June 29, 2012

Saving Money on Prescription Meds: A Few Tips

Americans spend an average of $59 a month out of their own pockets for prescription medications, according to a 2011 Consumer Reports survey. And 12 percent of those surveyed said they spend more than $100 a month... or $1,200 a year.

These out-of pocket costs are sure to escalate. A recent report from the Kaiser Health News indicated that the new normal for employer health insurance plans will be the high-deductible plans that once were regarded as "catastrophic" alternatives for people with limited financial resources. Seventy percent of large companies recently surveyed by the benefits consultant firm Towers Watson said they'll offer high-deductible insurance by 2013, combined with personal accounts that let patients buy medical services with pretax dollars, often funded by the employer.

But nearly a fifth of these Fortune 500 companies claimed that high-deductible coverage would be the only option in 2013.

So, faced with the ever-escalating cost of drugs and the shrinking reimbursement by employers and the government, what can we can do to spend less on medicine?

June 27, 2012

Alzheimer's: Where Are We?

I’ve often said in this space that – although I already have prostate cancer and Parkinson’s disease – what I fear most is Alzheimer’s. I’ll bet many of you feel the same way.

So, in my daily travels across the internet, I watch for information about the progress researchers are making in their quests for treatments. Here’s a quickie, elementary “primer.”

The most promising research is addressing two different “hallmarks” of the disease:
  1. amyloid plaques, and 
  2. neurofibrillary tangles. 

June 26, 2012

Do Trans Fats Cause All Those Angry, Irritable People?

new study by researchers at the University of California at San Diego showed that consumption of dietary trans fatty acids (dTFAs) -- the unsaturated fats found in fried foods and commercially processed products like crackers, cookies and pies -- are associated with people who are angry and irritable.

The UCSD team used baseline dietary information and behavioral assessments of 945 adult men and women to analyze the relationship between dTFAs and aggression or irritability. The survey measured such factors as  history of aggression, conflict tactics, self-rated impatience and irritability. It also uses an “overt aggression” scale that tallies recent aggressive behaviors. Analyses were adjusted for sex, age, education, and use of alcohol or tobacco.

June 25, 2012

Thanks To Our Lobbyists and Politicians, I Continue To Rob My Children, Grandchildren and Great-Grandchildren

In a blog post earlier this year, I suggested calling my generation "The Lucky Generation," sandwiched between "The Greatest Generation" and "The Baby Boomers." Born between 1926 and 1945, most of us were too young to fight in World War II. But we went to college, entered the workforce, and launched our careers during the Golden Age for the U.S. economy (1947-1972).

We had a much easier time getting jobs, promotions, cars, houses, and savings than earlier generations. But now, each generation following mine seems to be experiencing a harder -- not easier -- time than the one before.

Yet our government's programs and resources strongly favor us seniors. Several press reports these past few weeks reminded me just how distorted and unfair this trend has become.

Seniors Are Better Off than any Other Age Group but Still Get Most of the Government $$
Here are some facts I've seen reported:

June 22, 2012

Mindfulness Meditation Study Confirms What I Already (Sort of) Knew from My Own Experience

I just KNEW that my mindfulness meditation (MM) was helping me. Now, there’s evidence – modest but validating and encouraging – that MM causes positive changes in the brain.

In a study published June 11 in the e-journal Proceedings of the National Academy of Sciences, researchers using MRI technology showed that even brief MM training caused measurable changes in the brain’s so-called “white matter.”

Study co-author Michael Posner, professor emeritus at the University of Oregon-Eugene, said, "The notable physical changes suggest that short-term meditation can improve self-control, mood, stress response and immunity response." Certainly improvements I could use!

Here’s how the study worked:
 

June 21, 2012

Update on Curcumin's Potential for Treating Parkinson's and Alzheimer's and Cancer, etc, etc....

I've written several posts over the past few months about curcumin, the active ingredient in turmeric, the curry spice that Indians call the "holy powder." Curcumin has a lengthy history in ancient cultures, both for its culinary and medicinal attributes.

