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Prescription Costs and Humor

In April, I usually try to write a humorous column in honor of April Fool’s Day.  Humor is vital to my health, and I believe there is a national shortage of levity. Today I’m keeping my blog short. I’ll leave it to you to judge whether this is comedy or tragedy, keeping in mind that humor often follows tragedy.

The following comes from a cartoon by John Carr:

A man is picking up a prescription at his local drugstore. The pharmacist says, “The good news is…at a thousand dollars a pill, it only takes five pills to meet your deductible.”

Unfortunately, this is all too true…However, I can’t tell you how often I’ve seen patients get high quality help and reduction of prescription costs from programs such as NeedyMeds. If you are facing high drug costs, ask for help. In the meantime, apply humor. Laughter may not cure all ills, but it sure makes them more bearable.

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Shingles, Vaccines and Picnics

Some of us are old enough to remember having preventable diseases. I recall measles, mumps, chicken pox and rubella (aka German measles). Each left a distinct memory.

Measles were the worst. I remember hallucinating from the high fever I had. My mother got them and we had to endure my father’s burnt toast and overcooked eggs for a few nights. I wasn’t very sick with German measles, but in the days before reliable contraception, we couldn’t leave the house, lest we infect any pregnant women.

Chicken pox were hideous, and I still have a couple of scars from them. I got mumps the last week of second grade. We had a school picnic and a field trip, so I didn’t tell anyone I was sick. However, my swollen neck betrayed me. I tried to suck in my cheeks and challenge the school nurse’s diagnosis, but she wasn’t having any of it. I was sent home.

These memories play a significant part in my decision to be vaccinated against any preventable disease. I don’t want to miss another picnic or take an unnecessary sick day again. I lived with hepatitis C for 25 years, a disease for which there is no vaccine. Life is short. So when I hear ‘vaccine,’ I’m all in.

On Tuesday, I was vaccinated against shingles. Shingrix is the newest version of this vaccine. I had the older version (Zostavax), a far less effective vaccine. Overall, Zostavax works about half of the time, dropping to about 18 percent in people over 80. I could see my 80-year-old self with shingles missing more than just the school picnic, so I got the Shingrix.  

If you’ve ever known anyone with shingles, you know how painful it is. We are talking pain that can last for months or even years. Approximately 1 in 3 people in the United States will develop shingles in their lifetime. That’s about a million cases a year in this country. Since risk of shingles increases with age, I thought it prudent to be vaccinated as soon as possible.

There is a Shingrix shortage, so it took a bit of patience and diligence to get the vaccine. Yes, I did get some side effects. My arm hurt a bit and is red. I felt tired and achy the day after. This is a normal immune response and tells me my immune system is doing exactly what it is supposed to do. It is NOT because of anything wrong.

The only side effect that I didn’t like was the cost. I paid $165, and since this is a 2-dose vaccine, presumably the second co-pay will be similar. The woman next to me paid only $20 for her vaccine. In other words, the cost depends on your insurance plan. I received the vaccine through my local pharmacy.

Here’s to life without shingles!

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National Donate Life Month

April is National Donate Life Month.  Most of us know that we can donate blood and our organs. Did you know that after you die, your skin can help burn victims? Your corneas can give sight to two people. Upon death, there is the potential to donate your heart, kidneys, lungs, pancreas, spleen, intestines, skin, bone, veins, lymph nodes, the entire eye or just the cornea, and soft tissue, such as ligaments, tendons, and muscle. Instead of the entire liver, sometimes only liver cells are used for transplantation purposes. Bone from two donors has kept my neck stable for decades. Thank you donors!

You don’t have to die to be an organ donor. Living donors made more than 6,000 transplants possible in 2017. Living donation saves two lives: the recipient and the next one on the deceased organ waiting list. Kidney and liver patients who are able to receive a living donor transplant can receive the best quality organ much sooner. It saves a lot of suffering.

From tissue to your entire body, the donation save lives and brings hope and relief to families and friends of recipients. You can also donate money to help keep donation programs solvent.  Click here to become a registered donor and proclaim your intention to help save lives.

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Exercise is not the best tool for weight loss. However, if you want to feel better, sleep better, reduce the risk of various chronic diseases, and feel like you can do everything better, exercise is the best tool in the toolbox. According to the Centers for Disease control and Prevention (CDC), some health benefits start immediately after activity, and even short bouts of physical activity are beneficial.

Studies show there is benefit to ANY physical activity. It can be slow and long or short and intense. It doesn’t matter if you do all your daily exercise at once or do it five minutes at a time. The point is to do something, and do it daily.

However, if you want to aim for precise goals, here are the recommendations from the Physical Activity Guidelines for Americans. “To attain the most health benefits from physical activity, adults need at least 150 to 300 minutes of moderate-intensity aerobic activity, like brisk walking or fast dancing, each week. Adults also need muscle-strengthening activity, like lifting weights or doing push-ups, at least 2 days each week.”

What is moderate to vigorous physical activity?

There are various was to measure intensity. I prefer the concept of relative intensity. Using this method, people pay attention to how physical activity affects their heart rate and breathing. Intensity level is subjective. What may be intense for one person may be less intense for someone else. For instance, I don’t play tennis, but if I were to try, I would probably be huffing and puffing after the first serve. On the other hand, I do aerobic dance, and it takes me a bit of effort to raise my heart rate.

