Health for life

While the Disease Management Care Blog tries to be an equal opportunity cynic and generally sides with policy underdogs and lost causes, it supposes that its conservative leanings sometimes comes through in its writing. 

That was enough to prompt a series of well-written email exchanges with Greg Brown, a retired educator from the Kansas City area. He did a great job of compactly summarizing the views of supporters of the current version of health orm. 

It seems to boil down to five main arguments:

1. Medicare and Social Security: While passage of these landmark safety net programs was likewise met with deep concerns about the erosion of liberty, their ultimate success cannot be denied.  Most of the persons who are against the Affordable Care Act are ironically happy to have the feds appropriate a portion of their income in exchange for economic security in their old age. They cant have it both ways.

2. This is not buying shoes:  One role of the federal government is to step in when markets fail, and that has been amply demonstrated when it comes to health insurance. While its difficult enough to remember to even buy a product that you may not need, shopping for the best value in commercial insurance is practically impossible.  Proposals to expand this unworkable solution are a pipedream.

3. The public good: Keeping people from going bankrupt in the course of an unexpected illness is everyones interest.  Its ultimately a better bargain for society to proactively manage this with near-universal insurance than to deal with poverty after the fact.

4. Purchasing power: To date, Washington DC has chosen to not flex its purchasing power with providers.  Think of how much cheaper drugs would be if Medicare leveraged this for Part D.  Just wait until the happens in the rest of health care system and how much all of us will all benefit. 

4. Status quo: Even if you dont accept the track record of Medicare, the realities of buying insurance, the merits of a public good and the advantages of purchasing power, the status quo has led the U.S., compared to the rest of the developed world, to be a unsustainable per-capita cost outlier.  Something has to change. and theACA is doing just that.

I am not an expert by any stretch. I am just an interested layman. I really wish Obama had pushed for a single payer or at least a strong government alternative delivery system. But here we are and as imperfect as it is, it is the best thing I see on the horizon right now. It does at least attempt some cost controls, it broadens access, and it may lead to better quality with a focus on health outcomes rather than billable procedures. At least it attempts to address all three.

Image from Wikipedia

While aspirin has been shown to be effective in preventing heart attacks in men, it also increases the risk of gastrointestinal bleeding and possibly stroke, even at low doses. As such, national guidelines suggest that aspirin be used for prevention only in men at higher risk for cardiovascular events, so that the benefits of aspirin are greater than its adverse effects.

Recent data suggest that aspirin may also be effective for reducing cancer deaths. Would the possible combined health benefits of reducing heart attacks and cancer outweigh the risks of gastrointestinal bleeding and stroke for middle-aged men?

A research team, including UNC scientists, reports that including the positive effect of aspirin on cancer mortality influences the threshold for prescribing aspirin for primary prevention in men. The benefit of aspirin for cancer mortality prevention would help offset the risks and thus lower the age and increase the number of men for whom aspirin is recommended.

Their results were published in the June issue of the Journal of General Internal Medicine.

Michael Pignone, MD, MPH, and study lead author, says, “We found that including a risk reduction for cancer deaths had a substantial impact on the overall benefits of aspirin, especially for early middle-aged men from 45 to 55 years of age. Based on this effect, several million men who were not previously good candidates for aspirin prevention would now become eligible.

The U.S. Preventive Services Task Force, of which Dr. Pignone is a recently appointed member, recommends aspirin for primary prevention in men “when the potential benefit of a reduction in myocardial infarctions outweighs the potential harm of an increase in gastrointestinal hemorrhage.” This recommendation was issued in 2009, before the potential benefits for cancer reduction were recognized.

With the rising tide of juvenile type 2 diabetes, the debate on school lunches is one which is slowly starting to take the stage. It is, however, one of those subjects in which everyone has an opinion -- but not many have an actual evidence based opinion. Throw in the wrench that every school district is different, and youll find mudslinging from all sides of the opinion spectrum:

Why cant parents just make healthful lunches for students? 