It has been described by today's scientific researchers as "the unsung hero" among many more widely touted nutrients. Strangely, while it hasn't received a lot of publicity, it has been the subject of more scientific study than any other compound, and most of those studies have been very encouraging about its potential to treat such ailments as:
  • Alzheimer's, Parkinson's, MS and other neurodegenerative diseases.
  • Cancer
  • Diabetes
  • Cardiovascular disease
  • Arthritis 
  • Depression
Background
One of the leading researchers on curcumin is Ajay Goel, PhD, director of epigenetics and cancer prevention at the Gastrointestinal Cancer Research Lab at Baylor University Medical Center in Dallas. He has studied curcumin for 15 years and notes that curcumin is the only botanical whose clear efficacy has been demonstrated by science. Almost 5,000 peer-reviewed studies now exist to support curcumin's beneficial effects. (See my previous post for a report on a recent interview with Dr. Goel.)

June 20, 2012

Do I Need That Annual Physical and All Those Tests? Part 2: Questionable Tests

The impetus for most of the recent media reports questioning the value (or at least the frequency) of many tests and procedures comes from the Choosing Wisely campaign initiated by the American Board of Internal Medicine (ABIM) Foundation. Last April, it published a list of 45 overused tests and procedures that physicians and patients should think twice about.

Background
The Choosing Wisely campaign was sparked by a 2010 article in the New England Journal of Medicine by medical ethicist Howard Brody, MD, PhD, who challenged each specialty medical society to produce a list of
overused tests or procedures. Here's what he proposed:
The Top Five list would consist of five diagnostic tests or treatments that are very commonly ordered by members of that specialty, that are among the most expensive services provided, and that have been shown by the currently available evidence not to provide any meaningful benefit to at least some major categories of patients for whom they are commonly ordered. In short, the Top Five list would be a prescription for how, within that specialty, the most money could be saved most quickly without depriving any patient of meaningful medical benefit. Examples of items that could easily end up on such lists include arthroscopic surgery for knee osteoarthritis and many common uses of computed tomographic scans, which not only add to costs but also expose patients to the risks of radiation.
The ABIM Foundation followed up on this proposal by sponsoring the Choosing Wisely project and encouraging other specialty societies to join in. The list of 45 questionable tests and procedures released in April came from nine societies. The Foundation has also recruited nearly a dozen consumer groups, including Consumer Reports, to help disseminate the reports.

June 19, 2012

Do I Need that Annual Physical and All those Tests? - Part 1: The Annual Physical

Annual head-to-toe physicals for healthy Americans may become a thing of the past as we try to combat our soaring health care costs, physician Elisabeth Rosenthal argued earlier this month in an article in the New York Times.

A few days later, Dr. Nancy Snyderman made the same point on NBC's Today Show. (Sorry, a commercial appears first.)



A debate is underway about whether many formerly routine medical tests are really needed. But for now, let's just talk about annual physicals. Tomorrow, I'll discuss recommendations for other tests.

June 18, 2012

"As our institutions decay, is our sense of right and wrong crumbling as well?"

I had several topics in mind for today's post, but then I read the lead-in (above) to Maureen Dowd's piece on our "moral dystopia" in the Sunday Review section of the New York Times. After reading the piece, I decided to urge everyone I know to read it.

Since I want you to read the full piece, I won't make a full summary here. I'll just say it begins with the trial Dowd is now covering: Jerry Sandusky, the Penn State football coach, is accused of sexually abusing young boys he was supposedly mentoring. Dowd's piece focuses on Mike McQueary, the former Penn State assistant coach who entered the school's locker room late one night glanced into the showers and saw Sandusky sodomizing a young child -- the "little boy who was never found, who was never even sought by Penn State officials." Rather than step forward to stop the rape, McQueary left to talk it over with his father and a family friend. In the morning, he reported what he saw to coach Joe Paterno. He then "went along with the mild reining in of Sandusky who continued his deviant ways."

June 15, 2012

EXERCISE: Trying to Heed My Own Advice But I Could Use That Promised New Motivation Pill

Exercise, exercise, exercise.

I’m not getting enough, and I’ll bet you’re not, either.

Yesterday I wrote about the Frontline program on Parkinson’s. In that documentary, a researcher said that a well-designed exercise program is better for many of us with PD than all the meds we take.

And let’s be clear: exercise benefits EVERYBODY: young and old, healthy and ill. With all the flawed studies and inconclusive findings out there, there isn’t much we can count on for sure. But we can count on this: exercise is good for us. If we’re not exercising in some way – and we can all find some real way to exercise – we are CHOOSING to NOT take care of ourselves. We’re clever about making excuses not to exercise: too busy, feeling tired, crummy weather, do it tomorrow. When we make those excuses, we are choosing NOT to take care of ourselves. We’re downgrading health -- our very well-being -- on our list of important things.

