Kiss It Goodbye DC Residents

Put your head between your legs and just kiss it! Just kiss it! Not a way to live but its a way leading to your untimely death. We can't let that happen to you. Others might not be concerned but we want you to live. We're not doctors, we're not politicians, we're not medical professionals. We leave that to others. We find and verify the information and their sources and bring the news to you. Sometimes we do reach conclusions not always supported by the data. We'll admit the above is not a foregone conclusion but... You'll see later in the story.

"Although heart disease, cancer, and cerebrovascular diseases are the top three leading reported causes of death in the United States1 (54 percent of all deaths) as well as in the District of Columbia (52.7 percent of all deaths) in 2007, research has shown that approximately one-half of all deaths nationally are actually due to preventable causes. These preventable causes of death, defined by McGinnis and Foege in 19932, include tobacco/smoking, poor diet, physical inactivity, alcohol, microbial (infectious) agents, toxic agents, firearms, motor vehicle, sexual behavior, and illicit drug use, as well as two additional causes (uninsurance and medical errors) identified by the Institute of Medicine and applied by the state of Wisconsin." - DC Department of Health (DCDOH)

It doesn't matter what's happening nation wide if its not reflected locally. What matters is what's happening in your area, in your city, jurisdiction, state or town where you live is what concerns us. Shouldn't that concern those who are responsible for taking care of us? We think it should.

This is what we've been saying. From last month's Black History Month story we said: "What we should learn from this African American History Month is that the history of the FDA is too little critical health information provided too late. If history of the African American experience tells us anything is that to wait can be too late." From the news that there are other places in the United States where you can have a better quality of life and care we said: "Every jurisdiction needs to aim higher than Hawaii's Kauai which most certainly will be aiming to continue to be the best in the nation." While we said that the Mayor of Washington, DC said:

“Information like this is the key to residents making smart decisions about their health,” said District of Columbia Mayor Adrian M. Fenty. “This report illustrates clearly how much we have to do to help people live healthier lives, because the choices we make can have serious impact on our health.” - (DCDOH)

To which we have to ask the very obvious question and those choices are what exactly? We get the blaming the victim part with the responses from a three (3) year old report but if you recall we've been focused on the things that keep us alive. The problem with old information, other than it makes you make repairs to late to be of use to anyone, is its old. Think of what you should do to make high school a better experience for you now. Or now that you've had you're teeth pulled you'll brush the ones you no longer have next time. Hindsight is twenty twenty and really useless if you only stay focused on the hind. Unfortunately the most recent information that we the people have is 2006, thanks to the Center for Disease Control and Prevention (CDC). The information they report is from the local departments of health from the local jurisdictions. That information is updated weekly. It's how we get our flu stats.

CAUSES OF DEATH By Jurisdiction 1ST 2ND 3RD 4TH 5TH District of Columbia North Carolina Maryland Virginia United States of America North Carolina Virginia

“This Report is for lay people, policy-makers, and health practitioners to use as they work to improve their own health, and the health of those that they serve. Knowing that these causes of death are preventable should be particularly empowering, because knowing that we can take actions to reduce the burden of a disease can give us all hope, ” said DOH Director Dr. Pierre Vigilance “We encourage people to use this report to impact health at the individual, community, and institutional levels, and to make decisions that improve our collective health and wellness.” - DC Department of Health (DCDOH)

There's no conclusion in this report (PDF). It's a review of old and outdated information to which no conclusion is drawn except - it's your fault! We conclude that if you're a resident of the District of Columbia like the old joke where the man is bitten by a poisonous snake while relieving himself in the woods with his best friend calls a doctor who tells him that he has to suck the poison out to save his friends life. The bitten man who is holding his himself asks his best friend what the doctor says and his best friend tells him: "You're going to die!"

Remember we said earlier at you'll see and ended with but... They're not the ones who as so suck out the poison was how we were going to end that statement. The mayor and the DC Department of Health are the ones who do have to suck out the poison. They're the ones whose responsibility is to suck out the poison.

