Indoor Air Quality – How I Made the Air I Breathe Healthier By Using NASA Research

Some of you may be wondering why I said in my first post that I’d rather have house plants than an air purifier.  I chose house plants because they do not use any energy other than sunlight, and because my research did not convince me that air purifiers were significantly better than houseplants.  Thus, I preferred the cheaper, more natural option.

What I said in the previous post:

To me, [naturopathic self-healing] means utilizing evidence-based natural solutions when possible, such as using house plants to improve the quality of the air in my house, rather than buying an air purifier.

The Spousal Unit and I had talked for years about getting an air purifier.  We thought that putting an air purifier in the bedroom would help us get better sleep.  I had read blogs and websites written by asthmatics and allergy sufferers who highly recommended air purifiers with HEPA filters, and they were pretty persuasive.  The only thing holding me back was the price – $500+ for a one-room HEPA filter air purifier.

“Maybe I could start with something less expensive,” I thought.  “What about those Himalayan salt lamps?”  According to the advertisements, a Himalayan salt lamp “works as an air purifier by emitting negative ions into the air.”  And they retail for $25-$30 for a smaller lamp.  So I did some research.  Unfortunately, I found that Himalayan salt lamps do not emit negative ions in a large enough quantity to have an actual effect on your indoor environment.  For a thorough examination of Himalayan salt lamps, I recommend this post over at A Breath of Reason blog.  Bottom line: they don’t improve air quality.

Ok, what about beeswax candles?  They are also touted as being good for air quality because they release negative ions.  Nope, Skepticcystic over at A Breath of Reason debunked beeswax candles too.  (See this post.)  According to her research, not only do beeswax candles not release stable negative ions, but there is no scientific evidence that beeswax is healthier to burn than other types of wax.  So, although some would argue that you should avoid the phthalates in artificially scented candles, the type of wax  a candle is made of doesn’t appear to make a difference to indoor air quality.  Bottom line: Regardless of what they are made of, burning candles does not improve indoor air quality.

So back to air purifying machines…

For a practical overview of air purifiers, check out this article from ConsumerReports.  For example, ConsumerReports suggests:

“Before you buy an air purifier, try some simple, common-sense steps to reduce indoor air pollution. Begin by vacuuming often, banning smoking indoors, minimizing use of candles and wood fires, and using exhaust fans in kitchen, bath, and laundry areas.”

As the article continues, various claims made by air purifier companies are tested.  ConsumerReports cautions that ozone-producing air purifiers are actually harmful to your health and should be avoided, particularly if you have allergies or breathing problems.  This is confirmed by the American Academy of Asthma Allergy & Immunology:

“There is no debate about the negative effect of ozone…with the FDA concluding there is no place for ozone in medical treatment.” (See article here.)

For more information on the pros and cons of air purifiers, read this article from the New York Times, in which Steven Kurutz, an allergy sufferer, tested six popular air purifiers.  Here are a few excerpts from his article:

“For all their high-tech wizardry (some claim to be able to eliminate particles 0.3 microns in size and smaller), air purifiers occupy the same category as faith-based wellness products like nutritional supplements.”

And,

“Over the years, the Federal Trade Commission has taken action against several makers of air purifiers, including brands like Honeywell and Oreck, for unsubstantiated allergy-relief claims or for advertising that their devices removed virtually all impurities from the indoor air people breathed.”

According to ConsumerReports’ deputy home editor, Celia Kuperszmid Lehrman, whom Kurutz interviewed for the article,

“The first thing you need to know about an air purifier is that most people don’t need one.”

However, some doctors do recommend air purifiers for their patients, particularly children who suffer from asthma.  So, if you have asthma or allergies (or both), talk to your doctor about whether an air purifier would be beneficial for you.

According to the American Academy of Allergy Asthma & Immunology:

“There is no definite evidence of filtration clinically benefiting patients with allergic disease, but this may be the result of the studies being of insufficient durations to prove benefit.   The best review of the topic is by Sublett et al in 2010, a report of the Indoor Allergen Committee of the American Academy of Allergy Asthma and Immunology.” (See AAAAI article here.)

The Bottom Line for Air Purifiers: The different things you may be allergic to (dog allergens, cat allergens, mite allergens, mold, pollen, etc.) have different-sized particles.  You will see the most benefit if you select an air purifier that is designed to filter the particle size of the allergen that most affects you.

Conclusion from the Sublett et al report:

“As far as optimal choice of cleaning devices, initial cost and ease of regular maintenance should be considered. Portable room air cleaners with HEPA filters, especially those that filter the breathing zone during sleep, appear to be beneficial.

For the millions of households with forced air HVAC systems, regular maintenance schedules and the use of high-efficiency disposable filters appear to be the best choices.

However, further studies and research in this area are desirable to make more definitive recommendations in the role of air filtration on improving disease outcomes.”