For kicks, I just searched “exercise” on my own blog, and was directed to THIRTY TWO different posts about exercise. These commentaries describe how exercise helps people with high blood pressure, diabetes, cognitive and memory challenges, depression, Parkinson’s, arthritis, and heart disease. It also helps keep people with Parkinson’s – like me – balanced and on our feet.

June 14, 2012

An Update to Frontline's Excellent 2009 Report on Parkinson's

This week, PBS's Frontline reran its excellent 2009 report about Parkinson's Disease: My Father, My Brother, and Me. If you haven't seen it, I'd urge you to view it: Iverson Frontline. A 2012 update to the film appears at the end of this post.

The story was reported by Dave Iverson, who received in 2004 the same news his father and older brother had heard years earlier -- he had Parkinson's disease. The documentary reviews the role that genetics might play as a contributing factor. I was particularly intrigued by the story of a gene mutation that might cause a predisposition to PD. That particular genetic mutation was found in people around Carthage -- along north Africa's Mediterranean coast -- and also among people living along the Norwegian coast. Had the Vikings, in their wide explorations, brought this genetic heritage with them? With his own Norwegian ancestry, Iverson was especially interested.

June 13, 2012

Cranial Electrotherapy Stimulation: Longer Strides, Faster Gait, and Fewer Falls for People with Parkinson's?

Cranial Electrotherapy Stimulation (CES) – a therapy approved by the FDA in 1991 to treat anxiety and depression – has now been shown to increase walking speed and stride length in people with Parkinson’s disease. The good news: those results are encouraging, since the improvements may reduce the falls and movement-related injuries that affect many PWPs. The bad news: the study group was very small – only ten people.

This particular study was conducted by researchers at the Department of Physical Therapy & Rehabilitation at the University of Maryland School of Medicine, and used the Fisher Wallace Stimulator to deliver the “gentle electrical current” through dampened sponge electrodes attached to subjects’ heads. The electrical stimulation apparently encourages the production of serotonin and other neurotransmitters typically associated with elevated mood, ease of sleep, and reduction of anxiety. As it is, those of us with PD often experience problems with sleep and depression – as I have – so this therapy may be useful for us for more than just gait improvements.

Those ten participants each received three different treatments:
  1. 20 minutes of CES, 
  2. 20 minutes walking on a treadmill, 
  3. 20 minutes of CES AND treadmill 
Stride length and walking speed increased MOST for participants after the first – CES only – therapy. We’ll need additional, more thorough, studies to determine whether longer CES sessions (more than 20 minutes), conducted through an expended study period provide additional stride and gait benefits to people with PD.

June 12, 2012

Trial of Alzheimer's Vaccine on Humans a Success!

Yesterday I wrote about a new clinical trial on humans to test a vaccine for Parkinson's disease (PD). Today's post concerns the positive results from a test for a vaccine against Alzheimer's disease (AD).

For now, there is no cure for either disease, though scientists continue to pursue a variety of avenues in their search. Vaccination currently seems the most popular.

Alzheimer's Vaccine
According to the World Health Organization, dementia (an umbrella term than encompasses AD) is the fastest-growing global health epidemic. As we get healthier and live longer, the incidence of dementia increases.

The prevailing hypothesis about its cause involves the amyloid precursor protein (APP), which resides in the outer membrane of nerve cells. If these proteins are not routinely broken down, they can form a harmful substance called beta-amyloid, which accumulates as plaque and kills brain cells.

A decade ago, the first human vaccination study resulted in too many adverse reactions and was discontinued. That vaccine activated certain white blood cells (T cells), which attacked the body's brain tissue.

The new treatment, used in a study led by Karolinska Institutet in Sweden, involves active immunization with a vaccine designed to trigger the body's immune defense against beta-amyloid. The researchers found that 80 percent of patients involved in the trials developed their own protective antibodies against beta-amyloid without suffering any adverse side effects over the three years of the study.

The researchers believe that patients with mild to moderate Alzheimer's can tolerate the CAD106 vaccine used in this study. As is so often the case, larger trials must now be conducted to confirm the vaccine's efficacy.

Source:  Lancet Neurology, June 6, 2012

June 11, 2012

Clinical Trial Underway -- Using Humans -- on New Vaccine for Parkinson's Disease

There is intriguing news from Vienna about a new clinical trial involving a vaccine for Parkinson’s disease (PD).

