Hidden Options: There's more to your health insurance plan than you think!

For those of you with employer-sponsored or private health insurance, it is imperative that you know how your plan works. The company that provides your health insurance benefits, contracts with a whole network of practitioners who provide services. Most often, and predominantly so in the US, these networks are called "managed care" networks. Simply put, managed care is a cost-control system that rationalizes the use of health care services. Subsequently, a Health Maintenance Organization (HMO) provides comprehensive services to you, for a prepaid fee from your insurance company.

Your insurance company wants you to stay healthy. When you fall sick, your insurance company bears the burden of the expenses your sickness generates. The company also understands that paying for prevention of illness is a lot cheaper than paying for a cure/recovery. In essence, your insurance company is there to work with you before you fall sick, and provide "preventive" services at no cost or very low cost.

Do you know what preventive services your health insurance plan provides?

Preventive services are services that help you maintain and enhance your health so that you have a lower risk of falling sick. For example, screenings like free comprehensive annual physical examinations, immunizations (speaking of which, I get free Flumist under my plan, no more flu shots, how cool is that?), special gender and age-based procedures such as mammography, colonoscopy, pap smear etc. Though every company differs in the range of services provided, most of them, if not all, have a special division called the Preventive Evaluation and Management Service, that is incorporated into even the most basic plans! Call customer service and ask about yours! If you are unsure of your preventive benefits, call your company or read your detailed explanation of benefits.

You can obtain safe, sound advice on a variety of issues such as oral health, injury prevention, car seat safety, breastfeeding, aspirin prophylaxis for cardiovascular risk, tobacco use, substance abuse, obesity, exercise, and even free diet and nutritional counselling!!

I called my insurance company again last month and had a lovely chat with the wellness specialist about my ongoing struggle with back pain. We talked about posture, body mechanics, back strengthening exercises, diet, stress reduction and a whole lot more. A week later, I received a ton of useful information in the mail about back safety, simple exercises that can be done at home, warning signs, precautions etc. I also found out that in the event that my physican recommended back massage, my insurance plan would cover all the expenses at participating locations. Who knew? Which reminds me, last year, as a birthday gift for my sweetie, I made an appointment for him for a 90 minute-long back massage at a local upscale spa. Our insurance company provided a discount and my sweetie got a wonderful, relaxing birthday gift for less!

As far as exercising at the gym, many insurance companies have contracts with local gyms to provide discounted membership plans and even susidized personal training services. One insurance company I know takes 15% off monthly premiums in return for proof of active gym membership. You can also purchase health and lifestyle products at a lower cost.

This month, assign yourself to an important task. Remember to familairize yourself with your health insurance plan's preventive services. Call your insurance company. Sign up online on their website and access a wealth of information on nutrition, health assessment and even chat with an online health coach! Many insurance companies provide 24 hour nurse support, live wellness coaches and health educators.

There's more to your health insurance plan that you think!

Be well!
Anita

Embracing Change: What a butterfly can teach us!

As the sun began to set yesterday evening, I took a quiet walk in the park. The collective stress of a long day spent caring for two high-energy kids had taken its toll on my mind and body. The purpose of my evening stroll was to empty my mind of its clutter and noise. I wanted to switch to "rest" mode, if you will. However, no matter how hard you try, nature has its own invisible way of connecting with our hearts. You start by admiring, appreciating and enjoying the wonderful delights around you and before you even realize it; you are beginning to drift into a level of deep soul-stirring you never knew existed. The quiet lessons of life whisper in your ears once the maddening noise of your day has died down.

When I take a walk in the park, I am usually transported into a world of awe and wonder, marveling at the beauty of nature. Often times, I find myself drawn into a realm of calm questioning, why, how, what and so on. Last evening, I sat on a wooden bench at the park and watched a single beautiful monarch butterfly as it flitted back and forth tasting the sweet nectar from an abundance of delicate flowers. And my mind spontaneously began following the butterfly, thinking about how it came to be, drawing on a lesson or two from childhood science classes. The butterfly wasn’t born that way. It became what it is today, as I see it, through a carefully designed, systematic process. From egg to larva to pupa to adult, the stages are distinct and structured. Beauty does not appear out of thin air. Virtue does not just happen. It becomes!

