Budget ACA: 3-10 Essential Benefits, 2nd Edition, by J.D. Meyer

1. Ambulatory patient services. [Outpatient care]
2. Emergency services.
3. Hospitalization. [Inpatient care]
4. Maternity and newborn care
5.Mental health and substance use disorder services, including behavioral health treatment.
6. Prescription drugs.
7. Rehabilitative and habilitative services and devices.
8. Laboratory services
9. Preventive and wellness services and chronic disease management;
10. Pediatric services, including oral and vision care.

Health insurance plans must cover these benefits https://en.wikipedia.org/wiki/Essential_health_benefits

Right now, it’s all ten or none. Pay a fine if you choose none……. How about a budget version: (2) Emergency Services, (6) Prescription Drugs, & (1) Ambulatory patient services [Outpatient care]? Limit eligible clients to those who make $20K/year or less.

Let’s change the paradigm from younger healthy people would rather pay a fine than go for all ten. My new proposed paradigm is let the poor choose the three most important!

I know what it’s like to work over 40 hours/week with three part-time jobs and no insurance: adjunct instructor at a community college, construction assistant, and substitute teacher. This was my career from 1994-1999. I’d developed asthma in 1987. Trust me, summer is construction asst. only, and that faded out of the picture after I got a full-time teaching job (2001-2006), followed by COPD (2005).

Why did I choose those three benefits? Emergency Room visits are very expensive, and in the USA, we let the sickly get help and hopefully pay later. I got on Medicaid by showing my record of ER visits from 2008-2012 to social workers, despite living in Texas—the largest state not to expand Medicaid.

I could afford an inhaler and nebulizer fluid, but not Advair. Fortunately, I learned about botanicas from living in a predominantly Mexican-American neighborhood and got gordolobo (mullein leaves) and eucalyptus.

I went to clinics that generally served the poorer part of the population. Through “Ambulatory patient care [Outpatient care],” more would be able to afford the office visits themselves and have a regular doctor.

I hope my “Budget ACA: 3-10” brings a helpful new angle to American Health Care. It’s such a hotly debated topic, and we seem to have more difficulties than most OECD nations. My first edition was mistaken in choosing 9. Preventive and Wellness Services and Chronic Disease Management over 1. Ambulatory Patient Services [Outpatient care]. Outpatient care is more basic.I bet plenty of poor people would rather buy “Budget ACA: 3-10” than pay a fine–looking forward to feedback.

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Art of Peace Statement 2017, by J.D. Meyer

The Art of Peace implies a wide range of peace-making efforts. I’m going to analyze this issue according to four views: (1)my North Korea approach, (2) health, (3) apprenticeships, (4) the fiscally responsible approach to defending DACA and fighting The Wall. But first, I’d like to give an account of my spiritual experience some 30 years ago like a previous speaker. Self-confidence in one’s sincerity is the goal of the unity of knowledge and action (chih hsing ho-i). “Spontaneity as conforming to pattern-principle” (tzu-jan chi li) is another way to express having self-confidence in one’s sincerity.

I‘m a devout Twitter fan. I offered a different view of the North Korea crisis. “#NorthKorea wants praise for its nuclear weapons as a cash crop—their only crop! Make sure the bomb isn’t ticking #Diplomacy,”

I’m a member of COPD internet support groups and have written about health issues on my Word Press blog. Wear oxygen canula under your nebulizer mask to improve its efficiency. Also utilize your C-PAP while awake to end a bad exacerbation. I helped a depressed diabetic friend recently by telling her about the benefits of eating cactus (nopalitos). I buy my cactus already sliced, usually pickled in a jar. I don’t battle the quills.

How about more apprenticeships, as proposed by Tim Kaine and three other senators? The business would get a tax break, and the intern would make some money while they learned a valuable trade. People with a good job are more likely to be peaceful.

I’m a member of the local Indivisible group, a Fareed Zakaria Fan Club, and related closed Facebook groups. Let’s defend DACA and renounce Trump’s Wall through fiscal responsibility. It would take an average of $10.4K per person to expel a Dreamer. Moreover, we’ve heard many big business honchos, such as Mark Zuckerberg, protest against this proposal. Check out Congressman Henry Cuellar (D–Laredo, TX). 40% of agriculture workers overstay their visas. The Rio Grande is safer than the U.S. average. A wall is a “14th Century solution.” Texas Republican Senator, John Cornyn, prefers drones in environmentally-sensitive areas, such as the Santa Ana Refuge. The Wall would hurt ecotourism and reduce money coming into South Texas, among other atrocities. So when I say, let’s save focusing on humaneness concerns for a future generation, I sound like Booker T. Washington in a parallel universe!

