Health insurers must provide transparency tools to consumers on Jan. 1

Health insurers are required to provide transparency tools via their websites starting Jan. 1, 2016, to consumers who are enrolled in their plans. The tools provide information about treatment costs, quality of care and other patients� experience with the medical providers. These tools have not been readily available to consumers before now. The requirement is in the Affordable Care Act and is being implemented in Washington state now.

Each insurer must provide written verification to the Washington state Office of the Insurance Commissioner by Feb. 1 of each year that the company is in compliance with this state law, which was enacted by the 2014 Legislature. The OIC provides a form for health insurers to fill out and send to us, called an attestation. We are required to post the form 60 days before it's due.

You can read more about the rules the OIC wrote to implement this requirement, which were recently adopted, or about the state law (RCW 48.43.007). The OIC also provided instructions and the attestation form for insurers to return to us by Feb. 1, 2016.

Because Even With Health Insurance, You Still Tough It Out.

Diabetes makes us tough - but I don't always want to be tough. 
I don't always want to consider the cost re: every diabetes move I make. 
With that being said - I'm going to plow through the muck and find the lotus - but I gotta bitch a little bit~
########

You walk around with a new infusion site that you unknowingly placed in a patch of skin that doesn't really absorb like it should, but you're afraid you'll run out of infusion sites before your next shipment of pump supplies gets delivered in January. 
So you make excuses. "Maybe I shouldn't have had the leftover mash potatoes with my leftover turkey, at dinner - it MUST have been those damn mashed potatoes." OR "I didn't get my exercise in today and it shows." But deep in your heart, pancreas, and mind, you know it's because it's the ghost of zombie sites past - that the new infusion site has hit a zombie patch of skin - not quite dead, but definitely not alive in the sense that it's not utilizing the insulin that's going into your body from the electronic pancreas that's clipped to your hip.

But you decide to tough it out because insurance. 

You walk around in the high hundreds to low 220s and then some - and you use copious amounts of insulin. You blow through your Monday and you make it your bitch with a vengeance because NOTHING is going to stop you.
You correction bolus, finish one project and start another and you don't stop - until you can't take it anymore. 

Then you remove the less than 24 hour old infusion site from the zombie spot and put in a new one. 

And a little over an hour later your numbers drop back to normal. 

And you feel mad and guilty all rolled into one - Mad because another part of your body has betrayed you - And mad because a box of infusion sets equals a car payment. 

Mad because your deductible is so high you will most likely never reach it by January. 
Guilty because you picked the wrong worn out patch of skin. 

Guilty because even with rotating sites like boss, you're one of the reasons that patch of skin is now longer subcutaneously astute. 

But you're damn thankful that the new site works and that you have backup infusion sites. 

And then you write a blog post, ASAP because you have to articulate how you're feeling to people who "get it," and you haven't even utter the D word. 

Tips for holiday travelers

Are you traveling for the upcoming holiday? Here are some travel tips to help keep you safe and informed.

Driving

Traveling by plane
Other travel tips

#IwishPeopleKnewThatDiabetes (dot) Org Is Up & Running!

"You have to lift your head out of the mud and just do it." Terri Garr~

"Friendship is born at the moment when one person says to the other: What! You too? 
I thought I was the only one." C.S. Lewis~
########

For those of you who have been asking me and waiting , the  #IwishPeopleKnewThatDiabetes website is now up and running!

And with your help, the site can continually grow into a mixed media gallery/teaching tool, and be a place where people living with diabetes can share their thoughts and feelings through mixed media formats that will inspire and educate others in the process.

And a place where people sans diabetes can come away with a better understanding of what it�s like to live with diabetes and become both educated and inspired in the process. 

The past few months I�ve reached out to a few Diabetes Online Community friends to submit blog posts, artwork, and videos and what they've submitted is pretty damn special. 
Please click on the link below and and give a look.


The site is still a work in progress re: the layout and video plugins - but it's up and running and  your submissions, thoughts, and comments are needed to make it complete! 

Check it out and thanks in advance! 

Health Care and Thanksgiving in 2015

It�s that time of year that families gather together to celebrate and give thanks for all their blessings, and look forward to spending time around a table laden with bountiful food and drink. Thanksgiving is a uniquely American holiday, and it has been celebrated in one form or fashion since the Pilgrims made nice with the Native American Indians in the 1620�s. About 400 years of  togetherness sometimes has its benefits, and sometimes not.

According to the History Channel, in November 1621, after the Pilgrims� first corn harvest proved successful, Governor William Bradford organized a celebratory feast and invited a group of the fledgling colony�s Native American allies, including the Wampanoag chief Massasoit. Now remembered as American�s �first Thanksgiving��although the Pilgrims themselves may not have used the term at the time�the festival lasted for three days.

