Health Care and Angst

When you worry about something, are you the type of person who constantly thinks about the situation and keep it as a dominant thought? Or do you feel that your anxious state of mind soon may pass with a resolution of some sort? Angst, often confused with anxiety, is a transcendent emotion in that it combines the unbearable anguish of life with the hopes of overcoming this seemingly impossible situation, according to the Urban Dictionary.

Without the important element of hope, then the emotion is anxiety, not angst. Angst denotes the constant struggle one has with the burdens of life that weighs on the dispossessed and not knowing when the salvation will appear. Here is an example:

An airplane crashes into the side of a remote snow-covered mountain; those passengers that worry about their lives without hopes of survival only face anxiety. In contrast, those passengers who worry about their lives with hopes of survival but do not know when the rescue party will arrive face angst.

The word itself was developed out of old German language and translated into English from German. Angst "neurotic fear, anxiety, guilt, remorse," came from Old High German angust, from the root of anger. George Eliot used it (in German) in 1849, and it was popularized in English by translation of Sigmund Freud's work, but as a foreign word until the 1940s, according to the Online Etymology Dictionary.

Angst is very commonly displayed in the teenage years. According to the The Observer online, Twice as many girls are suffering "teenage angst" as boys, according to research done in the UK that suggests growing up in Britain is toughest on young women. As many as 900,000 teenage girls describe themselves as "unhappy and depressed", and there is evidence that they have become more miserable over the past three years.

The problem is said to be particularly acute for those from lower socioeconomic backgrounds, according to a report published by the think tank Demos. The research follows recent studies which suggest that girls also lead unhealthier lifestyles than boys, skipping meals to lose weight, as well as drinking and smoking too much. Girls are more anxious than boys about their appearance, careers and a celebrity culture that places a premium on good looks. Some young women also feel burdened by an increased expectation to continue to move into areas of work that had been male-only. More info about this study can be found at this site: .

According to this website, , these are some of the reasons why teen girls bury their angst:

Fear of Exposure--Self-consciousness, which peaks during the adolescent years, inhibits many girls from revealing their struggles. They are afraid of being even more scrutinized by adults who already monitor their ups and downs. "My mother is constantly interrogating me about my friends. If I tell her anything bad that happened, it just makes it worse. Then she has to know everything!"

Need for Autonomy--Teens are working hard to establish age appropriate separateness from their parents. Thus they avoid admitting to weaknesses that could result in dependency. "If I show my parents my poor grade on my math test," and, "they're going to take over my entire life. They'll keep asking me if I studied, and then my dad will insist on helping me every night and probably confuse me more."

Fear of Repercussions--Almost without exception, girls are afraid of what their parents will do if they find out they are overwhelmed or struggling. "They'll make me see a tutor and I won't have any time to myself. And if I did really bad, they might say I can't go online anymore or go out with my friends on weekends."

Reluctance to Raise Parental Anxiety--Girls are keenly aware of the challenges in their parents' lives, such as jobs, poor health, marital conflicts, divorce, and single parenthood. They also know that merely mentioning their struggles in some area or another can instantly provoke or inflame their parents' worries. Skilled at empathizing, teens often fear "making things even worse."

Avoidance of Flaws--In the midst of developing their own identities, girls' self-confidence is already shaky. Unable to recognize that they are still evolving, they often see their deficiencies as permanent flaws--a view that is sometimes shared by adults. "Parents and society want you to be perfect. If you have one or two bad days, they think you're just this really bad person."

Comparisons to the Ideal--Girls' most obvious and available adult role models, their mothers, are middle-aged women who often have come to terms with themselves and their accomplishments. What teens don't usually see are their mothers' false steps, early mistakes, and insecurities, which women themselves have either forgotten or take for granted. Idealizing their mothers can inhibit girls from revealing their own struggles.