So now we’ve examined a variety of ways to make peace. The possibilities are endless. To conclude, try to bring serious data to your argument in this hot-headed era. Strong self-respect is important; don’t let yourself get run over. For improving self-knowledge, check out a free online MBTI-style site, such as http://www.16personalities.com

COPD Dude Goes to a Chiropractor with the Impulse Adjusting Instrument, by J.D. Meyer

I taught for 20 years, especially Developmental English/Writing & ESOL–before my COPD got too bad. Now I’m on SSDI with Medicare, Medicaid, and Cigna Health Spring insurance. I have gone to chiropractors on a regular basis twice in my life–after my asthma diagnosis and need for an albuterol nebulizer, but before the COPD verdict: emphysema and bronchitis.

Bratcher Chiropractic is a father-son team and the only Cigna-approved chiropractors in Tyler, Texas. The chiropractic science has really changed in the last fourteen years! There’s no more roller ball on a table kneading your back like bread dough, followed by the doc popping you with his hands in the three regions of your back. Nowadays, there’s a wild little machine that looks like a home construction tool called the Impulse Adjustment Instrument, and it is wonderful! The pamphlet describes the benefits as (1) Extreme Speed, (2) Controlled Force, and (3) Frequency Tuned Waveform.

The Extreme Speed refers to the Impulse being “twice as fast as other adjusting instruments, and 100x faster than manual adjustments. The gentle thrust is faster than the body’s tendency to tighten up and resist the adjustment.” Believe me, my neck used to be very resistant to popping by hand! Controlled Force describes the “three different force settings for different parts of the body and to treat patients of all ages.” Frequency Tuned Waveform shows that the “Impulse is specifically tuned to the natural frequency of the body that joints, muscles, and nerves respond.” The impulse is “controlled by micro-computer circuitry housed within the device.”The Impulse Adjusting Instrument is patented and an FDA (Food & Drug Administration) registered device.

So far (three visits), my doctor has commented that I only have 50% movement in my neck and a dislocated rib cage! It turns out that the bad lung crowd is vulnerable to such rib cage issues. The sessions are really faster than chiropractic treatments of yesteryear.

By the way, I quit driving a car several years ago, and have become a recognized authority on the the Tyler Transit. It’s a journey starting with Purple South (or Red South), followed by Yellow SW. This time on the way back, I just took one bus to the second hub–Bergfeld Center and walked the 1.3 miles home.

When I got home, I happily made the following announcement, “I just overcame a mental block. For the first time, I walked home from Bergfeld Center (actually the CVS to be exact). I walked down Broadway to beautiful Charnwood, then crossed over to Houston from tiny Niblack. I had just been to Bratcher Chiropractic. My FEV (Forced Exhale Volume–peak flow meter) was a staggeringly high (for me) 350 upon entering my place!!….Many times I’ve walked home from La Michoacana and Downtown–roughly the same distance. …Ready for the I have a Dream event Downtown at 6:30.”

I will be going to Bratcher Chiropractic twice a week for several weeks. While I wait for the Yellow SW to return, I’ve gone to a Wal-Mart grocery store in search of strong cheap red wine and beer, granola bars, and spicy Taki snacks. My backpack contains reading and writing material, along with my lined canvas bag for groceries–and even lunch. So my adventure is more than medical, it’s travel to an unfamiliar part of the city for me.

I’m keeping my G.P. and pulmonologist updated on my progress–a practice that reveals my love of teaching and research. Remember those middle back vertebrae are connected to your lungs. Consider getting chiropractic treatment if you have asthma or COPD.

When fat becomes really dangerous! from Fit for Fun, RT by Johanna Fellner (English/German)

When fat becomes really dangerous!
The majority of us are afraid of being overweight. Latest research says: right! How to measure it yourself – and when it becomes dangerous …
From Fit for Fun, Found by Johanna Fellner @FellnerJohanna, Originally in German, English by Google Translate

A few more pounds on the ribs? Och, is not so bad – fitte Thickness are still healthier than slack slender, right?
No, unfortunately probably not.
The latest research at University College London, reported in the summer of 2017, confirms the theory that weight gain is a risk factor even if blood pressure, glucose and cholesterol are normal, “says Camille Lassale, In comparison, 7,000 people with heart disease were already suffering from heart disease. According to this, blood pressure and blood values are the most important and meaningful parameters for their own healthy well-being, however
With increasing weight our metabolism suffers and comes more and more frequently near or in the red area.
The assumption of the researchers: The metabolism in the still “healthy thicknesses” had the negative development only not completed completely, but the “fat end” will follow in the Wortsinne. Your final thesis: “The concept of the healthy overweight is no longer valid!”
• Be that as it may, whoever wants to know precisely about the overweight, should not go after feeling, but should use serious measuring methods. It is best to combine three methods: Then you know exactly whether you are overweight or not!

