambiguous terms manufacturers have been using. The words waterproof, sweatproof, and sunblock are now not allowed,but you may see "water-resistant," "sweat-resistant,"and just plain "sunscreen". I wish this would be enforced,as there is still much of this on local shelves. I have looked andreported this to store managers, but it is not taken off the shelves. The FDA does need to enforce what they mandate.
The good outcome of FDA finally issuingsome rules is that now they can be revised to make sunscreens moreeffective. EWG has been a leader in getting manufacturers to improveproducts and for the last three years there has been improvements;however, there is more to be accomplished when three quarters of thesunscreens on the market still are of poor quality and do not meetthe needs of people or often are not even meeting standards. Untilsome heavy fines are levied against manufacturers for mislabeling andfalse advertising, we will probably continue to see inferior productson store shelves. Some heavy fines should also be levied againststore chains and other outlets that bring out what remains from prioryears inventory for sale.
Read about sunscreens here is thisMedscape article and here for the WebMD discussion. Although I can'trecommend it, for those that need to be positive about what they arepurchasing, check out EWG's website here.
Nursing Shortages – Oh Really?
To contact us Click HERE
Nursing shortage seems like anothermyth. In some areas of the USA, this is true. In other areas, thereis an honest shortage, but it may not last long. What are some ofthe factors affecting the field of nursing? There are some obviousanswers and some almost obscure answers.
Two of the most telling answers areone; older nurses are not retiring because of the economy and maywell have a spouse without a job. The second and more frighteninganswer is hospitals are just not replacing nurses as they leave. Whyyou might ask? The reduction in profits is largely to blame andincreases in hospital administrator salaries are adding to thispressure.
Although many hospitals have positionsfor nurse aids, more hospitals are adding them in place of nurses. This will increase the workload for remaining nurses, but thehospitals are striving to keep profits increasing. How are thehospitals determining this? They have people patrolling the floorsof the hospitals, counting patients, watching nurse activities andother variables. These people report to the administration abouttheir observations.
This may sound cruel, but many nurseshave brought this on themselves by their actions or maybe I shouldsay lack of doing their duties. I have been in a few hospitals andactually seen this and wondered how the hospital could make moneywith the nurses sitting around the nursing station. In one visit toa friend, the five hours I was there they sat and never made rounds. Call buzzers would go off and still they did not move. They wouldsend an aid to check and only leave the nurse's station if it wassomething urgent. The patient I was visiting needed a shot everyfour hours, but while I was visiting, no shots were given.
Even a trip to the nurse station didnot get a shot. In this case, I called the doctor and explained whathad happened. The doctor said he would be there in a few minutesand he was. He came in an entrance away from the nurse's station andcame directly to the room. He checked the chart and asked how long Ihad been there. Next, he headed to the dispensary to get themedication for the shot and the syringe. He asked why his patienthad not been given a shot on time. The answer was it was not listedon the patient file. He came to the room, gave the shot, and thenwent back to the station with the patients chart in his hand.
I don't know more as visiting hourswere over and the nurses were checking every room and making sure allvisitors were leaving. The whole time I had been there, no roundshad been made by the nurses, but the aids had come and gone ratherregularly. From what I observed, the five nurses had a gab fest thewhole time and I don't think four had gone anywhere except to use theladies' room and one to the cafeteria to bring back food for all.
In another hospital, I knew there werevery few patients on that level, but the nurses were constantlychecking rooms and I very seldom heard a call bell (or buzzer)sounding. About every 15 to 20 minutes, a nurse would be in to checkon my wife, checking pulse and blood pressure and moistening her lipswith water on a cloth. When shift time came, one of the day nursesstayed and two others reported in plus a couple of aids. Even theywere making rounds and checking on the few patients. A very clearcontrast when compared to my visit to a friend.
From the second article, this seems tobe the case I have described above and varies from hospital tohospital. Some nurses are extremely busy and at some hospitals, itis difficult to see nurses at work. Even patients are complaining atthese hospitals. Although this is seldom talked about, hospitalsthat have strong unions are where the most complaints originate. Others say it depends on the strength of the director of nursing. And, it may be a combination of these.
Either way there are several scenariosthat may play out in the next few years. I disagree with thescenarios discussed in this blog, but he may be right as he is aninsider and I am a patient. I suspect there will not be anoversupply of nurses because many will leave for employment that ismore lucrative. Hospitals will work diligently to reduce the nursingstaff and replace many with nurse aids to reduce labor costs and atthe same time bring in pharmacists to administer medications andmanage inhouse pharmacies. Unions will be either forced out orgreatly weakened all as a means of increasing profits.
Nursing shortage seems like anothermyth. In some areas of the USA, this is true. In other areas, thereis an honest shortage, but it may not last long. What are some ofthe factors affecting the field of nursing? There are some obviousanswers and some almost obscure answers.
Two of the most telling answers areone; older nurses are not retiring because of the economy and maywell have a spouse without a job. The second and more frighteninganswer is hospitals are just not replacing nurses as they leave. Whyyou might ask? The reduction in profits is largely to blame andincreases in hospital administrator salaries are adding to thispressure.
Although many hospitals have positionsfor nurse aids, more hospitals are adding them in place of nurses. This will increase the workload for remaining nurses, but thehospitals are striving to keep profits increasing. How are thehospitals determining this? They have people patrolling the floorsof the hospitals, counting patients, watching nurse activities andother variables. These people report to the administration abouttheir observations.
This may sound cruel, but many nurseshave brought this on themselves by their actions or maybe I shouldsay lack of doing their duties. I have been in a few hospitals andactually seen this and wondered how the hospital could make moneywith the nurses sitting around the nursing station. In one visit toa friend, the five hours I was there they sat and never made rounds. Call buzzers would go off and still they did not move. They wouldsend an aid to check and only leave the nurse's station if it wassomething urgent. The patient I was visiting needed a shot everyfour hours, but while I was visiting, no shots were given.
Even a trip to the nurse station didnot get a shot. In this case, I called the doctor and explained whathad happened. The doctor said he would be there in a few minutesand he was. He came in an entrance away from the nurse's station andcame directly to the room. He checked the chart and asked how long Ihad been there. Next, he headed to the dispensary to get themedication for the shot and the syringe. He asked why his patienthad not been given a shot on time. The answer was it was not listedon the patient file. He came to the room, gave the shot, and thenwent back to the station with the patients chart in his hand.