While no record exists of the historic banquet�s exact menu, the Pilgrim chronicler Edward Winslow wrote in his journal that Governor Bradford sent four men on a �fowling� mission in preparation for the event, and that the Wampanoag guests arrived bearing five deer. Historians have suggested that many of the dishes were likely prepared using traditional Native American spices and cooking methods.

Because the Pilgrims had no oven and the Mayflower�s sugar supply had dwindled by the fall of 1621, the meal did not feature pies, cakes or other desserts, which have become a hallmark of contemporary celebrations. For a lot of detail about the history of this holiday, go to this site: http://www.history.com/topics/thanksgiving/history-of-thanksgiving.

One major component that is part of Thanksgiving is the food. People get in a festive mood and begin preparing days in advance for the main feast of the holiday, and other meals leading up to it as well as afterwards�it is a major event. The Food Network has some incredible ways to you to make your guests feel as though they�ve dined and experienced Nirvana. Here is your path to gourmet victory: http://www.foodnetwork.com/thanksgiving.html.

Additionally, as if that�s not enough, the New York Times has a significant Thanksgiving food �How To� cooking guide that shows every neophyte baker or aspiring gourmand the best way to prepare about any dish you wish: http://cooking.nytimes.com/thanksgiving. And Southern Living Magazine displays every possible Thanksgiving side dish you could want: http://www.southernliving.com/food/holidays-occasions/thanksgiving-dinner-side-dishes.

As well, there are parades and football games to watch on the big screen television or on your electronic devices. Thanksgiving Day parades are held in some cities and towns on or around Thanksgiving Day. Some parades or festivities also mark the opening of the Christmas shopping season. Some people have a four-day weekend so it is a popular time for trips and to visit family and friends.

Most government offices, businesses, schools and other organizations are closed on Thanksgiving Day. Many offices and businesses allow staff to have a four-day weekend so these offices and businesses are also closed on the Friday after Thanksgiving Day. Public transit systems do not usually operate on their regular timetables. Thanksgiving Day it is one of the busiest periods for travel in the USA. This can cause congestion and overcrowding. Seasonal parades and busy football games can cause disruption to local traffic. More information about what goes on in America is found at this website: http://www.timeanddate.com/holidays/us/thanksgiving-day.

Thanksgiving is one of the busiest travel seasons of the year, with tens of millions of people flying, driving and headed out of town. For some the journey is short, and for others it�s a major travel event. The American Red Cross provides very helpful advice if you�re bustling the family off to Grandma�s house for the holiday: http://www.redcross.org/news/article/Travel-Safety-Tips-for-Thanksgiving-Travelers.

And, you�ll especially want to be careful about fire safety during this holiday, whether in the kitchen when preparing meals or in the home when having a fire in the family den fireplace. ABC News has some great advice: http://abcnews.go.com/blogs/lifestyle/2014/11/5-fire-safety-tips-to-keep-in-mind-this-thanksgiving/.

Even though Thanksgiving is celebrated as a wonderful day and season of giving thanks for all your blessings, there are some safety precautions you should take to ensure that your celebration doesn�t get derailed.

Turkey safety�the turkey is the biggest star. Make sure he evokes a round of applause�not a round of visits to the bathroom or, worse, the hospital.

Buy carefully.
         Avoid fresh, stuffed turkeys; buy your turkey at least 1-2 days before you cook it, and keep it in the fridge; keep it in the freezer if you�ve bought it earlier.

Defrost properly.
         Thaw in the refrigerator (every 4-5 lbs. needs one day to thaw).
         Submerge the turkey (wrapped in leak-proof packaging) in cold water (every 1 lb. needs 30 minutes to thaw) that should be changed every half hour.
         Microwave in a microwave-safe pan, removing any packaging and following the manufacturer�s instructions.

Cook immediately after thawing.
         Avoid slow cooking or partially cooking the turkey.
         At 165 degrees F at least.
         Opt to cook the stuffing separately.

Use a thermometeron the innermost part of the thigh and wing, as well as the thickest portion of the breast, to ensure that the turkey is well cooked.
         Don�t carve at once; give the juices time (20 min.) to settle.
         Keep Clean!
         Wash your hands with soap and water before and after handling food.
         Keep all surfaces and utensils clean.
         Never handle cooked and raw food together, in order to avoid cross-contamination.
         Keep raw meat away from vegetables or other uncooked food.

The Thanksgiving dinner should be fun and festive, not fearful and dangerous. A significant amount of safety information about all things Thanksgiving is found at this website: http://www.atlantictraining.com/safety-tips/thanksgiving-safety-tips.php. As well, the CDC has some safety tips for you to follow about food prep: http://www.cdc.gov/features/turkeytime/.