Ok, so I could buy an expensive HEPA filter air purifier for my bedroom, which might help us sleep a bit better.  Are there any other options?

That’s when I remembered that house plants help improve indoor air quality.

Most of us learned in school that plants breathe in carbon dioxide and breathe out oxygen (roughly speaking), which is great for humans because we breathe in oxygen and breathe out carbon dioxide.  So having plants in the house helps increase the oxygen level in the air and decrease the carbon dioxide level.  But indoor plants can do more than just produce oxygen.

NASA published research in 1989 which demonstrated that house plants help reduce indoor air pollution.  Due to the energy crunch in the 70’s, buildings became more air-tight to reduce energy costs associated with escaping heated or cooled air.  But then occupants began developing health problems, and researchers determined that decreased air flow in buildings led to higher concentrations of carbon dioxide and volatile organic compounds (VOCs) in the indoor air.

Three of the VOCs NASA focused upon in its research were benzene, tricloroethylene, and formaldehyde.  These chemicals pose various health hazards that range from skin and eye irritation to headaches, asthma, and cancer (pp. 3-5).  Assuming we’d like to avoid these health hazards, what can we do to reduce the levels of these chemicals in our homes?

As NASA points out, “The first and most obvious step in reducing indoor air pollution is to reduce off-gassing from building materials and furnishings before they are allowed to be installed.” (p.2)

The best way to reduce chemical indoor air pollution is to choose lower-VOC or zero-VOC options for furnishings, floorings, and other elements inside your home (wall paint, flooring glues, shower curtains, etc).  That way, you’re bringing less VOCs into your house to begin with.  (There are lots of good articles about this on the web; I encourage you to Google-Fu them.)

In addition to reducing VOCs by using less-toxic cleaning supplies, lower-VOC paint, etc., we figured “If it’s good enough for NASA, it’s good enough for us,” and bought houseplants – lots of houseplants.

Before I bought the plants, I did an online search and found many helpful articles.  This article at Lifehacker.com has a graphic of various houseplants and the chemicals they filter best.  And since houseplants have not fared well at my house in the past, I also read articles, including this one, on low-maintenance, hardy houseplants.  See this article for a good overview of the benefits of houseplants, including how many you need per room/ per square foot.

In the end, I decided to buy plants that didn’t have runners that would wind up all over the house (I’m looking at you, golden pothos).  I found a local nursery and selected plants for various rooms based on the available sunlight in those rooms, the amount of available space, and what looked good to me.  Be sure to check how big each plant typically grows, so you don’t buy ones that will outgrow the space you bought them for.

For the bedroom, I selected a snake plant (a.k.a. mother-in-law’s-tongue; see picture at top of post) because they are one of the only plants that continue to take in carbon dioxide and give out oxygen at night.

So far, it’s been about six months and none of the houseplants has died.  In fact, nearly all of them are thriving.  It’s hard to say whether our indoor air quality has improved, since we don’t have a way to test it.  But at least we know that science is on our side, and we didn’t waste our money on air purification myths like beeswax candles or salt crystal lamps.

CAUTION: Many low-maintenance houseplants are toxic to dogs, cats, and sometimes children if they chew on the plants.  If this is likely to happen in your home, make sure you know which plants are toxic, and put them where pets or children cannot reach them.

 

 

Guest Post: A Diet for Everyone

 

[Here’s another in the series of healthy eating and lifestyle posts from Dave Banko.]

Shortly after I started eating more healthily, another TV program aired called, “50 of the World’s Best and Worst Diets.” Countries were ranked by average lifespans, rates of obesity, and other health issues, then related to their diet and lifestyle. The results are fascinating!

Worst Countries

#50 – Marshall Islands

  • Health – Highest death rate from diabetes
  • Diet – White (refined) rice, tinned [canned] vegetables, and high-fat processed meats

#49 – Russia

  • Health – ¼ of men die before age 55, high rates of liver disease, alcohol poisoning and car accidents
  • Diet – High consumption of Vodka

#44 – Mexico

  • Health – 1/3 of the population is obese
  • Diet – Lots of soft drinks and processed calories, lack of fresh and natural foods

#43 – USA

  • Health – High diabetes and obesity
  • Diet – Super-sized portions with processed food and cheap sweeteners like corn syrup (fructose)

#38 – Australia

  • Health – Fastest growing rate of obesity
  • Diet – Plenty of Meat and Beer!

Best Countries

#13 – South Korea

  • Health – Lowest obesity rate
  • Diet – Lots of fresh fish and lots of vegetables and fermented foods

#10 – Netherlands

  • Health – Tallest people in the world
  • Diet – Lots of milk and milk products!

#8 – France

  • Health – Low levels of cholesterol and heart disease
  • Diet – Red wine, cheese, high saturated fat dishes!