I don't know more as visiting hourswere over and the nurses were checking every room and making sure allvisitors were leaving. The whole time I had been there, no roundshad been made by the nurses, but the aids had come and gone ratherregularly. From what I observed, the five nurses had a gab fest thewhole time and I don't think four had gone anywhere except to use theladies' room and one to the cafeteria to bring back food for all.
In another hospital, I knew there werevery few patients on that level, but the nurses were constantlychecking rooms and I very seldom heard a call bell (or buzzer)sounding. About every 15 to 20 minutes, a nurse would be in to checkon my wife, checking pulse and blood pressure and moistening her lipswith water on a cloth. When shift time came, one of the day nursesstayed and two others reported in plus a couple of aids. Even theywere making rounds and checking on the few patients. A very clearcontrast when compared to my visit to a friend.
From the second article, this seems tobe the case I have described above and varies from hospital tohospital. Some nurses are extremely busy and at some hospitals, itis difficult to see nurses at work. Even patients are complaining atthese hospitals. Although this is seldom talked about, hospitalsthat have strong unions are where the most complaints originate. Others say it depends on the strength of the director of nursing. And, it may be a combination of these.
Either way there are several scenariosthat may play out in the next few years. I disagree with thescenarios discussed in this blog, but he may be right as he is aninsider and I am a patient. I suspect there will not be anoversupply of nurses because many will leave for employment that ismore lucrative. Hospitals will work diligently to reduce the nursingstaff and replace many with nurse aids to reduce labor costs and atthe same time bring in pharmacists to administer medications andmanage inhouse pharmacies. Unions will be either forced out orgreatly weakened all as a means of increasing profits.
Nutrition and Aging – Some Signs
To contact us Click HERE
Yes, I am discussing the topic ofnutrition again. With the concerted efforts of the Academy ofNutrition and Dietetic (AND) to become a monopoly in the field ofnutrition and force people with degrees in nutrition out of businessunless they become certified or licensed under their organization,people will need to learn nutrition on their own. We should notaccept the teachings of a monopolistic organization that uses mantrasand mandates.
I am hoping our state legislature willcontinue to protect the nutritionists of our state. It is refreshingto talk to them and know that they will work with you as anindividual. They know that in nutrition, “one-size-does-not fitall,” and each person has individual needs depending on age,ability to exercise, and general health. Since I am in the class ofelderly, they work with me to attempt to balance my nutritionalintake.
For those of us in the eldergeneration, we need to avoid many of the normal teachings of the ANDand learn that many years of whole grains (i.e. high carbohydrate)and low fat have done damage to us. We often need more protein,higher fat content in our food, and less carbohydrates than ouryounger generations. Even they might do better with fewercarbohydrates.
When I started to look for information,I thought this article in WebMD may have been useful, but it is notas specific or as helpful as I had hoped. The article focuses onanemia and iron deficiency more than anything. It rightly brings upthe B vitamins, but fails to point out any specific deficiencies andsigns to be aware of if you have any of the vitamin B deficiencies. This is the reason I do not like articles mentioning registereddietitians as they are not getting paid to be informative, thereforeit is all generalizations.
We need to be aware of other people onthe Internet that also bring in small items about nutrition and thosewriting about low carbohydrate diets. David Mendosa does like tomention foods that work for him. You should subscribe to his posts. Jenney Ruhl now has a book out titled Diet 101 that I have notbeen able to read, but hopefully will in the near future.
Other sites that are about nutritionexist, it is just finding them. Yes, here are a few I read, not on adaily basis, but as I can or they have a blog posted.
http://www.marksdailyapple.com/#axzz1pEQ4nwE5
http://www.diabetes-warrior.net/
http://myoptimalhealthresource.blogspot.com/
http://wholehealthsource.blogspot.com/
http://www.healthcentral.com/profiles/c/17/index
Yes, I am discussing the topic ofnutrition again. With the concerted efforts of the Academy ofNutrition and Dietetic (AND) to become a monopoly in the field ofnutrition and force people with degrees in nutrition out of businessunless they become certified or licensed under their organization,people will need to learn nutrition on their own. We should notaccept the teachings of a monopolistic organization that uses mantrasand mandates.
I am hoping our state legislature willcontinue to protect the nutritionists of our state. It is refreshingto talk to them and know that they will work with you as anindividual. They know that in nutrition, “one-size-does-not fitall,” and each person has individual needs depending on age,ability to exercise, and general health. Since I am in the class ofelderly, they work with me to attempt to balance my nutritionalintake.
For those of us in the eldergeneration, we need to avoid many of the normal teachings of the ANDand learn that many years of whole grains (i.e. high carbohydrate)and low fat have done damage to us. We often need more protein,higher fat content in our food, and less carbohydrates than ouryounger generations. Even they might do better with fewercarbohydrates.
When I started to look for information,I thought this article in WebMD may have been useful, but it is notas specific or as helpful as I had hoped. The article focuses onanemia and iron deficiency more than anything. It rightly brings upthe B vitamins, but fails to point out any specific deficiencies andsigns to be aware of if you have any of the vitamin B deficiencies. This is the reason I do not like articles mentioning registereddietitians as they are not getting paid to be informative, thereforeit is all generalizations.
We need to be aware of other people onthe Internet that also bring in small items about nutrition and thosewriting about low carbohydrate diets. David Mendosa does like tomention foods that work for him. You should subscribe to his posts. Jenney Ruhl now has a book out titled Diet 101 that I have notbeen able to read, but hopefully will in the near future.
Other sites that are about nutritionexist, it is just finding them. Yes, here are a few I read, not on adaily basis, but as I can or they have a blog posted.
http://www.marksdailyapple.com/#axzz1pEQ4nwE5
http://www.diabetes-warrior.net/
http://myoptimalhealthresource.blogspot.com/
http://wholehealthsource.blogspot.com/
http://www.healthcentral.com/profiles/c/17/index
23 Haziran 2012 Cumartesi
Elderly and Cars
To contact us Click HERE
It never ceases to amaze me that when we talk about something new in class I open my eyes up to what's going on in the world and how the world designed for users of all abilities. It never occurred to me how hard it was for an elderly person to get out of a chair or something like that which is to us so simple.
Have you ever seen an elderly person get into a car? That seems to be no easy feat either. I have a great aunt Evelyn who is 96 right now and she just barely started using a walker in the past year because it got to the point where it was incredibly hard for her to just get that one foot in front of the other with a cane..so now she has her "cadillac," which is just the name for her walker.