According to, sometime around age 11, kids begin to realize the power emotions play. From realizing the attention that a slammed door grabs to experiencing sympathetic pangs of angst for a forlorn friend, many children are drawn to drama. Fueling the instinctual drama of many tweens or teens, some children seem to be magnets that also regularly attract angst-ridden friends. Combined with an adolescent's natural tendency to evoke a dramatic scene, having teen drama king and queen friends can be a parent's worst nightmare!

If you've been trying to curb your child's appetite for drama or to make better choices in friends, you're not alone. Although drama can be frustrating and counterproductive, you can take steps to ensure you no longer feel like you're fighting an uphill battle. Young boys tend to bottle up their emotions until they can no longer contain their feelings. Boys will often explode by shouting, or melt down into an angry pile of tears.

Many teens turn to drama because they're looking for additional attention. It is possible your daughter is trying to belong to a social group. She may be struggling with peer pressure or how to express herself to her family and friends. Talk with her to provide clarity as to how she develops friendships and chooses to express her feelings, concerns or fears, according to

Dramatic young men might be teetering between wanting to be babied and wanting to be treated like an adult. They might be feeling conflicted between pressure to "act like a man" and the childlike desire to be coddled. Taming your teen drama king or queen takes a skillful mix of patience, creativity and persistence. Provide consistent boosts to your child's self esteem and confidence to eliminate the need to gain attention through drama and the associated angst. More details can be found at this site: .

Actually, angst is an emotional state that is prevalent in just about every age group and type. Although usually more widely displayed in teens and young adults, older men and women experience angst as well. One major aspect of this psychological and social malady is that if left untreated or unattended over time, the symptoms may develop into darker aspects of mental trauma. If you feel you are suffering from angst, and it appears to be getting worse and not better, then seek professional help through a counselor, pastor, physician, or someone trained to deal with this type of health issue. Better to know, and the less angst you have.

Until next time.


Health Care and Nail Fungus

Have you ever been victim of a common disease that infects your nails, especially your toe nails? Toenail fungal infections (onychomycosis) aren't pleasant. If you have had it, you may experience anything from toenail discoloration, awful odor and discharges, to the nail completely dropping off. While it can seem worrying at the time, the good news is that it is treatable.

The future good health of your toenails is generally assured, provided you continue to take good care of them and observe appropriate precautions to avoid future infections. Be aware that treating nail infections, while certainly easy and doable, is a long process and will likely require the involvement of a doctor.

According to the National Institutes of Health (NIH), onychomycosis, is a chronic infection of the fingernails and/or toenails by dermatophytes, yeasts and molds leading to gradual destruction of the nail plate. It is more likely to affect toenails, particularly the first toenail, than fingernails. And, recent surveys in the United States suggested that 7 to 10 percent of the population is affected. An infected nail often will have unsightly white/yellow or orange/brown patches or streaks. It can also turn thicker, crumbly, ragged or dull, according to the Mayo Clinic. In some cases the nail will emit a slightly foul odor and it may separate from the nail bed, a process known as onycholysis.

According to this website: , onychomycosis is not self-healing and may be a source of more widespread fungal lesions on the skin, or vice versa. Both topical and oral treatments are available. Oral antifungal medications such as terbinafine (commonly marketed under the trade name Lamisil), itraconazole (Sporanox) and fluconazole (Diflucan or Trican) encourage the growth of new, non-infected nail, while slowly cycling out infected portion of the nail, according to the Mayo Clinic. The medication is usually taken for six to 12 weeks, but a toenail may take up to 78 weeks to grow fully and preventative measures should be taken during that gap to avoid recurrent infection.

Over-the-counter antifungal creams and ointments generally do not help cure onychomyocis because of poor penetration into the nail, according to the NIH. However, some nail lacquers have shown to be somewhat effective in a large study where only nails infected at the free edge were treated.

Successful eradication of the fungus may still leave the nail looking permanently abnormal because of trauma to the nail bed and nail plate by the disease, according to a 2007 article published in the Journal of the American Academy of Dermatology. Therefore a cure should be based on lab tests and not on visual appearance.