"The Mission of the Department of Health is to promote and protect the health, safety and quality of life of residents, visitors and those doing business in the District of Columbia. Our responsibilities include identifying health risks; educating the public; preventing and controlling diseases, injuries and exposure to environmental hazards; promoting effective community collaborations; and optimizing equitable access to community resources." - About DC Department of Health (DCDOH)

To us, this kind of conclusion is not funny. We'll do what we can to keep this from happening to you and to us. Maryland, North Carolina and Virginia residents - At Ease! As You Were!

Natural Heart Care

The Mayo Clinic is known for quality health care and being in the forefront of research however when it comes to research review they're results not so forefront(y)! While the major publications (CNN,Reuters, US News and World Report, WebMD) find the review (based on a search of PubMed and MEDLINE databases, for literature on herbal supplements published between 1966 and 2008. Search terms included cardiovascular agents, complementary therapies, herb–drug interactions, and cardiovascular disease interactions) news worthy. We think their conclusions are very unnews worthy:

The authors encourage physicians to ask patients about concomitant use of herbal therapies, in particular among patients who are taking cardiovascular medications with narrow therapeutic windows such as digoxin and warfarin. Increases in research, which provides controlled clinical evaluations of herbal therapies and improvements in regulation and oversight of such therapies, are warranted. (Use of Herbal Products)

That reads more like a sticker on your drugstore medication than a careful well reasoned progressive scientific analysis.

Mayo's "Lean Enterprise Institute" which speaks of being "at the pinnacle of patient care, leadership keeps looking for ways to improve — and now they’re looking to lean." (PDF) We're all working with leaner resources and as patients will be making choices based on less income. What we don't need is for the best to do leaner research.

St. John's Wort is used to treat depression as a natural substitute to prescription drugs. As more and more people lose their jobs and health insurance natural and lower costs remedies seem more likely to be sought out.

"The "focus of cardiovascular research at Mayo is congestive heart failure. One of the questions that we've been dealing with is: What does the most dangerous snake in South America have to do with human heart failure? The answer is that the green mamba snake of South America and the human heart both produce very potent peptides that regulate heart and kidney function." Robert Simari, and I'm the chair of the cardiovascular research division at the Mayo Clinic in Rochester, Minnesota." (ABC News)

Natural remedies aren't unfounded in their claims for healthy results. The argument has to be what's best and affordable for those with and without the financial wherewithal to pay for the best treatment for the money. That's what real lean leadership should, in our opinion (though that should go without saying), be. What are the medical costs for such short cuts.

"Mayo Study Shows Stroke Incidence Related to Angioplasty Remains Steady over Past 15 Years - Research results 'somewhat surprising' because patients are older, have more complicated disease "Eighty-four patients, or three or four in 1,000 patients, had a stroke or a TIA, and 23 percent of those were mini-strokes, according to senior author Rajiv Gulati, M.D., Ph.D."

While such results for eighty-four patients is very good. We applaud this type of research from MAYO but for the suffering settling is not an option and any, especially natural or low cost, alternative would be desired. Scientific research is wonderful and we support it but it's not the be all and end all in every case or there would never be any side effects.

We do agree with MAYO's review conclusions. Before starting or ending any natural medicines or treatments please, please, please speak to your physician. More importantly try to find a physician who is knowledgeable enough about such treatments who can adequately address your condition and concerns. In our area there are plenty to choose from.

Simply Not The Best

Our concern is that all of us in business and in life don't always do our best. We're really critical of ourselves and we often admit to slot and inactivity knowing that there is better way of living. What made "this country great" has always been our drive to do better - together - rich helping poor, healthy helping infirmed, strong helping weak. That's the American way - united we stand. Whether that was in achievements, inventions or families we strive to go beyond what we've done before to what we can do today.