#7 – Kuna Indians

  • Health – Lowest levels of cardiovascular disease and blood pressure
  • Diet – Lots of chocolate (up to 5 cups a day) in combination with plantains, coconuts and fish

#5 – Japan

  • Health – longest life expectancy for women
  • Diet – Rich in vegetables and fish

#3 & 2 – (Greece & Italy)

  • Health – Long life span
  • Diet – Rich in legumes, fruit, vegetables, fish, olive oil, wine, dairy, pasta, whole grain rice, and red meat

#1 – Iceland

  • Health – Longest overall average life span
  • Diet – fish, red meat and dairy from grass-fed animals, and few fruits and vegetables

Why is this important? Diet information is about as confusing as it gets, fat or no fat, all meat or vegetarian, carbs or no carbs. If you look at these best diets in the world, it seems to only add to the confusion.

  • How can the best diet in the world include few fruits & vegetables?
  • How can the French have such low levels of cholesterol and heart disease with a diet loaded with high saturated fat?
  • Who got excited when they saw #7 was high in chocolate?!

The facts are:

  • Icelanders eat the fresh produce from the land and sea with little processing.
  • The French consume rich food, but in small portions and take their time – enjoying life.
  • The Italians eat pasta with every meal, (made from complex carb flour) even when dieting, with lots of fresh, simple ingredients and small portions.

Most of the diet plans out there were put together as something that worked for someone else. But it wasn’t mine, or what I like to eat.

Recipes are helpful, but need to be adapted to what you like to become a healthy eating lifestyle you can sustain.

There are general principles to follow:

  • Avoid or minimize: sugar & sugary products, processed foods, foods with lots of chemicals, and refined foods
  • Reduce portion sizes – This goes without saying as the curse of our own abundance in a super-sized or ‘all you can eat’ culture.

The countries with the worst diets overindulge in less-healthy food and empty calories.

  • Balance & variety – our bodies need lots of different nutrients for health. I’d be wary of any program that eliminates or focuses on any one food group.
  • 80/20 rule – ‘I adhere to the 80/20 rule. I eat healthily 80 per cent of the time, and that leaves me free to eat what I want for the remaining 20 per cent. And those cheat meals taste so much better when they are a treat rather than the norm,’ Bear Grylls. I follow this myself, relaxing my program on the weekends to have some ice cream, mashed potatoes, or other treats which I avoid during the week.

I’ll share more about the principles and specific techniques in future posts.

For now, pick a balanced program closest to the type of food you generally like to eat, and use it as your starting point. But don’t be afraid to experiment and adapt it to what you like and what works for you.

Until next time!

Dave Banko

P.S. – In case you were interested, here’s the link to the countries in the middle.

[Note from Crew Dog: Looking for a diet starting point, but don’t have time to read all of the “What’s the Right Diet for You?” information?  Start with the guidelines in this article.]

 

Guest Post: The Journey to Healthy Eating Habits and Weight Loss

Triple_Old_100_1Year

[Today we have a guest post from Dave Banko.  Thanks for sharing your inspiring story, Dave!]

My friend, Crew Dog, asked if I’d be a guest blogger, sharing my experience losing over 100 lbs in a year. I was thrilled by the offer and happy to share my experience!

As this is a complex subject, I will be doing a series of posts about various aspects of my journey and specific topics related to healthy eating and weight loss.

Let me preface by saying I’m not a doctor, nutritionist, or health professional of any kind.  I am a veteran, and I have struggled with my weight all my life.

I’m not a person who sits on the couch eating chips or ice cream.   Diabetes runs in my family, so I’ve been careful to avoid sugary food. I have been very active, but injuries over the years have slowed me down.

To put it frankly, I love life and good food!

But my love of food has gradually put on the pounds. On a fairly regular basis, I started another diet to try to lose weight. I tried pills, special recipes, cleansing purges, fiber, meal plans and countless hours in the gym – costing lots of time and money! I’d be good for a little while, maybe lose a few pounds, then something would happen, I’d have to stop and the weight came back plus more.

I even contemplated gastric bypass (and associated) surgeries.

However, when I went for the consultation and heard how strict a diet I would need to follow for the rest of my life, I felt “What’s the point” as it is really the diet I’d have to maintain to lose the weight without surgery.

I reached in excess of 360 lbs.

I felt old. I couldn’t walk far or up stairs. I sweated profusely in a heated room or in a crowd. I developed sleep apnea and needed a CPAP to sleep properly.

Then I was at a Christmas party in December 2014, my feet tangled on some coats, and I fell on my shoulder. I was in severe pain for weeks from such a simple fall.

I know I’m getting older (approaching 50), and the body doesn’t heal as quickly as it did, but I also know I landed with a lot of force and, if I were lighter, it wouldn’t have been so extreme. I determined I was ready to try again after the holidays, but didn’t know what I was going to do differently.

