Why CA Non-Grandfathered Plans Are Being Cancelled

The Covered CA health plan solicitation requires all health Insurers who participate in the Covered California Individual Exchange to "terminate all non-grandfathered health plans not later than December 31, 2013 or have a plan in place to terminate them by December 31, 2013".

Apparently some of the media and some of our less-than-truthful politicians are not trying to spin this as though the insurance companies have made some decisions on their own to cancel your coverage.  This is not even remotely true.

I noticed that Covered CA has moved the links to information on the health plans solicitation requirements (on the hbex site) so I will, as time permits, find the actual solicitation requirement which states what I wrote above.

Peter Lee is on record with the LA Times just 4 days ago (October 26th) confirming the same thing.  And he runs the exchange!  

Anthem is not canceling your plan because they want to.  Neither are Kaiser, Blue Shield nor Health Net.  They are forced to do it by Covered CA as part of the rules to participate in Covered CA.  Stop blaming the insurers, the exchange set the rule!

All these cancellations were prompted by a requirement from Covered California, the state's new insurance exchange. The state didn't want to give insurance companies the opportunity to hold on to the healthiest patients for up to a year, keeping them out of the larger risk pool that will influence future rates.

Peter Lee, executive director of Covered California, said the state and insurers agreed that clearing the decks by Jan. 1 was best for consumers in the long run despite the initial disruption. Lee has heard the complaints � even from his sister-in-law, who recently groused about her 50% rate increase.
"People could have kept their cheaper, bad coverage, and those people wouldn't have been part of the common risk pool," Lee said. "We are better off all being in this together. We are transforming the individual market and making it better. 

LA Times Article October 26th 


Anthem Blue Cross CA 2014 Provider Directories Finally Available

The Pathway Network provider directories are now online for searching.  Anthem will be using the Pathway/Pathway-X networks for all 2014 Individual & Small Group health plans in California.

Use the link below to access the PDF directories (it's not searchable online yet) for your area to find out which providers are in-network for ObamaCare coverage plans from Anthem Blue Cross.

Anthem Provider Directories


Health Care and Candy

At the end of this month, All Hallows Eve, an explosion of candy greater than at any other time of the year is going to happen, whether you like it or not. The last day of October is historically celebrated in the US as Halloween, harkening back to the days when people believed in evil spirits, witches, goblins, and all things netherworldly.

Straddling the line between fall and winter, plenty and paucity, life and death, Halloween is a time of celebration and superstition, according to History.com. It is thought to have originated with the ancient Celtic festival of Samhain, when people would light bonfires and wear costumes to ward off roaming ghosts. In the eighth century, Pope Gregory III designated November 1 as a time to honor all saints and martyrs; the holiday, All Saints� Day, incorporated some of the traditions of Samhain.

The evening before was known as All Hallows� Eve and later Halloween. Over time, Halloween evolved into a secular, community-based event characterized by child-friendly activities such as trick-or-treating. In a number of countries around the world, as the days grow shorter and the nights get colder, people continue to usher in the winter season with gatherings, costumes and sweet treats.

By the 1920s and 1930s, Halloween in the US had become a secular, but community-centered holiday, with parades and town-wide parties as the featured entertainment. Despite the best efforts of many schools and communities, vandalism began to plague Halloween celebrations in many communities during this time. By the 1950s, town leaders had successfully limited vandalism, and Halloween had evolved into a holiday directed mainly at the young. Due to the high numbers of young children during the fifties baby boom, parties moved from town civic centers into the classroom or home, where they could be more easily accommodated.
Between 1920 and 1950, the centuries-old practice of trick-or-treating was also revived. Trick-or-treating was a relatively inexpensive way for an entire community to share the Halloween celebration. In theory, families could also prevent tricks being played on them by providing the neighborhood children with small treats. A new American tradition was born, and it has continued to grow. Today, Americans spend an estimated $6 billion annually on Halloween, making it the country's second largest commercial holiday. Much more detail about this day can be found at this website: http://www.history.com/topics/halloween.

According to Chegg.com, Halloween is the one time of year when American children are allowed to consume so much candy they run the risk of inducing a sugar rush of colossal magnitude. Between mouthfuls of Hershey�s, Twix, and Reese�s how much do you know about those sweet treats? Well, here are 12 fun facts you probably didn�t know about candy.

         Americans purchase nearly 600 million pounds of candy a year for Halloween.

         An incredible 90 million pounds of chocolate candy is sold during Halloween week, taking a strong lead compared to other holidays. Almost 65 million pounds is sold during the week leading up to Easter and only 48 million pounds during Valentine�s week.