Also, according to the ASPCA, Thanksgiving is a time for friends, family and holiday feasts�but also a time for possible distress for our animal companions. Pets won�t be so thankful if they munch on undercooked turkey or a pet-unfriendly floral arrangement, or if they stumble upon an unattended alcoholic drink. Check out the following tips for a fulfilling Thanksgiving that your pets can enjoy, too, at this website: https://www.aspca.org/pet-care/general-pet-care/thanksgiving-safety-tips.

Overall, Thanksgiving is a time to celebrate your blessings and be thankful for all you have. Take time to remember what and who are important, and say a simple prayer to Him for that which provides the real reason you can give thanks.


Until next time.

2015 DiabetesMine Innovation Summit



Today, along with other fantastical Diabetes Patient Advocates, I have the honor of attending the DiabetesMine Innovation Summit being held at Stanford University's Medical School, at the Li Ka Shing Conference Center. 
The DiabetesMine Innovation Summit is a �Diabetes Think Tank� consisting of patients; Pharma, inventors, investors, HCP, manufacturers and payers sdiscuss diabetes innovation in all dimensions. 

I�m beyond thrilled to be attending the summit and I�m incredibly grateful to DiabetesMine for once again spearheading this yearly event and for choosing me as one of the 2015 Patient Voices Scholarship winners. 

Do you want to join in and watch the Diabetes Mine Innovation Summit conversation unfold online? 
Go for it! Jump on the twitter and follow the hashtag:  #DBMineSummit.

FTR: My travel, lodging, and some meals are paid for by the scholarship offered by DiabetesMine, but all thoughts are mind and mine alone.

Columbia United Providers will notify enrollees about withdrawal from Washington market


Columbia United Providers (CUP) this week informed the Office of the Insurance Commissioner that it is voluntarily withdrawing from the individual health insurance market.

The company, which is based in Vancouver, Wash., also said that it intends to sell its Medicaid business to Molina Healthcare. That proposal is subject to approval by the Insurance Commissioner.

Here are answers to some questions about CUP�s announcement:

Why did CUP voluntarily withdraw from Washington?

The company cited business reasons for the voluntary withdrawal.

How does CUP�s withdrawal affect the Washington health insurance market?

CUP offered individual plans in Clark County only. As of November 2015, CUP had fewer than 100 enrollees in the individual market. These plans were offered only through the Washington Health Benefit Exchange. The company also managed insurance coverage for about 55,000 enrollees in Medicaid plans in Clark County. The Washington Health Care Authority (HCA) oversees Medicaid in Washington.

HCA is aware of CUP�s withdrawal from the Washington market and its proposal to sell its Medicaid business to Molina Healthcare.

How does this affect those who enrolled in Exchange plans?

The Health Benefit Exchange is aware of CUP�s withdrawal and proposed sale. The Exchange is reaching out to any enrollees who selected CUP for 2016 to assist them in choosing another plan. CUP 2015 enrollees will be covered through the end of the year and can select alternate coverage for 2016. Any CUP enrollee who wants to change coverage for the remainder of 2015 may request a special enrollment.

How will current enrollees be notified CUP�s decision?

The company is responsible for notifying, by Nov. 19, 2015, all individuals who have purchased individual coverage through CUP, to be effective on or after Jan. 1, 2016, that their coverage is terminated. The company�s plans will no longer be listed on the Washington Healthplanfinder.

Even with CUP�s voluntary withdrawal, Washington remains a competitive market with a wide selection of choices. There are five companies that sell individual plans in Clark County. Overall in Washington, there are 14 insurers and more than 200 plans available for consumers for coverage in 2016.

Will existing claims be paid?

Washington state insurance law requires that all claims be paid and that company make plans for payment. At this time there is no concern about the company paying existing claims for enrollees in its Washington plans.

OIC has saved auto insurance consumers nearly $26 million since 2010

The Office of the Insurance Commissioner's rate decisions have saved auto insurance consumers nearly $26 million in premiums since 2010.

Personal auto insurers are required to file their proposed rates and rating plans with our office whenever there's a rate change. Our actuaries review the proposed rates, rating plans, and supporting documentation to be sure that the rates are not excessive, inadequate or discriminatory.

From 2010 through 2014, the rates we approved for the top 20 personal auto insurers in Washington saved consumers nearly $26 million in premiums.
  • 2014: $6.2 million 
  • 2013: $8.9 million 
  • 2012: $5.6 million 
  • 2011: $2.7 million 
  • 2010: $2.7 million 
Read more about auto insurance in Washington state.