"Nations, like men, often march to the beat of different drummers, and the precise solutions of the United States can neither be dictated nor transplanted to others. What is important is that all nations must march toward a increasing freedom; toward justice for all; toward a society strong and flexible enough to meet the demands of all of its own people, and a world of immense and dizzying change." - Robert F. Kennedy

The headlines from CNN - Women's health an 'urgent priority', The Associated Press (AP) and the U.S. News & World Report highlighted AIDS, only TIME trumpeted - Why Sexism Kills. While the original World Health Organization (WHO) press releases stated: "WHO calls for action beyond the health sector to improve the health of girls and women" -

• Despite progress, societies continue to fail women at key times
• Women provide the bulk of health care, but rarely receive the care they need
• Women live longer than men but these extra years are not always healthy
• Despite some biological advantages, women's health suffers from their lower socio-economic status
• Policy change and action is needed within the health sector and beyond

It's easy for this nation to ignore the world when it tries to lead and direct what was usually our domain. The United States is the world leader and we set the pace for the rest to follow. We're not use to taking orders the same way PearlieMae's not use to doing what we need to do to take care of ourselves. However when it's our loved ones there is nothing we won't do to make them safe, healthy and better.

I'll pray for you, you pray for me
I love you
I need you to survive
I won't harm you
With words from my mouth
I love you
I need you to survive - David G. Frasier(View)(Listen)

Have a wonderful Veteran's Day. If you have a vet in your life, write, call, email send love in any and every way you can. If you are a Vet - we salute you! Thank you. Thank you. Thank you!

We're Not Number 1! We're Not Number 1!

Maybe to ABC News health care is a game that can be won or lost. When they treat health care as something with a scorecard they ignore the report. While we as a jurisdiction may be ahead of the curve none of us as a nation are winning.

Oh, sure Maryland is ahead of District of Columbia and Virginia it doesn't mean Maryland's got the best care in the US. All the jurisdictions are above the norm and better than most in the situation and in this game that's not saying a whole heck of a lot. As you would expect Virginia is better than the DC when it comes to health care. In a game of health its more disease care than health. We're number twenty-six (26) with a bullet. We're number twenty-six! Doesn't just fall off the tongue does it?

• District of Columbia    Overall   -   26
• Maryland   Overall   -   17
• Virginia   Overall   -   22

"The Commonwealth Fund (CF) is a private foundation that aims to promote a high performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults."

We recommend that you read the original report from the CF. "Among the states that moved up the most in the overall performance rankings, Minnesota rose within the top quartile to become the fourth-ranked state, with significant improvement on multiple indicators. In three states—Arkansas, Delaware, and West Virginia—plus the District of Columbia, at least half of the performance indicators improved by 5 percent or more. Leading states set new benchmarks for 20 of the 35 indicators with trends."

2009 Ranking	Revised 2007 Ranking
1   Vermont     2   Hawaii     2   Iowa     4   Minnesota     5   Maine     5   New Hampshire     7   Massachusetts     8   Connecticut     9   North Dakota    10   Wisconsin    11   Rhode Island    12   South Dakota    13   Nebraska	1   Hawaii     2   Vermont     3   Iowa     4   Connecticut     5   New Hampshire     6   Massachusetts     7   Maine     8   Rhode Island     9   Minnesota    10   Nebraska    11   Wisconsin    12   North Dakota    13   South Dakota

There is room for improvement across all states.
"All states have substantial room to improve. No state ranked in the top quartile across all performance indicators. On some indicators, even the top rates are well below what should be achievable. In each of the states with the highest overall rankings, several indicators declined by 5 percent or more; each also had some indicators in the bottom quartile or half of performance. At the same time, in each of the lowest-ranked states, there were certain areas of performance that improved—some quite significantly."