Overweight Recognize: 1. Body Mass Index

For a long time, it was considered the measure of all things and divided into the categories under, normal and overweight as well as obesity. The formula for calculating the body mass index is: Body weight in kilograms, divided by body size in meters to the square (For our BMI calculator). For example, a woman weighing 68 kilograms, which is 1.70 meters tall, would have a value of 23.5. This would be within the range of normal weight.

Overweight starts at a value of over 25. For values over 30 of overweight or overweight, also called obesity. The problem with the BMI is that the index does not distinguish between fat and muscle mass, so that a well-trained athlete could be in the overweight area, although he is top-fit and extremely muscular. Example: Box World Champion Wladimir Klitschko! Here the formula does not apply, and other factors must be added.

Identify overweight: 2. Body fat percentage

The body fat percentage says something about the distribution of fat and muscle mass.
The value can be a good addition to the BMI and goes beyond simply determining the overweight.
For measuring, there are several methods – for example, the Caliper method, in which the thickness of the fat deposits is measured at different body points with a kind of pincers. Or the impedance measurement: a weak current is sent through the body and an analysis of the tissue is made on the basis of the resistance. The impedance measurement also provides information on the water content of the body. Both should be best done by the doctor.

Body fetuses for private use can also provide an indication and, above all, document a development in diet or training. However, they often only measure the upper or lower body. The lower body measurement, for example, often results in very high values in women with the typical pear figure (rich po and thigh), since they have stored a lot of fat there – but this can not be transferred to the entire body. Women naturally have higher values than men, and are already feeling more often with overweight.
How much body fat you can have: Click here!

Overweight Recognize: 3. Belly circumference

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Sounds banal, however, is quite meaningful – especially with regard to the health risk of overweight. Because the inner stomach fat is particularly metabolic-active and carries the main debt of diseases such as diabetes, hypertension or metabolic disorders.
• For men, an increased risk starts with an extent of 94 centimeters, from 102 it is markedly increased.
• For women: increased risk from 80 cm, markedly increased from 88 cm.
To measure simply place a measuring tape around the abdomen loosely around the belly. It is best to measure in the morning before breakfast and breathe out easily.

The FIT FOR FUN-DIET as E-BOOK

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Ab wann Fett wirklich gefährlich wird!
Vor Übergewicht fürchten sich die Meisten von uns. Neueste Forschung sagt: zu recht! Wie du es selbst messen kannst – und wann es gefährlich wird …

Ein paar Pfunde mehr auf den Rippen? Och, ist doch gar nicht so schlimm – fitte Dicke sind doch immer noch gesünder als schlaffe Schlanke, oder?
Nein, leider wohl eher nicht.
Neueste Forschungen am University College London, über die im Sommer 2017 berichtet wird, erhärten die Theorie, dass bei Übergewichtigen “zusätzliches Gewicht ein Risikofaktor ist, auch wenn Blutdruck, Blutzucker und Cholesterin normal sind”, wie es Studienleiterin Camille Lassale ausdrückt. Verglichen wurden dabei 7000 bereits herzkranke Menschen mit herzgesunden Menschen. Demnach sind Blutdruck und Blutwerte für das eigene gesunde Wohlbefinden zwar die wichtigeren und aussagekräftigeren Parameter, aber
mit steigendem Gewicht leidet unser Stoffwechsel und kommt immer häufiger nahe oder in den roten Bereich.
Die Annahme der Forscher: Der Stoffwechsel bei den noch “gesunden Dicken” habe die Negativ-Entwicklung nur noch nicht komplett vollgezogen, das “dicke Ende” werde aber im Wortsinne nachkommen. Ihre finale These: “Das Konzept von den gesunden Übergewichtigen gilt nicht mehr!”
• Wie dem auch sei: Wer es beim Übergewicht genau wissen will, sollte nicht nach dem Gefühl gehen, sondern seriöse Messmethoden anwenden. Am besten ist es sogar, du kombinierst drei Methoden: Dann weißt du genau, ob du übergewichtig bist oder nicht!