Diabetes as Kintsukuroi

My mother was fascinated with the art of porcelain and two of my closest friends are Master Potters. So yep, Kintsukuroi speaks to me - for all sorts of reasons~
######


Kintsukuroi courtesy of google~
Kintsukuroi, �to repair with gold�; the art or repairing pottery with gold or silver lacquer and understanding that the piece is more beautiful for having been broken."
Interesting phrase and theory is it not? Most in our society look at anything broken as throwaway items - but not the Japanese -  the consider Kintsukuroi pottery to be more beautiful for having been broken. 

Kintsukuroi finds and celebrates the beauty in the flaws - And I�m totally down with that. 

There were times when I considered myself broken because of certain aspects of my life. Broken because of the people I loved and who are no longer alive and the status of my permanently busted pancreas. 

Perceiving myself as "being broken" stopped me in my tracks - even though my legs worked perfectly.

But I�m not broken because of losing loved ones or my busted pancreas, I am anything but. And I choose to see myself as Kintsukuroi. 

Those I�ve lost are with me still - and I find comfort in the memories. And while I still shed tears for them - I find myself smiling when I think of them and I gain strength from their memories every day.  

Diabetes has left marks on my body and my soul. My are fingers scarred and callused from years of checking my glucose. Scar tissue is a theme throughout my body - my abdomen has deadspots from 13 years of insulin pumping, as do my arms and legs from 25 years of multiple daily injections before  pump therapy. 
Thanks to diabetes, my tendons play tricks on me, forcing me to listen to and take notice. 

Diabetes has perpetually caused me to say I�m sorry, even when I�m not.

But diabetes has given me the gift of empathy - a gift I am truly grateful because we live in a world where so many people are depleted of empathy and consider empathy as weakness and a threat, 

Diabetes has made me lean on others - and has allowed others to lean on me.

Diabetes makes me listen to my body, even when I don�t want to. 

Diabetes has helped me to develop a twisted and wonderful sense of humor.

Diabetes has forced me to be tenacious and get back up again. 

And as previously stated,  diabetes has caused me to feel broken. 
But now I see that there�s beauty in the flaws - there are works of art in the gold and silver flecks of strength and resilience that make me who I am. 


Kelly as Kintsukuroi - more beautiful, strong, and resilient for having been broken.

The DOC (Diabetes Online Community,) as Kintsukuroi -more beautiful, strong, and resilient for having been broken.

Washington wildfire victims: Hire smart when repairing, rebuilding

As Washington consumers begin to rebuild and repair their homes and businesses after this summer's wildfires, we are partnering with the Washington State Department of Labor and Industries (L&I) to share this message: Hire registered contractors.

Unregistered contractors often have no bond or liability insurance, don�t get building permits, and fail to provide workers� compensation insurance to their employees. It�s a risky combination that leaves property owners financially vulnerable if workers are injured on their property or the contractor does shoddy work � or takes a down payment and never returns.

Construction contractors are required to register with L&I. In turn, L&I confirms that they have a business license, liability insurance and a bond � requirements that give property owners some monetary recourse if something goes wrong.

Hiring registered contractors provides the best chance for success and to protect your investment.

Hire Smart to avoid rebuilding and repair headaches
  • Verify your prospective contractor�s registration at www.ProtectMyHome.net or call 1-800-647-0982.
  • Get at least three written bids.
  • Check contractor references.
  • Pay only as work is completed.



Colgate Total� And the American Diabetes Association's �30 Days of Laughter� Campaign

Humor, it�s what gets me through the day and it�s what keeps me sane. 

And humor is how I deal with diabetes on a daily basis - I figure if I can laugh at all the crap diabetes brings into my life, I can spend more time owning my diabetes, instead of my diabetes owning me. 
A few months back, the folks from Colgate Total reached out to me to team up with them in their 30 Days of Laughter campaign. 

The campaign focuses on diabetes, the importance of good oral health and using humor as a coping mechanism when it comes to living the diabetes life.
YEP, my interest was piqued!
Look, I know a lot people, diabetes or not, don�t do well when it comes to going to the dentist - I also know that good oral hygiene, a.k.a, taking care of our teeth and gums is especially important to people living with diabetes.  

For 30 days, beginning today, (November 12th,) and ending on December 11th
t3 ( a person who loves someone with diabetes, regardless of the D type,) Joey Fatone, Colgate Total, and the American Diabetes Association will encourage the DOC (Diabetes Online Community) to participate in �30 Days of Laughter� by using the #30daysofLOL hashtag, to share memes, tweets, statuses pictures, videos and blog posts. 

MySugr and Colgate Total have created an incredibly cool Monster Selfie app for you to tame your diabetes monster and show off your smile during #30DaysofLOL and beyond!