The Michael J. Fox Foundation is jazzed enough about the trial to have committed one and a half million dollars to it. This support may in part explain Fox’s comments several weeks ago, when he suggested that the most likely opportunity for progress against PD would probably NOT emerge from stem cell research, which for years has been a primary focus.

This new study is small: no more than 32 people. But it’s an important first step in moving vaccine studies from rodent to human participants. On June 5, AFFiRiS AG – a biotechnology company based in Austria – announced the start of Phase 1 in its study of the PD vaccine “PD01A.” By introducing antibodies that target the protein alpha-synuclein (alpha-syn), the new vaccine aims to disrupt and neutralize the possible toxic effect of this clumping protein – which seems to be a pathological “hallmark” of PD. (During his interview, Fox repeatedly mentioned the promise of working with "biomarkers." Alpha-syn accumulation is such a biomarker.)

Going Beyond Dopamine Replacement
So far, PD meds – like L-DOPA, introduced half a century ago – impact only the disease’s symptoms. The recent excitement about the gel pump therapy essentially uses that “old” technology: introduce a substance into the body which the brain then converts into dopamine, to offset dying neurons and improve “communication” between brain and body. (Yes, the pump at least has introduced the novel element of “continuous” medication into the mix – a step forward.)

But to date, no intervention has been shown effective in altering or halting the progress of the disease. Leaders of this new trial hope the vaccine will change all that. Said AFFiRiS CEO Walter Schmidt, "Worldwide, for the first time immunotherapy is applied for the treatment of Parkinson's. It is a so-called ‘First-in-Man’ and ‘First-in-Kind’ trial, because PD01A is the first medication worldwide aiming for clinical efficacy by modulating the metabolic pathway of alpha-syn.” 

June 8, 2012

A Day with My Water Garden, Mosquitoes, and Great Blue Heron

5pm Wednesday -- A Great Blue Heron* waits patiently for his supper. I watched him for over half an hour before he finally gave up and flew away.
*00PS! I stand corrected. A knowledgeable neighbor tells me this is a yellow-crowned night heron.

10am Thursday -- The goldfish come out from hiding to get their breakfast fish food.

10:30am Thursday -- It's a beautiful day with only a slight chance of rain. I'd like to do some work in the garden and then, if the mosquitoes will let me, rest and read in my secluded nook at the back of the garden.  So, I decide to use my new non-toxic garlic spray that I wrote about earlier this week.

5:45pm Thursday -- The ultimate test of the garlic spray. It's prime time for the mosquitoes to be out and about and I'm sitting in the garden, wearing shorts and short sleeves, for the coffee hour I usually spend on  my screened porch. I've had this outdoor furniture for years, but it never gets used during mosquito season.

I fully expect that I'll give up on this experiment and quickly head up that path for the haven of the screened porch.

7pm Thursday -- A new world record: over an hour sitting outside without a single mosquito bite!

My Water Pond and Mosquitoes
Last summer in the worst of our mosquito plague, I looked out the window and saw one of my neighbors down on her hands and knees peering into my pond. It's a common misconception that water gardens breed mosquitoes. But water gardens do not exacerbate the mosquito problem.

In fact, water gardens helps keep mosquitoes in check. Bodies of water attract dragonflies and damselflies; these creatures are often called "mosquito hawks." The average dragonfly consumes hundreds of mosquitoes every day. Dragonfly larva also eat mosquito larva. And water gardens like mine contain fish, which eat  mosquito larvae in the pond.

I have goldfish, and I also bought several mosquito fish from my neighbor Doug Dupin, a mosquito warrior. Doug has been offering what he calls "victory ponds" to his neighbors. He describes these ponds as little fish bowls containing a plant and mosquito fish. The mosquitoes lay their eggs on the surface of the water, and the fish quickly snap them up.

Bill Eck, my Bartlett Tree rep who warned against toxic, commercial anti-mosquito treatments (see http://bit.ly/KOqVZo.), reassured me that my water pond, with its fish and constantly circulating water from the waterfall pump, was not a likely mosquito breeder. But -- just to be on the safe side -- I also toss in floating mosquito "donut dunks" that kill mosquito larvae.

Most residential mosquito problems originate from standing water in downspouts, pots, toys, tarps, etc. I have a jar of small pellets that contain the same chemical used in the donut dunks, and I toss a handful of the pellets into my bird bath and a downspout opening on the ground where water collects... and any other place where I see standing water that can't easily be dumped out. 

June 7, 2012

Coffee and Alzheimer's and Me: Finally! One of My Addictions Is Found To Be Healthy!

