Smart Hospital Beds in Our Future?

Can we have a smart hospital bed in our future? This may happen if hospital bed manufactures come on board with current technology.

John LaCourse may soon have his name on a lot of hospital beds. He is a professor and chair of the University of New Hampshire's Department of Electrical and Computer Engineering. His research may soon represent a leap forward in hospital patient care. He is presently negotiating with hospital bed manufacturers to add his programmed algorithm technology to make hospital beds “smart” computerized beds.

This research looks very promising and is on the fast track to becoming a reality. It will be useful for many applications including, blood pressure monitoring, prevention of bed sores, sleep apnea, and potentially many other applications.

The microprocessors will be incorporated in the bed and must be standardized as a plug-and-play so medical devices can share information and communicate with each other. This will provide patient information which will hopefully reduce care errors.

Read the article here for more information. This is something I am looking forward to seeing come to fruition. These could prove very useful, not only in hospitals, but also in nursing homes, hospice care, and even in home care. This may also have applications for continuous blood glucose monitoring and insulin pump use.

Exercise

Before starting any exercise regimen be sure that you talk to your doctor and get his permission. Your doctor may have some advice that you would be wise to follow. And your doctor may want to do some tests that will help guide the advice s/he gives you particularly if you have any medical limitations.

Exercise is generally considered one of the keys to weight loss, managing blood glucose levels, and lowering the risk of cardiovascular problems. Many sites are touting the benefits of aerobic and resistance exercises. These are excellent for people without medical limitations.

What many people forget about is swimming. This is low impact and the water provides buoyancy for those with some medical restrictions. Your heart, your brain, and your entire body benefits from exercise. Once you have your doctors approval, select the type of exercise that fits you goals and abilities. Make sure that the exercise is something you enjoy as this will aid you in maintaining a regular routine.

Many people walk every day. Some lift two to five pound weights while in a wheelchair using their feet or hands, or use their arms to push the wheels around the block. Do what you are capable of doing on a daily or regular basis. With winter basically here, many people are fortunate enough to have indoor equipment and can and do use it.

Some cities have swimming pools that are available year round for swimming, whether they are city owned or in a YMCA or YWCA or other organization. Some will allow use for a fee and some require yearly memberships. Some hospitals have small rehabilitation pools that can be used for a fee. So check around and ask questions.

In many cities there are malls that allow walking and this is great if they are indoor areas and have good distances. In a few areas there are stores that will allow you to walk indoors during the winter. Most request that you ask permission and complete some paperwork for their protection and yours if you fall or have something like a hypo and cannot communicate yourself.

This just scratches the surface of what is available or can be done for exercise. Those with medical limitations are often capable of more than they realize and with proper instruction and desire are often to stretch their abilities. Those that have no medical limitations need to put forth more effort to exercise.

This War Must Be Fought!

Normally I would wait to post this, but this demands action now!

This war is with the government and our ill advised bureaucracy that is out to kill people with chronic diseases, namely diabetes. This would otherwise be called Medicare. And we all know this means that the insurance companies will follow this lock-step.

For the background of what is going on, please take time to read the post of December 1, 2010 by Lee Dubois. I know others will be writing about this also. Take time to read his blog now and then come back. I know that your blood pressure will go up, and hopefully you remembered to take your medication last night.

It is bad enough that we have to fight for every test strip that we can get and ask our doctors to go to bat for us to get a few extra strips, but to have medicare dictate that we will only be allowed one test strip if you are on oral medications and three if on insulin it totally out of line and could be fatal for some. We all need to test if we think we might be having an episode of hypoglycemia.

What is so frightening is this time your doctor will not be able to argue for you. This will be the rule and no exceptions will be allowed. It is bad enough that these decisions are not up for public comment before being enforced, but to ram this down our throats is totally unconscionable.

Therefore - call the Congressional Switchboard at 1-866-220-0044. If you give them your zip code they’ll connect you with your Senator’s office. Each Senator apparently has a Healthcare Liaison. Give that person an earful. I lifted this from Lee's blog and I hope that this is acceptable because of the need to do this.

I would also suggest that you email your senators at this link and make the subject attention the Healthcare Liaison. In the first sentence get their attention by stating that Medicare has overstepped their boundaries or wording to this effect.

Do this now and don't wait. Also contact any friends that you know might support you and have them do this as well.

Diabetes Awareness Month Ended

I am not sad to say good bye to this month. Some good projects were started, but at the same time a lot of money was flushed down the drain not benefiting anyone with diabetes and certainly not educating the general public.

What we need is a year-round effort to put diabetes education front and center to the nation and the world. We don't need anymore wasting money on blue lights and the electricity that lit them. This money could have been better spent on some one page advertisements (or even half-page ads) explaining the difference between the types of diabetes and educating a lot more people than lighting a few buildings.

While many people liked seeing the buildings lighted in blue, the people that understood the meaning were those that already know much of the differences between the types of diabetes. They also know about diabetes because they have this disease.