Well, right now, some schools are actually BANNING parents from preparing school lunches for their kids, claiming it is the parents making unhealthful meal choices. Of course, this is often true... No one can deny that. But it also makes many of us with diabetic loved ones CRINGE at the thought of what a school cafeteria lady, or health department, might think is a healthful school lunch. These places often lack in options. Im thinking a main course of carbohydrates slathered in cheese and hot dogs, with a side of carbohydrates slathered in butter or salt, with a dessert full of carbohydrates, and a glass full of carbohydrates (because it has vitamins, so it must be good for your health, unlike that can of soda.) Your main sources of protein come from that powdered, grade A government issued cheese, and that powdered, grade A government issued milk. YAY. To top it off, throw an apple at it, for good measure, because apples make ANYTHING look healthy.

Some will argue, why cant parents just trust the school lunch system? 

I always got healthful meals from the school system, and I turned out JUST fine. I love these people the most. To them, anecdotal evidence is ALL the evidence that anyone will ever need, and it somehow, trumps everything. Its like seeing nothing but yellow parakeets, and assuming there are ONLY yellow parakeets in existence because thats all your local store carries. (Never mind that many of these folks have NO IDEA what a healthy meal even looks like, and tend to think that all a kid needs to do to stay healthy is to avoid candy and soda, and eat lots of fruitsandvegetables.)

Well, heres something that will blow your mind.

Did you know that the original idea of a  food pyramid started  as a way to help  ease food costs by spending money on basic,  cheaper foods, and still get nutrition? The rest  of the foods were meant as complements  to enhance whatever nutrients were missing.  Ever since the USDA started making low fat,  high carb recommendations in the 80s, and  implemented its OWN food pyramid in 1992,  obesity rates have skyrocketed.

The USDA describes their National School Lunch Program as: "a federally assisted meal program operating in public and nonprofit private schools and residential child care institutions. It provides nutritionally balanced, low-cost or free lunches to children each school day. The program was established under the National School Lunch Act, signed by President Harry Truman in 1946."

Right away, when you brush away the chaff... what should jump at you is the low-cost descriptor used in this paragraph. What does this, casually thrown in, adjective have to say about this program? What is hidden between the lines? Well, what they dont tell you is that the National School Lunch Program started as a way to help a poor, starving population, through government subsidies --  the same subsidies programs which are still, to this day, overpowering our agricultural industry, and making it possible to produce mass amounts of low quality, less nutritionally dense foods. (McDonalds anyone?) When you invest in low quality, less nutritionally dense foods, they become LOW-COST, and easy to mass market to a multitude of industries, and other countries. Smaller farms CANNOT compete with the HUGE agribusiness industry that has come to dominate the markets, including... you guessed it -- the school lunch program market. While the school lunch ladies, might VEND food for you, it usually comes pre-packaged, pre-made, or ready to make sources, and local state federal agencies will contract their local school lunch program to a food service management company, to save a few bucks. If your local school district does not contract to one of these, they are the EXCEPTION.

The three companies, right now, that dominate the industry are Aramark, Compass Group, and Sodexo. They mass market less nutritional foods, serve nutritionally imbalanced meals, cut corners to save dollars, and contract with fast food giants to market to kids -- yes, including, soda manufacturers. Not only that, but they have been under investigation in the past, for serving foods SO low in quality, they were rejected by fast food industry safety standards. (Its gotta take a lot of balls to serve a kid something WORSE than fake fast food meat.) They have such a strong arm in the system, many of them have been able to lobby, and block legislation that would improve standards, including legislation that would have banned soda vending machines in some schools, for example. 

So when you throw in less nutritionally dense foods (so, even if you have a small serving of them, theyre still not so great for you,) in an array of unbalanced meals (all carbs, and hardly anything else), no allowances for or enforcing of portion control (and just eat what you want, and how much you want of it), and the attending results of kids who will a.) not feel the stop and go of their hunger signals anymore, and b.) constantly feel hungry because they got no real nutrition, you will get increased likelihood of illness, development of chronic diseases, and a national fat kid tsunami.

Thats right... every time your kid eats at one of these national school lunch programs, its eating food thats probably worse than McDonalds. (And even if it would appear "balanced," the fact is... its still food that is nutritionally inferior. Remember that. Its like comparing a home made creme filled cake, to a Twinkie. They are technically, the same thing, but thats where it ends. One of them still has FIBER, and many, many vitamins and minerals. Ill let you guess which one that is.)

Are you freaked out yet? YOU SHOULD BE.