Übergewicht erkennen: 1. Body-Mass-Index

Er galt lange als das Maß aller Dinge und teilt in die Kategorien Unter-, Normal- und Übergewicht sowie Fettleibigkeit ein. Die Formel zum Berechnen des Body-Mass-Index lautet: Körpergewicht in Kilogramm, geteilt durch Körpergröße in Metern zum Quadrat (Hier geht´s zu unserem BMI-Rechner). Bei einer 68 Kilogramm schweren Frau, die 1,70 Meter groß ist wäre das zum Beispiel ein Wert von 23,5. Das würde im Bereich des Normalgewichts liegen.

Übergewicht beginnt bei einem Wert von über 25. Bei Werten über 30 von krankhaftem Übergewicht beziehungsweise Fettsucht, auch Adipositas genannt. Das Problem beim BMI: Der Index unterscheidet nicht zwischen Fett und Muskelmasse, so dass ein durchtrainierter Sportler im Übergewichtsbereich landen könnte, obwohl er topfit und extrem muskulös ist. Beispiel dafür: Box-Exweltmeister Wladimir Klitschko! Hier greift die Formel nicht, und es müssen weitere Faktoren hinzugezogen werden.

Übergewicht erkennen: 2. Körperfettanteil
Der Körperfettanteil sagt etwas über die Verteilung von Fett- und Muskelmasse aus.
Der Wert kann eine gute Ergänzung zum BMI darstellen und geht über die reine Ermittlung von Übergewicht hinaus.
Zur Messung gibt es verschiedene Methoden – etwa die Caliper-Methode, bei der mit einer Art Kneifzange die Dicke der Fettfallen an verschiedenen Körperstellen gemessen wird. Oder die Impedanzmessung: Dabei wird ein schwacher Strom durch den Körper geschickt und anhand des Widerstands eine Analyse des Gewebes erstellt. Die Impedanzmessung liefert zusätzlich Informationen über den Wassergehalt des Körpers. Beides sollte am besten vom Arzt gemacht werden.

Körperfettwaagen für den Privatgebrauch können ebenfalls einen Anhaltspunkt liefern und vor allem eine Entwicklung bei Diät oder Training dokumentieren. Sie messen allerdings oft nur den Ober- oder Unterkörper. Die Unterkörpermessung beispielsweise ergibt bei Frauen mit der typischen Birnenfigur (üppiger Po und Schenkel) oft sehr hohe Werte, da sie eben dort viel Fett eingelagert haben – was jedoch nicht auf den gesamten Körper übertragbar ist. Frauen haben naturgemäß ohnehin höhere Werte als Männer und schlagen sich schon deswegen gefühlt öfter mit Übergewicht herum.
Wie viel Körperfett du haben darfst: Klick das hier!
Übergewicht erkennen: 3. Bauchumfang

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Klingt banal, ist jedoch ziemlich aussagefähig – vor allem im Hinblick auf das gesundheitliche Risiko von Übergewicht. Denn das innere Bauchfett ist besonders stoffwechselaktiv und trägt die Hauptschuld an Krankheiten wie Diabetes, Bluthochdruck oder Stoffwechselstörungen.
• Für Männer beginnt ein erhöhtes Risiko ab einem Umfang von 94 Zentimetern, ab 102 ist es deutlich erhöht.
• Für Frauen: erhöhtes Risiko ab 80 cm, deutlich erhöht ab 88 cm.
Zur Messung einfach ein Maßband etwa in Bauchnabelhöhe locker um den Bauch legen. Am besten misst du morgens vor dem Frühstück und atmest dabei leicht aus.

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When fat becomes really dangerous!

2017 NE TX Community Health Worker Coalition Conference, By J.D. Meyer

The 2017 Northeast Texas Community Health Worker (CHW) Coalition Conference was held on July 14th at TJC West. According to the official booklet, the CHW conference addresses “the role CHW Workers/Instructors play in creating access to care, reducing care costs, and promoting health and happy communities.” The Conference stressed “the importance of CHW(I)’s reducing health disparities; return on investment; and methods of overcoming barriers to CHW(I) program success.” Participants who attended the entire conference received six CEU (Continuing Education Units). “Presentations can be downloaded after the conference at the following link: http://tinyurl.com/y7brtht7

There were three main presentations. “The CHW and Public Health: The UT Health NE Experience,” was delivered by Jeffrey L. Levin, M.D. “Creating and Maintaining Health Workplace Environments,” was given by Terrence Ates, M.ED and Detective John Ragland. “CHW Self-Care—Focusing on You While Giving to the Community,” was presented by LaShonda Malrey-Horne, MPH.
The CHW of the Year was presented to the late Cynthia Keppard, the former director of the NE TX CHW Coalition. Several of her family members were in attendance.
There were three Breakout Sessions also—a choice of 18 sessions. First, I attended “Helping Clients Self Manage Chronic Disease,” by Marcus Wade, LMSW & CHWI. Then I went to “A Community Health Worker’s Guide to Texercise Classic,” by Jeanie Gallegly, MS & CHWI. The last breakout session for me was “Tobacco Danger,” by Lana Herriman, BS.
There were several organizations serving as vendors and sponsors. For example, I was able to pick up the Cigna Health Spring Provider Directory and Over-the-Counter Products Catalog in the lobby. Lunch was from Jason’s Subs; snacks were available too. Once again, the annual NE TX CHW Coalition Conference was a success that drew a huge crowd.