         Over 10% of annual candy sales happen the days leading up to Halloween � that is nearly $2 billion dollars in sales.

         Chocolate is clearly the preferred choice of sweets for many. Of the $1.9 billion sold in Halloween candy each year, $1.2 billion was on chocolate candy and only $680 million on sugar candy.

         The top selling candy: Candy Corn. Americans purchase over 20 million pounds of it a year, though it is unlikely that every last one of those millions of candies was actually consumed.

         After the beloved Candy Corn, the leading best sellers are as follows: Snickers, Reese�s, Kit Kat and M&M�S.

         Candy Corn is the most searched-for candy term in Google � more popular than candy apples, gummy worms, and candy pumpkins. Searches for Candy Corn are up 10 percent from October, 2010.

         Out of all 50 states, Alabama searched for candy corn the most!

         Which state searched the most for organic candy? Colorado. Oregon searched most for gluten-free candy, and Kentucky took the lead in sugar-free.

         This Halloween more people are searching for gluten-free candy than sugar-free candy. Google searches for gluten-free candy are currently 20 percent higher than searches for sugar-free candy.

         The day of the year with the most candy sales? October 28th. And of all the 365 days in the year, the top five candy selling days are all in October.

Even though the economy has tightened everyone�s budget, that does not stop them from splurging on this one holiday. The average American household spends $44 a year on Halloween candy!
And what about kids? The average Jack-O-Lantern bucket holds about 250 pieces of candy amounting to about 9,000 calories and about three pounds of sugar, according to the California Milk Processors Board. Not all of it gets eaten. Most U.S. children consume between 3500 and 7000 calories from candy on Halloween. This is a lot. �A 100-pound child who eats 7,000 calories worth of candy would have to walk for almost 44 hours or play full-court basketball for 14.5 hours to burn those calories�,  says Dr. Donna Arnett, chair of the Department of Epidemiology in the University of Alabama at Birmingham�s School of Public Health, according to CNN. More info on this subject is available at this website: http://blog.sfgate.com/sfmoms/2011/10/31/guess-how-much-halloween-candy-americans-eat/#1595101=0.

Regardless of your feelings about Halloween, in general a lot of candy gets eaten. Make sure that you brush and floss after any of your treats, and be careful not to consume too much candy at one time. You won�t want to suffer the after affects of too much sugar, or a stomach that gets bloated on significant calorie intake at one time. Your dentist may love you because you come back after a Halloween binge, but you may wish that you paid more attention to your smile instead of your stomach. By the way, pass me that industrial size bag of M&Ms!

Until next time.


Understanding Anthem Blue Cross CA 2014 Plans & Networks

Anthem has not yet rolled out all of the plans/networks/information for 2014 ACA plans but I want to update what we will all be seeing in the near future as choices for health insurance enrollment with Anthem Blue Cross.  

Some areas will not have a PPO option like LA county/Orange county and will have an EPO and HMO option.  Other areas will have a PPO option.  The Anthem program for 2014 will break down like this:


The ACA networks for Anthem individual plans will be called "PATHWAY" and all participating providers will need to be contracted with the appropriate Pathway network.

Pathway PPO
Pathway HMO
Pathway Tiered (EPO)

Provider searches (once available online) will show two versions of Pathway for searching, Pathway and Pathway-X.  Pathway indicates off-exchange and Pathway-X indicates on-exchange.

EPO will be a tiered network with lower costs for inpatient & outpatient services in tier 1.

Plan names will reflect if plan is on-exchange or off-exchange as follows:

On-Exchange: Bronze, Silver, Gold, Platinum
Off-Exchange: Core, Essential, Preferred, Premier

Anthem will offer a total of 26 health plans across California (not all in all regions).  These will include:

On Exchange and "Mirrors" Off-Exchange
Bronze - 4
Silver - 3
Gold - 3
Platinum - 3
Catastrophic - 1

Off Exchange Only not Mirrored
Core (Bronze) - 8
Essential (Silver) - 4
Preferred (Gold) - 0
Premier (Platinum) - 0
Cat - 0

PPO and EPO Plans will be referred to as "Direct Access" and HMO will be "Guided Access".