Whenever we go to South Dakota to visit her she always wants to take us to dinner. Getting her into the car is quite an extensive operation. She has to grab onto something to be able to even get a grip on getting herself in the car and when she finally gets a grip she almost has to take her other hand and manually move her foot up into the car. Once she gets one foot in the car she just kind of plumps down and every time she comments on how it's so hard for her to even do something so simple.
She just does not move like she use to and it bums me out that it's not even easy just to get her into the car and take her somewhere.
Have you every watched an elderly man or lady be helped into a car? Generally they are always holding on to someone and bracing themselves so that they have even more leverage to get into a car.
Have you ever seen an elderly person get into a car? That seems to be no easy feat either. I have a great aunt Evelyn who is 96 right now and she just barely started using a walker in the past year because it got to the point where it was incredibly hard for her to just get that one foot in front of the other with a cane..so now she has her "cadillac," which is just the name for her walker.
Whenever we go to South Dakota to visit her she always wants to take us to dinner. Getting her into the car is quite an extensive operation. She has to grab onto something to be able to even get a grip on getting herself in the car and when she finally gets a grip she almost has to take her other hand and manually move her foot up into the car. Once she gets one foot in the car she just kind of plumps down and every time she comments on how it's so hard for her to even do something so simple.
She just does not move like she use to and it bums me out that it's not even easy just to get her into the car and take her somewhere.
Have you every watched an elderly man or lady be helped into a car? Generally they are always holding on to someone and bracing themselves so that they have even more leverage to get into a car.
ADA Guidelines Taught in the Workplace
To contact us Click HERE
Have you ever walked through a store and been thinking about the ADA guidelines of how far apart pieces of furniture need to be in order for someone in a wheelchair to get through? In most cases whatever store your in is compliant with these guidelines. Generally it's because somebody working there has some knowledge of how things are suppose to be so that they can have a great shopping experience for everyone.
I work in retail and it amazed me how many different people knew about the standards and what not. We would be changing up the store and there was always someone who was like but is that the standard distance apart for a wheelchair. However, now I don't seem to hear it as much anymore. I feel like the guidelines and standards should be taught in part of the training when you or anyone is becoming a new associate. I feel like it's important that everyone should know so that if someone wasn't paying attention some other co worker could remind them that things need to meet those guidelines.
Sometimes I feel like not enough people are aware that there are even standards unless they have a family member in a wheelchair or they themselves are in one. I never really thought about it until I started up my design classes where I became very aware of these things. We want everyone to be able to enjoy the world and the mall and all these amazing stores as well and it's not fair if the fixtures are to close together so that someone can't get through.
I work in retail and it amazed me how many different people knew about the standards and what not. We would be changing up the store and there was always someone who was like but is that the standard distance apart for a wheelchair. However, now I don't seem to hear it as much anymore. I feel like the guidelines and standards should be taught in part of the training when you or anyone is becoming a new associate. I feel like it's important that everyone should know so that if someone wasn't paying attention some other co worker could remind them that things need to meet those guidelines.
Sometimes I feel like not enough people are aware that there are even standards unless they have a family member in a wheelchair or they themselves are in one. I never really thought about it until I started up my design classes where I became very aware of these things. We want everyone to be able to enjoy the world and the mall and all these amazing stores as well and it's not fair if the fixtures are to close together so that someone can't get through.
Let's Focus on the Up Side...
To contact us Click HERE
For this blog I wanted to write about the up side of things we are getting RIGHT in the world of human factors. I didn't want to find anything negative or something could improve on, because, let's face it....the world is always changing and adapting. Slowly, but surely. I've recently been apartment hunting a little for when I get married in August. During my search I have almost always come across a little wheel chair sign at the bottom of the website I was looking at townhouses on. For a while I couldn't figure out what it meant. Then I took a drive to one of the town homes I had looked at online and I realized that most apartment complexes or even town home community make special areas for the handicap to live. For instance these particular town homes I was looking at were all multi level and when I drove around I saw some one level homes.
It dawned on me later that that particular row was for the handicap, because they were all one level, they had special parking so that those residents didn't have to go so far to get into their home.
It impressed me, and maybe it's only something small. However, I love that they do this because they are able to have all kinds of residents and don't have to turn away residents who wouldn't be able to live in a multi level home.
It dawned on me later that that particular row was for the handicap, because they were all one level, they had special parking so that those residents didn't have to go so far to get into their home.
It impressed me, and maybe it's only something small. However, I love that they do this because they are able to have all kinds of residents and don't have to turn away residents who wouldn't be able to live in a multi level home.
Designing Isn't Just for Adults..
To contact us Click HERE
I think that our field kind of has some negative views sometimes. People don't really know what we do or understand what we do. They think that we simply "fluff pillows and pick paint chips."
However, we know that this isn't the case. We know that we do much more than this. People don't understand that we are going to school to make their lives better and more comfortable. We know stuff that could make a difference in the way that they live.
It never ceases to amaze me the amount of knowledge I learn everyday about our field of choice. When I gave my presentation last week it amazed me the certain things we could do to even improve a newborns room by putting in sound systems. Or even when Marcene did the presentation on health care environments and she talked about how they were painting their machines bright colors or making them look like something cool and not a big scary MRI machine. It's amazing how even just those small touches can improve the way a child might behave and not be scared to go to the doctor.
There is all sorts of knowledge out there for us to learn how to design and it's not just for adults and elderly. It's very useful for children too.
However, we know that this isn't the case. We know that we do much more than this. People don't understand that we are going to school to make their lives better and more comfortable. We know stuff that could make a difference in the way that they live.
It never ceases to amaze me the amount of knowledge I learn everyday about our field of choice. When I gave my presentation last week it amazed me the certain things we could do to even improve a newborns room by putting in sound systems. Or even when Marcene did the presentation on health care environments and she talked about how they were painting their machines bright colors or making them look like something cool and not a big scary MRI machine. It's amazing how even just those small touches can improve the way a child might behave and not be scared to go to the doctor.
There is all sorts of knowledge out there for us to learn how to design and it's not just for adults and elderly. It's very useful for children too.
Expectant Mother Parking.
To contact us Click HERE
I'm intrigued by these parking spots. I tried googling actual rules and regulations for these spots and I couldn't really find out much. I was looking for how far along you have to be to actually use these parking spots. I saw a couple blogs though and these spots don't seem very popular just because it sounds like people abuse them more than actually use them for good. I think they are a good idea if they were enforced better. I don't think someone who is only like 6 weeks or so pregnant not even showing and has no side effects yet should be able to take advantage of these.