Still, some people have blind faith in their National School Lunch Programs... And disbelieve or disregard those who try to stand up against it, and call for change. (Including some politicians.) But folks are fighting BACK. 


Folks like Sarah Wu, who "compelled by her own frustration with school meals — both as a mother and a teacher ... known anonymously as "Mrs. Q." committed to eating school lunch every school day in 2010 just like her students. Mrs. Q documented her experience and described the meals by blogging, tweeting and sharing photos on her blog Fed Up With Lunch: The School Lunch Project." Her blog is one of the first blogs to help capture national attention on this very concerning issue. Mrs. Q risked her employment on this... and there were many days I worried shed get caught. Still, I cheered for her. Her voice has been effecting some serious awareness and change... but we need more.

More, nationally, as well as globally... Like little 9 year old, Martha Payne, from Scotland... who writes about her poor lunch school program at NeverSeconds. While youre not going to see her giving you an in-depth analysis on the corruption, and backdraft, of agribusiness subsidies... she will hold up every meal to critique, and scrutiny, so you can see with your own eyes what she and her peers are being served.

America is at a critical point, right now... we are at a point where its starting to matter very little what type of food you eat, because it was all cheaply made, and nutritionally bankrupt. Movies like "King Corn," "Supersize Me," and "Food, Inc.," have created some discussion... but quickly get swept under the rug as passing the buck, and not taking personal responsibility for what we eat. But we are clearly living in a very obesogenic environment where it is getting increasingly difficult to make right and wrong decisions, and increasingly easy to be deceived. Yes, a lot of foods that make false health claims have food labels, and we could be better trained and educated at reading them... but what if we thought we were eating meat, and instead were getting meat with an incredibly high risk of bacteria, and lots of corn filler? What if it was given to us by a school lunch program, with no labels (just trust), and not the you should know better, fast food industry?

Yes, we have freedom of choice, in America... as to what we eat. But to what EXTENT should we let the government and the food industry tamper with our food supplies? Market to us? To children who havent yet developed some of the necessary critical thinking skills, and disciplines, to make good life choices? (Especially, when they dont even have a parent around, to help...) Or to populations with less income, less education, and less access to nutritious alternatives?

The rights and freedoms of those who want to make me less healthy (and not just by consuming more fats and sugars, mind you), start mattering VERY LITTLE to me... when the lives of children, and the future of our nations are involved.

I dont know how ALL chronic illnesses, cancers, and autoimmune conditions come to pass... but sometimes, I have a very good idea what might be contributing to their explosion... And its not just having an extra piece of pie.

Theres no question that high levels of good cholesterol—also known as high-density lipoprotein (HDL)—seem to be protective against heart disease. Rather than depositing fat into the blood vessels the way the "bad" cholesterol (low-density lipoprotein (LDL)) does, HDL appears to carry cholesterol away from blood vessels to the liver. From there, the liver processes it for removal from the body.

However, adequate levels of HDL might not be enough. Several recent studies have suggested that many cases of heart disease occur in people with normal levels of HDL cholesterol. Consequently, some researchers believe that even if people have adequate amounts of HDL cholesterol, it might not work well. Such HDL may not fulfill this molecules other important duties in the body, such as reducing inflammation and acting as an antioxidant.

Because exercise has the potential to protect against heart disease in a variety of ways, Christian K. Roberts and his colleagues at UCLA tested whether HDL in men who weight trained regularly behaved in a healthier way than HDL in sedentary men. They found that the men who didnt exercise were more likely than those who weight trained to have dysfunctional HDL. Having faulty HDL was associated with numerous other risk factors for heart disease, including high triglycerides and a higher trunk fat mass. This finding held true regardless of the mens weight, which suggests that maintaining a "healthy" weight isnt as important for healthy cholesterol function as being active by regularly performing strength training.

The article is entitled "Untrained Young Men Have Dysfunctional HDL Compared to Strength Trained Men Irrespective of Body Weight Status." It appears in the Articles in PresS section of Journal of Applied Physiology, published by the American Physiological Society. It is available online at http://bit.ly/1eQgZ1u.