And on Wednesday December 2rd, at 8 pm EST there will be a 1 hour Twitter chat with Colgate (@Colgate) and the American Diabetes Association (@AmDiabetesAssn,) and (hosted by yours truly, @diabetesalish) where diabetes and diabetes humor will take center stage. I hope you�ll use the #30DaysofLOL hashtag and join in the fun!


YEP.
It's how I feel and I made that!
Why am I involved? Any program that uses humor to encourage diabetes education and empowerment is something I want to be part of. 
On a personal note: Diabetes or not, there was a time when, yours truly, worked at a Dentist�s office.  Without getting into the details, I saw things there that scared me and made me want to take care of my teeth and gums. 

On a professional note: When I saw that fellow Diabetes Advocates including the American Diabetes Association (@amdiabetesassn,) mySugr (@mysugr,) Divabetic (@MrDivabetic,) and Sofrito For Your Soul ( @urbanjibaro,)were involved, I immediately agreed to join in the �30 Days of Laughter,� campaign. 

And from the bottom of my busted pancreas and regardless of your diabetes type, I sincerely hope you�ll join in #30DaysofLOL, too. 

For more information on the campaign, here�s the link to the �30 Days of Laughter,� press release. 

For more info about diabetes and oral health, click on OralHealthandDiabetes.com

***Full Disclosure: I�m being compensated by Colgate Total, for my work consulting on the �30 Days of Laughter campaign. As always, all thoughts/opinions posted on Diabetesaliciousness are mine and mine alone. I think #30DaysofLOL a great campaign and I'm honored to be a part of it~

#LaceUp4Diabetes Giveaway ~

I've participated in #laceUp4Diabetes for the past few years. 
Every time I wear my sneaks and look down at my laces - I smile and feel motivated. 

I like to walk because it clears my head, makes my ass look good, and it's great for my blood sugars.
But some days motivating myself to exercise takes more work than the actual workout itself .
Somedays I just don't feel like exercising - and when I take those first few steps and force myself to walk, I'm always so glad I did.

For the past 3 years I've participated in Novonordisk's #LaceUp4Diabetes program, part of Novo's  Cornerstones4Care.com , a "personalized support program for people living with diabetes and their partners."

I'm all about diabetes support and helping others.
I'm all about getting my exercise on every month, but especially in November because of Bigbluetest.org.
I'm going to be giving away 3 pairs of #laceup4diabetes laces (I've already promised a pair to a PWD (person with diabetes) who has jumped back on the workout bandwagon without fanfare and has stuck with it, and I'm keeping a pair for myself.

Here's how you can win a pair.
Leave a comment on the blog, and to up your chances, leave a comment on diabetesaliciousness facebook page, like the above pic on my instagram page, and tweet about it on the twitter and tag me @diabetesalish.
I will pick the winner tomorrow night at 10 PM will and post the winners on Instagram, Facebook, twitter and the blog immediately after.

All winners will be chosen via Random.Org
If I haven't heard from the winners by Friday, I will choose new winner(s).

GOOD LUCK! 

Health Care and Legionnaires Disease

Several years ago a strange illness was diagnosed after many attendees of a conference in 1976 became very sick. American Legionnaires returning from a state convention in Philadelphia began to fall ill with mysterious symptoms including pneumonia and fevers up to 107 degrees. Several of the conference attendees died, and no laboratory tests could determine the cause of their illness, which quickly became known as Legionnaires� disease. Over 30 people died. Many more were hospitalized for several weeks.

It took researchers six months to determine that the illness had been caused by a bacterium, Legionella pneumophilia. Doctors now know this illness usually succumbs to the timely prescription of proper antibiotics, according to the New York Times. The bacterium, which in this case was apparently spread from the hotel�s air-conditioning system, is a cause of pneumonia and other illnesses worldwide. A more detailed background story of this illness is available at this site: http://www.nytimes.com/2006/08/01/health/01docs.html?pagewanted=all&_r=0.

CDC researchers named the species of bacteria Legionella pneumophila because the second word means "lung-loving" in Latin. This bacteria is actually very common in the natural world and only causes trouble when it gets into people's respiratory systems. It finds your lungs to be an especially comfortable place because they have conditions the bacteria prefer�they are warm and moist, according to ScienceClarified.com.

Legionella are found to exist naturally in stagnant water, and in the Philadelphia case, the CDC traced the outbreak source to the hotel's air conditioning system whose condenser was vented very close to its air intake system. This meant that the large air conditioning system, which had not been cleaned for some time, had the common Legionella germ growing in it, which people then inhaled after the organism had gotten into the air intake pipes. Read more at this site: http://www.scienceclarified.com/Io-Ma/Legionnaires-Disease.html

However, while the disease can be treated with antibiotics, many times it is misdiagnosed and it is estimated that only 5-10% of cases are ultimately reported. The fatality rate of Legionnaires� disease has ranged from 5% to 30% during various outbreaks and can approach 50% when treatment with antibiotics is delayed. More information about the history of Legionnaires� Disease is available at this website: http://www.thelegionnaireslawyer.com/history-legionnaires-disease/.