At the beginning of 2015, the stars aligned!

I was in the right frame of mind to start, a friend of mine started a Facebook group of friends to encourage each other to lose weight and adapt a healthier lifestyle, and a program was aired on TV called, ‘What’s the Right Diet for You?’ (referenced in the 9 February post Food, Glorious Food!).

What’s the Right Diet for You? was a 3 part series put together by doctors, nutritionists, and dietitians from Cambridge and Oxford Universities. Rather than prescribing a formula to follow to lose weight, they first addressed why people are overweight, then provided strategies to address the root causes.

This is the first time any program really addressed the root causes, physiologically and mentally, of why we overeat, and put together a comprehensive strategy for a lifestyle of healthy eating, not just a short-term diet. They then supported the strategy with experiments demonstrating the science behind the advice.

I recorded the programs and watched them over and over, adapting the strategies for me, and the pounds starting melting off. I was stunned by the results!

So far, I’ve lost 132 lbs in a little over a year, and have 9 more lbs to go. My target is to reach my military weight.

Unfortunately, I was too embarrassed by the way I looked and had so little confidence of real success that I didn’t take a proper “before” picture. The one in the side-by-side photo above was the best I can find from when I was generally around 350-360 lbs. In the middle is when I reached 100 lbs lost, and the right is 130 lbs lost.

I wish I could provide links for you to watch the programs yourself, but they are no longer available on YouTube. I will try to do justice to the information imparted over a series of blog posts.  If you are where I was in December 2014, get ready.

Rule #1 – This is a healthy eating lifestyle, not a diet!

Accept this now. What I will be sharing is not a short-term diet, but a plan for a long-term healthy eating lifestyle.

[Note from Crew Dog: I hope you will follow along as Dave shares his techniques and experiences with us in a series of guest posts on healthy eating and weight loss. For links and downloads on “What is the Right Diet for You?”, see the previous post Food, Glorious Food.]

 

 

Health Hack: Morning Checklist

The military loves checklists.  For some career fields, it feels like there’s a checklist for every action except going to the can/head/toilet. (Number 1 – check.  Number 2 – check.)

For many of us veterans, using checklists has become a deeply ingrained habit pattern.  So why not harness the checklist habit pattern and utilize the checklist tool to create a healthier lifestyle?

Particularly if you have a health condition that affects your memory, thought-process, or motivation, a checklist can be a very helpful aid.  Why not use  checklists as a health life hack? (“Life hacking refers to any trick, shortcut, skill, or novelty method that increases productivity and efficiency, in all walks of life.”)

Research indicates that it is often beneficial to take positive actions whether or not we “feel like it”.  Since I frequently wake up feeling crappy and either forget to accomplish some or most of my morning routine or just don’t feel like doing it – but I know that my morning routine is good for my health & wellbeing – I have decided to implement a morning checklist.  While it’s easy to destroy my morning routine by gradually skipping more and more days, it’s much more difficult for me to intentionally not accomplish the checklist.  So, for me, routine checklists are an effective life hack.

This is my Morning Checklist:

Morning Health Checklist – One Sick Vet

(Feel free to print it out and use it, or create your own.)

You could also use a daily health journal, a spread sheet, or a chart (like a kid’s chore chart) on the wall or refrigerator or bathroom mirror.  Whatever works for you.  (Anyone know of an app for that?)  The key is to find a way to get yourself to consistently make healthy choices and take healthy actions whether or not you feel like it, or to find a method that helps you remember when you are having difficulty remembering.

What will you do to hack your health today?

Medical Procedures: What It’s Like To Get An EMG (Electromyography)

Raise your hand if you’ve got a bad shoulder (badum ching!).  Yup, me too.  Although I had surgery to repair it a year ago, I’ve had some lingering problems.

Since physical therapy (PT) hasn’t resolved the functionality problems with that arm, my primary care manager (PCM) ordered some diagnostic medical procedures to try to determine what’s causing the problems.  One of the procedures that was ordered was an electromyography.

Electromyography (EMG) is a diagnostic procedure that assesses the health of muscles and the nerve cells that control them (motor neurons).  According to the Mayo Clinic,

“Motor neurons transmit electrical signals that cause muscles to contract. An EMG translates these signals into graphs, sounds or numerical values that a specialist interprets…EMG results can reveal nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmission.”

In my case, they were trying to determine whether a pinched nerve in my neck was causing the problems with my arm.

Electromyography is an outpatient procedure that typically takes about an hour.  EMG is often done in conjunction with a nerve conduction study (NCS), which I also had.  NCS is the measurement of “the speed of conduction of an electrical impulse through a nerve. NCS can determine nerve damage and destruction” (Johns Hopkins).

According to WebMD,

“Nerve conduction studies are done before an EMG if both tests are being done. Nerve conduction tests may take from 15 minutes to 1 hour or more, depending on how many nerves and muscles are studied.”