Methodology

The researchers worked with 90 men between the ages of 18 and 30 who already had established exercise habits. They separated these participants into three groups: lean men who weight trained at least four times each week, overweight men who also weight trained at least four times each week, and overweight men who had no structured exercise regimen. The researchers took some basic physical measurements from the volunteers, including height and weight, waist circumference, blood pressure, and body composition. They tested the volunteers muscle strength and their carotid artery thickness (a sign of heart disease), and they took a blood sample. The researchers analyzed that sample for a variety of different molecules present, including cholesterol, insulin, various markers for heart disease including triglycerides and C-reactive protein, and sex hormones. They also checked the volunteers HDL to see how well it functioned as an antioxidant, a sign of how well their HDL works in general.

Results

The study authors found that HDL functioned better in the participants who had a regular weight-lifting program, regardless of their weight—overweight exercisers HDL has similar effectiveness as an antioxidant as the lean exercisers HDL cholesterol. Both groups HDL performed significantly better than those who didnt exercise. Such dysfunctional HDL was associated with numerous other factors associated with heart disease, such as elevated triglycerides and trunk fat mass.

Importance of the Findings

These findings suggest that regular weight training might improve HDL function and protect against heart disease, even in those who remain overweight. Although indices of weight were associated with HDL cholesterol function, differences in fitness, the authors say, may be a better measure of who has healthier functioning HDL cholesterol, and theore, who is at risk of heart disease.

"The role of obesity in the risk of coronary heart disease may indeed be largely accounted for by differences in fitness," the authors say.

Beware, 7 The disease When Flooding | Ministry of Health, particularly the Directorate General of Disease Control and Environmental Health (PP & PL), again reminding the public of the threat of infectious diseases during the flood season.

Through electronic messages to Kompas.com, Wednesday (04/04/2012), Director General of PP and PL Prof. Dr. Tjandra Yoga Aditama said it also reminded the whole range of health care in the area and the technical implementation unit (UPT) P2PL DG-related issues availability of logistics, personnel preparedness enhanced surveillance for mapping vulnerable areas, and improved coordination, both across programs and across sectors.

In addition, P2PL also will alert the rapid response team at every level, to take immediate action when the discovery of a potential threat to the possibility of an increase in infectious diseases.

Tjandra explained, there are some infectious diseases to watch out for the public in relation to flooding and anticipation as the following steps:

1. Diarrhea. Diarrhea disease is closely associated with individual hygiene (personal hygiene). In the rainy season with high rainfall, the potential for increased flooding. At the time of flooding, sources of public drinking water, especially drinking water from shallow wells, will also corrupted. In addition, at the time of the flood evacuation would normally occur with limited facilities and the facilities department, including the availability of clean water. It all becomes a potential cause of diarrheal disease with rapid transmission.

Anticipations: the public are reminded to remain vigilant and avoid the attack of diarrheal diseases in a way, first, get used to washing hands with soap every time they eat or drink and after defecating. Second, get used to boil drinking water to the boil every day. Third, keep the environment clean, avoid piles of garbage in your neighborhood. fourth, contact the nearest health worker immediately if any symptoms of diarrhea.

2. Dengue fever. During the rainy season, usually there will be increased brood where Aedes aegypti mosquito, which is mosquito-borne dengue fever. This is because during the rainy season, much like the garbage cans, old tires, and certain places and there is a pool filled with water for some time. Puddle of water that eventually becomes a breeding ground for mosquitoes. With the increasing population of mosquitoes as transmitters of disease, the risk of infection also increased.

Anticipations: The community actively participating with the movement of 3 M, which buried the cans, drain the water reservoirs on a regular basis, and close the water storage in the meeting. In addition, the community is expected soon to bring family members to the health facility when one is ill with symptoms of high fever for no apparent reason, accompanied by signs of bleeding.

3. Leptospirosis disease. Leptospirosis disease is caused by bacteria called leptospires. This disease is one of zoonotic diseases transmitted by animals or for animals. In Indonesia, the animal is a rat-borne primarily through the feces and urine. In the rainy season, especially during floods, the rats that live in burrows of land will come out to save themselves. Mice will be hanging around human excrement and urine that mixes with water flooding. Someone who has a wound, then play or submerged in flood water that was mixed with feces or urine of mice that contain bacteria lepstopira, potentially infected and falling ill.