According to APMA (American Podiatric Medical Association), because it is difficult to avoid contact with microscopic organisms like fungi, the toenails are especially vulnerable around damp areas where you are likely to be walking barefoot, such as swimming pools, locker rooms, and showers, for example. Injury to the nail bed may make it more susceptible to all types of infection, including fungal infection. Those who suffer from chronic diseases, such as diabetes, circulatory problems, or immune-deficiency conditions, are especially prone to fungal nails. Other contributing factors may be a history of athlete's foot and excessive perspiration.

Treatments may vary, depending on the nature and severity of the infection. Your podiatrist can detect a fungal infection early, culture the nail, determine the cause, and form a suitable treatment plan, which may include prescribing topical or oral medication, and debridement (removal of diseased nail matter and debris) of an infected nail, according to APMA.

Newer oral antifungals, approved by the Food and Drug Administration, may be the most effective treatment. They offer a shorter treatment regimen of approximately three months and improved effectiveness. Your podiatrist may also prescribe a topical treatment, which can be an effective treatment modality for fungal nails. In some cases, surgical treatment may be required. Temporary removal of the infected nail can be performed to permit direct application of a topical antifungal. Permanent removal of a chronically painful nail that has not responded to any other treatment permits the fungal infection to be cured and prevents the return of a deformed nail.

Trying to solve the infection without the qualified help of a podiatrist can lead to more problems. With new technical advances in combination with simple preventive measures, the treatment of this lightly regarded health problem can often be successful, according to this website: . And, a separate website with the National Nail Fungus Organization shows treatment options: .

Fungi are everywhere, but you can take steps to prevent them from infecting your nails. Prevention is especially important after you�ve been treated for a fungal nail infection, as the recurrence rate is high. According to this website: , here are basic tips for practicing good nail hygiene:

� Keep your hands and feet dry. Towel yourself off thoroughly after swimming, bathing, or showering�including between your toes.
� Keep your nails short and clean. Trim your toenails straight across.
� Don�t pick at the skin around your nails. Those cracks are just invitations for fungi to enter.
� Wear absorbent socks�ones that wick moisture away from your feet. And change your socks frequently.
� Remove your shoes whenever possible, but especially after exercising. Wear open-toe shoes when appropriate.
� Use an antifungal spray or powder in your shoes.
� Wear flip-flops or other shoes when visiting public showers, gyms, and swimming areas.
� Wear rubber gloves when washing dishes or doing other tasks that require putting your hands in water. Be sure, though, to dry the gloves thoroughly by turning them inside out.
� Don�t share nail clippers, nail files, shoes, or socks.
� If you get manicures and pedicures, make sure the salon you patronize sterilizes its instruments between customers�or, better yet, bring your own instruments.

Often times, it is hard to eliminate nail fungus once you have it, it will cost you time and money. Doctors advise their patients that it is always better to be cautious and try to prevent it. Having this type of ailment not only affects your health but also your psychological and psychosocial development. Being cautious about your health is very important. Nails that are infected with fungus not only look terrible, they can also interfere with whatever you are doing on a daily basis.

You might think that having nail fungus is nothing serious; but once it affects you and the ailment becomes severe, that�s when you may regret not having it treated during its early stage of development. Once the situation becomes worse, the harder it is for the ailment to get cured. It will cost you not just large amount of money since the treatment and its prices varies, but it will also give you more stress than you can even imagine. See your doctor if you feel you may be experiencing nail fungus, and do yourself a favor by seeking early treatment.

Until next time.

Covered California...And Then There Were Twelve

In late May Covered California announced that there would be 13 health plans in the individual & family health exchange.  

This week one of the 13 health plans, Ventura County Health, changed position and withdrew
from the exchange at least until 2015.  

So, Ventura County's health plan is out leaving 12 total plans available for open enrollment beginning in October.