According to the Centers for Disease Control (CDC), Illness caused by Legionella continues to be detected, now more than ever. Each year, it is estimated that between 8,000 and 18,000 people in the United States need care in a hospital due to Legionnaires' disease. More illness is usually found in the summer and early fall, but it can happen any time of year.

Legionella is a type of bacterium found naturally in fresh water. When people are exposed to the bacterium, it can cause illness (Legionnaires� disease and Pontiac fever). This bacterium grows best in warm water, like the kind found in:
         Hot tubs
         Cooling towers (air-conditioning units for large buildings)
         Hot water tanks
         Large plumbing systems
         Decorative fountains

Cooling towers use water to remove heat from a process or building. They are often part of the air conditioning systems of large buildings. In contrast, home and car air conditioning units do not use water to cool, so they do not aerosolize water (spread small droplets of water in the air) and are not a risk for Legionella growth. More info is located online at this site: http://www.cdc.gov/legionella/about/history.html.

Patients with Legionnaires' disease have pneumonia and in addition may have clinical findings suggestive of a systemic disease, according to this website: Open-Access-Biology.com .The symptoms and signs of the disease are often quite variable. The majority of patients have fever, which is usually one of the earliest signs of the illness. Accompanying the fever may be anorexia, myalgia, rigors, and headache.

Clinical diagnosis also may indicate chest pain, shortness of breath and cough may or may not be prominent findings. The cough may or may not be productive, and when it is productive the sputum can be bloody, purulent, or scant and mucoid. In some patients the absence of purulent sputum production, chest pain and cough may fool clinicians into discarding pneumonia as a possibility. When chest pain and haemoptysis are prominent the patient may be suspected of having a pulmonary infarction.

Abdominal pain, diarrhea, nausea and vomiting may occur as well, symptoms that have led to consideration of intra-abdominal infections and inflammatory conditions such as appendicitis, peritonitis, abscesses, inflammatory bowel disease and diverticulitis.

Elderly and immune-compromised patients may not have fever or findings that localize to the lung. Confusion and memory loss are common presenting findings. Much less common are frank encephalopathy, focal neurological findings, seizures and meningitis. A deep dive into the clinical analysis of all aspects of Legionnaires� Disease can be found at that same site: http://www.open-access-biology.com/legionella/edelstein.html.

According to OSHA, some people have lower resistance to disease and are more likely to develop Legionnaires' disease. Some of the factors that can increase the risk of getting the disease include:
         Organ transplants (kidney, heart, etc.)
         Age (older persons are more likely to get disease)
         Heavy smoking
         Weakened immune system (cancer patients, HIV-infected individuals)
         Underlying medical problem (respiratory disease, diabetes, cancer, renal dialysis, etc.)
         Certain drug therapies (corticosteroids)
         Heavy consumption of alcoholic beverages

Early treatment reduces the severity and improves chances for recovery. The drugs of choice belong to a class of antibiotics called macrolides. They include azithromycin, erythromycin, and clarithromycin. In many instances physicians may prescribe antibiotics before determining that the illness is Legionnaires' disease because macrolides are effective in treating a number of types of pneumonia, according to OSHA.

Avoiding water conditions that allow the organism to grow to high levels is the best means of prevention, according to OSHA. Specific preventive steps include:
         Regularly maintain and clean cooling towers and evaporative condensers to prevent growth of Legionella. This should include twice-yearly cleaning and periodic use of chlorine or other effective biocide.
         Maintain domestic water heaters at 60�C (140�F). The temperature of the water should be 50�C (122�F) or higher at the faucet.
         Avoid conditions that allow water to stagnate. Large water-storage tanks exposed to sunlight can produce warm conditions favorable to high levels of Legionella. Frequent flushing of unused water lines will help alleviate stagnation.

If you have people living with you who are at high risk of contracting the disease, then operating the water heater at a minimum temperature of 60�C (140�F) is probably a good idea. Consider installing a scald-prevention device. More detailed information is located at this website: https://www.osha.gov/dts/osta/otm/legionnaires/faq.html.

Legionnaires�s Disease can be deadly if not properly diagnosed. Any incident you experience of flu-like symptoms, especially if you�ve been traveling, should be reported to your doctor or a health care professional. Don�t take chances that it may be something minor like a cold or other type of nominal illness. Not many individuals contract this disease, but those who do should take immediate action to get prompt medical attention.