SOL17: World Asthma Day, Publicizing Dr. Tedros of Ethiopia for Director of WHO, etc.

I’m a retired teacher, disabled due to asthma and COPD. I developed asthma in 1987 and COPD in 2005. I got on SSDI in 2010. By 2012, I was on Medicare and Medicaid and had moved to the Hospital District, aka. Midtown, in Tyler, Texas–my third neighborhood in the largest city in East Texas.

Nowadays, I spend much of my time on Twitter and Facebook. I was happy to see that World Asthma Day fell on Slice of Life Tuesday today. One of the best articles that I read today was about the reasons for the rise in inhaler prices–a chilling indictment of “Big Pharma.” http://www.motherjones.com/environment/2011/07/cost-increase-asthma-inhalers-expensiveWhy You’re Paying More to Breathe

The happiest pack of articles that I’ve encountered lately is about Dr. Tedros of Ethiopia–the leading candidate for Director of the World Health Organization (WHO). http://www.huffingtonpost.com/entry/dr-tedros-is-the-leader-the-who-needs_us_59075cd2e4b03b105b44ba96?ncid=engmodushpmg00000004 Dr. Tedros is the Leader that WHO Needs

A sad article that I read was about Trump ending Michelle Obama’s program, “Let Girls Learn.” http://www.dailykos.com/story/2017/5/1/1657898/-Trump-administration-ends-Michelle-Obama-program-to-educate-girls-and-lift-them-out-of-povertyTrump administration ends Michelle Obama program to educate girls and lift them out of poverty Then I had a great idea. What if Dr. Tudros is able to revive Mrs. Obama’s program if he’s elected Director of WHO!

A different type of sad article shows that pollution causes lung disease. India is the most polluted country in the world with 13 of the 20 worst cities. Anti-asthma medicine has increased a staggering 43% in the past four years. Furthermore, it’s harder to measure the effects of air pollution in rural areas. Climate change is a big issue in political debate, despite its near unanimous recognition by science. However, how can pollution be denied at all? http://www.hindustantimes.com/health/world-asthma-day-india-chokes-sales-of-medicines-rise-43-in-4-years/story-mt5V9Kdqv4yGF062ZOmC6I.html World Asthma Day: India chokes, sales of medicines rise 43% in 4 years

To conclude, I started with the reasons for the rising cost of asthma inhalers, a graphic view of the actions of “Big Pharma.” Then I lamented the end of Michelle Obama’s project, “Let Girls Learn. ” Educated girls are more likely to be healthy and maybe wealthy. Then I campaigned for Dr. Turkos of Ethiopia for Director of the World Health Organization (WHO). Ethiopia has experienced dramatic health improvement through his guidance. I speculated that he may be able to save Mr. Obama’s project. Finally, I ended with the increase in asthma in India due to its air pollution. Nobody tries to deny that pollution can cause health problems. To conclude, improving health not only involves medical advances, but sound political decisions and cleaning up the planet!

Dealing with a Bad COPD Exacerbation & Maybe Dodging an E.R. Visit (3rd Edition)

By J.D. (“Joffre”) Meyer
Those of us with COPD (Chronic Obstructive Pulmonary Disorder) live with the strong risk of an exacerbation that is severe enough to go to the Emergency Room by way of ambulance. I developed asthma 18 years before COPD too. We face a mix of lung spasms, excess chest phlegm, and a low FEV (Forced Exhale Volume). Asthma-COPD Overlap Syndrome (ACOS) is known for increased breathlessness and sputum–but a better response to inhaled corticosteroids.

It’s typical for me to have some coughing and wheezing when I awake, and sometimes after a walk. Choice #1 is using an asthma rescue inhaler, such as Pro-Air. It’s like a “Bud Light” version of the nebulizer, as both use albuterol. But the likelihood of its effectiveness goes downhill if our attack is more than simply mild. Rule #2 is not to take the long-term inhalers during an acute attack, such as Advair or Symbicort, and Singulair.