Health Care and Gray Hair

If you have ever looked into the mirror and found one day that you had a gray hair, then join the club. It may be a sudden shock to see your first one, but sooner or later, if you live long enough, those locks of auburn, red, blonde, brown, or black will start to turn to a silver or gray colored tint. One of the most successful industries in the world is the hair color business�providing an answer to those who feel that vanity must outweigh the truth of time.

Getting gray, silver, or white hair is a natural part of growing older, and here's why, according to The Nemours Foundation. Each hair on your head is made up of two parts:

1. a shaft � the colored part you see growing out of your head

2. a root � the bottom part, which keeps the hair anchored under the scalp

The root of every strand of hair is surrounded by a tube of tissue under the skin that is called the hair follicle. Each hair follicle contains a certain number of pigment cells. These pigment cells continuously produce a chemical called melanin that gives the growing shaft of hair its color. Melanin is the same natural chemical that makes your skin's color fair or darker. It also helps determine whether a person burns or tans in the sun. The dark or light color of someone's hair depends on how much melanin each hair contains.

As you get older, the pigment cells in your hair follicles gradually die. When there are fewer pigment cells in a hair follicle, that strand of hair no longer contains as much melanin and becomes a more transparent color � like gray, silver, or white � as it grows. As people continue to get older, fewer pigment cells are around to produce melanin. Eventually, the hair looks completely gray.

People can get gray hair at any age, according to The Nemours Foundation. Some people go gray at a young age � as early as when they are in high school or college � whereas others may be in their 30s or 40s before they see that first gray hair. How early you get gray hair is determined by your genes. This means that most people start having gray hairs around the same age that their parents or grandparents first did.

Gray hair is more noticeable in people with darker hair because it stands out, but people with naturally lighter hair are just as likely to go gray. From the time a person notices a few gray hairs, it may take more than 10 years for all of that person's hair to turn gray. Some people think that a big shock or trauma can turn a person's hair white or gray overnight, but scientists don't really believe that this happens.

Even the seemingly accelerated speed at which certain sections go gray (temples first for some, the crown area for others) and the exact shade of gray you get (white, charcoal, or any of the other variations) are genetically predetermined. Your head has roughly 100,000 hair follicles, and each functions autonomously. If one runs out of melanin, even if you pluck the resulting gray hair, there is no impact on surrounding follicles, according to Prevention Magazine.

While going gray is a normal and unavoidable part of the aging process and is not of itself associated with disease, some autoimmune diseases can cause premature graying. However, some people start going gray in their 20s or earlier and are perfectly healthy. Also, according to, smoking is known to increase the rate of graying. Anemia, generally poor nutrition, insufficient B vitamins, and untreated thyroid conditions can also speed the rate of graying. And, your hair will also change texture, so it is a good idea to switch to products especially formulated for graying hair. And, don't forget to deep condition your hair on a regular basis.

According to YouBeauty Magazine, researchers have also found that hydrogen peroxide (a powerful bleaching agent) is produced naturally in the hair follicle, but it's broken down by enzymes. As you age, those enzymes dwindle, letting the hydrogen peroxide bleach hair from the inside out. Most people will have some gray hair by their 50th birthdays. Different ethnicities tend to go gray at different ages. Speaking in broad generalities, the average is mid-30s for Caucasians, late 30s for Asians and mid-40s for people of African descent. But, others hold onto their hair color until they�re 80.

According to Dr. Oz�s Blog, whether you are seeing your first grays, or are already into the salt-and-pepper zone, dealing with gray hair can be frustrating. Fortunately, there are plenty of tricks to make emerging grays look stylish and chic. Here are a few:

Whatever You Do, Do NOT Pluck! -- Sure, when it�s just a stray strand or two, grabbing the tweezers can feel super tempting � but you may live to regret the shortcut. Plucking can damage the hair follicle and the strand may never grow back � and as you age and your hair naturally thins, you�ll need every strand of hair you can get. Gray hair is perfectly good hair � it just needs pigment.