Health Care and ElderCare

Are you one of those adults who is now responsible for taking care of older adults?  Are you responsible for overseeing parents or older family members who now look to you for care? Or, are you someone who is in the business of elder care, and that is either your profession as a caretaker or business owner? Regardless of your status, if you are dealing with issues related to helping seniors or older adults and their health care and lifestyle, then you may need some additional advice along the way.
According to LifeHealthPro, elder care planning is essentially a comprehensive strategy that helps define a senior�s wishes and assists designated caregivers and/or advocates in handling the physical, personal and financial affairs of a senior aging into the last phases of life. Long-term care (LTC) is just one, very important segment of total elder care planning.

Unfortunately, LTC as well as other elder care issues are topics of discussion often avoided or delayed by families. But planning for elder care is one of most important discussions a family can have. When planning takes place at the eleventh hour, mistakes can happen and opportunities are lost. Helping clients become aware of what issues should be in order and how important planning is for an elder�s comfort shows the client the total value you bring as an advisor.

Discussing long-term care and elder care issues takes time and should be done step by step, with compassion. Unless you also practice as an attorney, you likely won�t be the person to implement some of the elder care plan�s steps. But you can provide a checklist your clients should consider completing, and if your clients lack the appropriate professionals to help get their plan in order, you can refer them to one of your recommended contacts, such as an attorney. More info can be found at this site: http://www.lifehealthpro.com/2013/08/27/elder-care-planning-an-important-part-of-the-long-?t=ltci.

Senior citizens have difficulty at times processing information. Changes in physical and mental abilities that may occur with age can be difficult to detect�for older adults and their family members, friends, and caregivers too. To help in determining when an older adult may need assistance in the home, according to www.Eldercare.gov, their site has compiled a list of 10 warning signs. Any one of the following behaviors may indicate the need to take action. It is also important to inform the older adult�s physician of these physical or psychological behavior changes. Has your loved one:
         Changed eating habits, resulting in losing weight, having no appetite, or missing meals?
         Neglected personal hygiene, including wearing dirty clothes and having body odor, bad breath, neglected nails and teeth, or sores on the skin?
         Neglected their home, with a noticeable change in cleanliness and sanitation?
         Exhibited inappropriate behavior, such as being unusually loud, quiet, paranoid, or agitated, or making phone calls at all hours?
         Changed relationship patterns, causing friends and neighbors to express concerns?
         Had physical problems, such as burns or injury marks, which may result from general weakness, forgetfulness, or misuse of alcohol or prescribed medications?
         Decreased or stopped participating in activities that were once important to them, such as bridge or a book club, dining with friends, or attending religious services?
         Exhibited forgetfulness, resulting in unopened mail, piling of newspapers, not filling their prescriptions, or missing appointments?
         Mishandled finances, such as not paying bills, losing money, paying bills twice or more, or hiding money?
         Made unusual purchases, such as buying more than one subscription to the same magazine, entering an unusually large number of contests, or increasing purchases from television advertisements?

As people age and live longer, financial, legal, health care and long term care issues affect families, not just individuals. According to this website, http://www.eldercare.gov/ELDERCARE.NET/Public/Resources/Factsheets/Face_the_Facts.aspx   you can find significant details on this topics. And, here are some key considerations:
         Figure out what financial benefits are provided by your parents� Social Security and pension. Determine if they are eligible for other financial programs.
         Ensure that each family member has a living will. Know where all your parents� insurance policies, wills, trust documents, tax returns, investment and banking records are located.
         Investigate what type of long term care insurance coverage may be best for your parents or for yourself! Generally, premiums are lower when policies are purchased at younger ages.
         Identify what community services are available that can help your parents maintain independence in the home for as long as possible. Learn whether housing options are available to meet their changing needs.
         Family members may not understand how their parents� estate planning could impact their own financial status as well as that of their children.

Health care is a high-cost necessity, so it is crucial to know what is available to meet your family member�s needs, and what they are eligible to receive. Most adults over age 65 are covered by Medicare, the federal health insurance program that helps pay medical expenses for older Americans and younger people with disabilities. However, Medicare does not cover all needs, such as long term care including nursing homes or extended care, and Supplemental Insurance (also called Medigap insurance) might be necessary to cover additional health costs, according to Eldercare.gov.
Medicaid, on the other hand, is the federal and state insurance program that helps pay the health care costs of low-income individuals of any age. Long-term care insurance is available through the private market to assist individuals to cover the cost of long-term care services such as home health and nursing home care. Ask...

         As your health status changes, are you prepared to meet your long term health care needs?
         Do you have proper health insurance coverage (not too much or too little)?
         Are you comfortably able to pay for prescription drugs and other out-of pocket health care costs?
         Who are your doctors and how can they be contacted?
         Where do you keep your insurance card, Medicare information, and other important health care documents?