Since they were going to need access to my arm and shoulder (and trapezius, as it turned out), I wore a track suit with a tank top underneath. They asked me to take off the track suit jacket and lie down on an examining table.

To prepare for the NCS, the person administering the torture procedure asked me to move my fingers, hand, and arm in several different directions so she could determine her targets.  These she marked on my arm with a marking pen.  She fastened several electrodes to my hand and fingers with tape (see picture below), and proceeded to zap me with a machine that looked like a taser (but used less voltage, obviously).

 

This is not a pleasant sensation.  It typically wasn’t too painful, except when she applied multiple shocks in the same location.  The second or third consecutive shock in the same spot became more and more painful.  For the most part, she told me what she was going to do before she did it, which helped me prepare.  When she told me she needed to do 10 shocks in the same place, I knew two things: 1) It was going to hurt like hell, and 2) I’d better do the stress management/relaxation breathing techniques I learned at the base Wellness Center.

Breathing techniques, whether learned through biofeedback training or as part of yoga or meditation can be very helpful for managing pain or stress.  I use them whenever I am having an uncomfortable/painful/stressful medical procedure.  Of course, in this case, relaxing was a bit more challenging, since my body was also jerking from the shocks.  For some of the shocks, only my hand/wrist twitched.  But for some of them, my opposite leg jumped.  Several times I got a cramp in my arm muscles, and toward the end, I got a cramp in the muscles in my lower back.

That was part one.  Part two was the EMG.  “During a needle EMG, a needle electrode inserted directly into a muscle records the electrical activity in that muscle” (Mayo Clinic).

The needle is inserted into various muscles.  It didn’t hurt most of the times it was inserted, since it is a very fine needle.  It did hurt when it was inserted into the trapezius muscle.  Once it is inserted, the doctor taps on the needle, and sometimes moves it around inside the muscle as she listens to the signal.  As you can imagine, this doesn’t feel very good.  Then she asks you to engage the muscle.  You can hear an increase in signal noise while you are engaging the muscle.  This also doesn’t feel very good, as the needle feels like it is stabbing you more.

These tests may be done only on one side of your body (one arm, one leg, etc.), or they may be done on both sides of your body in order to compare results.  In this case, they only tested the problematic arm, not both, and the doctors were able to give me my results at the end of the procedures.

The good news is they didn’t see any evidence that I have a pinched nerve in my neck.  The bad news is that these diagnostic procedures didn’t help determine the cause of the problems with my arm.

After the tests: I had one righteous bruise, and I was tired for the rest of the day.

According to WebMD:

“After the [EMG], you may be sore and have a tingling feeling in your muscles for up to 2 days. If your pain gets worse or you have swelling, tenderness, or pus at any of the needle sites, call your doctor.”

“If you still have pain after the [NCS]:

  • Put ice or a cold pack on the sore area for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin.
  • Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.”

How NOT to Do It: Applying for VA Disability Years After Military Separation

Something slightly different today: I had the opportunity to write a guest post for The Military Guide.  Started by a Navy veteran who transitioned to an early retirement lifestyle after 20 years of military service, The Military Guide covers subjects such as financial independence and early retirement from a military perspective.  If you’re interested in ways to parlay military pay and benefits into savings, investments, and possibly a side hustle or two so that you, too, can avoid working or can work on your own terms after you separate from the military, head on over there and check it out.  Doug Nordman, the founder of The Military Guide, retired in his early forties and now surfs and supports veterans causes.  With some hard work and careful planning, that could be you!

The post I wrote for The Military Guide covers my experience of filing for VA disability well *after* I separated from the military.  Hopefully it will be a cautionary tale of what NOT to do, if you are still on active duty. Or, perhaps, it will give you the motivation to go ahead and apply for VA disability benefits, even if it’s been *years* since you separated from the military.  Check it out and let me know what you think.

Becoming a Critical Consumer of Health Information

“Everything we hear is an opinion, not a fact.  Everything we see is a perspective, not the truth.” – Marcus Aurelius

It is increasingly difficult to distinguish between signal and noise these days.  Information sources tend more toward being the first to release information (“getting the scoop”), and less toward fact-checking before distribution.  They also tend more toward hyperbole, and less toward sober, objective reporting.  When you add cognitive biases such as confirmation bias to the pressure to draw high ratings or optimize traffic to your site, the signal can become very hard to detect.

In other words, how do you know if health information is accurate or effective?  As of 2009, alternative medicine was a $34 billion-a-year business.  How do you know you’re not spending your hard-earned money on modern-day snake oil?

One place to start is here.  This article, provided by the National Institutes of Health (NIH), gives an overview on how to evaluate health information.