Play With Your Part Line--For many women especially, grays often grow in more heavily on one side of the head than the other. If grays are more prominent on one side, try switching your part to the other side. A zigzag or diagonal part may also help conceal grays that are growing in more scattered around the head.

Cut Hair So It Falls Forward--For those who have grays are around the face or on the sides of their head, ask your stylist to cut layers shorter in the back and longer in the front so that hair falls forward. A blowout with a brush that accentuates the forward-falling motion can help cement the clever style.

Although gray hair is often seen as a stigma in society, there is something to be said about a man or woman who wears their silver locks with dignity. Gray hair has as far back as ancient times been regarded as a sign of wisdom. Even the Bible talks about the stateliness of gray hair in the Book of Proverbs:

Proverbs 16:31��Gray hair is a crown of glory; it is gained in a righteous life.�

Proverbs 20:29--The glory of young men is their strength, but the splendor of old men is their gray hair.

So, although in modern society gray hair may be discounted and frowned upon by a majority of people, those with gray hair, when combined with wisdom, have something to offer. You may wish to listen to them, especially when you need advice on life changing decisions or even the small choices, such as what hair color should you use to keep looking young.

Until next time.

Health Care and Shin Splints

If you are an athlete, especially a runner, or engage in physical activities like jogging, cross country or marathon races, then likely you are familiar with shin splints, or know someone in those sports that have suffered from them. Shin splints is a common injury that affects athletes who engage in running sports or physical activity. This condition is characterized by pain in the lower part of the leg between the knee and the ankle. Plus, ignoring this type of injury may result in a more serious condition such as a stress fracture or breakage of the bones.

The term "shin splints" refers to pain along the inner edge of the shinbone (tibia), according to the American Academy of Orthopaedic Surgeons (AAOS). Shin splints typically develop after physical activity, often associated with running. Any vigorous sports activity can bring on shin splints, especially if you are just starting a fitness program. Simple measures can relieve the pain of shin splints. Rest, ice, and stretching often help. Taking care not to overdo your exercise routine will help prevent shin splints from coming back.

The AAOS continues to mention that shin splints (medial tibial stress syndrome) is an inflammation of the muscles, tendons, and bone tissue around your tibia. Pain typically occurs along the inner border of the tibia, where muscles attach to the bone. In general, shin splints develop when the muscle and bone tissue (periosteum) in the leg become overworked by repetitive activity. Runners are at highest risk for developing shin splints. Dancers and military recruits are two other groups frequently diagnosed with the condition.

Shin splints often occur after sudden changes in physical activity, according to the AAOS. These can be changes in frequency, such as increasing the number of days you exercise each week. Changes in duration and intensity, such as running longer distances or on hills, can also cause shin splints. Other factors that contribute to shin splints include:

� Having flat feet or abnormally rigid arches
� Exercising with improper or worn-out footwear

More detailed info about shin splints can be found at this site: .

According to the National Institutes for Health (NIH), begin the healing process with 2 - 4 weeks of rest.

� Rest completely (other than walking for daily activities) for at least 2 weeks.
� You can try other training activities, such as swimming or biking.

After 2 - 4 weeks, and when the pain is gone, you can start running again. Increase your activity level slowly. If the pain returns, stop exercising right away. Warm-up and stretch before and after any exercise. Use ice or a cold pack over the area for 20 minutes, twice a day. Over-the-counter pain medications will also help. Talk with your health care provider or a physical therapist about wearing the proper shoes, getting orthotics for your shoes, and running on the right types of surfaces. Treatment depends on the cause of the problem. Although shin splints are seldom serious, you may need to call your health care provider if:

� The pain continues and is persistent, even with rest
� You are not sure whether your pain is caused by shin splints
� You don't improve with home treatment after several weeks
� You have a stress fracture

You can find more detailed health information from the NIH about shin splints here at this site: .

