1.01 - September 16, 2009

Letter from the Editor: Consumer dissatisfaction with U.S. healthcare system

There isn’t a week that goes by that I don’t hear a complaint from a client about how they had to spend hours waiting to see their doctor, how another clinic charged them a fee they weren’t expecting, or how their insurance company wouldn’t cover any of their expenses. Frankly, people are fed up with the current healthcare system in this country, and healthcare professionals aren’t much happier. Insurance coverage and reimbursement have been reduced to a juvenile game of offer/counter-offer based on complex algorithms and the subjectivity of claims officers. This has lead to a decline in the amount of healthcare providers willing – or able – to put up with the status quo. Combine that with an increasing and aging population and you’re left with an inflated patient to practice ratio, increased wait times, and unhappy customers.

To illustrate this dissatisfaction, here is a recent story that a patient told me about his experience with another clinic:

I was referred to an imaging center to get a colonoscopy to see if I had diverticulitis. I contacted the imaging center and scheduled an appointment. I asked them how much the procedure would cost and whether my insurance policy would cover it. The representative at the imaging center told me that I would have to contact my insurance company.

I called my insurance company and they told me that they didn’t have enough information to help, and that I would have to call the imaging center back.

I called the imaging center back and the rep I spoke to said that I would have to speak to someone in billing.

I was transferred to billing and they told me they couldn’t get me a price because they needed a CPT code.

I was transferred back to scheduling and I was told that someone would call me back three days before my test to let me know how much it would cost.

I never received a call.

On the day of my procedure, I checked in and was asked to sign a form agreeing that I would be responsible for all fees incurred from my procedure regardless of insurance coverage. I asked again what the cost would be and was told that my insurance company should have told me. I was left with an ultimatum; sign the form and pay an unknown amount of money out of my own pocket or cancel the procedure and jeopardize my health.

This is just one of a number of examples of how healthcare providers have forgotten who their clients are. In any business, common sense dictates that you take care of the people that give you money. Unfortunately, healthcare companies have forgotten that they need to take care of their patients, not the other way around.

There’s an old quip that states, “If you want to be successful, do the opposite of what everyone else is doing.” At Human Health Specialists, we strive to do the opposite. Our clients don’t have to wait for hours to see a doctor. We disclose all fees associated with their treatment beforehand. We consult with their insurance provider to get them as much coverage as possible. The healthcare system is a mess, and we continually do our best to make things as painless as possible for our clients, because we’re in the business of taking care of them, not the other way around.

The Bountiful Benefits of Blueberries

Vaccinium Cyanococcus, also known as the common blueberry, is regularly touted as a “superfood,” a “miracle fruit,” and “very tasty.” Blueberries have earned such high praise; their list of health benefits ranges from preventing cancer to improving cognitive function, and their combination of sweet and tart makes them a true delicacy. These minuscule berries and their minuscule-er parts offer colossal health benefits that make them a quintessential health food and a daily dietary necessity.

Benefits

As far back as the 1950’s, blueberries were being extolled for treating common ailments like diarrhea, pinwork infections, and infantile dyspepsia. Today, they’re more famous for their antioxidant potential – beget by their rich anthocyanin and phenol content – which is the reason for so many of their incredible health benefits. Some of these benefits include the following:

• Prevent cancer
• Prevent cognitive decline associated with aging and various diseases
• Prevent bone loss
• Lower blood pressure
• Reduce risk factors for cardiovascular disease, metabolic syndrome, and diabetes
• Help prevent urinary tract infections
• Reduce inflammation
• Reduce exercise-induced oxidative stress

It’s not just the antioxidants in blueberries that promote optimal health (they just happen to get all the attention). Blueberries also contain a whole bunch of vitamins and minerals, are a good source of fiber, and are an excellent source of low glycemic index (GI) carbohydrates. One hundred grams of fresh blueberries (~2/3 C) contains 2.4 grams of fiber, 77 milligrams of potassium, 14.5 grams of carbohydrates and only 57 calories. This amount of berries also has an oxygen radical absorbance capacity (ORAC, a higher-is-better measure of free radical scavenging power) of 6552; that’s about 1500 and 3000 points higher than the same amount of raspberries and strawberries, respectively.