And this article in The Guardian explains a few of the reasons we can get it wrong: cognitive biases.  As one scientist in the article explains, “As a health condition degrades and there become fewer and fewer treatment options, the tendency to try anything rises. The confounding part of this equation is the concept of human hope – and that, unfortunately, is what undermines science every time. We hope that something will work, we believe that something will work.”

When I was healthy, I thought going to the doctor was like going to a car mechanic: you tell them what’s wrong and they fix it.  But when I developed a chronic health condition, I learned that doctors don’t always know how to “fix it”.  I also learned that they often don’t want to admit that they don’t know how to fix it.  I have a great deal of respect for the one and only doctor who told me, “You know more about your condition than I do.  You’re talking over my head, and I’m just going to refer you to a specialist because this is way beyond my areas of expertise.”  I have a great deal of contempt for the multiple doctors who have been unwilling to admit (perhaps even to themselves) that this is a case that *should* be referred to a specialist, and insist on trying to treat it themselves even though it is obvious to me that they have insufficient knowledge of or experience with this condition.

So, yes, when traditional medicine failed to heal me and my quality of life decreased to the point where I could hardly work and rarely left the house, I started exploring alternative medicine.  I want to believe that I will find ways to manage my condition and live a satisfying life.  Part of that has to do with hope, but a bigger part has to do with trying to regain a sense of control.  So, I’m willing to explore alternatives – but I’m also a frugal skeptic who doesn’t want to throw away money on things that don’t work.  I’m used to providing evidence to support my statements, and I expect others to do the same.

What I am finding is that it’s difficult to find empirical evidence for alternative treatments.  Many of them have not been scientifically studied, or the number of studies or number of participants are small.  So we don’t really know whether they work or not.  There are a growing number of blogs and websites that recommend various alternative treatments, but I am hesitant to endorse any of them because I find that they cite each other as support for their statements, but I can’t find scientific evidence for their claims.  That doesn’t necessarily mean that what they are saying is wrong – I just can’t prove they’re right.

It’s human nature to believe something we hear from someone we trust.  If a treatment “worked” for our friend, or someone they know, we’re often willing to try it ourselves.  The problem is that we don’t know for sure *if* it worked or *why* it worked.  Thus, we don’t really know whether it will work for us.  And we often don’t know if there are any potential side-effects or interactions with treatments, medications, or supplements we’re already trying.  We’ve all done it – but it’s a game of roulette, really.

So how can you become more informed about alternative treatments?  I have found a few information sources that have been very helpful for me.  For learning more about vitamins, minerals, supplements, and nutrition, I go to Examine.com, a site run by editors who examine primary peer-reviewed research on these topics, or to the Mayo Clinic’s website.  For a skeptical, science-based analysis of various alternative treatments, I turn to The SkepDoc, written by Harriet A. Hall, MD, a retired family physician and former Air Force flight surgeon. She writes about “medicine, so-called complementary and alternative medicine, science, quackery, and critical thinking”. She also is one of the editors for Science-based Medicine, a website that tackles “issues and controversies in science & medicine”.  There are also some very thought-provoking articles at A Breath of Reason, which is run by a skeptical cystic fibrosis patient.  In her own words: “I started this blog as a way to offer science-based refutations for other CF patients and their loved ones to refer to when swimming through the sea of misinformation flowing around the internet, TV media, bookshelves and health stores claiming to better your health in one way or another.”

I’ll add to this list as I discover new resources, and be sure to check out the Resources page.  Finally, always ask yourself: what does this person, website, company, or organization have to gain by promoting this treatment or product?  What is their motive for providing this information?  What evidence can I find to support (or refute) their claims?

If you know of other sources of scientifically tested health information, please share them with us.  Knowledge is Power!

Guest Post: Applying for VA Disability at Military Retirement

Today we have a guest post about one veteran’s experience applying for VA disability in conjunction with retirement from the military:

“I recently retired from the military. I was fortunate to have some people knowledgeable in VA procedures to help me find my way through the little known avenues of applying for VA benefits. For starters, I was in a career field that discouraged complaining to the military doctors about physical ailments. That does a great disservice to the military member when it comes time to separate. If the ailment is not in your records, then it is difficult to prove to the VA that it was service connected. Fortunately, again, my last assignment was not as operational and I used that time to get to the doctor and get all of my problems written into my medical records. That did require many trips to the base/post hospital, but those trips were worth the effort, even if they did not resolve the issue. As I got close to my retirement date, I began the process of getting into the VA system.

The second thing I did was to attend the Transition Assistance seminar offered by the military. While not everything in this seminar may be relevant to you, the visit from the VSO (Veteran’s Service Organization) representative (if he or she is any good) WILL be worth your time. If you cannot attend the TA seminar, please contact a VSO representative BEFORE separating from the military. They are often found at VA hospitals and military hospitals, or a list can be found on the VA website. They will help you fill out the proper forms and get started. Applying before you separate makes things easier.