Sitting silently on my bench, deep in relaxed thought, I began to, somewhere on some deep level, draw a parallel between the butterfly and my life. Do I allow myself to change or do I cling to old thought patterns and habits. Do I let go of the past and transition to beauty? Is there room in my life for splendor and virtue to manifest? Am I patient with myself, not seeking to rush through life, aiming to attain what only time and providence will allow at the opportune moment? Do I settle with what is OR do I look forward to what can be?

Folks, we all know that change is inevitable. Do we channel that change for the better, like that gorgeous monarch butterfly? What avenues do we allow ourselves to grow and evolve? Are there relationships and associations that drain the positivity and creativity from our lives? Do we choose to surround ourselves with those who can laugh with us, celebrate our successes and support us through life’s trials? Or are we entangled in a maze of inertia that keeps us where we are, forever, going thru’ each passing day unconsciously.

Time and tide wait for no man. Make use of today’s opportunities. Embrace the freshness and perspective that change can bring. Our lives are a manifestation of our true inner beauty and value. As uncomfortable as change can sometimes be, we must allow ourselves to be transformed within divinely guided parameters.

As I began to grasp onto all of the wisdom that little colorful butterfly birthed in my spirit, I watched it flit away till it was tiny little speck among the branches, against the silhouette of the setting sun. I walked back home with a quiet joy in heart, knowing I had a quiet conversation with nature, and in that stillness, my spirit was once again revived.

Could happen to anyone, anytime! H1N1 is in the air.

Emerged in Mexico, traveled halfway around the globe, catapulted governments and health care organizations in a wild frenzy, beset with controversy in the media, the infamous H1NI virus has already inflicted enough damage. Hype aside, let’s try to figure out exactly how this dreaded virus can affect your life, your family, your place of work. What can we glean from all the information and controversy that’s out there? What exactly do you need to know?

First and foremost, we are all still learning about this new influenza virus. It is a novel strain of the swine flu, which means that although the swine flu has been around before, this particular type of virus has not. Why do we call it the “swine flu”? Because the virus is similar to the influenza virus that caused the flu in pigs in the US. The H1N1 virus can spread from person to person the same old way that seasonal flu spreads: coughing, sneezing, touching objects that contain the virus. What is the most effective prevention strategy available to all humans everywhere: Hand Washing!! Drinking water and eating cooked pork are not known to transmit the virus. (so much for the poor pigs who were martyred to save humanity)

Infected people may manifest with the usual fever, sore throat, runny nose, cough, headache, body aches, chills and fatigue. Some people have reported diarrhea and vomiting. Most people have recovered without hospitalization, some have become severely ill and unfortunately, there have been fatalities. Older adults (above 65 years), children below 5 years of age, pregnant women and those with chronic diseases such as asthma are most vulnerable. An infected person can infect others from day 1 of contracting the virus, and may actually become sick only about a week later. This is why prevention is a huge deal! You do not have to actually be physically sick to be transmitting the virus to others.

Just to put this in perspective, did you know that each year, in the US, an average of 36,000 people die from seasonal flu-related complications and more than 200,000 people are hospitalized from flu-related causes. We are talking about the ordinary flu, not the H1N1 virus. Of those hospitalized, 20,000 are children younger than 5 years old. Over 90% of deaths and about 60 percent of hospitalization occur in people older than 65 (www.cdc.gov)

Here’s the Big Question: How do we protect ourselves and others?

Cover your cough, Shield your sneeze, Avoid touching your eyes, nose, and mouth- your hands can spread germs into these areas. Wash hands with soap and water. Get a hand sanitizer gel like Purell. I have one in my bag, the kids bags, the car, at work, everywhere! And they come in handy tubes and mini-bottles. Stay home if you are sick. Teach your children to wash their hands.