Anticipations: To avoid the onset of the disease leptospirosis, people are encouraged to perform anticipatory measures as follows: First, suppress the population and avoid the rats that roam the neighborhood, to always maintain the cleanliness. Second, avoid playing in the water during a flood, especially if you have injuries. Third, use protection, such as shoes, when forced to enter flooded areas. Fourth, immediately go to health facilities when sick have sudden symptoms of fever, headache, and chills.

4. Acute respiratory infections (ARI). The cause of ARI may baerupa bacteria, viruses, and various other microbes. The main symptoms can be btuk and fever. If severe, it may or may be accompanied by shortness of breath, chest pain, and others.

Handling: Rest, symptomatic treatment according to symptoms, and may be required to address the causes of causal treatment; increase endurance, and prevent transmission to the people around (eg by covering your mouth when you cough, do not spit at random). Factors such as the gathering of many people in flood-shelter also play a role in transmission of respiratory infection.

5. Skin diseases. Skin diseases can be infectious, allergic, or other forms. If the flood season comes, then the main problem is that good hygiene is not maintained. As well as the ISPA, gathering a lot of people also play a role in transmission of skin infections.

6. Other gastrointestinal diseases such as typhoid fever. In this case, food hygiene factors play an important role.

7. Worsening of chronic diseases that may indeed have suffered. This happens because the lower resistance due to a prolonged rainy season, especially when flooding for days.

Tjandra also recalls that people always maintain a clean healthy living behaviors (PHBs), eat a good, clean, adequate rest, and always do the hand washing with soap (CTPS). Instead, make CTPS while before eating, before preparing food, after defecation, after cleaning a child, and after being a dirty environment and animal environment.

Source: kompas.com

We live in a busy world. As much as we want to be able to stick to our normal gym schedule, life throws us scheduling curve balls: an emergency staff meeting, playing the chauffeur to and from soccer practice, that girl you met at the gym asks you to catch dinner tonight. These things happen. In order to stay faithful to your fitness goals, here are five quick fixes when time isnt on your side. Use these when youre in a pinch but still want to kick your endorphins into high gear.

1. Maximize Your Lunch Break

Most of us have a little bit of a reprieve during the day: those precious minutes we call our lunch break.  If you know that you wont have the time to make it to the gym today, use your lunch break to your advantage--you can maximize your down time while still giving your body the fuel it needs with an energy or protein bar, meal replacement, or protein shake. Many companies have on-site fitness facilities that can be used to get a full gym workout in. And when in doubt, take a walk around the neighborhood.


2. Watch Your Waistline

As important as exercise is to reaching your fitness goals, theres a second half to that equation: healthy eating. And unfortunately the office is where most of us throw that part out the window. If youre like me, your office is surrounded by delicious, but not always healthy, meal choices. And sometimes youre skipping a gym date for a fancy dinner date instead. Dont sabotage yourself. If you know you arent making the gym today, opt for food options that will help your goals: power foods like avocados, lean meats and other lean proteins, and good carbs like fruit.

3. Back to Basics

Hershel Walker, the great Heisman trophy-winning football player, Olympic bobsledder, and Mixed Martial Artist, chiseled his physique in three steps without really having to step into the gym: push-ups, sit-ups, and sprints. Try this: in between commercials on your favorite primetime program, perform twenty push-ups and sit-ups each. Repeat for all commercials in a one-hour programming block. Its the TV workout. And it will help you stay on track even when you cant get to the gym.

4. Make-Up Day

Every working man and woman values the two days at the end of the week like they were made of solid gold. But, if you skipped a gym day this week, use your weekend to make It up. You dont have to forgo your weekend either. Take a mountain biking trip, go for a hike, hit the beach for a fun run or some kayaking action. You can still enjoy your day off while getting that workout in.

5. Dont Beat Yourself Up

Remember, if you miss a day or two, its not the end of the world. Many times we need that rest. Just remember that its important to not get off track, because that can derail your fitness goals. If you skip a day, just work that much harder the next time youre in the gym.
_http://www.fitday.com/fitness-articles/fitness/5-quick-fixes-when-you-cant-get-to-the-gym.html

"I do what I have to do, so that I can do what I want to do."

Life is not a simple exercise for me. While it just seems to come naturally to some, its just not so, for me. Having a positive state of mind is a continuous choice I have to make, and it is a continuous decision to stop self destructive thoughts in their tracks, and choose to believe the positive mantras that might seem cheesy, or ludicrous to me.