I did read in some cities these spots were for expecting mothers AND those who had young children like infants or toddlers which also is a good idea because it could be hard to juggle a shopping cart and try to keep 3 kids in line and be parked clear at the end of the isle. I know that we have some of these in some spots in Utah, but I don't usually see them everywhere.
I'm intrigued by these parking spots. I tried googling actual rules and regulations for these spots and I couldn't really find out much. I was looking for how far along you have to be to actually use these parking spots. I saw a couple blogs though and these spots don't seem very popular just because it sounds like people abuse them more than actually use them for good. I think they are a good idea if they were enforced better. I don't think someone who is only like 6 weeks or so pregnant not even showing and has no side effects yet should be able to take advantage of these.I did read in some cities these spots were for expecting mothers AND those who had young children like infants or toddlers which also is a good idea because it could be hard to juggle a shopping cart and try to keep 3 kids in line and be parked clear at the end of the isle. I know that we have some of these in some spots in Utah, but I don't usually see them everywhere.
21 Haziran 2012 Perşembe
Why Doctors Fear Starting Patients on Insulin
To contact us Click HERE
This is a Canadian study, but isapplicable to the U.S. physicians as well. The opening statement isa little surprising when the myths about insulin are considered. For many U.S. patients, the myths are out in full force and bothdoctors and patients seem to believe many of them. But, I digress.
The statement that doctors are morereluctant to start their patients on insulin than the patients arethemselves says volumes and must be explored. Dr. Catherine Yu, aresearcher at the hospital's Keenan Research Centre and senior authorof the paper states, "There are no clear recommendations onthe safest and most effective way to start patients on it, and sophysicians are often hesitant to do so."
“Dr. Yu and colleagues analyzedpast studies to find out what barriers existed to starting patientson insulin, and how insulin compared to other blood sugar loweringmedications in terms of its effect on blood sugars and weight. Theythen made recommendations for physicians and other health careproviders based on evidence from the past studies.”
Theirfindings were published in the online edition of the Canadian MedicalAssociation Journal.
What they found is that doctor's fearsof common side effects such as weight gain and low blood sugar wereamplified compared to their patient's fears, and that doctors weremore concerned than their patients about the possibility ofinjection-related pain and anxiety. They also discovered that manydoctors where only familiar with the insulins of past usage and olderdelivery systems. They needed to be reeducated about the newerinsulins and methods of delivery.
Like many of us now usinginsulin, we find it much easier to use and if we use care and learnto use it properly. Instead of eating to a certain amount ofinsulin, we need to learn to count our carbohydrates and adjust ourfast acting insulin accordingly. This will prevent most of the riskof low blood glucose and by limiting our carbohydrates, we canprevent the weight gain many fear. Exercise if medically able isanother way of assisting the prevention of weight gain.
Although Dr. Yu's suggestion ofstarting patients on a once a day injection of long acting or 24 hourinsulin while reducing the oral medications is good, those of us inour group all went from oral medications one day to insulininjections the next day. Granted this worked well for us and we werecomfortable with this transition, some doctors are not. This is whywe like our endocrinologists and the assistance they were able togive us.
When insulin myths are taken out of theequation, adapting to insulin use for most people can be efficientlyaccomplished. Education is required for using the best injectionsites and matching rapid acting insulin to carbohydrates to beconsumed. It is also wise to eat at regular times and is a person isill and does not feel like eating, then do not inject the rapidacting insulin. More frequent testing is required and this mustbecome a habit so that adjustments may be made for higher or lowerblood glucose readings preprandial (before meals).
This is a Canadian study, but isapplicable to the U.S. physicians as well. The opening statement isa little surprising when the myths about insulin are considered. For many U.S. patients, the myths are out in full force and bothdoctors and patients seem to believe many of them. But, I digress.
The statement that doctors are morereluctant to start their patients on insulin than the patients arethemselves says volumes and must be explored. Dr. Catherine Yu, aresearcher at the hospital's Keenan Research Centre and senior authorof the paper states, "There are no clear recommendations onthe safest and most effective way to start patients on it, and sophysicians are often hesitant to do so."
“Dr. Yu and colleagues analyzedpast studies to find out what barriers existed to starting patientson insulin, and how insulin compared to other blood sugar loweringmedications in terms of its effect on blood sugars and weight. Theythen made recommendations for physicians and other health careproviders based on evidence from the past studies.”
Theirfindings were published in the online edition of the Canadian MedicalAssociation Journal.
What they found is that doctor's fearsof common side effects such as weight gain and low blood sugar wereamplified compared to their patient's fears, and that doctors weremore concerned than their patients about the possibility ofinjection-related pain and anxiety. They also discovered that manydoctors where only familiar with the insulins of past usage and olderdelivery systems. They needed to be reeducated about the newerinsulins and methods of delivery.
Like many of us now usinginsulin, we find it much easier to use and if we use care and learnto use it properly. Instead of eating to a certain amount ofinsulin, we need to learn to count our carbohydrates and adjust ourfast acting insulin accordingly. This will prevent most of the riskof low blood glucose and by limiting our carbohydrates, we canprevent the weight gain many fear. Exercise if medically able isanother way of assisting the prevention of weight gain.
Although Dr. Yu's suggestion ofstarting patients on a once a day injection of long acting or 24 hourinsulin while reducing the oral medications is good, those of us inour group all went from oral medications one day to insulininjections the next day. Granted this worked well for us and we werecomfortable with this transition, some doctors are not. This is whywe like our endocrinologists and the assistance they were able togive us.
When insulin myths are taken out of theequation, adapting to insulin use for most people can be efficientlyaccomplished. Education is required for using the best injectionsites and matching rapid acting insulin to carbohydrates to beconsumed. It is also wise to eat at regular times and is a person isill and does not feel like eating, then do not inject the rapidacting insulin. More frequent testing is required and this mustbecome a habit so that adjustments may be made for higher or lowerblood glucose readings preprandial (before meals).
What is Your Diabetes Diet?
To contact us Click HERE
At times I wish I was an expert, then Irealize this is not something you can be educated for nor to bedesired. I enjoy being able to write about many topics and not bechained to an organization or profession. As a patient, I am able toadvocate and write about topics from a patient's perspective,applying what I experience and learn from others. When people thatwant us to believe they are experts, I sometimes need to stop andquestion if they are truly what they want us to believe.