According to Runner�s World Magazine, experts agree that when shin splints strike you should stop running completely or decrease your training depending on the extent and duration of pain. Then, as a first step, ice your shin to reduce inflammation. Here are some other treatments you can try:

Gently stretch your Achilles if you have medial shin splints, and your calves if you have anterior shin splints. Also, try this stretch for your shins: Kneel on a carpeted floor, legs and feet together and toes pointed directly back. Then slowly sit back onto your calves and heels, pushing your ankles into the floor until you feel tension in the muscles of your shin. Hold for 10 to 12 seconds, relax and repeat.

In a sitting position, trace the alphabet on the floor with your toes. Do this with each leg. Or alternate walking on your heels for 30 seconds with 30 seconds of regular walking. Repeat four times. These exercises are good for both recovery and prevention. Try to do them three times a day.

If you continue running, wrap your leg before you go out. Use either tape or an Ace bandage, starting just above the ankle and continuing to just below the knee. Keep wrapping your leg until the pain goes away, which usually takes three to six weeks. What you're doing is binding the tendons up against the shaft of the shin to prevent stress..

Consider cross-training for a while to let your shin heal. Swim, run in the pool or ride a bike. When you return to running, increase your mileage slowly--no more than 10 percent weekly. Make sure you wear the correct running shoes for your foot type specifically, and over-pronators should wear motion-control shoes. Severe over-pronators may need orthotics. Have two pairs of shoes and alternate wearing them to vary the stresses on your legs.

Avoid hills and excessively hard surfaces until shin pain goes away completely, then re-introduce them gradually to prevent a recurrence. If you frequently run on roads with an obvious camber, run out and back on the same side of the road. Likewise, when running on a track, switch directions. If you are prone to developing shin splints, stretch your calves and Achilles regularly as a preventive measure. More information about how you can treat shin splints can be found at this site: .

Shin splints in general can be very painful, and if you ignore the symptoms lead to more severe health care problems. If you need medical assistance in severe cases, as always consult your physician. Athletes know the secret to healthy living is taking preventive care of themselves. If you are a professional runner, or even a fitness hobbyist who likes to run or exercise, follow the common sense routines that help prevent this type of injury.

Until next time.

Covered California SHOP Small Group Plans Announced

Today Covered California released a list of carriers who will offer plans inside of the SHOP Small Group Health Exchange beginning in January 2014.

I have links below to the information at Covered California.  Six total insurance carriers for the entire state, 3 plans in LA Metro and 3 here in Santa Clara County.

The six "finalists" for SHOP include:     

*Blue Shield of California
*Kaiser Permanente
*Health Net of California 
*Western Health Advantage
*Chinese Community Health 
*Sharp Health Plan

Conspicuously absent from the Covered California small group SHOP exchange are national carriers Aetna, UnitedHealth and Anthem (Anthem Blue Cross CA is a subsidiary of Anthem/Wellpoint).  

Covered California SHOP Press Release (8/1/13)

Covered California SHOP Brochure with rates and plans by rating area (8/1/13)


Michael Lujan Resigns - Director of Sales for Covered California

I knew about this yesterday morning after exchanging a couple of e-mails with Michael but didn't feel it should be blogged until it was published publicly. The substance of any personal communication I have had with Michael will, of course, remain private.

As announced by the Sacramento Bee yesterday afternoon, Michael Lujan, who served as Director of Sales and Marketing for the Covered California SHOP small business exchange, has resigned on Wednesday, July 31 with effective end date of August 9th.

I hate to see him go but I am sure that he has good reasons to make a change at this time. Michael has always been available to me (and other agents) to answer questions and concerns about both the SHOP small business exchange and the individual & family plan exchange.

I am sure others will join me in wishing Michael Lujan continued success in the future.


New Medicare cards are coming starting in April

The Centers for Medicare & Medicaid Services (CMS) will start mailing redesigned Medicare cards to beneficiaries in Washington state aft...