One of the most difficult things you may ever have to do is to hand over or share the caregiving of the seniors in your life. For some reason, either you think you know them best and therefore can care for them the best; or because you really feel it is your responsibility, you are very reluctant to trust others to care for your elders, according to www.eldercare.com . But this attitude, although admirable, in most cases is not practical or even doable for the family caregivers. So what can you do to move forward mentally and then actively to change this situation? More details can be found at this site: http://eldercare.com/how-to-ensure-excellent-elder-care.
Eldercare can be a challenge, especially if you have special needs or limited resources. Find resources in your community and online. There are many organizations that can help you. Realize that millions more have walked in your shoes, so you are not alone. Don�t be afraid to ask for help, and when you may start feeling overwhelmed, it�s okay to reach out for assistance. Don�t try to go it alone, and remember that your senior relatives still love you even though they may have difficulty in expressing those feelings.

Until next time.

Covered CA Certified Agents - How To Get To Your Account, Agent Number & Dashboard

Because I'm a nice guy and I'm hearing that many CA agents don't know how to get to their profile/dashboard/account on Covered CA once they have been certified, I wanted to post how to do it.  Covered CA will not advise you of the steps to access your agent # or certification #.

Once you have completed training and the final exam, and have provided the signed contract pages and E&O and all of that to Covered CA, the following steps:

Before I forget, you need to use Internet Explorer for part b as it won't work on Chrome nor Safari (I didn't try Firefox but heard that it won't work either).  You will also need your original log in username and password from when you originally registered with Covered CA back in August (not your learning center log in) so I hope everyone kept that log in information from the registration.


1.  Go to www.coveredca.com and click on the start button
2.  Once the Calheers screen comes up, click on the "find help near you' link at the top and do a name or zip code search and see if you have been uploaded into the system.
3.  Once your name and profile appear as uploaded in the system, go to step B below


4.  Using IE, got back to www.coveredca.com and click on the start button
5.  When the Calheers screen comes up, scroll down to the bottom and click on the "Go to Enrollment Counselor Homepage" link under Certified Enrollment Counselor and Insurance Agents
6.  That will take you to a log in screen and you have to use your log in that you set up initially back in August when you first registered with Covered California.  (This only works with internet explorer, if you use chrome or safari it will just spin and never log in)
7.  Log in with your original log in from your initial registration and it will take you to your broker dashboard (https://v.calheers.ca.gov/hix/broker/dashboard)
8.  Click on the "Account" tab at the top  then on the drop down menu select "Certification Status"
9  This screen will provide both your Covered CA Agent Number and your Certification Number.

As your dashboard contains e-mail inbox and will also be the location where any leads from Covered CA are delivered to you, you need to check this daily.

Anyway, this is how you get to your agent dashboard and obtain your Covered CA Agent # and Certification #.  


Health Care and Cutting

There is a certain population that suffers from a disorder causing individuals to cut themselves, known as �Cutting.� According to info on this website, http://www.ulifeline.org/topics/135-cutting ,  cutting is the act of intentionally inflicting harm on oneself. Cutting isn�t a suicide attempt, though it may look and seem that way. Cutting is a form of what is known as �self-injurious behavior� or �non-suicidal self-injury.�

Other types of self-injury include scratching, burning, ripping or pulling skin or hair, swallowing toxic substances, self-bruising, and breaking bones. While cutting may occur on any part of the body, it is most common on the hands, wrists, stomach, and thighs. Tattoos and body piercing aren�t usually considered self-injury, however, unless they�re meant specifically to cause harm.

Self-injury is an unhealthy way to cope with emotional distress. Some people cut themselves when they feel overwhelming sadness, anxiety, or emotional numbness. Others do it to feel in control or relieve stress. A few see it as a way to �purify� their bodies. Girls tend to cut themselves more than boys do, although cutting can happen with anyone. It often begins between the ages of 12 and 15, but studies suggest 30-40% of college students who cut begin at 17 years or older.

Cutting is frequently linked to childhood abuse (especially sexual abuse), depression, anxiety, eating disorders, post-traumatic stress disorder, borderline personality disorder, and substance abuse problems. An estimated one-half to two-thirds of people who cut also have an eating disorder. And although cutting is rarely meant as a suicide attempt, it is not uncommon for people who cut to think about suicide.
It can be hard to understand why people cut themselves on purpose. Cutting is a way some people try to cope with the pain of strong emotions, intense pressure, or upsetting relationship problems. They may be dealing with feelings that seem too difficult to bear or bad situations they think can't change, according to this site, http://kidshealth.org/teen/your_mind/mental_health/cutting.html  .