I dont really know why I am like this... and I could psycho-analyze it to death, but Im not sure how helpful that would be. Im pretty sure that some of the hurdles Ive faced (especially in my childhood) have helped me develop a somewhat dim view of the world. Things like childhood obesity, a grim personal appearance (thanks to undiagnosed PCOS), constant exhaustion and mood swings (thanks to undiagnosed Hypothyroidism), uninvested parents and a lack of personal development, etc.

I felt so alone most of my childhood, and so inadequate, that I spent it trying to pursue instant gratification. In my teen years, eating and TV became my sole companions and comforts, while my family was mostly off in their own world. Its still like this today, you know. I dont get social phone calls from family, nor so much as a card on a birthday, or a holiday... and quite frankly, I dont remember the last time I got anything at all in the mail, from them, or even a social phone call. You can see why a child would try to drown itself with love in the form of whatever one came across -- be it food, or TV, or what have you. Pick your poison.

When one is swimming in loneliness, illness induced mood swings, life induced anxiety, and self loathing... it is extremely hard to have self control of any kind. Whether it be with your rigerator, or with your checkbook, or whatever brings you immediate release. Whats worse is that when you dont have deadlines or commitments of any kind, you can put off desperately needed changes, for as long as possible and tell yourself that tomorrow, you will start; but when someone tells you that you have NO choice, that its the hour zero and you need to buckle down, or else... your life turns into a shiny, red button. Do not press the shiny red button, they say... You must guard yourself to never press the shiny red button. Everyones anticipating, and policing you. Everyone knows.

History Eraser Button

This is what life is like for many of my fellow type 2 diabetics, right now... A shiny red button. Its easy to understand how one gets to that kind of place, and ever soooo hard to help someone get out of that place, see the light, and understand that although life may be smacking us with its behind (like the announcer guy on this Ren and Stimpy video), that we have a choice. We indeed have a choice, and our lives dont automatically go down the drain... Our destinies are not planned for us. We MAKE our own futures; we write them today.

There comes a time – or several times – in the course of things when eating healthfully and inexpensively goes right out the window. Maybe you’re working on a major project. Maybe you’re having a baby. Maybe you’re quitting your job, finding a new one, marrying, moving, or trying to get over the passing of a loved one. Rightfully, you have other concerns.

And you know what? That’s okay.

The Artist Formerly Known as Husband-Elect and I just wrapped up the busiest and most joyous month of our lives, during which we ate approximately two vegetables. (Wait. Is frosting a vegetable?) Preparing nutritious meals was next-to-dead-last on our list of priorities, just above keeping up with the Mets. (*grumble*) Instead, we were penning vows, seeing to the happiness of 140 loved ones, and entering a state of marital bliss unrivaled, even by a really good pot of macaroni and cheese.

Now, we’re home. The wedding festivities and pasta-packed honeymoon are over. We knew it would happen eventually. And with it done, it’s time to resume dietary normality. And once this time – this busy, emotionally haywire time – passes, you will, too.

Meanwhile, here are a few tips to get you through the rough parts.

Take it easy on yourself.
Order takeout. Choke down your five-minute hospital cafeteria lunch. Scarf that three-year-old bag of Sun Chips from HR’s vending machine. Because right now? At this very second? Keeping a budget and a strict calorie count doesn’t matter. What does matter: getting enough in your body to keep going. Forget the rest.

Remember, it’s only temporary.
Of course this doesn’t go for every situation. Kids are pretty permanent, and there are some jobs in which 70-hour weeks are the norm. But once you complete your task and/or get the hang of your new situation, everyday existence will become easier. I promise. Same goes for that interminable project, your inaugural home ownership, or even the tragedy that might consume your world right now. Time will pass, and there will be a dazzling light and pot of delicious turkey chili at the end of your seemingly endless tunnel.

Don’t be afraid to ask for help.
There are people who love you, and in pressured times, they will trip over themselves to feed, cook, or otherwise shove food into your mouth. If no one volunteers, go ahead and ask. Whether it’s a friend, a family member, or a benevolent government agency, somebody is going to step up. Never forget that, and try to do the same for others when you can.