If someone just sneezed or coughed into their hands and touched a doorknob or elevator button, the virus can stay there and infect a new person anywhere from 2-8 hours after it is deposited on the object. Always sneeze/cough into a tissue, not into your hands.

Now for the controversial vaccine: The US Dept. of Health and Human Services has awarded multi million dollar contracts to pharmaceutical and biotech firms to manufacture a vaccine that could offer protection. A Connecticut based company has produced a first batch of about 100,000 vaccines. Other firms are in the process of manufacturing vaccines. Educate yourself on the pros and cons of any new, or for that matter already-existing vaccine. My job requires me to obtain a mandatory flu vaccine this year. There are media reports and sobering predictions of potential deaths this virus can cause this fall.

As we all prepare to wind up a lovely summer and head into the cooler months, let’s remember to take prevention seriously. Make hand washing fun for yourself and for your kids. Let it be a part of your daily routine, something that you automatically train yourself to do right now, so that it becomes habit no matter where you go. Always remember, knowledge is power! Prevention is your responsibility! To vaccinate is recommended but eventually, it is your informed choice. And a little prayer goes a long way!

For more information and updates on the H1N1 virus, check out: http://www.pandemicflu.gov/

Be well!
Anita

Tackling ER-phobia

Millions of Americans make visits to the ER every year. Most of them, if not all, are frightened to say the least. First there's the uncertainty of visiting an unfamiliar location, a possible campout in a crowded waiting room, figuring out how to converse with professionals who are constantly on the move and want to get straight to the point, fear of the diagnosis, tests, prognosis...the list goes on.

I have not had the opportunity to provide one on one care in the ER, at least not in the last 10 years. However, in my role as administrator, I handle emergency services operations. That includes oversight of the ER in addition to the rest of the hospital. Be it a sudden influx of patient walkins, ambulance entries or a complex trauma situation involving a local community, I have seen what the ER does to people. Not only does one have to worry about oneself, but get a first hand peek at all the the other emergencies going on. Talk about adding injury to insult.

Do you know what an emergency is? Is the person involved struggling to breathe, suffering from chest pain, losing consciousness or bleeding? Is there a child involved? Do you know when to call 911?

When you do go to the ER, don't go alone! Take a person with you, that can advocate for you, if need be. If you have questions, and you will, ask. ask. ask.

So who are you going to meet in the ER? The TRIAGE RN is specially trained to prioritize patients based on their level of severity. The ER RN is charged with taking care of a team of patients. ER RNs are highly skilled and contribute in major ways to the diagnostic process. The ER Physician diagnoses you and directs your treatment. ER Techs help with obtaining vital signs, documenting, drawing samples etc. The Registration Clerk asks you for your insurance information and obtains your signature on a pile of forms. You have people coming at you from every direction and they're all there to help.

Remember to be open and honest. Are you on Viagra? Say so. Are you on drugs, alcohol? Are you a pregnant teenager? Have you self-medicated, wrongly? Let them know.

When you receive treatment, ask what and why? If you do not get a warm, fuzzy response, don't take it personally. The ER is quite a crazy place and everyone is doing their best. If you have concerns about your care, speak up. Ask to speak with the Charge Nurse. She runs the ER and is there to help.

Frankly, I love feeling the energy in a busy ER. There's nothing like a team of skilled doctors, exceptional nurses and support staff to make a difference, most times, between life and death. As a patient in the ER myself, I have experienced the distress patients sometimes go through. Nothing can be fast enough and it seems as if no one really cares. They do, they're accountable and responsible for you. And sometimes, you may need to be assertive and remind people of that fact.

Last but not least, remember to stay informed. Prepare to be patient. Anticipate delays. Focus on the end result and stay positive.

For more information, check out: http://www3.acep.org/patients.aspx?id=26018

Be well!

