So many of us struggle with health issues, and poor insurance. At times, it can seem that we are helpless. This diary isn't intended for those with serious health problems and serious insurance issues, and my heart goes out to you! Also, let me be clear that I am not an MD. If you have an MD, and you have any health issues that are beyond the maintenance level, you should seek your MD's advice. And, of course, you should always seek an MDs advice before attempting to lose weight! (Yeah, right, as if...Disclaimers completed.)
What I am is an RN, one who does community health nursing and I work, everyday, with people who probably could have avoided their illnesses and/or added years of productive living if they had only known a few simple things, which I'll try to list below the fold.
First the obvious stuff: If you smoke, stop it. Right now. Just stop it. Most people who smoke think in terms of getting lung cancer, and they envision themselves dying from it. Well, you can wish it was that easy! You are far more likely to get COPD (Chronic obstructive pulmonary disease) and struggle for years to even breathe, while tethered to an oxygen line or if you've the energy to try to get out, hauling a portable oxygen tank with you. It takes an enormous amount of energy to breathe when you have COPD. And it is difficult to eat, because digestion takes away some of that energy, and the process of eating interferes with you being able to breathe. It is difficult to get enough nutrition when you have advanced COPD. You end up having to take drugs that can cause you to be shakey and interfere with your sleep, make you susceptable to bruising and rips in your skin from someone simply holding your arm to help you get up, weaken your bones and your immune system. While it is very sad, and very true, that some people get COPD for no known reason, most of them get it from smoking.
If you eat too many refined carbs and sugar, stop it. Right now. Just stop it. Not all carbs are bad, but refined white flour mixed with hydrogenated vegetable oils or starchy foods fried in them are killing us! Eat some veggies, switch to whole grain breads, brown rice. Treat yourself occasionally with something sweet, gooey, chocolatey or iced but don't make it a frequent indulgence! Make it for something really special, enjoy it thoroughly, and then go back to the food that your body craves for balance: complex carbs and unprocessed veggies and fruits.
Most people just worry about weight. Well, you can wish it was that easy! When you eat the typical American diet, you are setting yourself up for diabetes and high blood pressue, CAD (Coronary artery disease), CHF (Chronic heart failure). Yes, you could have a heart attack, but that isn't the worst of it. When you have CHF, your circulatory system fails because your heart can't handle the load any longer. Fluid builds up in your legs, feet and lungs. The skin begins to break down on your legs, and you get open, draining, painful wounds that are very difficult to heal and become infected easily. You get lung infections easily, and you have the energy and respiratory problems I mentioned with COPD, but you usually also have excess weight from fluid build up on top of it. The drugs that you take to ease the load on your heart can dehydrate you (even as the fluid build-up, called edema, continues in your legs and feet) and can cause your blood pressure to drop to levels that are so low you become dizzy and weak. It is an extremely difficult condition to control well, and unfortunately, it is very common. When you hear that heart disease is America's #1 killer, you think they mean heart attacks, don't you? Nope. They mean CHF.
Diabetes predisposes you to kidney problems, circulatory and heart problems (including CHF) and skin and eye problems. Avoid developing it. If you have it, keep your blood sugar under control. The easiest way to avoid it is to avoid sugar and simple carbs. Once you have it, you even have to limit good carbs like fruits and whole grains. Obesity can cause "insulin resistance". Your own pancreas produces insulin, which your body must have in order to digest carbohydrates. As you gain weight, it takes more and more insulin for your body to work correctly. Eventually, your pancreas just can't keep up any longer. You have become insulin resistant, and you will develop diabetes. (Note: I am fighting obesity myself. I know how hard it is. I wish there was a magic answer. It is far better to avoid getting fat in the first place, which is increasingly hard to do in our society. Childhood obesity is truly an epidemic, and I weep for every one of these kids. This is a healthcare crisis, largely brought about by the food industry and by cut-backs in the programs that used to provide -- back when I was a kid -- hot, nutritious school meals made onsite following sound dietary guidelines. There is something very wrong when fast foods and junk foods are sold in our schools.)
There are simple things that you can do to monitor your own health, once you stop smoking and start eating a healthy diet. They don't require prescriptions, or insurance.
You can monitor your own blood pressure and pulse, or attend health screenings that are held in various senior centers, drug stores, "health fairs", etc. There are several monitoring devices available for between $35 to $75. One fits around your wrist like a large watch, and several go around your upper arm. If your upper arm is too big for an arm cuff, by the way, you can put the cuff over your lower arm and center it so that the tubing runs down from your inner arm under your thumb. (Don't do it if you have carpal tunnel or circulatory/nerve damage in your hands)
Your blood pressure should be below 140/80 and above 90/50. If it is consistently above 130/70, make every effort to avoid salted food and quit adding salt to your food, cut down to less than 2 cups of coffee a day, and do whatever it is you do that makes you feel relaxed and mellow. Meditation is good, changing the channel to New Age or Jazz, even practicing slow and deep breathing when you're stuck in traffic or feeling time pressure.