Therefore, I would like to challenge my fellow bloggers to think seriously about finding out whether their local newspapers accept columns written by them about diabetes. Some will even put them in the health section while others will put them on the opinion page. Most local newspapers will not pay for this, but this should not stop you from trying to educate their readers.

My local paper accepts letters to the editor or columns written for the Health section. After the new year, I will be submitting a monthly column for the Health section. While this will not bring me any money, at least I feel that I will be able to help educate people about diabetes in my small corner of the world.

Diabetes' civil war

This is the Chicago Tribune's attempt to stir the pot.  These people had to know when they gave permission to be quoted what the subject of the article was. If I were these people, I would not want to brag about this.

Others are a little more relaxed in their view and for this I am thankful. Check out this blogger and the links he shows, for a little more balanced view.  Note: the link in the last sentence has been broken.

This deserves no more discussion.

More Snake Oil Sales

So far I have not found this in American news sources, but this from the Jamaica-Gleaner is disturbing. Titled “The Diabetes Deception” this article is about as false as they get. While the author is correct that about 95 percent of people have Type 2 diabetes, but to say this is curable, degrades all people with diabetes.

To declare that Type 2 is a lifestyle-related disorder instead of a disease, is wording that snake oil salespeople use profusely. For many Type 2 people, the diagnosis is often made too late and the damage to the pancreas is already done. If the medical community and the American Diabetes Association (ADA) wakes up and advises doctors to be aggressive in their diagnosis, what these people advocate may be possible, but still will not be a cure. See a supporting study that I blogged about for that here.

Using exercise and nutrition may possibly delay the onset of Type 2 diabetes. If the person is overweight or obese, then the reduction of weight will aid in reducing insulin resistance. Even these measures will not ensure a cure, but still are highly advisable to delay full onset of diabetes.

Many of the lifestyle changes promoted by this article will indeed promote good health and delay full diabetes, but there is nothing that will prevent or “cure” diabetes. Let any of these people stop doing regular exercise, over eat carbohydrates, and stop following the recommendations, and Type 2 diabetes will take over without hesitation.

The other argument for eating only low glycemic foods is a good guide, but not fool-proof in preventing diabetes. Total low glycemic eating habits may also not be as healthy for diabetes as they proclaim. Dr. William Davis in his “The Heart Scan Blog” will inform you about some of the dangers in a low glycemic diet. At the same time he also believes in a cure for diabetes. See his blog here. I can't say I totally agree with him, but he at least does not promote snake oil cures.

Some people are talking about early detection of problems with the pancreas and what can be done to reverse the problems, but still these are not cures and if not followed very strictly, will still develop into diabetes Type 2. So read with care.

Components of Lifestyle Change?

This may be just semantics; however, I would like to clarify some parts of the term “lifestyle”. The definition from an on line dictionary says lifestyle is a way of life, the attitudes, tastes, moral standards, economic level, etc., that comprise an individual or group.

This of course says nothing about diabetes and managing diabetes. In my reading, blogging, and participation in a few diabetes forums, I have seen lifestyle described many ways. I have a slightly different perspective as most writers start off with diet.  I believe the elements of lifestyle change should start with exercise if you are physically and medically able. It is the key that generally makes the rest of lifestyle fall into place.

What you need to recognize is that all are interlinked and bypassing one part of lifestyle change will normally make changes generally unachievable. What different writers choose of emphasize depends on their philosophy and how they view their career. Most that work in the medical profession, be they doctors, nurses, educators, dietitians, or licensed caregivers, must follow the guidelines of the American Medical Association, the American Diabetes Association, and other professional medical groups if they want to have their license updated and current.

Since I answer to myself and a few bloggers that agree exercise should be listed first, this is where I will start. This is the list I have pulled together from various sources. It may not agree with everyone's list, but for me, the list needs to be updated as changes are found that affect the way we look at diabetes and lifestyle.

The main elements of lifestyle should or must include the following; exercise, sleep, food, medication, illness, hormones, stress, heart health care, and two other elements, alcohol and smoking. Some people would include weight loss. For me this needs to be part of exercise and food changes plus others to effect weight loss.

Exercise – If you are physically and medically able, get your doctors okay to exercise, and remember to exercise good judgment and don't do something that will be wrong and cause injury. Start out slowly and build up gradually. Regular exercise helps make insulin more readily available and reduces insulin resistance. Find a form of exercise or a mix of routines that you enjoy and follow through with it.

Food – Healthy eating is important and even more important if you are unable to exercise. It is good to be consistent in eating times and amount of food. Whether you eat low carb or another way, learn to use your meter to determine how different foods affect your blood glucose. Learn to coordinate your food with the medication you are taking.

Sleep – Where did this come from? It is not included on most lists, but should be after a study I wrote about here. I keep being surprised how important sleep is to our well being as a person with diabetes. That is the main reason I am adding it to lifestyle and encouraging all to get the sleep needed. If you are having trouble getting enough sleep, change your habits and if that does not help, talk to your doctor about doing a sleep study to determine if you have a form of sleep apnea.