Well in advance of retiring, I went to medical records at my installation and had them make two copies of my complete medical record: one for me and one for the VA. This can often take a few months. I suggest you never give up your copy of your medical records. I went over my complete record and made a list of everything I ever saw a medical professional about while on active duty. The VSO representative will want a copy of your medical records to review as well, so be sure to give them a copy. My VSO found things to apply for that I would have completely ignored. I was surprised at what I got disability for and what I did not get disability for. I also highly recommend reviewing the e-CFR, Title 38, Chapter 1, Part 4 available on-line to see what the VA can give you disability for. I did this around the time that I applied for my appeal to the VA’s initial decision and wish I had reviewed them sooner. They are available here.

Even if the VA only gives you a zero compensable disability for something, it is in your records as service connected and can be upgraded later if the problem gets worse. The important thing is having proof that you had the condition while you were on active duty. If you have it in your VA medical records from your separation exam, then it is, as I understand it, by definition, service connected.

Eventually, the VA set up an appointment to review my case with a VA Physician’s Assistant (PA) but you may see a doctor there. This is where they assessed the degree of my physical ailments. This doctor or PA will not assign any disability. They fill out paperwork and send it off to others who will decide your VA fate. The doctor/PA will probably be very friendly (as mine was) and you can be friendly as well, but remember, they are there to assess you and you are there to convince them that you actually are impaired. (I am, of course, assuming that you are impaired and not trying to game the system. Please do not try to apply for things that are not actually wrong with you. Fraud is dealt with harshly by Uncle Sam.)

A few months later I got the results from my appointment with all the data on my 70% disability and information on disability pay. As I mentioned, I did appeal the decision on basically everything that the VA turned me down for that I knew gave me trouble. After going through the same process a second time, I was finally awarded a 100% disability. They had neglected to assess one of my biggest disabilities, plus I was awarded a few smaller percentage disabilities that had been zeros previously. Overall, because I started early and was knowledgeable on the process, the entire ordeal, although long (7 months for initial rating plus another 7 months for the appeal), was not as difficult as I had been expecting.

If you are eligible to be seen at the VA, I recommend going at least annually to get a check-up just to keep your file current even if you get your primary care somewhere else. I do this and feel a bit out of place due to my age. If you are newly retired or separated, you may feel a bit out of place at the VA as well, but don’t let that scare you into avoiding it.

Finally, there are lawyers out there listed on the VA website who specialize in dealing with the VA. I thought that seeing one early in the process would help. It did not. Remember, they work for a fee, while the VSO representative works for the organization they represent, and there is no charge to you. I am not disparaging the lawyers, but as the lawyer I saw told me, there was nothing he could do until the VA had rejected my claim. If you feel the VA is not giving you the disability you deserve and the VSO representative is at the end of his ability, then by all means consider one of those lawyers, but do not waste money on a consultation before you need it.” – Die Fledermaus

Thanks, Die Fledermaus, for sharing your experience with us.

***I (Crew Dog) STRONGLY recommend that you consult with a VSO BEFORE filing your initial claim – they have the experience to make the claim stronger and the process smoother.***  For example:

Filing a VA claim – AMVETS

Filing a VA claim – VFW

VSOs for benefits claims assistance, career guidance, and more

Advice from a lawyer: 8 ways to improve your disability claim

Here are some additional resources that may help you if you are applying for VA disability compensation benefits:

What is all this, anyway? A thorough explanation provided by MOAA

Understanding the VA disability application process

Getting started (pre-discharge from service)

Applying for benefits (all benefits)

Compensation

VA service-connected disability compensation rates

38 CFR Book C, Schedule for Rating Disabilities

Legal presumption of disability

Another Vet’s experience: Lessons I learned filing for disability benefits

How do veterans file a PTSD claim?

The VA denied my disability claim. Now what?

 

Dealing with a Health Condition or Disability that Others Can’t See

Unseen disabilitiesSome disabilities are visible, and others are not. They each have their own challenges. I can’t personally speak about what it’s like to have a disability that is obvious to others. If someone who has experience with that would like to write a guest post for this blog about their experiences, please contact me.

My disability is chronic and debilitating, but it is not visible. When it is flaring up, people sometimes notice symptoms. But most of the time, it is not obvious. While that means I don’t always have to deal with other people’s biases or awkwardness, it also means that other people typically don’t understand or respect my limitations.

It can be difficult for others to accept or remember your restrictions when “you don’t look sick” – especially if they have never personally experienced a chronic illness or disability. They may become offended when you cancel plans you had made with them, or don’t keep in touch as often as you used to. Or, because they don’t understand your limitations, they may try to convince you to do things you know would be detrimental to your health.  They may even imply that you are lazy or “faking.”