Work good food in where you can.
Sporadically, in the midst of chaos, a cheap salad will present itself to you. (I think Confucius said that.) Eat it. A simple, occasional nod to nutrition will fuel you just as well as half a pizza. And if you can easily find a convenient provider of healthy, low-cost meals? Bonus. Food fuels mood, and keeping your spirits up is vital right now.

Do the best you can with what you have.
Forget keeping up with the Joneses. This ain’t the time. Use your available resources as best you can. If that means three weeks of pantry meals, so be it.

Pick a date to get back on the horse.
I don’t know about you, sweet readers, but I would do bupkis without deadlines. During nerve-racking periods, having that red-letter date provides a definitive end point for stress habits (ex: eating fast food), as well as a psychological starting point for new behaviors (ex: eating home-cooked meals). Plus, on a simpler emotional level, it’s just something to look forward to. Real world example: When projects devolved into anarchy at my old job, we repeated this like a mantra: “Think of it. Next Wednesday this will all be over.”

Help others in the same situation.
What goes around comes around. The love you take is equal to the love you make. Quid pro quo, Clarice. In other words: Pitch in, dearies. Somebody out there could use the assistance.

Readers, how do you eat during difficult or stressful periods? Do you agree or disagree with any of this advice? What practices make life easier? How can we best help others? The comment section is way open. Let’s help some brothers and sisters out.
_http://cheaphealthygood.blogspot.com/2010/10/when-not-to-eat-cheaply-healthy-and.html

This isnt exactly what I wanted to write about, tonight. Im not exactly an "on-schedule" blogger, but I know this is definitely not what I was expecting to write about, tonight.

[Before I proceed, though... I just want to say that I dont want ANY pity. No pity... No feeling sorry for me... No hurting for my circumstances. No advice on what I could have done better (I will rip you a new one, if you do, just be forewarned). Life is what it is, and we are all dealt... what we are dealt, sometimes. Whatever that is. There are people, right now, going through a LOT more difficult circumstances. They deserve our support... so dont you worry about me. Also, this post might have a lot of swearing.]

I just need to process, and I need to vent. So to heck with it.

... Where do I start, I dont know. Its such a blur,  now.

Last Sunday.

Last Sunday, running my hands through my hair, while wanting to put it up in a clasp, I found a large, swollen lump or area on the upper right side above the nape of my neck. It wasnt entirely dissimilar to the one on my left side, but distinctly swollen feeling, and sore if one put gentle pressure on it... and irradiating discomfort.

Of course, being The Angry Type 2 Diabetic that I am, I freaked out... said a few choice phrases rhyming with "What the fructose??" and sort of felt the clammy feel of panic rising up my spine. (You never want to feel that kind of panic when you have no insurance.)

I decided, though... that I was going to remain calm. (HA!) Just monitor it for the week, and wait until Thursday (today), for the Free Clinic, to get it checked out. As things sometimes go, I started feeling... unwell.  "Woozy," feverish... just uncomfortable from the growing pressure in that area of my head... The "soreness" was starting to radiate down to my right shoulder, down my neck... And today, well, it was just difficult to focus, at work, and I noticed I couldnt really walk a good distance without feeling... just weird. Light-headed. Nauseated. "Its okay, though," I thought... "Today is the Free Clinic, and theyll have a look at it."

Now, the Free Clinic in my town is basically a rat pack of some medical professionals of various ilks who volunteer to provide some basic/minimal health care to uninsured people, no questions asked, and which only generally meets on Thursday evenings, from 6-8 pm. You have to arrive at 4 pm, though, and make quite the long line. Waiting for care often averages between 4-6 hours... and its first come first served, of course. They can only see about 15 people.

The problem is... they used to have a somewhat permanent building, which has since been torn down by their tenant -- the next door church, while they make some new additions and changes to their facilities. So, the Free Clinic now has to share space with the next door church, and can only meet whenever the heck the church is not having some event. Which basically means... whenever a magic 8-ball decides.

I walk out there... just praying, praying under my breath that they are meeting. Lo and behold, as Murphys Law loves me so much... They are not meeting. I think its because of some stupid Pancake Day crap. I dont know. (Insert your personal sensibilities approved curses here.)