Processing and presentation

Besides being healthy, blueberries are also versatile. They come in forms ranging from fresh and frozen to canned, jammed, jellied and juiced. But do all of these various forms of blueberry goodness offer the same great health benefits? The short answer is no. Each of these methods does preserve the blueberry’s antioxidant content, but other factors must also be considered including shelf life, fiber content, and the addition of other ingredients (especially milk* and sugar). The following chart lists the pros and cons of the various blueberry processing methods and gives each an overall grade.

Type	Pros	Cons	Grade
Frozen	• High antioxidant and nutrient content • Fiber is preserved • Long shelf life	• Antioxidant, vitamin and mineral content may still be reduced over time	A
Fresh	• High antioxidant and nutrient content • Fiber is preserved • Pesticides can be washed off	• Perishable • Seasonal • Expensive	A
Cooked	• Antioxidant content is preserved • Most vitamins and minerals are preserved • Fiber is preserved • Pesticides can be washed off before cooking	• Antiproliferative** activity is reduced (depending on the degree of heat used) • Some vitamins and minerals may be destroyed • Additional calories may be necessary depending on use	B
Dried	• Antioxidant content is preserved • Some vitamins and minerals may be concentrated • Fiber is preserved • Long shelf life	• Antiproliferative activity is reduced (varies according to drying method) • Pesticides are concentrated • Sugar content is concentrated • Some vitamins and minerals may be destroyed • Water content is lost	C
Canned	• Antioxidant content is preserved • Most vitamins and minerals are preserved • Fiber is preserved	• Antiproliferative activity is reduced • Pesticides may not be removed • Some vitamins and minerals may be destroyed • Extra sugar is usually added • Additional calories are necessary for use in pies and pastries	C
Juice	• Antioxidant content is preserved and extra may be added • Most vitamins and minerals are preserved and extra may be added	• Antiproliferative activity is reduced • Pesticides may not be removed • Fiber is lost • Some vitamins and minerals may be destroyed • Sugar content is concentrated and extra may be added	D
Jam/jelly/spread	• Antioxidant content is preserved • Most vitamins and minerals are preserved	• Antiproliferative activity is reduced • Pesticides may not be removed • Fiber is lost • Some vitamins and minerals may be destroyed • Sugar content is concentrated and extra may be added	D

Conclusion

Blueberries offer tremendous health benefits in a small, tasty package. You should be eating at least a cup of them (or at least some type of berry) everyday. Preferably, they would be of the fresh or frozen variety, but other forms still contain many health promoting ingredients and can be added to many dishes and desserts to improve their nutrient content.

*Combining blueberries with dairy, especially whole milk, reduces their antioxidant capacity.

**Antiproliferative in this case refers to inhibiting the growth of cancer cells.

Fish Oil and Omega 3s: The alpha fatty acids

Over the past decade or so, every doctor, nutritionist, trainer, and health information know-it-all has written or spoken about the benefits of fish oil, specifically the omega-3 (n-3) fatty acids DHA and EPA. In case you missed the memo, they’re really good for you. Like, really good.

Benefits

Some of the hundreds of health benefits from n-3s include the following:

• Reduced inflammation and risk of inflammatory diseases
• Reduced risk of heart disease, cancer, diabetes and stroke
• Improved cognitive function, mood, and immune function
• Lowered VLDL, LDL , triglycerides, and blood pressure
• Increased HDL
• Reduced negative effects from stress

Fish oil is a virtual panacea. If there’s a threat to your health, fish oil will most likely improve it or help prevent damage from it. There’s just one problem: most Americans don’t consume nearly enough n-3 fatty acids, especially compared to our cave dwelling ancestors.