Anita

My Doctor = My Advisor! A Changing Role

Gone are the days when all you needed to do was walk into a doctor's office, answer a barrage of questions, get yourself examined, donate body fluids for tests, and do a follow up visit. You went home with a prescription for medication that you diligently consumed until the next aggravating symptom came along!

The twenty first century with its knowledge explosion, technological advancement and heightened consumer awareness has created a new reality. In case you didn't notice, the healthcare field has not remained immune. The mindset of the general public is still lagging behind and is struggling to keep pace with the way the world has shaped and moulded healthcare as it is today. Doctors don't play detectives anymore. Have you noticed that wait times are longer, appointment times are shorter, conversations are hurried and the doctors' offices are generally buzzing with fast-paced activity. You rush in, rush out, and most often, your questions remain unanswered.

References tell us that a patient has an average of only 8-10 minutes per appointment with his doctor, in some cases upto 18 minutes depending on the specialty. Doctors are more aware these days of patients rights and responsibilities and will let patients set the direction of the brief doctor-patient interaction. Do you know your rights and responsibilities as a patient? You can obtain a copy of your medical records. You can keep them private. What about informed consent? Times are changing. Are you prepared to change with the times?

Patients obtain information from various sources. A doctor plays the role of advisor. He is there to help you navigate through the maze of information you have and present a series of alternatives. You decide what's best for you. That is the bottom line. The pressure is on YOU!

So what? Here's the fallout. Are you equipped to make your own decisions? Have you done your homework? Do you have a handy list of questions? Do you know your alternatives? Are you prepared to be your own advocate? In the end, rules, regulations, bureaucracy and third parties decide what you need and don't need. Are you prepared to challenge the status quo if need be? What about second and third opinions? Are you well versed with your explanation of benefits?

You have got to get in the game and play it well. After all, the only person this affects is YOU! The good thing is: You can make it work for you!

For more on patients' rights, check this out: http://www.nlm.nih.gov/medlineplus/patientrights.html

Be well!

Anita

Read up! Know the facts!

The neighborhood park is my most handy refuge when the confines of the home cannot contain my little ones. A walk in the park isn't always a great experience though. My 3 and a half year old had an insect bite at the park last week. The arthropod decided to go for her left eyebrow. After a fun evening of exercise and play, we got back home and I noticed a little bump on her eyebrow and some redness. Aware of her exaggerated local reaction to mosquito bites, I decided to play it safe and gave her a dose of Benadryl that night. We woke up the next morning to a red, painful, swollen eye. A dose of painkiller, some hydrocortisone ointment and 8 hours later, it seemed not to subside one bit.

I turned to my best friend and advisor in the world: Google!! I read all you could possibly read about insect bites, kids and bites in the vicinity of the eye. Ten minutes later, I knew what to watch for: periorbital cellulitis and possibly orbital cellulitis. They are both potentially scary and could lead to grave complications.

Armed with my newfound knowledge, I decided this was not one of those things that "self-resolve". No waiting and watching. I made a quick visit to the Pediatric ER. Anushka was diagnosed: possible periorbital cellulitis!! She was started on antibiotics and the ER doctor commended me "I'm glad you came now. These things can progress pretty rapidly in a matter of hours, requiring hospitalization or a surgical procedure". Wow!! I heaved a sigh of relief as I drove back home. At a routine stop at a traffic light, I peeked in the rear view mirror to see my daughter happy and content, enjoying her popsicle as she watched the activity on a busy street.

As a mom, I knew I did what I was supposed to do. I listened to that little inner voice AND I did my homework. I was relieved and confident that I could count on my instincts.

Read up! Educate yourself! If you have a PC and an internet connection, you have no excuse!

For more on children and insect bites, check this out: http://www.nlm.nih.gov/medlineplus/insectbitesandstings.html

Be well!
Anita

Stop! Have you had your Physical this year?