Hence, when I saw this article with thetitle “Diabetes Diet” I had to read it to see what they weresaying. True the title is a misnomer as there is not a diet specificto diabetes. There may be people that think this or want to believethis, but there can only be suggestions that fit us as individuals,that we have found work for us, and what our blood glucose meter saysworks for us. The experts don't want us to use our meters.
This article starts with the properlead-in and is understandable. Let me back up and clarify that. Diet is the word used and we all understand that diets fail. Foodplan is a more appropriate description for what people with diabetesneed. The author starts the second paragraph right and I quote thefirst four sentences. “There is no prescribed diet plan forthose with diabetes. Rather, eating plans are tailored to fit anindividual's needs, schedules, and eating habits. A diabetes dietplan must also be balanced with the intake of insulin and oraldiabetes medications. In general, the principles of a healthydiabetes diet are the same for everyone.”
I may be reading something into the“plan must also be balanced with the intake of insulin and oralmedications;” however, I will try not to think this means that theinsulin or dosage of oral medications determines the amount of foodto be eaten. The last sentence in the paragraph above is whatdisturbs me, and the sentence that follows just confirmed mythoughts.
“Consumption of a variety of foodsincluding whole grains, fruits, non-fat dairy products, beans, andlean meats or vegetarian substitutes, poultry and fish is recommendedto achieve a healthy diet.” Yes, the high carbohydrate, lowfat mantra is again the saying of choice. The individualization ideais thrown out and it is the same one-size-fits-all mantra they havebeen preaching for years. This makes this author no different fromothers.
They all want us to think they arepromoting the individual (platitudes) but they eventually fall back to the sameapproach. The article is downhill after that and I will come backfor another point later. While reading and thinking about thisarticle, I have wondered why in discussing food plans, nothing isever mentioned about blood glucose testing. This would give meaningto the individualization as everyone would be different and foodplans would take on a more individual flair.
Yes, but I keep forgetting about theobvious collusion between government agencies and medicalorganizations and related groups of “experts” and the fraudulentintent of misleading diabetes patients. This lengthy list includesthree (no four) government agencies and four organizations. On oneside is the USDA, which sets the food policy and this, is promoted bythe American Diabetes Association, the American Association ofClinical Endocrinologists, the American Association of DiabetesEducators, and the Academy of Nutrition and Dietetics. On the otherside are the Centers for Medicare and Medicaid Services and theNational Institutes of Health and the Centers for Disease Control andPrevention funding studies to prove that patients do not need to testthat often and derive no benefits from testing. The goal ispreventing patients from knowing how foods affect their blood glucoselevels and finding out how bad the advice is, being promoted by our“experts.” This is probably the reason that self-monitoring ofblood glucose is discouraged by the four organizations.
The point that the author makes nextreally makes me vent and rant. It also gives me cause to never beconsidered an expert. I have to quote, “Many experts, includingthe American Diabetes Association, recommend that 50% to 60% of dailycalories come from carbohydrates, 12% to 20% from protein, and nomore than 30% from fat. People with diabetes may also benefit fromeating small meals throughout the day instead of eating one or twoheavy meals. No foods are absolutely forbidden for people withdiabetes, and attention to portion control and advance meal planningcan help people with diabetes enjoy the same meals as others in thefamily.”
The only good advice in the above quoteis about people with diabetes possibly benefiting from eating smallmeals throughout the day. Some of us call this grazing and this doesbenefit many people with type 2 diabetes. I am currently using afood plan of 10% to 20% carbohydrates, 20% to 35% protein, and 45% to60% fat. I am feeling better and all indications show positiveeffects in better diabetes management and lipid panel results.
At times I wish I was an expert, then Irealize this is not something you can be educated for nor to bedesired. I enjoy being able to write about many topics and not bechained to an organization or profession. As a patient, I am able toadvocate and write about topics from a patient's perspective,applying what I experience and learn from others. When people thatwant us to believe they are experts, I sometimes need to stop andquestion if they are truly what they want us to believe.
Hence, when I saw this article with thetitle “Diabetes Diet” I had to read it to see what they weresaying. True the title is a misnomer as there is not a diet specificto diabetes. There may be people that think this or want to believethis, but there can only be suggestions that fit us as individuals,that we have found work for us, and what our blood glucose meter saysworks for us. The experts don't want us to use our meters.
This article starts with the properlead-in and is understandable. Let me back up and clarify that. Diet is the word used and we all understand that diets fail. Foodplan is a more appropriate description for what people with diabetesneed. The author starts the second paragraph right and I quote thefirst four sentences. “There is no prescribed diet plan forthose with diabetes. Rather, eating plans are tailored to fit anindividual's needs, schedules, and eating habits. A diabetes dietplan must also be balanced with the intake of insulin and oraldiabetes medications. In general, the principles of a healthydiabetes diet are the same for everyone.”
I may be reading something into the“plan must also be balanced with the intake of insulin and oralmedications;” however, I will try not to think this means that theinsulin or dosage of oral medications determines the amount of foodto be eaten. The last sentence in the paragraph above is whatdisturbs me, and the sentence that follows just confirmed mythoughts.
“Consumption of a variety of foodsincluding whole grains, fruits, non-fat dairy products, beans, andlean meats or vegetarian substitutes, poultry and fish is recommendedto achieve a healthy diet.” Yes, the high carbohydrate, lowfat mantra is again the saying of choice. The individualization ideais thrown out and it is the same one-size-fits-all mantra they havebeen preaching for years. This makes this author no different fromothers.
They all want us to think they arepromoting the individual (platitudes) but they eventually fall back to the sameapproach. The article is downhill after that and I will come backfor another point later. While reading and thinking about thisarticle, I have wondered why in discussing food plans, nothing isever mentioned about blood glucose testing. This would give meaningto the individualization as everyone would be different and foodplans would take on a more individual flair.
Yes, but I keep forgetting about theobvious collusion between government agencies and medicalorganizations and related groups of “experts” and the fraudulentintent of misleading diabetes patients. This lengthy list includesthree (no four) government agencies and four organizations. On oneside is the USDA, which sets the food policy and this, is promoted bythe American Diabetes Association, the American Association ofClinical Endocrinologists, the American Association of DiabetesEducators, and the Academy of Nutrition and Dietetics. On the otherside are the Centers for Medicare and Medicaid Services and theNational Institutes of Health and the Centers for Disease Control andPrevention funding studies to prove that patients do not need to testthat often and derive no benefits from testing. The goal ispreventing patients from knowing how foods affect their blood glucoselevels and finding out how bad the advice is, being promoted by our“experts.” This is probably the reason that self-monitoring ofblood glucose is discouraged by the four organizations.