Until next time. 

8 Is Great~



8 is great!
It�s been crazy as of late and I'm glad for that. 
But the craziness has made me me forget a few things - Like picking up the dry-cleaning I dropped off two weeks ago, a friend's recent Birthday, and a dermatology appointment that was scheduled for this Tuesday - thankfully they called on Friday to reschedule or I would have missed it - even though it was on my iCalendar (and I'm religious about using my iCalendar,) because it wasn't on my brain's radar. 
And then 15 minutes ago ( just as I was about to write my Diabetes Awareness Month, Day 8, facebook status,) I suddenly, said out loud: SHIT, tomorrow my blog turns 8 years old!
How the hell did that happen? 
When I started blogging about diabetes I�d never read a diabetes blog before. 
It�s not that I didn�t know people with diabetes before finding the DOC, because I did.
 I met my first friend with diabetes when I was 8.
(sidebar: there's that number again!)
 I went to diabetes camp, my neighbor had diabetes, so did two upper Classmen and an under Classman I'd gone to high school with. 
Over the years, I'd met others with diabetes here and there. 
Also, HELLO, have you seen my family tree?

But did I have a sense of diabetes community? 
Nope.
Did I understand the power of community? 
Nope, not until I started blogging about diabetes.
And for decades, I wore an anchor of diabetes guilt around my neck and I wasn�t even aware it was there. 
Since finding the DOC, I�ve found my tribe, a community of friends who have become family, and I've found my greatest passion - helping others with diabetes!
I�ve also learned (and am still learning,) to let go of whatever happened in the past with my life, diabetes and none diabetes related, so I can have a better now and a more fantastical future.

The DOC taught me to develop and use my diabetes voice - and I will continue to.
I�ve unfurled my diabetes freak flag, I�m getting my diabetes freak on, daily. 
And I�m great with that! 
And I�ve learned that together, the power of WE, can move mountains. 
And I�ve seen mountains move and made mountains move with all of you, because we as a community are mountain movers!  
I love moving mountains with you guys. 
I love and appreciate turning to you when I�m in need of support, and I hope I�ve been able to support you when you�ve needed it.


I don�t know what the next 12 months will bring me, but I know the DOC will continue to act as my rudder in life and my life with diabetes. 
And I know that the DOC will continue to steer me on course, and in the direction of better, towards the point of becoming and positive change.

So while I might have forgotten that my blog turns 8 on Monday and have scheduled other cool stuff on my blogs plate for tomorrow, 
I will never forget that blogging and finding the DOC has changed my life dramatically and for the better. 

Thanks and I love you guys!! 
Xoxo

Health Care and Dizziness

Being dizzy is symptomatic of several medical or underlying health issues. Dizziness can be caused by different reasons and should never really be taken lightly, especially if you are experiencing it on a regular or sustained basis.

According to HealthLine, dizziness is the feeling of being lightheaded, woozy, or unbalanced. It affects the sensory organs, specifically eyes and ears. It can cause fainting. Dizziness is not a disease but a symptom of other disorders.

Vertigo and disequilibrium may cause a feeling of dizziness, but those two terms describe different symptoms. Vertigo is characterized by a feeling of spinning. Disequilibrium is a loss of balance or equilibrium. True dizziness is the feeling of lightheadedness or nearly fainting.

Dizziness is common. The underlying cause of dizziness is usually not serious. Occasional dizziness is nothing to worry about. However, frequent or sustained dizziness is another problem.

Seek medical attention if you have recurring bouts of dizziness with no apparent cause. Also seek immediate help if you experience sudden dizziness along with a head injury, a headache, neck ache, blurred vision, hearing loss, a loss of motor ability, a loss of consciousness, or chest pain. These could indicate serious issues. More detailed info can be found at this website: http://www.healthline.com/symptom/dizziness.

According to the Mayo Clinic, dizziness has many possible causes, including inner ear disturbance, motion sickness and medication effects. Sometimes it's caused by an underlying health condition, such as poor circulation, infection or injury. The way dizziness makes you feel and your triggers provide clues for possible causes. How long the dizziness lasts and any other symptoms you have also help pinpoint the cause. Factors that may increase your risk of getting dizzy include:

Age: Older adults are more likely to have medical conditions that cause dizziness, especially a sense of imbalance. They're also more likely to take medications that can cause dizziness.

A past episode of dizziness:If you've experienced dizziness before, you're more likely to get dizzy in the future.

Dizziness can increase your risk of falling and injuring yourself. Experiencing dizziness while driving a car or operating heavy machinery can increase the likelihood of an accident. You may also experience long-term consequences if an existing health condition that may be causing your dizziness goes untreated. Much more detailed material is located at this website: http://www.mayoclinic.org/diseases-conditions/dizziness/basics/definition/con-20023004.