Then you have to make the tough decisions. Is this something that you think will go away; get better on its own? Am I overreacting? Is this... something that... could potentially get worse very quickly, and kill someone? Is this something that can be stopped, but it just needs immediate attention? I dont know... Do I go to the ER (because the local medical clinic is closed... and, even if it was open, they wont see me because I have no insurance and a hefty past medical bill that I cant prioritize to pay right now (dont judge me... you dont know me... and they wont let me pay anything less than an outrageous amount, every month...), while so underemployed and on food stamps...)? Or do I chance it?

Reluctantly, I decide... Im going to go to the ER. I dont want to be the freak on tomorrows front cover story that died within days, from something simple, or who knows what. The worst they can do is turn me away. And I was wrong. The worst they can do is shame me, while turning me away.

The doctor didnt even really look, or touch the area much. He basically pushed my hair around, said it looked exactly like the left side of my head, that he didnt see any physical injuries, and then asked have I ever cared to examine the left side of my head...

(Yes, doctor, the rest of us who arent doctors are certainly idiots... We go entire lifetimes NOT touching our own bodies.)

....and then proceeded to tell me it was probably just me being worried about it, or at the very most a resented lymph node. He dismissed my other symptoms with the wave of a hand, gave me a smirk and a suppressed laugh, and said that I need to just let it stay like that, and come back in a week if it got much worse (with big disbelief all over his face).

I tried, very unsuccessfully to get his attention. He just basically acted like I was bullshitting him, and walked off.

Nurse Patronizer walks in. Nurse Patronizer notices Im quite angry. I dont recall whatever tipped it off... (pffft!) But... Nurse Patronizer says to me "I dont know what you two discussed," and boy do I let the flood gates go... and I start crying, right there. She begs me to give her 5 minutes and goes off, basically to talk to Full of Himself Doctor, who says "Oh, she needs to just watch the area for 2 or 3 days (yeah, rather than a week, like he had said before... hmmm)..."

Nurse Patronizer repeated over and over again how it wasnt that I had no insurance, while at the same time pushing a flyer on me to go to the Free Clinic tonight.... After I had spent a good chunk of time explaining to them that the Free Clinic was closed. They wouldnt believe me, and kept asking me *why* it was closed. Now how in the &#$@ should *I* know?! All they had was a sign posted about "We will have No Free Clinic Tonight, 03/01/2012." Im not their schedule keepers!

So, really... hmmm... If you are not punishing me for not having insurance, then perhaps you were punishing me for your perceived notion that Im using the ER as a PCP providers office, and not waiting until whenever the heck THEY would have given me an appointment (should I had been able to get one, which I know from experience, that I would have not, because of my outstanding bill. I know how those jerks work, too.)

So, off they sent me... With apparently, a few "lessons" for the road:

• Youve lived with your body for 35 years... and are quite educated, Liz, but you dont know your own head;
• You have no insurance, and are underemployed, so you must be subhuman, or some mentally unstable person making stuff up... abusing our services;
• You are nothing more than money;
• I hope you dont die, but good luck. Suck it up, butter cup.

U.S. Department of Agriculture (USDA) nutritionist Susan Raatz, physiologist Matthew Picklo, and cooperators have found that farm-raised Atlantic salmon maintains its healthy levels of omega-3 fatty acids when baked.

Two omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), are abundant in oily fish such as salmon, tuna, mackerel, and herring. Some data have shown that consuming 250 milligrams daily of EPA and DHA—the amount found in a 3-ounce salmon fillet—is associated with reduced risk of heart-disease.

While eating seafood rich in omega-3 fatty acids is known to reduce risk of heart disease, it has not been known whether baking causes loss of omega-3s in farm-raised Atlantic salmon. The team also examined the extent to which baking Atlantic salmon alters healthful fatty acids through oxidation that leaves unhealthy compounds, such as toxic omega-3 oxidation byproducts.

The researchers demonstrated that baking salmon to the proper temperature does not decrease its content of beneficial omega-3 fatty acids. They found that baking actually decreases the presence of fatty acid oxidation byproducts. Preparing the fish based on restaurant and safety guidelines—to a tender-but-safe 145 degrees Fahrenheit rather than overcooking—was a key factor, according to authors.

The research was published in the Journal of Agricultural and Food Chemistry.