So we go for our dear friend, the nebulizer, and pour a vial of albuterol or albuterol-ipratropium in the receptacle. We get “Albut-Iprat” when our condition becomes worse. I just started getting Combivent, the stronger “Albut-Iprat” inhaler. Our next choice is mask or “pipe.” Most say the pipe-like hose is better because we get more of the medicine. So here’s my first original suggestion. If you wear the mask, put your oxygen canula up your nose (assuming you own one). Really tired COPD sufferers may have difficulties with the pipe.

Speaking of phlegm, keep a plastic can with a lid handy, such as my old Folger’s coffee can, the regular 10.3 oz. size. Don’t even consider swallowing that phlegm. I’m not trying to be funny because it’s not. Don’t expect to be able to run to spit in the nearest toilet or sink either. Make sure you drink enough water too–a likely weak area for most people. 1.5 liters daily should be enough since other fluids are okay; vegetables and fruits are full of water too. I use an attractive purple jug for my water, so I’ll notice it better! I can keep the squirt cap on when I take my many morning pills. Then I remove the cap for water guzzling! Now I’m exploring fruit-flavored water to increase my likelihood of really hydrating. Furthermore, local water systems have been breaking down lately!

Now let’s look at the OTC (over-the-counter) medicines. For your chest congestion, take some guaifenesin; that is, Mucinex or a generic version. COPD is a mix of emphysema and bronchitis. Bronchitis is like having a perpetual chest cold while emphysema is a destruction of the lung sacs and a lack of elasticity in the lungs.

What if you have nasal congestion? A saline nasal spray will open a constricted nose. Later I submitted this article to COPD Breathing Buddies of Facebook, and I was warned about Sudafed. This drug may reduce nasal congestion, but Sudafed can raise your blood pressure, which may happen anyway during a COPD attack. Lately, I’ve been adding ginger root slices, eucalyptus leaves, and even garlic cloves to my morning coffee drip bin. My goal is to reduce inflammation.

If you have severe or moderate COPD, take your Daliresp pill. I have allergies to Bermuda & Johnson Grass, so I have allergy pills to take–an OTC generic equivalent of Claritin called Loratadine, a non-drowsy tablet and now Montelukast, my newest prescription. I keep a daily pill reminder box by my bed, as I have a total of six per day–not all bad lungs related. By the way, since you’re taking all these pills have a water bottle next to your bed. The more water you drink, the more the mucus will be thinned.
Here’s my second original tip. If you have a C-PAP machine for sleep apnea, you can use it when you’re wide awake to force air into your inelastic, sagging emphysema-ridden lungs! Don’t overuse your nebulizer; try a wide range of strategies to stop the COPD attack.

Please check out my methods for battling severe COPD exacerbations! Maybe I have a higher tolerance for pain than many, or a fear of walking home from the E.R. before sunrise? My latest severe attack lasted for 1 hour & 40 minutes!!
And when you quit choking, take those long-lasting spray/powders: Advair or Symbicort and Singulair or whatever.

Consider calling your G.P. M.D. later for an office visit. Last week I got a shot of Salumedrol, a steroid, at her office. Then I got prescriptions for prednisone pills and a Z-Pac antibiotic.

SOL Tuesday: Shopping at Family Dollar for a Low-Fat/Low-Sodium Cardiac Diet

I spent a half week at the East Texas Medical Center (ETMC) Cardiac floor for COPD & hypertension. I’m on disability for COPD and asthma. Usually, my blood pressure isn’t bad, but in it was in mid-September 2016. It was my first overnight stay in a hospital in five years. Previously, I’d assumed my diet was okay because I eat a balanced diet. I’m no carnivore, for I like grain, vegetables/fruits, and dairy. My diet is if I see food, I eat it. Recently, I’d become aware of anti-inflammatory foods to cope with my Asthma-COPD Overlap Syndrome (ACOS). http://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation Foods that Fight Inflammation

So I’ve been shopping with memories of the Cardiac Diet in my mind. Now, I check all foods for saturated fat, cholesterol, and sodium. I made sure I bought Mrs. Dash, the salt substitute, for starters. Texas Pete, a Louisiana type hot sauce, makes the cut with only 3% sodium per tsp. Texas Pete is the hot sauce for Church’s Chicken too.

Cheese was on the not-there list at the hospital. So I surveyed all the cheese at Family Dollar. Much to my amusement, the lowest fat/lowest sodium cheese is the cheapest generic cheese in Family Dollar! It’s simply called, Singles, an “imitation pasteurized process cheese food.” Saturated fat is 5% and sodium is 9% per slice, and the package has 16 slices for a mere $1.25! However, it didn’t melt well, so I’ve switched to Shredded Velveeta at 10% saturated fat, and it tastes way better.