Past and present

It’s estimated that prehistoric Homo sapiens consumed a ratio of n-6:n-3 fatty acids between 4:1 and 1:1 (the lower the ratio the better). Presently, the average American consumes a ratio closer to 30:1. One major factor for this difference is that our distant ancestors had no problem finding rich sources of n-3 fatty acids, especially animal brains and bone marrow. Today, despite being in an era of food abundance, our ability to locate untainted sources of naturally occurring n-3s is getting increasingly difficult (at least not without dropping a significant amount of cash in the process). The widespread and copious use of corn in animal and fish feed hasn’t helped; it has lead to a significant reduction in the amount of naturally occurring n-3s in the meat, poultry, eggs, and fish sold in stores. You’ve probably seen this before but it’s worth restating: the ratio of n-6:n-3 fatty acids is three times higher (4.8:1.6) in meat from corn fed cattle versus grass fed cattle.

Solution

At this point, you’re probably wondering, “What can I do about it?” “How can I get the n-3s I stand to benefit so much from without having to hunt (pun intended) for inexpensive sources at the grocery store or farmer’s market?” Simple, supplementation. Fish oil supplements are a dime a dozen, and cost about the same. That’s not to say, however, that they’re all created equal – far from it. It’s important to know what to look for when you’re trying to find a high-quality fish oil supplement. Some things to consider:

1. DHA/EPA concentration. A highly concentrated fish oil supplement will contain about 700 mg of DHA and EPA (combined) for every 1000 mg (1 g) of fish oil.
2. Triglycerides, not esters. Research has shown that the triglyceride form of DHA and EPA is better absorbed than the ester form.
3. Vitamin E. Oils quickly become rancid if they’re exposed to heat or light. Vitamin E is a natural antioxidant that helps protect the fish oil from going bad before it reaches your belly.
4. Purified or micro distilled. Purification is vital for removing the PCBs, DDT, heavy metals and other contaminants found in farm raised fish.

<shameless plug>It just so happens that Human Health Specialists sells a highly concentrated, purified fish oil supplement that contains Vitamin E and uses the triglyceride form of DHA and EPA. Check out the products page on our website for more info</shameless plug>

Conclusion

For most of us, finding or affording natural, untainted sources of n-3 fatty acids is next to impossible. Fish oil supplements offer an inexpensive, convenient way to add DHA and EPA to your diet. That’s good news for your wallet and your health. Like, really good.

Dealing with Chronic Fatigue Syndrome

Chronic fatigue syndrome (CFS) is a debilitating disorder characterized by extreme fatigue that is not improved by rest and may be worsened by physical or mental activity. Those with CFS often suffer a substantial reduction in their ability to perform ordinary activities, and for most people with CFS exercise is an agonizing experience.

Paradoxically, exercise has been shown to help alleviate the symptoms of CFS, and in fact may have both short and long term benefits including lessening the severity of one’s fatigue and improving their ability to perform typical everyday activities. While exercise may increase the quality of life for someone with CFS, it is important to consider the type and duration of exercise as well as the individual’s tolerance.

High impact aerobics, running sprints, weight lifting to failure and other high intensity activities are not appropriate for most people with CFS. Instead, they should look at exercise simply as intentional movement designed to have a specific effect on the body with an achievable goal in mind. No special equipment is necessary; no instructional videos are required; just basic intentional movement.

If you have CFS, a good place to begin (if you are not currently active) is to exercise for 15-20 minutes, 2-3 days per week. This can include something as simple as a few yoga stretches, some core strengthening exercises, or walking on the treadmill. The key is to start small and increase per your comfort level. Don’t get caught up in the more is better attitude; doing too much, too soon will leave you sore, jaded, and feeling worse than before you started. Remember, a stable structure can’t be built without a solid foundation.

A few simple exercises to get you started:

Cat-camel up

Cat-camel down

The key with the cat-camel is to maintain a comfortable range of motion.

Dying bug start

Dying bug right

Dying bug left

The key with the dying bug is to keep the low back pressed flat against the floor.

As little as six minutes per day of exercise has been shown to lessen the effects of chronic fatigue syndrome. Anyone who has struggled with CFS will agree that those are six long, challenging minutes. In the end, however, regular exercise will go a long way in improving the symptoms of CFS and developing one’s ability to handle everyday activities. The keys are to start small, progress as capable, and stay consistent.