Before my condition became debilitating, I didn’t understand when someone with a chronic health condition told me that sometimes it was just too exhausting to go to church because so many well-meaning people would come up and ask how they were doing. I didn’t understand when I read on a blog that a person with a chronic health condition had gotten divorced because they just didn’t have the energy to cope with their health *and* try to sustain a relationship. Now I understand.

If you have an unseen illness or disability, and you have people in your life that you would like to have a better understanding of your reality, I highly recommend this post by Christine Miserandino.  (You can also download it from that website as a pdf.) It’s called The Spoon Theory, and it’s the best explanation I’ve seen of what it’s like to live with a chronic, debilitating condition.  Even if they still don’t really get what it’s like to be you after reading the article, at least it will give you a common vocabulary to explain things to them.  I find it very helpful to be able to say, “I don’t have enough spoons for that,” or “If I do this with you, it will take all of my spoons, or nearly all of my spoons, and then I won’t be able to do x, y, or z.  Is that how you would like me to spend my spoons today/ this week?”  It helps make my reality a little more tangible for others.

P.S. – If you’re wondering what the people at church “should” have said to the person with the health condition – if you’re wondering what the “right” thing is to say to someone you know is coping with an illness or disability – I recommend “It’s nice/good to see you.”  It acknowledges that you noticed I haven’t been around, and you noticed I am here today, but it doesn’t require me to spend my limited energy talking about my health.  If I’m feeling well enough to be here today, I probably don’t want to be reminded that I frequently *don’t* feel well enough to attend, and I don’t want to feel defensive about my limitations.  Just say “hi” – it’s enough.

Proposed Health Care Hikes in Pentagon’s 2017 Budget Proposal

Another good reason to embrace preventive health and self-care: retiree health care benefits continue to erode.  Recent proposals would make health care significantly more expensive for retirees and their families.

According to this article in Military Times, the Pentagon’s proposed 2017 budget includes several changes to the existing Tricare system and to the fee structure.  The most significant price change is the proposed implementation of an annual healthcare fee for “working-age retirees” – retirees (and family members) who are not yet eligible for Medicare.

Under the proposed plan, Tricare would be re-structured into two choices: Tricare Select, which provides care through military treatment facilities (MTFs) and is similar to the current Tricare Prime option, and Tricare Choice, which provides care through civilian providers and is a hybrid of the current Tricare Extra and Tricare Standard options.  Tricare Select would cost $350 for an individual or $700 for a family (per year).  Tricare Choice would cost $450 for an individual or $900 for a family (per year).  Please see the Military Times article for proposed co-payment rates and other proposed fees, which would be in addition to the annual enrollment fee.  What’s the bottom line?  According to MOAA’s president, retired Air Force Lt. Gen. Dana Atkins, “the full array of fee changes would mean about a $500 to $600 annual increase for retired families under 65 who use in-network providers and an increase of more than $1,000 a year for those using out-of-network providers” (MOAA article on the proposed changes here).

The proposed budget also includes increases to the catastrophic caps for beneficiaries.  For retirees, the cap would increase from $3,000 to $4,000, and participation fees would not count toward the caps.

Military Times states, “According to budget documents, the changes are designed to entice more beneficiaries to use military hospitals and clinics by continuing to offer care at these facilities at no cost to patients and curb the rising costs to DoD of private care.”  As has previously been pointed out on this blog, this places patients in a very difficult position when MTFs in their area are at capacity and not accepting new patients.

Furthermore, MOAA is concerned about the robustness of the non-military network of providers.  In the MOAA article, Lt. Gen. Atkins asserts, “One of the main access problems is that many doctors don’t want to be in the current network.  We’d like some assurance that will be fixed.”

The new system would require annual enrollment, and families who fail to enroll and pay the enrollment fee will forfeit coverage for the plan year – in other words, coverage would no longer be automatic, and if you don’t sign-up during the enrollment period, or fail to pay the fee, you would have no military healthcare for that year.  While it is suggested that requiring annual enrollment would bring Tricare in line with civilian heath plans, one wonders about ulterior motives.  Research has repeatedly shown that individuals are more likely to participate in benefit plans that are opt-out, rather than opt-in (read more here, here, or here).

These proposed changes are intended to change beneficiary health care behaviors.  In other words, if it costs more to see doctors and specialists, and it costs more to have prescriptions filled, maybe you won’t use them as often.  (Of course, if you miss the sign-up window, you won’t be using them at all that year.)

There are many ways to respond to these proposed changes.  I choose to respond to a future that most-likely includes increased healthcare fees by taking actions to improve my health.  How about you? Why not take control of your health and your finances by practicing informed preventive health and avoiding increasingly more expensive co-pays?  You may find that managing your health through diet, exercise, meditation, or other self-care practices could reduce your need for medications and reduce the frequency of your visits to the doctor.  Why not focus on the part of the equation you can control?