In general, if you are doing moderate-intensity activity you can talk, but not sing, during the activity. If you are engaged in vigorous-intensity activity, you will not be able to say more than a few words without pausing for a breath.

According to the CDC, examples of moderate-intensity activity are:

  • Walking briskly (3 miles per hour or faster, but not race-walking)
  • Water aerobics
  • Bicycling slower than 10 miles per hour
  • Tennis (doubles)
  • Ballroom dancing
  • Gardening
  • Examples of vigorous-intensity activity are:
  • Race walking, jogging, or running
  • Swimming laps
  • Tennis (singles)
  • Aerobic dancing
  • Bicycling 10 miles per hour or faster
  • Jumping rope
  • Heavy gardening (continuous digging or hoeing)
  • Hiking uphill or with a heavy backpack

Not ready for this amount of activity? Any exercise is better than none. I don’t care if you are walking once around the table, it is better than sitting all the time. In fact, prolonged sitting is very unhealthy.

If you are new to exercise, be sure to talk to your medical provider before starting. Start slow and only do what feels comfortable. Most of all, do it. Find ways to battle every excuse. Make exercise a non-negotiable part of your life. It may be hard, but it is worth it.

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Most of us are familiar with the United States Food and Drug Administration (FDA). This agency is largely responsible for the regulation and safety of food and drugs in this country.  

Occasionally, the FDA attracts controversy. I am not going to step in to the storm of opinions about the FDA. Rather, I want to call readers’ attention to another organization, one without government ties: the Institute for Safe Medication Practices (ISMP).

ISMP is the first non-profit organization dedicated to the collaborative development, education, and advocacy of safe medication practices. It has been in existence for more than30 years. ISMP has an impressive record of improving safe medication practices.

Most recently, I received a notice of ISMP’s campaign to increase awareness about drugs that look-alike and sound-alike (LASA). ISMP has named these the List of Confused Drug Names.

ISMP recommends using the list to determine which medications require special safeguards to reduce the risk of errors and minimize harm. This may include strategies such as:

  • Using both the brand and generic names on prescriptions and labels
  • Including the purpose of the medication on prescriptions
  • Configuring computer selection screens to prevent look-alike names from appearing consecutively
  • Changing the appearance of look-alike product names to draw attention to their dissimilarities

Some of the drugs on the list are extremely common. Further, they aren’t medicines that I would want my doctor or pharmacist to confuse. For instance, if I am taking the anti-inflammatory medicine Celebrex, Cerebyx or Celexa would not be welcome substitutes.  It would be disastrous to confuse epinephrine and ephedrine.

You can reduce your risk of a medication error by taking an active role in your own health care. Here is how:

  • Learn about the medications you take. Read the package information. Ask questions and discuss your concerns with your doctor, pharmacist and other health care providers.
  • Be sure your health team knows all the prescriptions, supplements, recreational drugs and over-the-counter medication you are taking. Ask if there is potential for interactions between your drugs or any food that you might take.
  • Notify you health care provider about any medications that you’re allergic to or that have caused problems for you in the past.
  • Let your doctor know if you may be pregnant.
  • Never cut, crush or chew a pill unless your doctor or pharmacist says it’s safe.
  • When possible, use the same pharmacy for all your prescriptions.
  • Before taking a medication, check to see if it is on the LASA list. If so, ask your pharmacist to confirm that the drug he or she filled is indeed the one prescribed.
  • Report side effects or other reactions to your doctor.
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Health and Happiness

Last year I gave up pursuing happiness and I am happier for it. Actually, I gave up pursuing everything. Instead of trying to be a better meditator, exerciser, sleeper and eater, I removed all the shoulds, whips and carrots, and just let myself be alive. The irony is that now I am a better meditator, exerciser, sleeper and eater.

I attribute the change to 65 years of trying things that didn’t work. I think I just ran out of ways to fail and found something that works.

The other helpful tool is that I stumbled upon teachers that inspire me. It’s the proverbial, “When the student is ready, the teacher will appear.” The teachers appeared in Dan Harris’s 10% Happier podcast. Then I read his book. After that,  I downloaded a 7-day free trial of the 10% Happier app. It was so helpful, I plopped down the money for a year’s subscription. After 45 years of trying to meditate and spending most of the time wishing it was over, I now have an incredible meditation experience. I look forward to it, and am often surprised at how quickly the time passes.

Meditation is more than a tool for happiness; it’s a tool for health. Research reports solid evidence that meditating can help lower blood pressure, and decrease pain. Meditators demonstrate better cognition as well as improved immune systems. And these are just a few of the benefits.

Here are the really cool parts about meditation: it doesn’t cost anything, there are no negative side effects, and you can do it anywhere, anytime. A big upside with no downside other than it takes a few minutes every day. Is there anything stopping you from giving it a try?

Tip: If the 10% Happier app doesn’t fit in your budget, there are lots of free meditations on the 10% Happier podcast. And many of the guests on this podcast have their own podcasts and free meditations.

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