Medication – Be sure that you follow the doctors instructions. Yes, I know that you want to avoid all medications. This is an excellent goal if you are diagnosed early on and can make this work. Remember that you need to consider getting the diabetes managed as soon as reasonably possible. Do discuss with the doctor getting off medications if you do it. If you do bring diabetes under good management and the doctor wants to keep you on medications, then ask yourself if a change needs to be considered.

Heart health care – Because people with diabetes are at 50 percent risk of having cardiovascular events, many of the same changes for diabetes help with heart health. It is still necessary to consider medications for heart health. Exercise and food choices become primary for heart care and managing cholesterol and hypertension.

Illness – This was a little surprising until I thought about how illness affects our diabetes management. So as an element of lifestyle change we need to learn to take our medications timely and know when to talk to the doctor about variations like illness which can cause problems unless we know not to take certain medication to prevent hypoglycemia. This means having a plan with your health care team of what medications to take or not take during an illness.

Hormone levels – This is normally for women who have problems with blood glucose swings related to the monthly menstrual cycle. I personally think the authors failed to talk about the change in life for women and problems some men can have when male hormones cause problems and can affect blood glucose as well. You need to talk about this with your doctor to be prepared for these changes.

Stress – This is definitely a lifestyle change that affects everyone with diabetes. When stressed, almost anyone can toss aside their usual good diabetes management practices, forget to eat healthy foods, and lose control of your blood glucose. Prolonged stress may prevent insulin from working properly which also creates additional problems. Some find logging your stress level (1 to 10 scale) each time you log your blood glucose level helps them see patterns and allow you to adjust accordingly. Learn about ways to relax and find ways to reduce stress.

Alcohol – This can be a bad one if not thought out. First, you need to talk this over with your doctor. Alcohol can aggravate diabetes complications like nerve damage and eye disease. If your diabetes management is excellent, and the doctor agrees, an occasional alcohol drink with a meal may be okay, but a daily drink is generally discouraged.

Smoking - This is a habit that must be broken. Many writers do not want to cover this lifestyle change that needs to happen, and the sooner the better. Not only does this increase the effects of neuropathy, but it can affect an increase in cardiovascular risks. Do not take this lightly, the effects of continuing to smoke do not make blood glucose management easier.

To sum up, these are the lifestyle changes that need attention for those of us with diabetes.

Pharmacies Becoming Sources for Medical Care?

Normally I will not post the same blog to both of my blogs.  I feel this topic needs the exposure so that people can determine for themselves where they want to be on this issue. 

Is this what we want or what we need? I have to wonder if this will be a good thing for people with chronic diseases. I am not sure I want my medical care retailized or taken care out of a storefront. But this is the latest desire from Walgreens – to become your one-stop health care facility.

Walgreens and other large retail pharmacies are lobbying to make this a fact of life. I do not want to have nurse practitioners in charge of my medical health care. I am thankful that in some of the more remote areas or largely rural areas in the United States, nurse practitioners have been needed to get medical care to people and have done excellent work. This has been a necessity because of the lack of doctors in these areas. But for a retail store like Walgreens in non-rural area, this runs against my better nature.

Walgreens is wanting to do this because of the “national shortage of primary care doctors”. They are proposing to “assist patients in managing chronic conditions of diabetes, hypertension, and high cholesterol”.

We have to wonder if we are going to be prescribed extra drugs or medications as a result. Is the American Medical Association going to allow this to happen? Are the states going to allow this to happen? It is happening in some states that have nurse practitioners, but I hope that this does not come to pass in our more populated states.

Many pharmacies are now giving blood screening, flu shots, and other medical advice mainly under the supervision of pharmacists. This is not always the best for many patients as they do not check any medical records to verify allergies and other medical conditions which might preclude some treatments.

What many are banking on is the new health care act providing insurance to people and they want to cash in on the potential increase of cash. And Walgreens is not bashful about saying this.

Before I would want to utilize pharmacies (or what name they will change to), I would want to know who is responsible for writing the prescriptions and whether they have met the education requirements necessary to be able to write prescriptions. Are the pharmacies going to require filling the prescriptions in their store or can these prescriptions be filled at any pharmacy?

These are just some of the questions that need to be answered before I would accept pharmacies taking over primary medical care. Will pharmacies be required to have doctors available to consult or oversee and supervise prescriptions with appropriate approvals available for states to audit? Will this action create or necessitate more state agencies to oversee questionable medical decisions and audit procedures? Will this just increase medical fraud, Medicare, Medicaid, and other fraudulent practices.

And with the shortage of nurses that exists today, where will all of the nurse practitioners come from? Or will they come from our hospitals and doctors offices thus creating a more critical shortage there?

Before this becomes practice, I would hope that our federal and state legislators will examine this very carefully. The last question I would want answered or information made available to the public is the political contributions made in the last election and to whom were they made.