Some people cut because they feel desperate for relief from bad feelings. People who cut may not know better ways to get relief from emotional pain or pressure. Some people cut to express strong feelings of rage, sorrow, rejection, desperation, longing, or emptiness.
There are other ways to cope with difficulties, even big problems and terrible emotional pain. The help of a mental health professional might be needed for major life troubles or overwhelming emotions. For other tough situations or strong emotions, it can help put things in perspective to talk problems over with parents, other adults, or friends. Getting plenty of exercise also can help put problems in perspective and help balance emotions.

But people who cut may not have developed ways to cope. Or their coping skills may be overpowered by emotions that are too intense. When emotions don't get expressed in a healthy way, tension can build up � sometimes to a point where it seems almost unbearable. Cutting may be an attempt to relieve that extreme tension. For some, it seems like a way of feeling in control.
The urge to cut might be triggered by strong feelings the person can't express � such as anger, hurt, shame, frustration, or alienation. People who cut sometimes say they feel they don't fit in or that no one understands them. A person might cut because of losing someone close or to escape a sense of emptiness. Cutting might seem like the only way to find relief or express personal pain over relationships or rejection.

People who cut or self-injure sometimes have other mental health problems that contribute to their emotional tension. Cutting is sometimes (but not always) associated with depression, bipolar disorder, eating disorders, obsessive thinking, or compulsive behaviors. It can also be a sign of mental health problems that cause people to have trouble controlling their impulses or to take unnecessary risks. Some people who cut themselves have problems with drug or alcohol abuse.
Some people who cut have had a traumatic experience, such as living through abuse, violence, or a disaster. Self-injury may feel like a way of "waking up" from a sense of numbness after a traumatic experience. Or it may be a way of reliving the pain they went through, expressing anger over it, or trying to get control of it, according to KidsHealth.org.

Myths and facts about cutting and self-harm, according to this site  http://www.helpguide.org/mental/self_injury.htm:
Because cutting and other means of self-harm tend to be taboo subjects, the people around you�and possibly even you�may harbor serious misconceptions about your motivations and state of mind. Don�t let these myths get in the way of getting help or helping someone you care about. Much more information about this topic is available at the website.

Myth: People who cut and self-injure are trying to get attention.
Fact: The painful truth is that people who self-harm generally do so in secret. They aren�t trying to manipulate others or draw attention to themselves. In fact, shame and fear can make it very difficult to come forward and ask for help.
Myth: People who self-injure are crazy and/or dangerous.
Fact: It is true that many people who self-harm suffer from anxiety, depression, or a previous trauma�just like millions of others in the general population. Self-injury is how they cope. Slapping them with a �crazy� or �dangerous� label isn�t accurate or helpful.

Myth: People who self-injure want to die.
Fact: Self-injurers usually do not want to die. When they self-harm, they are not trying to kill themselves�they are trying to cope with their pain. In fact, self-injury may be a way of helping themselves go on living. However, in the long-term, people who self-injure have a much higher risk of suicide, which is why it�s so important to seek help.
Myth: If the wounds aren�t bad, it�s not that serious.
Fact: The severity of a person�s wounds has very little to do with how much he or she may be suffering. Don�t assume that because the wounds or injuries are minor, there�s nothing to worry about.

According to this very important website, http://www.selfinjury.com/resources/faqs,   it is important for family to take the behavior seriously, but anger and hysterics are counter productive. It's important to keep the lines of communication open. Parents and friends should not be the therapist, it is helpful for self-injurers to have someone to talk to who can truly help them to identify the problem and learn healthier ways of responding.
It is difficult to know for sure as researchers have used different populations, measures and definitions of self-injury to collect their data. However, in general studies on adolescents in community samples report a lifetime prevalence of between 15-20%. These numbers are higher in clinical populations. Here are some signs if someone you know may be cutting:
         Unexplained cuts or bruises
               Kids who have trouble modulating emotional states especially sadness, fear and anger are at higher risk for self-injury.
      �         Low self-esteem as evidenced by a tendency to self-denigrate.
      �         Arms and legs are always covered such as wearing cold weather clothes such as long sleeves and pants in warm weather
               Presence of an eating disorder and possible substance abuse also seems related to risk for self-injury.

A parent's reaction is very important.