Unfortunately, that delicious slab of generic dark chocolate is off-the-scale for saturated fat at 41%! Hershey’s with Almonds has a staggering 71% saturated fat for the day. But all is not lost, Family Dollar chocolate syrup has no saturated fat! Here’s a pleasant surprise. Snack-Pack Chocolate Caramel Pudding has only 8% saturated fat and 5% sodium per cup. Furthermore, a four cup package only costs $1 at Family Dollar.

My beloved Family Dollar Sweet & Salty Peanut Granola Bars are OK at 10% saturated fat and 7% sodium per bar. Those peanut granola bars are so good with beer! Another generic granola bar favorite is Dark Chocolate-Peanut Butter Protein Chewy Bars. They’re a bit high in fat at 15% saturated fat, together with 7% sodium per bar. Snicker’s Ice Cream has only 15% saturated fat and 3% sodium for a half-cup–another mega-relief! I had to indulge myself on Halloween but within reason. So I bought a package of 6 “Fun-Size” Snickers bars. Two bars have 15% saturated fat and 3% sodium

Margaret Holmes Seasoned Collard Greens have 16% sodium per half cup, but a staggering 130% of your daily Vitamin A, and of course, no saturated fat. Family Dollar Diced Tomatoes have no fat and 8% sodium per half cup. Both are considered anti-inflammatory foods.

Dean’s Zesty Guacamole Dip from Brookshire’s–Tyler, Texas’s major grocery store– has 15% saturated fat and 8% sodium per 2 tbsp serving. Speaking of other favorite grocery stores, Granvita Ganola from La Michoacana only has 4% saturated fat and 1% sodium per serving. I also mix horchata (cinnamon rice milk powder) with low-fat milk from Meals-on-Wheels. Horchata only contains 3% saturated fat per 4 ounces, and I only need a tablespoon, as I mix the half-pint of milk with a half-pint of water. La Michoacana is the leading chain Mexican grocery store in Texas. Hey, sometimes I catch the bus instead of walking a block.

Sardines–my favorite seafood in a can–tomato, mustard, plain; which is the healthiest choice? Pampa Sardines in Tomato Sauce wins with 5% saturated fat, 11% sodium, and 15% cholesterol. Furthermore, a serving has 20% of daily Vitamin A. A 15 ounce sardines-&-tomatoes can has seven servings, and it’s only $1.75! Our sardines are a product of China that’s distributed by a Miami company. I love globalization. Alas, sardines in mustard sauce–my former favorite–finishes last in my health measures with 15% saturated fat, 17% sodium, and 20% cholesterol.

Peanut butter is a mandatory fixture in my pantry, so let’s check it out. Value Time Creamy Peanut Butter (a generic) has 15% sat. fat & 6% sodium in a 2 tbsp serving size. Total fat is far higher at 25%, not a common large gap between total fat and saturated fat. Gold Emblem Crunchy Peanut Butter has 12% sat. fat & 6% sodium per 2 tbsp serving size with 23% total fat. I bought my crunchy peanut butter at CVS Pharmacy. Did you hear CVS bought out Medicine Chest? Peanuts show a range of saturated fat/sodium, depending on the seasonings. Japanese peanuts win with only 11% saturated fat & 9% sodium. Honey peanuts contain 17% saturated fat and 5% sodium. Meanwhile, the two spicy peanuts clock in at 20% saturated fat & 15% sodium and 17% saturated fat and 14% sodium.

CONCLUSION: Hopefully, you liked my analysis of some key favorite foods–mostly from Family Dollar. I’m no health professional, just a disabled teacher. However, I’m certainly going to research what I eat from now on, and I seem to be improving. Furthermore, I can guarantee another revision with a sat.fat/sodium analysis of more food. I was glad to pass this article to a Family Dollar employee, who had some heart issues about a month before I got sick. Don’t you feel sorry for those who live in food deserts? Some apartment complexes in town aren’t close to any stores–let alone hospitals, pharmacy, and a pulmonology clinic. We’re really happy to have a dollar store–Family Dollar–in this neighborhood: Midtown (aka. Hospital District), Tyler, Texas.

Memories of My Three Walking Pneumonia Attacks, by J.D. Meyer

Watching Hillary Clinton cough during a speech and later stumble as she was leaving a 9-11 memorial service brought back memories of my three walking pneumonia attacks. I describe walking pneumonia as the “silent killer,” because you don’t know that you have it until it has gotten pretty bad and you end up in the E.R. of the hospital. Pneumonia is way different from noisy lung ailments such as asthma, bronchitis, emphysema, and COPD.