The point that the author makes nextreally makes me vent and rant. It also gives me cause to never beconsidered an expert. I have to quote, “Many experts, includingthe American Diabetes Association, recommend that 50% to 60% of dailycalories come from carbohydrates, 12% to 20% from protein, and nomore than 30% from fat. People with diabetes may also benefit fromeating small meals throughout the day instead of eating one or twoheavy meals. No foods are absolutely forbidden for people withdiabetes, and attention to portion control and advance meal planningcan help people with diabetes enjoy the same meals as others in thefamily.”
The only good advice in the above quoteis about people with diabetes possibly benefiting from eating smallmeals throughout the day. Some of us call this grazing and this doesbenefit many people with type 2 diabetes. I am currently using afood plan of 10% to 20% carbohydrates, 20% to 35% protein, and 45% to60% fat. I am feeling better and all indications show positiveeffects in better diabetes management and lipid panel results.
Our Informal Peer-to-Peer Group
To contact us Click HERE
Lest you think we talk about nothingbut diabetes, you would be wrong. Several are avid NASCAR fans andsome of us enjoy photography. A couple of the group are true geekswhen it comes to computers and they enjoy solving problems for therest of us. One of those into photography is an avid bird watcher asis another member that has several binoculars plus one with a builtin camera. We do enjoy talking about various topics outside ofdiabetes.
Diabetes is often our topic ofdiscussion and we have had plenty to research to discuss lately withall of us now on insulin with the exception of Sue who is not on anymedications. We all encourage her to do all she can to stay offmedications. She is still doing quite well in her efforts and likesthe positive feedback she receives from us. She spends some extramoney to test more frequently at present while she is learning howdifferent foods affect her blood glucose. Her doctor is supportingher and has been able to convince her medical insurance company toallow her extra test strips for a few months and then they will bringher back down in reimbursed test strips.
Among the ten of us, we see threedifferent diabetes specialists and it has been very interesting tocompare notes. Eight of the ten are within ten pounds of idealweight for their body build (some above and a few below) and only twoof us (Max and myself) are overweight. We are working to bring ourweight down. Both of us have been approached by our doctors toconsider bariatric surgery, but we agree this will not happen and ourdoctors have stopped pushing the topic. The hospital is pushing thetopic and we have told them to stop because for us it was not goingto happen.
We have even been approached by othersthat do not have diabetes wondering how we were resisting. We nowgive people a card with the applicable URLs on it when they ask aboutwhat we plan to do. We tell them it is a personal decision on ourpart, but they can do as they please; however, we think they shouldread what the surgeons will not tell them. One surgeon has askedthat I stop what I am doing and not answer people’s questions. Ipolitely said, if the person asks, he cannot prevent me from talkingabout it. I am only a patient and not an employee of the hospital,therefore he cannot do anything to me if another patient asks mequestions. I did say that we were not seeking these people out, butthey were coming to us with questions.
There are now three of us withneuropathy. One (Jason) is from diabetes and Max and myself fromother causes. Nine of the ten of us are on insulin and Ben and Allenare working diligently to keep their weight from creeping up and havebeen successful to date, by lowering their carbohydrate intake. Benand Allen are working with Barry to exercise daily and Max and I aretaking part, as we are able. Max is struggling now as he had twowarts removed from his left foot and his doctor will not allow him towalk except as needed for a few weeks and then with the assistance ofa crutch. His doctor is very pleased with the progress of healing.
Allen is now in the upper normal rangefor both Vitamin B12 and Vitamin D and feeling much better. Ben hasnot had any more depression problems and like he said, by workingdiligently he is holding steady with his vision and actually feels itis getting better. He has his next appointment late this month tohave his eyes examined again and we are all wishing him well.
I like photography, but lately I havebeen busy with other activities and have not had time to participatewith the rest. I have also been busy driving my wife to herappointments with the doctors and surgery for her injured shoulder,rotator cuff and torn tendons. Therefore, my projects have beentaking a back seat as well. I would not do otherwise, but it isstarting to wear on both of us. She needs assistance with herclothes, and her hair. I admit I do not do well in handling her hairand putting it up in a ponytail. For some this is easy, but for somereason I am not as coordinated as I need to be, and my fingers aretoo large.
Brenda will busy this summer with hergrandchildren. Her daughter and husband will be taking a secondhoneymoon. Like she said, they have earned it and she will be happyto have the two children for that time. Several of the group havevolunteered to assist on the weekends, but she assured us she wouldask only if needed. She did say that we would be invited for aSaturday afternoon.
Two of the group will be in Alaska formuch of the summer. One has a relative living in Juneau, and theyare planning to travel to some areas. We have asked for pictures. They said we may have to wait until they return.
Most of the rest will be here, exceptfor day trips to see some of the nearby sites and be a tourist forpart of a day. To everyone, in the northern hemisphere at least,have a great summer!
Lest you think we talk about nothingbut diabetes, you would be wrong. Several are avid NASCAR fans andsome of us enjoy photography. A couple of the group are true geekswhen it comes to computers and they enjoy solving problems for therest of us. One of those into photography is an avid bird watcher asis another member that has several binoculars plus one with a builtin camera. We do enjoy talking about various topics outside ofdiabetes.
Diabetes is often our topic ofdiscussion and we have had plenty to research to discuss lately withall of us now on insulin with the exception of Sue who is not on anymedications. We all encourage her to do all she can to stay offmedications. She is still doing quite well in her efforts and likesthe positive feedback she receives from us. She spends some extramoney to test more frequently at present while she is learning howdifferent foods affect her blood glucose. Her doctor is supportingher and has been able to convince her medical insurance company toallow her extra test strips for a few months and then they will bringher back down in reimbursed test strips.
Among the ten of us, we see threedifferent diabetes specialists and it has been very interesting tocompare notes. Eight of the ten are within ten pounds of idealweight for their body build (some above and a few below) and only twoof us (Max and myself) are overweight. We are working to bring ourweight down. Both of us have been approached by our doctors toconsider bariatric surgery, but we agree this will not happen and ourdoctors have stopped pushing the topic. The hospital is pushing thetopic and we have told them to stop because for us it was not goingto happen.