Chocolate Heart Health

Chocolate saves a heart from breaking and now every news report is saying the same thing without asking the same question on aspirin - "How much is enough?" The Stockholm/Boston report says that even a little is better than none but with our obese lifestyle any excuse is a good excuse to eat chocolate. Not any candy mind you, the review of the data says it must be chocolate. We're giving "kisses" as our wedding favors and its great to know we're being life savers even if we didn't consciously make the decision.

We can only access the free abstract which says: "Chocolate consumption was associated with lower cardiac mortality in a dose dependent manner in patients free of diabetes surviving their first AMI. Although our findings support increasing evidence that chocolate is a rich source of beneficial bioactive compounds, confirmation of this strong inverse relationship from other observational studies or large-scale, long-term, controlled randomized trials is needed."

From the very same Journal of Internal Medicine is a cautionary article publised earlier in the year: "The epidemic of obesity took off from about 1980 and in almost all countries has been rising inexorably ever since. Only in 1997 did WHO accept that this was a major public health problem and, even then, there was no accepted method for monitoring the problem in children."

While the reference is to Asia, Latin America and others to Swedish men obesity is a local problem with deadly consequences. Chocolate seems an easy solution to us the very lazy. Anything but diet and exercise and anytime the suggestion is adding chocolate to the mix whether it's coffee or candy - its the right perscription. A couple of kisses every other day sounds like just about the right amount IF we were to self medicate and we won't. We do have some extras though. There is a bag on the side of the bed so until their gone - what can it hurt?

While the review was of heart attack survivors the: "(o)bjectives. To assess the long-term effects of chocolate consumption amongst patients with established coronary heart disease. Design. In a population-based inception cohort study, we followed 1169 non-diabetic patients hospitalized with a confirmed first acute myocardial infarction (AMI) between 1992 and 1994 in Stockholm County, Sweden, as part of the Stockholm Heart Epidemiology Program." The news is reporting this as newest, greatest, latest health information clearly it isn't but we suggest that everyone use caution when following any advice, including ours.

Macho to the End

"Every man ought to be a macho macho man,
To live a life of freedom, machos make a stand,"

- The Village People, Macho Man

When we were children the men were told when we were hurt to shake it off and be a man. Real men don't cry. Stand up and take it like a man when we fell. As women we were told to be a big girl but that it was "OK" to cry. Men who wanted to cry were called girls names because real men didn't show emotions. When Pearlie came home to see her sisters when they greeted each other they cried and when it was time for them to leave they cried saying goodbye. They cried when they were happy and cried when they were sad.

The review of a new report shows that macho men don't usually seek medical attention or help. "Middle-aged men who strongly idealize masculinity are almost 50 percent less likely than other men to seek preventative healthcare services, according to a study—the first population-based analysis of men’s masculinity beliefs and preventative healthcare compliance—to be presented at the 104th annual meeting of the American Sociological Association..."

“For masculine men in blue-collar occupations, this research suggests that the masculinity threat of seeking health care is less concerning than the masculinity threat of not performing their jobs,” Springer said. “However, as job status increases among men who have strong masculinity beliefs, the likelihood that they will obtain preventative healthcare declines significantly. These findings provide some insight into the persistent gender paradox in health whereby men have a lower life expectancy at birth relative to women, despite having higher socioeconomic resources.”

Other than the adoration of women and other men what else does being a macho man get you? Is there no other benefits to being a manly man? There is! An agressive nature help men achieve over others and when men are injured its the most macho of men that fight their way back to fitness. Back in 2007 Science Daily published a report on the upside of the most macho. "It has long been assumed that men are not as concerned and don't take as good of care of their health," Glenn Good, associate professor of educational, school and counseling psychology in MU College of Education, said, "but what we're seeing here is that the same ideas that led to their injuries may actually encourage their recovery." You don't have to be a "Village People" to live a healthy life macho or not.