Summer is fun time! Parties, picnics and camping trips are happening all over my community! Doing what I love most, socializing with friends, I secretly carried out my own little experiment on unsuspecting human subjects. What's your shoe size? Your height? Your favorite drink? Most common emotion? Just some normal-sounding questions. I got answers as quick as a cat can wink it's eye! And then, I got down to business? What's your HDL? LDL? A few smart geeks from the Virginia Technology Corridor asked me if that was a new IT term for whatever :-)

The answers: What's that? Don't know, don't remember, that was a long time ago, not yet, maybe soon.....the list was endless. Sigh! Now, let's get the facts straight. All of these folks have great health insurance policies, primary care physicians and by golly, are well-educated and informed. They could talk for hours on politics, religion, culture, sports and entertainment. But when it came down to what mattered the most, they were literally clueless.

No judgment intended. I've been there myself. What's so important about a physical? Why do we need to know if our bodies are working the way they should? What's normal for me may not be normal for you. How do I know my normal, my baseline if I don't "check" myself.

What is it that puts me off. Is it the scheduling, the trip to the doctor, the wait, the thought of putting myself through an inspection? It really isn't any of these for most folks. People tell me they really don't need it, they're healthy, no sign of disease, no real discomfort, maintaining the status quo.

Prevention is always a boring topic. Until you hear of a neighbor, a friend or colleague who passed away in his sleep, of a major cardiac arrest that was largely preventable. Or the husband of a dear friend of mine, who was diagnosed with Colon Cancer on a routine colonoscopy. Identified and treated early enough, he is recovering and enjoying his family.

Your health is your most precious treasure. Don't let 2009 go by without get a complete checkup, that includes blood tests, urine tests, x'rays, cardiac evaluation and so forth. Know your numbers. Knowledge is power. What is your body telling you? Are you listening?

For more information on physicals for men and women, check out:
http://www.nlm.nih.gov/MEDLINEPLUS/ency/article/002125.htm

Be well!
Anita

Ignorance is not bliss!

In the summer of 1985, I recall accompanying my grandmother to the doctor's office. My grandmother had complaints of mild chest discomfort, or at least that's how she described it then. I'm sure she meant periods of excruciating chest pain and sleepless nights. However, stoic as her generation was, even the thought of verbalizing physical symptoms felt like complaining. And complain they did not, no matter what.

So, doll in tow, unaware of the sombre occasion, I skipped happily as we made our way to the doctor. After a pretty long wait in a crowded waiting room, it was our turn. I entered the sanctuary (docs were respected too much back then :-) and was politely asked to sit on a wooden chair in the farthest corner of the room.

My grandmother practically whispered her symptoms to the doctor whose frown grew deeper by the second, and began his physical examination. He prescribed some medicines, assured her she was going to be just fine, live a long life too, and sent us on our way. As we made our exit, he whispered in my ear to me to get my mom to see him as soon as possible. As little as I was, I did not underestimate the gravity of his stern words.

My mother rushed to the doctor. She was told the sombre diagnosis. Grandmom needed more love, more attention and regular treatment. Long story short, my grandmother died in her early nineties, 20 years later. She took her medicines religiously, boasted of her good health to everybody she met, and lived a happy life not even remotely aware of her cardiac condition. Her devoted family took her side and contributed positively to her care and survival.

Alas, that world has passed so quickly much like my carefree childhood. I live in another time, another age, another reality where that scenario seems all too bizarre. Can ignorance really lead to bliss? Not anymore!

I consider myself fortunate to have had what many would consider the best academic and clinical preparation in the health care field. As a clinician, educator and administrator in a variety of different health care settings, I have seen things play out the way the big shots think they should. As a patient, I have experienced it and frankly, and sadly so, it has been different.

In today's world, knowledge is probably the one irreplaceable commodity that one needs in every aspect of life. The more, the better! Ignorance is disastrous! Ignorance kills!

Be smart. Be wise. We're going to learn together and help each other. You can make it work for you! That's my goal!

Be well!

Anita

Picture: My grandmom with my daughter (her great-grand-daughter)