Occasional dizziness is very common in adults, but it may surprise you to learn that vertigo � a related but more serious condition that makes you feel like the room is spinning as you stand still � affects nearly 40 percent of people over 40 at least once, according to the University of San Francisco Medical Center.

While dizziness can make you feel momentarily unbalanced, and ranges in severity from merely annoying to seriously debilitating, vertigo may be a major symptom of a balance disorder. It can also cause nausea and vomiting.  Additional facts about dizziness are available at this site: http://www.everydayhealth.com/news/10-surprising-facts-about-dizziness-vertigo/.

According to the Vestibular Disorders Association, the body maintains balance with sensory information from three systems: vision,  proprioception (touch sensors in the feet, trunk, and spine), and vestibular system (inner ear). Sensory input from these three systems is integrated and processed by the brainstem. In response, feedback messages are sent to the eyes to help maintain steady vision and to the muscles to help maintain posture and balance.

A healthy vestibular system supplies the most reliable information about spatial orientation. Mixed signals from vision or proprioception can usually be tolerated. When sitting in a car at a railroad crossing, seeing a passing train may cause the sensation of drifting or moving, and feeling a soft, thick carpet underfoot as opposed to a solid wood floor can produce a floating sensation.

However, compensating for vestibular system abnormalities is more problematic. Just as a courtroom judge must rule between two sides presenting competing evidence, the vestibular system serves as the tie-breaker between conflicting forms of sensory information. When the vestibular system malfunctions, it can no longer help resolve moments of sensory conflict, resulting in symptoms such as dizziness, vertigo, and disequilibrium. Dizziness can also be linked to a wide array of problems and is commonly linked to blood-flow irregularities from cardiovascular problems. A lot of detailed material on this subject is available at this website: http://vestibular.org/node/2 .

Dizziness accounts for about 5% to 6% of doctor visits, according to the Merck Manuals. Dizziness may be temporary or chronic. Dizziness is considered chronic if it lasts more than a month. Chronic dizziness is more common among older people. People who have warning signs, those whose symptoms are severe or have been continuous for over an hour, and those with vomiting should go to a hospital right away. Other people may see their doctor within several days. People who had a single, brief (less than 1 minute), mild episode with no other symptoms may choose to wait and see whether they have another episode.

Doctors first ask questions about the person's symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of the dizziness or vertigo and the tests that may need to be done. In addition to warning signs, important features that doctors ask about include severity of the symptoms (has the person fallen or missed work), presence of vomiting and/or ringing in the ears, whether symptoms come and go or have been continuous, and possible triggers of the symptoms (for example, changing position of the head or taking a new drug).

Doctors then do a physical examination. The ear, eye, and neurologic examinations are particularly important. Hearing is tested, and the ears are examined for abnormalities of the ear canal and eardrum. The eyes are checked for abnormal movements. Additional details are available at this site: http://www.merckmanuals.com/home/ear-nose-and-throat-disorders/symptoms-of-ear-disorders/dizziness-and-vertigo.

Pregnant women also experience dizziness. It's not uncommon to feel lightheaded or dizzy occasionally. When you're pregnant, your cardiovascular system undergoes dramatic changes. Your heart rate goes up, your heart pumps more blood per minute, and the amount of blood in your body increases by 40 to 45 percent, according to BabyCenter.com.

What's more, during a normal pregnancy, your blood vessels dilate and your blood pressure gradually decreases, reaching its lowest point in mid-pregnancy. It then begins to go back up, returning to its regular level by the end of pregnancy. Most of the time, your cardiovascular and nervous systems are able to adjust to these changes, and there's adequate blood flow to your brain. But occasionally they don't adapt quickly enough, which can leave you feeling lightheaded or dizzy or cause you to faint.

The first thing to do is lie down so you won't fall and hurt yourself if you do faint. If you're in a place where it's impossible to lie down, sit down and try to put your head between your knees. And naturally, if you're doing anything that might put you or others at risk for injury, such as driving, pull over and stop right away. Lying on your side maximizes blood flow to your body and brain. It may keep you from fainting, and could relieve lightheadedness altogether. Lots of helpful information on pregnancy and dizziness is located at this site: http://www.babycenter.com/0_dizziness-and-fainting-during-pregnancy_228.bc.

Dizziness is typically not harmful, unless there is a more severe underlying cause. It�s definitely inconvenient and can be stressful. However, if you feel that symptoms are more severe than usual for any reason, see your doctor, or go to the nearest medical facility to get checked out. It may be nothing to worry about, or it might be a health situation that needs definite medical attention and diagnosis by a healthcare professional. Be careful.


Until next time. 

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