We have even been approached by othersthat do not have diabetes wondering how we were resisting. We nowgive people a card with the applicable URLs on it when they ask aboutwhat we plan to do. We tell them it is a personal decision on ourpart, but they can do as they please; however, we think they shouldread what the surgeons will not tell them. One surgeon has askedthat I stop what I am doing and not answer people’s questions. Ipolitely said, if the person asks, he cannot prevent me from talkingabout it. I am only a patient and not an employee of the hospital,therefore he cannot do anything to me if another patient asks mequestions. I did say that we were not seeking these people out, butthey were coming to us with questions.
There are now three of us withneuropathy. One (Jason) is from diabetes and Max and myself fromother causes. Nine of the ten of us are on insulin and Ben and Allenare working diligently to keep their weight from creeping up and havebeen successful to date, by lowering their carbohydrate intake. Benand Allen are working with Barry to exercise daily and Max and I aretaking part, as we are able. Max is struggling now as he had twowarts removed from his left foot and his doctor will not allow him towalk except as needed for a few weeks and then with the assistance ofa crutch. His doctor is very pleased with the progress of healing.
Allen is now in the upper normal rangefor both Vitamin B12 and Vitamin D and feeling much better. Ben hasnot had any more depression problems and like he said, by workingdiligently he is holding steady with his vision and actually feels itis getting better. He has his next appointment late this month tohave his eyes examined again and we are all wishing him well.
I like photography, but lately I havebeen busy with other activities and have not had time to participatewith the rest. I have also been busy driving my wife to herappointments with the doctors and surgery for her injured shoulder,rotator cuff and torn tendons. Therefore, my projects have beentaking a back seat as well. I would not do otherwise, but it isstarting to wear on both of us. She needs assistance with herclothes, and her hair. I admit I do not do well in handling her hairand putting it up in a ponytail. For some this is easy, but for somereason I am not as coordinated as I need to be, and my fingers aretoo large.
Brenda will busy this summer with hergrandchildren. Her daughter and husband will be taking a secondhoneymoon. Like she said, they have earned it and she will be happyto have the two children for that time. Several of the group havevolunteered to assist on the weekends, but she assured us she wouldask only if needed. She did say that we would be invited for aSaturday afternoon.
Two of the group will be in Alaska formuch of the summer. One has a relative living in Juneau, and theyare planning to travel to some areas. We have asked for pictures. They said we may have to wait until they return.
Most of the rest will be here, exceptfor day trips to see some of the nearby sites and be a tourist forpart of a day. To everyone, in the northern hemisphere at least,have a great summer!
Aggressive Glucose Control May Not Stop Kidney Failure
To contact us Click HERE
What is it about adding oral medicationon top of oral medication that romances researchers to believe thisis the only way to treat type 2 diabetes? In my reading over thelast five years, it seems that unless researchers can have a cocktailof oral diabetes medications, the researchers are not interested.
I doubt I will find out, but it isinteresting to speculate, especially after this from Yale School ofMedicine. Here researchers discovered that aggressive glycemiccontrol may not reduce risk of kidney failure. The researchers foundthat comparing usual treatment and controlling glucose with higherdoses of medication did not improve the chances of preventing kidneyfailure.
Since the results are cloaked behindthe veil of money, I am not able to determine what procedures wereused and what combinations of medications, if any, were used. Thewrite up about the research hides much information that could be ofvalue. I will say this as I think it could be true also. Theresearch did not reach the conclusion desired so they salvagesomething and explain the minimum to justify the study.
Since insulin is not mentioned or anyother medication by name, it is difficult to give any reliability tothis study. My interpretation is that this is again junk science andbecause the results were not what they wanted, we the patients learnnothing. If they had mentioned the medications by name and reallytried to inform us, we may have learned which medications are uselessfor treating end-stage renal problems. I also have to believe thatinsulin was not part of the study and only oral medications wereconsidered.
Since before the ACCORD study, stackingoral medications seems to be the only way to do studies. With theexception of Metformin which slows the release of glucose from theliver, oral medications work on the pancreas to produce more insulinand this means a quicker demise of the pancreas because it cannotcontinue to force out insulin as it is asked to do. Yet, this seemsto be the only topic for research.
Therefore, I think it is time thatstudies are required to have a insulin control group to compare theresults of oral medications against to see which gives the mostefficient treatment. Then maybe the studies could have more meaningand give people with type 2 diabetes some actual comparisons fordetermining which treatment to use. Granted, some additional testingwould be required of the pancreas before and after the study todetermine the amount of insulin the pancreas is capable of producing.
This could also open new analysis forconsideration as this is seldom mentioned in any of the current orrecent studies. Who knows, we could have many study participantsthat are producing small amounts of insulin and incapable of moreinsulin production. This could produce misleading results for anystudy if these are the people participating in the study producesmall amounts of insulin and the people in the control group canproduce greater quantities of insulin. The reverse scenario wouldproduce even more inflated results which the study wants. Yet thisis something seldom seen even in studies given wide publication andnot put behind a wall of money.
If it is the desire to prevent thegeneral public from analyzing the study, then there needs to be astandard criteria published that will let the public know that theseprocedures were followed. Until this is done, we need to beskeptical of most studies and how much we should rely on theiraccuracy. Oral diabetes medications have their place and studyunder different scenarios is needed; however, a group within anystudy needs to be using insulin for a more accurate comparison.
What is it about adding oral medicationon top of oral medication that romances researchers to believe thisis the only way to treat type 2 diabetes? In my reading over thelast five years, it seems that unless researchers can have a cocktailof oral diabetes medications, the researchers are not interested.
I doubt I will find out, but it isinteresting to speculate, especially after this from Yale School ofMedicine. Here researchers discovered that aggressive glycemiccontrol may not reduce risk of kidney failure. The researchers foundthat comparing usual treatment and controlling glucose with higherdoses of medication did not improve the chances of preventing kidneyfailure.
Since the results are cloaked behindthe veil of money, I am not able to determine what procedures wereused and what combinations of medications, if any, were used. Thewrite up about the research hides much information that could be ofvalue. I will say this as I think it could be true also. Theresearch did not reach the conclusion desired so they salvagesomething and explain the minimum to justify the study.