         Parents should not react with intensity (e.g., fear or anger )
      �         Threats (e.g grounding etc) and rewards (e.g., you can stay up later if...) are rarely effective
      �         They should not ask "Why are you doing this to me?," or even "Why did you do that?".
      �         Speak with your child calmly, and non judgmentally while expressing your love and concern.
               Listen, don't try to offer your opinion or "fix" the problem. The goal is to foster open communication
      �         Parents can state that they will educate themselves on self-injury so that they can better understand where their child is coming from
      �         Tell them that you are concerned about them and that they can talk to you about anything, and then follow through with that.

At appropriate times, talk with the person cutting themselves about their life, their friends, their behavior around others, their thoughts, and their beliefs. It is also possible to offer to pray for them, and request they seek spiritual counseling as well as other types of assistance. Be careful not to accuse or make insinuations that they are violating moral codes, even though self-mutilation can be considered in that context. Watch for behavior and attitudes out of normal activity and speech that causes concern, and always seek professional advice with this type of disorder.

Until next time.

Sorry To Be Gone So Long

Wanted to get a quick update out here.  Covered California Certification has been a complete time drain and far more lengthy process than I could have imagined.

First the 8 hour mandatory in-person training followed by 4-6 hours (turned into a lot more as the sliders on the slide screens online were jacked up) online followed by an open-book test. Once all of that was done waiting for the follow up e-mail from Covered California letting me complete the contract and become fully certified.  I guess i should be grateful it only took a full week to get that e-mail after I passed the exam (LOL).  

So yesterday I got the famous "e-mail" and contracting paperwork to fill out and sign.  Sent that in this morning so I wonder how long it will be until they actually let me know my login and let me do the profile updates.  

Man, what a process.  AHIP for Medicare Advantage is waaaaaay easier than this even with the carrier specific certifications after the AHIP training.  

Anyway, some day soon I will actually be a Covered California Certified Agent (my mom is so proud now) and can actually complete someone's enrollment and get credit for the sale.  Sigh.

Hope everyone is having a good autumn.

Oh, by the way, a couple of carriers have completely changed their agent direct links for online quotes and applications for 2014 and of course Quotit, my online quoting service, is not even quoting 2014 plans yet so I have to do a complete web site rebuild this week as well.  Sign again!


Health Care and Physical Stamina

How is your physical stamina? In other words, when you exercise or are engaged in any physical acitivity, are you breathless and exhausted within a few minutes, or can you keep going until the task is finished? Do you look for ways to help improve your physical stamina? Stamina means having the strength and energy to endure an activity, illness or stressful situation for an extended period of time.

People most commonly use the word stamina when referring to exercise, sports and other physical activities of the body or cognitive exercises of the brain. Generally, however, increasing stamina means decreasing fatigue when performing the activity. There are several ways to accomplish this task, according to health care writer Claire Walters:

Increased Physical Stamina is Beneficial for All Aspects of Health:
There are many aspects toa healthy lifestyle, and while the majority of the focus seems to be on diet and mental agility, it�s important not to underestimate the long term health benefits of maintaining a good level of physical stamina. Physical exercise has been proven to kick start the body�s basic systems into action and this is something that is particularly important as we grow olderThose who remain physically active for the longest tend to be much healthier in old age than those who have been very unfit for large portions of their later life, and there are many different reasons for this.

Fighting Obesity:
Obesity is one of the largest health issues in the US today, and again, while much of the blame is placed (rightly so) on the worsening standard American diet, a large portion of the blame can also be placed on the reduced amount of physical exercise that the average person is now engaged in. According to the American Health Rankings, two thirds of Americans are considered to be overweight or morbidly obese. The problem often stems from poor diet and lifestyle, both of which are controllable factors, however in most circumstances once a person becomes overweight , exercise becomes more difficult and the rate of exercise decreases with an increase in size. In essence, the bigger people get the less exercise they do, which is a vicious circle. Obesity is known to play a big role in the development of serious illnesses such as heart disease, stroke, certain cancers, and diabetes, so it�s vital for overall health to ensure that you are physically fit and active.

Positive Effects of Increased Physical Stamina:
Breaking the cycle of obesity begins with a change of diet and an increase in exercise. When increased physical stamina is the goal, and an exercise plan geared towards this is undertaken, the results can become exponentially positive. Not only does increased physical stamina result in weight loss, it also has numerous other health benefits. Exercise increases endorphin levels in the body, and this is has a positive effect on mood and motivation, and lowers stress. While working hard to increase your physical stamina, your body goes through a range of physical changes, both during and after the exercise, all of which promote a much better level of overall health. One of the reasons that many people opt to conduct exercise in the morning is that it leaves them feeling energized, and in good spirits, ready to take on the day with a positive attitude. This is down the �endorphin rush� that is produced after exercise, and it not only improves mood but also many physical symptoms.