"We firmly believe that moderate coffee consumption can appreciably reduce your risk of Alzheimer's or delay its onset" (emphasis mine).

This welcome quote comes from Dr. Chuanhai Cao, a neurologist at the University of San Francisco College of Pharmacy and the USF Health Byrd Alzheimer's Institute. Dr. Cao was lead author of a study on coffee and Alzheimer's just published in the June 5 issue of the Journal of Alzheimer's Disease. (http://bit.ly/MfYSlr)

The study involved monitoring memory and thinking process in people older than 65 (my people!) during a two-to-four year period. It found that coffee consumption reduced the risk of Alzheimer's Disease (AD) even among those already showing signs of mild cognitive impairment (MCI),which is an early sign of AD or dementia. Patients with MCI experience some short-term memory loss (sounds like me) and initial Alzheimer's pathology in their brains (let's hope this isn't me).

June 6, 2012

The Mosquito War: A Commercial Overkill and A Hopeful Do-It-Myself


Recently, our terrific cul-de-sac neighborhood gang debated whether or not to sign up for the mosquito abatement program available from the “Mosquito Squad.” On the face of it, the issue seems like a no-brainer, right? After all, wouldn’t a summer free of bites and scratches be a fine thing?

I am glad our Eskridge Terrace group choose NOT to enlist the Mosquito Squad’s services, since their sprays, I've learned, could also kill bees and other “good insects”… to say nothing of the pesticide's danger to the fish in my pond.

The Toxic Overkill Approch
Last week, I was talking about our concerns with Bill Eck, my Bartlett Tree rep. After he explained the dangers involved in the treatment used by the Mosquito Squad, I asked him if he could recap his concerns in an email. Bill took it one step further, asking first for comments from Dr. Don Booth from Bartlett’s research lab. Here is Dr. Booth’s email to Bill:

June 5, 2012

Mindfulness Meditation Is a Big Hit at Google... and a Giant Step Toward World Peace

Google offers hundreds of free classes to its employees. One of the most popular is called "Search Inside Yourself" (SIY), a course developed by Chade-Meng Tan, the first engineer at Google to leave the engineering department and join its "people ops." Wouldn't you just know that Google would come up with a name like that for something the rest of the world calls "human resources"?

To promote innovation, Google allows its engineers to spend 20 percent of their time working on independent projects unrelated to their jobs. Tan and a few other Google engineers used that time to develop a program designed to help employees use mindfulness meditation and emotional intelligence techniques in both their professional and personal lives. They collaborated with experts outside the company, including a Zen master, a CEO, a Stanford University scientist, and Daniel Goleman, author of Emotional Intelligence: Why It Can Matter More Than IQ.

More than 1,000 Google employees have taken the class, and there's usually a waiting list of 30 when it's offered, four times a year. The seven-week course accepts 60 employee "students."

The class has three steps:
  1. Attention training
  2. Self-knowledge and self-mastery 
  3. Creation of useful mental habits 

June 4, 2012

Levodopa / Carbidopa Gel Pump: New Hope for People with Parkinson's?

Every so often, I see a new piece of information about Parkinson’s disease that really grabs my attention. This morning, it was an article published May 29 on the online site for the Parkinson’s Research Foundation about a 69-year-old PWP who has gotten significant relief from levodopa therapy delivered continuously by pump directly into his body. The device is called a Levodopa Carbidopa Intestinal Gel pump (LCIG). Available in Europe for about ten years, it is now being tested in the U.S.

Bob Van Housen has been living with PD for 12 years, and had gotten to the point where he was taking four pills every three hours just to control his symptoms. Occasionally, he needed even more. If Bob didn’t take his meds, he was unable to walk or drive.

Even when he was “maxed out” on pills, Bob’s wife Carol explained, he was spending about seven hours every day in an “off” condition – basically unable to function. Having been an active guy all his life, Bob was willing and eager to join the clinical trial at The Cleveland Clinic. There, he was fitted with a pump that could deliver the levodopa / carbidopa in gel form directly – and continuously -- into his small intestine through a kind of feeding tube.

According to clinic director Dr. Hubert Fernandez, “The small intestine is the largest area in our gastrointestinal system that absorbs the medication. The tube strategically ends there so that maximum absorption of the levodopa occurs.” The steady, uninterrupted administration of the drug releases the patient from the regular “on” and “off” periods that Parkinsonians experience with their pills.

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