You can monitor your own blood sugar and cholesterol. The devices that check blood sugar, called glucometers, are relatively cheap. It's the test strips that are expensive. The good news is that most glucometers come with 10 or 20 test strips. I purchased a disposable glucometer with 50 test strips that takes up about as much room as a "C" battery for $35. Test strips are usually good for about a year if you don't get them wet or expose them to high humidity or heat. If you're not diabetic, you can test yourself 10 times during a year for less than $20 with a regular glucometer such as an Accuchek or One Touch, and most of those come with a relatively painless automatic lancet holder that quickly zaps your finger in order to get blood. Many can now be used on your forearm, also. You have to have lancets in order to poke your finger, so if the glucometer doesn't come with them (and again, most do come with about 10 lancets and 10 test strips, which are good for a year, usually) you need to buy a box of them.
Test your blood sugar first thing after you wake up before you eat anything; this is a "fasting blood sugar" and should be between 70 and 110. If it's between 110 and 140, watch your diet, as above and monitor it at least every few days until it is consistently below 110 and then avoid sugar like the plague and test it every month or so. It it's over 150, you have a problem. You really need to consult an MD. It's well worth the cost of the office visit, and if you don't have insurance to cover medication, tell the MD. Many of them have samples they will hook you up with, and they will try to prescribe meds that are less expensive if they can. If you control diabetes early, you stand a much better chance of avoiding the kidney, heart and eye problems that so many people develop before they even know they're diabetic.
Cholesterol testing kits are a bit more expensive, but work the same way: poke your finger, do the test. They come with instructions on foods to avoid eating for a day or so before you do the test, and with normal and abnormal result numbers. If your cholesterol is slightly elevated, eliminating shellfish, egg yolks, saturated fats and red meat may help and you should certainly try to do that, but your own body produces cholesterol and some people who eat very healthy diets and are outwardly very lean and toned have outrageously high cholesterol levels. If it doesn't come down, again, the expense of an MD visit is well worth it to avoid having a heart attack or stroke, or eventually developing CAD and needing invasive procedures to roto-root your blood vessels and keep your circulation normal.
Get a flu shot every winter. Avoid people who are obviously ill with colds or coughing. Wash your hands frequently, and carry a bottle of hand sanitizer in your car or your backpack, and use it after you touch anything that is touched by other people: ATMs, grocery carts, money from the cashier, etc. You don't have to be a dweeb about this and whip out the sanitizer then and there, but avoid touching your face or your kids until you discreetly are able to "wash" your hands.
If you're sick, stay home. If your boss demands that you come to work or that you go to the doctor to get an "excuse", it's on her head when the whole place comes down with what you've got. Always wash your hands after using the bathroom. It's estimated that about half the population doesn't do this, despite their insistence that they do. And you can't just wave your hands at the water, you have to wash for about 45 seconds and rub your hands vigorously together to clean them. Use a towel to open the bathroom door in a public restroom when you leave, and pitch it into the waste can while holding the door open with a foot. (Remember, almost half of the public doesn't wash their hands, and many who do don't do it long enough, and they touched that door)
If you have been on antibiotics, or if you know you've been overdoing it with sugar and you feel sluggish, or if you are getting itchy skin under your belly or other skin fold areas, your digestive system could probably use some Acidophillus/Lactobacillus -- get the capsules or tablets from a health food store, or commit to eating a container of live-culture yogurt daily for a month. It is amazing what this can do to help balance your system!
If you are a reasonably healthy adult and do these things, chances are good that you will avoid many of the health problems that you will need insurance for and that you will catch problems before they get out of control.
Final disclaimer: It is a really good idea to go to see your MD at least once a year, even if you have to pay for it. Keep records of your blood pressure, blood sugar and cholesterol, if you do the tests at home, and take them with you. Inform the MD of any over the counter medications that you routinely take. Let the MD know if you don't have insurance to pay for lab tests that are routinely ordered, and if you really need to have labs or x-rays done, find out what they will cost so it isn't a shock when the bill arrives. If you are having chest pain or gasping for breath, or spurting blood, for the love of God just call 911. Don't wait to see if it gets better by the morning. The quicker you get treated for a stroke or a heart attack, the less expensive it will be in the long run and your loved ones will appreciate your thoughtfulness in keeping yourself alive so that they may continue to enjoy your love and fellowship. Don't try to drive yourself to the hospital, and don't ask your loved ones to do it. The EMTs do this for a living and they're very good at it, and they don't think you're being dramatic or silly to call 911.
May we all have good health and happiness in the coming year, and may we get a single payor health system soon!
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California Nurses Association