Lack of Physical Stamina can have Adverse Effects:
Many people feel lethargic and struggle with finding motivation and energy, and these are all things which can benefit immensely from an increased level of physical stamina. When a person is extremely unfit, it can affect all areas of their life as it can become extremely de-motivating to struggle to complete basic physical tasks such as walking up hills, running, climbing large flights of stairs, and even engaging in sexual activity. An increase in physical endurance will benefit not only the physical aspect of being able to complete these tasks, but also the mental effects of feeling able and capable once more. The human body was designed to be physical strong and active, and as such, all aspects of it work best when you are having enough exercise. Many people experience health problems which they do not attribute to poor physical fitness, but when exercise levels are increasedthe health problems desist.

How to Increase Physical Stamina:
The good news is that there are plenty of different ways to increase physical stamina, and it can be and fun and interesting as you want it to be. The main concept is to increase your heart rate through physical activity for a sustained period of time. It�s a good idea to start off at a level that you are comfortable with and work up the intensity and time period from there. Don�t push yourself too hard at the beginning, but gradually increase over time as your body begins to get fitter. Activities which are beneficial for your physical stamina include strenuous walking, running, football, tennis, swimming, aerobics, cycling, or just about any other physical activity imaginable! 

Also, according to VibrantLife.com, twenty-five push-ups a day do not an athlete make, but combine those exercises you do for strength and endurance with a nutritious diet, aerobic conditioning, weight training, and a healthy lifestyle, and you can be at the top of your form-whatever your sport. Consider these 50 suggestions on their website; you may be in for a few surprises: http://www.vibrantlife.com/?p=152.

Here are some additional tips when you are participating in a program to increase physical stamina:
  • Motivate yourself to exercise every day, even when you are not feeling very energetic.
  • Increase training time by a few minutes each day.
  • Give yourself plenty of physical or cognitive breaks: Switch between the two to avoid fatigue.
  • Take daily relaxation breaks to help lower stress levels.
  • Eat fruits every day.
  • Practice meditation and breathing exercises daily.
Also, consider these warnings during any exercise program:
  • Don't drink caffeinated drinks such as coffee or energy drinks before aerobic exercise. They speed up your heart rate; and once you start exercising, your heart may be beat too fast, putting you in danger.
  • Keep a steady pace and don't break your routine. Taking a day off from the activity may be a helpful break, but allowing yourself to skip your routine for days at a time will make it much harder to get back in the routine.
  • Energy drinks are not healthy when consumed on a daily basis. Avoid overuse if you want a strong, healthy body with plenty of stamina.
Improving your physical stamina is a good thing. However, make sure that you consult your doctor or health care specialist for any programs that involve strenuous activities related to exercise. Also, remember the motto: �All things in moderation.� Don�t try to overdo it just to show off or prove something to yourself. Recovering from injury due to overzealous physical activity definitely puts a crimp into your style.

Until next time.

Health Care and Coughing

A cough is a sudden and often repetitively occurring reflex which helps to clear the large breathing passages from secretions, irritants, foreign particles and microbes. The cough reflex consists of three phases: an inhalation, a forced exhalation against a closed glottis, and a violent release of air from the lungs following opening of the glottis, usually accompanied by a distinctive sound. Coughing is either voluntary or involuntary. A cough is the most common reason for visiting a primary care physician in the United States.

According to Healthline, coughing to clear the throat is typically an infrequent action, although there are a number of other conditions that can cause more frequent bouts of coughing. In general, a cough that lasts for less than three weeks is known as an acute cough. A cough that lasts between three weeks and eight weeks, improving by the end of the period, is known as a sabacute cough. A persistent cough that lasts for over eight weeks is known as a chronic cough.

Most coughs will clear up, or at least significantly improve, within two weeks. If you cough up blood or have a �barking� cough, consult with a doctor. Any cough that has not improved after a few weeks may be serious and you should see a doctor. More info can be found here at this website: http://www.healthline.com/health/cough .