Since insulin is not mentioned or anyother medication by name, it is difficult to give any reliability tothis study. My interpretation is that this is again junk science andbecause the results were not what they wanted, we the patients learnnothing. If they had mentioned the medications by name and reallytried to inform us, we may have learned which medications are uselessfor treating end-stage renal problems. I also have to believe thatinsulin was not part of the study and only oral medications wereconsidered.
Since before the ACCORD study, stackingoral medications seems to be the only way to do studies. With theexception of Metformin which slows the release of glucose from theliver, oral medications work on the pancreas to produce more insulinand this means a quicker demise of the pancreas because it cannotcontinue to force out insulin as it is asked to do. Yet, this seemsto be the only topic for research.
Therefore, I think it is time thatstudies are required to have a insulin control group to compare theresults of oral medications against to see which gives the mostefficient treatment. Then maybe the studies could have more meaningand give people with type 2 diabetes some actual comparisons fordetermining which treatment to use. Granted, some additional testingwould be required of the pancreas before and after the study todetermine the amount of insulin the pancreas is capable of producing.
This could also open new analysis forconsideration as this is seldom mentioned in any of the current orrecent studies. Who knows, we could have many study participantsthat are producing small amounts of insulin and incapable of moreinsulin production. This could produce misleading results for anystudy if these are the people participating in the study producesmall amounts of insulin and the people in the control group canproduce greater quantities of insulin. The reverse scenario wouldproduce even more inflated results which the study wants. Yet thisis something seldom seen even in studies given wide publication andnot put behind a wall of money.
If it is the desire to prevent thegeneral public from analyzing the study, then there needs to be astandard criteria published that will let the public know that theseprocedures were followed. Until this is done, we need to beskeptical of most studies and how much we should rely on theiraccuracy. Oral diabetes medications have their place and studyunder different scenarios is needed; however, a group within anystudy needs to be using insulin for a more accurate comparison.
Telemedicine Aids Diabetes Management
To contact us Click HERE
The American Association of ClinicalEndocrinologists 21st Annual Meeting and Clinical Congress inPhiladelphia, PA has had some interesting topics coming out of itssessions. While they are not of an official nature until somethingshows acceptance or is passed through peer review, some topics areinteresting just the same. Telemedicine is an acceptable way todeliver care to endocrinology patients in rural areas, according to astudy given at the meeting.
Even with many states passing lawsrequiring patients to be seen by doctors before being issuedprescriptions, this still should not stop this proposal from gainingtraction. In a conversation with a friend from a northwestern state,he mentioned that a few doctors were considering and doing this, butanother group of doctors is opposing them. He commented that this isvery amusing for several reasons. Doctors bickering with doctors,but he found that it was the better doctors that were wanting to dothis and the doctors losing patients that were in opposition.
I asked if these were endocrinologistsand he said they were from a variety of specialties and primary care. He said that a few were already doing this with success and otherswere hoping this could be a big help for patients that needed totravel long distances in cutting down their travel. He also statedthat another doctor had several patients that needed to travel overlong distances and did not have computers, so he was consulting withthem on the telephone.
I agree that it is time for doctors totake the initiative and this statement is true. "There is anincreased prevalence of diabetes in rural compared with urban areas,which is compounded by the problem of a lack of endocrinologists,"said Rabia A. Rehman, MD, an endocrinology fellow at the Universityof Tennessee Health Science Center in Memphis.
The study took place in Tennessee andthe telemedicine unit of the University of Tennessee. There were 66patients from five rural areas that were referred by their primarycare providers. The study lasted two and one-half years.
Patients were interviewed and examinedusing the video conferencing in the telemedicine studio. A nurse wasused at the patient site and assisted the physician in assessing thegeneral condition of the patient. The nurse looked for swelling inthe legs and did a thyroid exam. Laboratory tests and managementstrategies were sent to the patients' primary care physicians forfollow-up.
The study author stated that, "Wethink it may be a little costly to set up the equipment up front. However, in the long-run, this will be cost effective, not only forthe patients but for overall healthcare," She continued,"This will save patients from traveling long distances,resulting in timely consultation and leading to better control.Improvement of HbA1c will also result in prevention of the multiplemorbidities and complications that result from uncontrolleddiabetes."
The American Association of ClinicalEndocrinologists 21st Annual Meeting and Clinical Congress inPhiladelphia, PA has had some interesting topics coming out of itssessions. While they are not of an official nature until somethingshows acceptance or is passed through peer review, some topics areinteresting just the same. Telemedicine is an acceptable way todeliver care to endocrinology patients in rural areas, according to astudy given at the meeting.
Even with many states passing lawsrequiring patients to be seen by doctors before being issuedprescriptions, this still should not stop this proposal from gainingtraction. In a conversation with a friend from a northwestern state,he mentioned that a few doctors were considering and doing this, butanother group of doctors is opposing them. He commented that this isvery amusing for several reasons. Doctors bickering with doctors,but he found that it was the better doctors that were wanting to dothis and the doctors losing patients that were in opposition.
I asked if these were endocrinologistsand he said they were from a variety of specialties and primary care. He said that a few were already doing this with success and otherswere hoping this could be a big help for patients that needed totravel long distances in cutting down their travel. He also statedthat another doctor had several patients that needed to travel overlong distances and did not have computers, so he was consulting withthem on the telephone.
I agree that it is time for doctors totake the initiative and this statement is true. "There is anincreased prevalence of diabetes in rural compared with urban areas,which is compounded by the problem of a lack of endocrinologists,"said Rabia A. Rehman, MD, an endocrinology fellow at the Universityof Tennessee Health Science Center in Memphis.
The study took place in Tennessee andthe telemedicine unit of the University of Tennessee. There were 66patients from five rural areas that were referred by their primarycare providers. The study lasted two and one-half years.
Patients were interviewed and examinedusing the video conferencing in the telemedicine studio. A nurse wasused at the patient site and assisted the physician in assessing thegeneral condition of the patient. The nurse looked for swelling inthe legs and did a thyroid exam. Laboratory tests and managementstrategies were sent to the patients' primary care physicians forfollow-up.
The study author stated that, "Wethink it may be a little costly to set up the equipment up front. However, in the long-run, this will be cost effective, not only forthe patients but for overall healthcare," She continued,"This will save patients from traveling long distances,resulting in timely consultation and leading to better control.Improvement of HbA1c will also result in prevention of the multiplemorbidities and complications that result from uncontrolleddiabetes."
Kaydol:
Kayıtlar (Atom)