Medical Oops

The health care debate continues to demand our attention as town halls become shouting matches and a new report released by the Hearts Newspapers have highlighted our concerns on the number of deaths as a result of medical mistakes. The report named the states where the reporting is open and the information available to the public and the standard "and the District of Columbia" tag was added. When he tried to investigate the information we found it ONLY available from the "Dead By Mistake" website. While the info is collected by DC it isn't collected or distributed by either DC, MD or VA - what it can cost us is our lives.

How do we survive IF we survive the emergency
room and our stay in the hospital? CBS news recommends: looking your doctor in the eye before surgery, writing on your body what should be done where it should be done and writing on your body what shouldn't be done, asking about what medications are being given to you and why. Who knew that Bill Cosby in the 60s and Malcolm in the Middle in the 90s would have the best solution to survive medical oops.

Great suggestions right? Not if you're unconscious or unable to verbally assist in your own recovery. Wouldn't it be better to have the procedure - whatever the procedure as an outpatient rather than in patient hospital care. The price would certainly be less than a day in a hospital bed which would reduce the costs of health care and give us better care. While hospitals would not report their complications the idea of reporting another facilities fatality might be possible.

What we need is a study on outpatient to inpatient survival rates. Lost in the health care debate is the patient and while patients death rates creep up at a one (1) percent increase per year. While it is only 1% it is still an increase and we can be the one. So we will contact the hospitals and evaluate and report which hospitals are opposed and why. What we find could save your life so continue to watch this space.

Love Stinks But UnMarriage Kills

"I'm all right I feel real light
I don't live a life that's uptight"
How Do You Feel? - 311

We're getting married on the Labor day and while we're wishing for an "rest of our lives" ending it's comforting or disturbing depending on your point of view to know that it's healthier if its to the end. Recent research from the Journal of Health and Social Behavior has found that government policies: "...encouraging marriage in order to promote health may be misguided. In fact, getting married increases one’s risk for eventual marital dissolution, and marital dissolution seems to be worse for self-rated health now than at any point in the past three decades." The study finds that over years it doesn't matter if you're living single and never married or if you never divorce you'll live a healthy life. The trouble is only if you interrupt whatever choice you make. This might also explain why our never married uncle has outlived all his married brothers and sister-in-laws.

Disease Care not Health Care

That is the most remarkably accurate term I've ever heard. While there may be some dispute over who said what and when I'm conferring my imginary powers of the definitive on the most brillant professor Mohammad Rahim Tobari

"Historically, our health care system has not been a true health care system but a disease care system, and that notion has to change," he said. "True health care reform must pay attention with not just lip service but with resources for public health and prevention if it is to have a major impact on true health care and also control the skyrocketing health care costs. Therefore, investment in primary and secondary prevention, which are true public health initiatives, must be an integral part of any health care reform." The second element, he said, is that basic coverage for all Americans is fundamental, not only for controlling health care costs but also for investing in the future of the country.

Enemy Us

The things that cause us (rather them) to die or get ill the most aren't nasties out to do us harm but to quote the comic strip POGO (or FLOOK if you're british) "I've seen the enemy and he is us." The top diesases (heart disease, cancer and stroke) are all avoidable. If we got regular checkups or if we lived a better life (exercising, eating healthy) we would live longer. The implication is that if we took better care of ourselves we'd never die. That of course is completely wrong. 

We (rather they) die of what they die of. We are born to die. In today's climate of rising health costs and rising unemployment the conversations are now about finally doing something about our growing under and uninsured. Failing to address this rising tide will only continue to depress any economic or social growth that a President of Hope might create. In the shadow of a now pandemic (the "swine flu"), failing to protect the most vunerable appears suicidal.

It's not a question of finally doing something, the question is and always was what, how much and when. Both Roosevelts, Calvin Coolidge, Truman, Kennedy, Johnson, Nixon, Carter and Clinton all have tried tackling the same problem with the same belief health care for all citizens. I mistakenly believed that this was a new concern.

Definition - Quality Health Care

"Accessible, effective, safe, accountable and fair..."

The Agency for Healthcare Policy and Research 2007