The first attack was in 1995 when I was an Adjunct Instructor of Developmental Writing at Mountain View Community College in northwest Oak Cliff. Some of my students noticed I’d been looking bad before I ended up getting my folks to take me to the E.R. of Baylor Hospital, which was near my centrally-located apartment in Old East Dallas.  I’d developed asthma eight years earlier, but only needed a rescue inhaler at the time. My other part-time job was as a construction assistant/groundskeeper for Medical Center of Mesquite. Plus, I played half-court basketball every weekend with my mentor prof friend, the late Lew Sayers, and his friends.  Immediately, I quit cigarettes for five years.

The second attack occurred in late 2005 when I was a full-time Instructor of Developmental English at Texas College, an HBCU in north Tyler. Strangely, I’d delivered a sermon entitled, “Best Practices and Biggest Challenges of Unitarian-Universalists,” and spoke way too fast that time. A few days later, I went to the doctor and discovered I not only had walking pneumonia but emphysema! By that time, I’d been using an albuterol nebulizer for eight years and Advair sporadically for a year or two.

The third attack was in 2011, and the worst of all of them as I was kept in the hospital for a few days after the all-too-frequent ER visit. By this time, I was on disability and waiting for Medicare to start. Fortunately, there was a computer for the patients to use. That’s where I met a middle school science teacher, who was there to visit an older relative. I ended up interviewing him about the Urban Gardens movement, and he knew plenty of websites. Later, I’d research the work of Detroit mayor and former NBA star, Dave Bing, for more information. There were some sites on urban vegetable farms from progressive Austin too. I ended up publishing an article on the topic, despite having an IV in my left arm while taking my first batch of notes! Now it’s on my website at https://www.academia.edu/1084754/Urban_Gardens

In conclusion, give Hillary Clinton a break. Walking pneumonia is sneaky, and it may not seem bad at first –even if you knew about it like her, unlike me. The important thing is making it to the doctor or hospital somewhat soon–instead of late. This article was delayed because of my hospitalization for COPD & hypertension, but no pneumonia!

2016 Northeast Texas Community Health Worker (CHW) Coalition Conference

The Northeast Texas Community Health Worker (CHW) Coalition held its second conference at Tyler Junior College West on Friday June 15, 2016. The Keynote Speakers were David L. Lakey, M.D.; Paul McGaha, M.D.; and Ardis Green, MPH. To begin the conference, Dr. Lakey presented, “Improving Health in Northeast Texas.” After lunch, we heard Dr. McGaha speak about the “Zika Virus: Implications for East Texas and CHWs.” The final talk was by Ms. Green, and it was entitled, “The New Diabetes Educator Paraprofessional Competencies.”

We chose three Breakout Sessions from a choice of eight. My choices were “Hypertension,” by Debbie Warren–a CHW Instructor; “It Takes a Village–The importance of Partnerships,” by Lori Arteaga, M.Ed.; and “Helping Clients Self-Manage Chronic Disease,” by Marcus Wade, LMSW & CHW Instructor.

The other Breakout Sessions were “Suicide Prevention in Youth: Part 1 & 2,” by Carolyn Harvey, Ph.D.; “Preconception, Pregnancy, and Tobacco,” by Jeanie Gallegly, MS & CHW Instructor; “Compliance: Confidentiality/HIPAA/PHI,” by Christie M. Cofer, BS & CHW Instructor; and “Chosen–The True Story of America’s Trafficked Teens,” by LaJuan Scott, MPA and Dreka Strickland, BS & CHW.

My choice of Breakout Sessions reflect that I have a chronic disease-Asthma and COPD-that got me on SSDI, and Medicaid/Medicare; furthermore, sometimes I get hypertension. As you can surmise, I see plenty of medical personnel and volunteer, so I know the importance of partnerships.

Improving Health in Northeast Texas

This presentation by Dr. Lakey was the ideal opener because of its broad focus and a call for action because our area’s health fairs poorly. Like all the other talks, we saw a Power Point and received a handout of those Power Points. Dr. Lakey defined Population Health as examining the overall health of an area–together with groups based on gender,age, and ethnicity. The Triple Aim is to improve the individual experience of care (quality and personal satisfaction), improve the health of the populations, and reduce the per capita cost of health care.

Despite spending more money on heath care than any country in the world, the U.S. only ranks #34 in Life Expectancy and #42 in Infant Mortality. Coincidentally, Texas ranks #34 among the states. Lack of health insurance is the major problem. Senior health for Texas is just #41. Moreover, Northeast Texas health is clearly among the worst in the state. So it keeps getting worse as you narrow the territory from nation to state to region.