Acute coughs can be divided into infectious (caused by an infection) and noninfectious causes, according to emedicinehealth.com. The easiest way to simplify the causes of chronic cough is to divide them into their locations with respect to the lungs. The categories are environmental irritants, conditions within the lungs, conditions along the passages that transmit air from the lungs to the environment, conditions within the chest cavity but outside of the lungs, and digestive causes. Much more detailed description can be found at this site: http://www.emedicinehealth.com/coughs/article_em.htm .

Coughs can be caused by a number of reasons, according to the National Institutes of Health (NIH). Recent upper airway infections, such as the common cold and flu, can cause coughs. Other common causes include:

�ACE inhibitors (medications used to control blood pressure)
�Allergic rhinosinusitis (inflammation of the nose or sinuses)
�Chronic obstructive pulmonary disease (emphysema or chronic bronchitis)
�Cigarette smoking
�Exposure to secondhand smoke
�Gastroesophageal reflux disease (GERD)
�Lung disease such as bronchiectasis, interstitial lung disease, or tumors
�Lung infections such as pneumonia or acute bronchitis
�Sinusitis leading to postnasal drip

Although coughing can be a troubling symptom, it is usually your body's way of healing, according to the NIH. Here are some tips to help ease your cough:

�If you have a dry, tickling cough, try cough drops or hard candy. NEVER give these to a child under age 3, because they can cause choking.
�Use a vaporizer or take a steamy shower. Both these things increase the moisture in the air and can help soothe a dry throat.
�Drink plenty of fluids. Liquids help thin the mucus in your throat and make it easier to cough it up.

NOTE: Medical experts have recommended against using cough and cold drugs in children under age 6. Talk to your doctor before your child takes any type of over-the-counter cough medicine, even if it is labeled for children. These medicines likely will not work for children, and they may have serious side effects. Medications available without a prescription include:

�Guaifenesin helps break up mucus. Drink lots of fluids if you take this medicine.
�Decongestants help clear a runny nose and relieve postnasal drip. Do NOT give children under age 6 an over-the-counter decongestant unless specifically told to do so by your doctor. You should check with your doctor before taking decongestants if you have high blood pressure.

Do not expect a doctor to prescribe antibiotics for viral infections like colds or flu. Antibiotics do not work on viruses. Antibiotics also will not help coughs from allergies. More details about coughing can also be found at this website: http://www.nlm.nih.gov/medlineplus/ency/article/003072.htm .

A persistent cough (chronic cough) is a common symptom prompting people to visit the doctor. Annoying effects of coughing, such as loss of sleep, sore chest muscles and leaking urine, can affect your quality of life and interfere with your daily activities, according to About.com. What does it mean if you have a cough that just won't go away?

A persistent cough doesn�t necessarily mean you need to be worried about lung cancer. There are many possible causes of this symptom, only one of which is lung cancer. But since the less common causes are often missed for some time, it is important to make an appointment to see your doctor even if you believe there is a good explanation. More detailed info can be viewed on this site: http://lungcancer.about.com/od/symptoms/a/Persistent-Cough.htm .

According to the Centers for Disease Control (CDC), the following measures to contain respiratory secretions from coughing are recommended for all individuals with signs and symptoms of a respiratory infection.

� Cover your mouth and nose with a tissue when coughing or sneezing;
� Use in the nearest waste receptacle to dispose of the tissue after use;
� Perform hand hygiene (e.g., hand washing with non-antimicrobial soap and water, alcohol-based hand rub, or antiseptic handwash) after having contact with respiratory secretions and contaminated objects/materials.

Healthcare facilities should ensure the availability of materials for adhering to Respiratory Hygiene/Cough Etiquette in waiting areas for patients and visitors.

� Provide tissues and no-touch receptacles for used tissue disposal.
� Provide conveniently located dispensers of alcohol-based hand rub; where sinks are available, ensure that supplies for hand washing (i.e., soap, disposable towels) are consistently available.

More details about this topic can be found at this site: http://www.cdc.gov/flu/professionals/infectioncontrol/resphygiene.htm , and this one: http://www.cdc.gov/flu/protect/covercough.htm .

Coughing may be very temporary or more serious. The determination of the cause of a cough usually begins by determining if it is specific or nonspecific in nature. A specific cough is one associated with other symptoms and further workup is dependent on these symptoms while a non specific cough occurs without other signs and symptoms. If your cough is consistent with no real apparent reason, it�s time to see your doctor. Always be pro-active with your health and practice preventive measures. See your family physician or go to a medical clinic to seek a diagnosis. Don�t try to figure it out on your own, especially if you are not a licensed health care practitioner. Coughing is inconvenient, but it can also be a sign of something more serious.

Until next time.

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