Diabetes forums can be an excellent learning place. Diabetes forum dlife had a good discussion about a visit to a doctors office and a subsequent call by the nurse in the office, that basically said the patient had an elevated blood glucose level and he was to watch his diet. His blood glucose test had been 126mg/dl which by current guidelines is diabetes.
This is two sided and not as black and white as many want it to be. Here is where I fault the doctors for not weighing in and explaining what pre-diabetes or diabetes actually means. Many just say, “watch your diet as your blood glucose is a little elevated”. Why is this so easy for doctors? Two answers and both equally in error.
First, they do not know what to do because they have heard that between 100 and 125 on the blood glucose scale is pre-diabetes, but they have their doubts since they have not kept up with the latest reasoning or guidelines. And second, they don't want to get their patients alarmed. Therefore they pass on the opportunity to educate a patient and help the patient get an early start on possible prevention for many years. This is where I say the doctors are doing harm.
What many doctors fail to understand that studies are finding that damage to the pancreas occurs earlier than many realize and this is the reason for the American Diabetes Association changing the diagnosis standards. Prediabetes is at least better defined for the diagnosis and treatment for women who are pregnant. Still doctors are not following the ADA.
At least the patient was asking questions and was sincere in wanting answers to understand what was going on and what to do next on the forum. This is a common occurrence as doctors are not doing their job.
What everyone needs to realize is that a fasting blood glucose reading of 125mg/dl and 126mg/dl are just numbers. They both indicate that the pancreas is in trouble and already has damage. Both are serious.
When fasting blood glucose is consistently above 99 mg/dl (5.5 mmol/L), this is considered prediabetes by the ADA in their latest Care Standards published in December 2010. This means that the pancreas is not functioning properly and the condition needs attention. Most doctor dismiss this as being something needing attention, and just tell the patient to watch their diet as blood glucose in elevated. If you get this reading, insist on getting the blood glucose reading so that at least you know how to treat it. And then, find an endocrinologist that will help.
How is the patient going to take this seriously when the medical community does not. Patients often just dismiss this as well and then in the next one to five years when the diagnosis comes back of diabetes, they are shocked and think they had done enough in reducing some sugars and doing some exercising. What they don't understand is that what they did was not a plan and the carbohydrate consumption was not controlled and the exercise may have been when they thought of it.
Both doctors and patients need to take fasting blood glucose readings of 100mg/dl to 125mg/dl (5.6 mmol/L to 6.9 mmol/L) seriously and develop and plan for treating this to prevent them from getting above the upper number. This takes planning and setting goals which must be followed seriously. The doctor needs to see the patient on a regular basis and use the HbA1c to see how good, or poorly, the patient is doing. Both should be prepared to review the plan and make adjustments.
Even if the fasting blood glucose level is 126mg/dl (7.0 mmol/L) and above, many people are still capable of controlling diabetes with nutrition and exercise. This does take commitment to this goal. Some are able to do this for years and some for a few decades. So this should be a goal. For some it will not happen because of other health problems and medical reasons that prohibit exercise. Even then, proper nutrition can be of benefit in keeping off medications.
January 20, 2011
January 18, 2011
Diabetes May Simplify Life's Choices
I can occasionally learn something by reading blogs of others, whether they are Type 1 or Type 2. Catherine Price at A Sweet Life dot org wrote a blog on January 17, 2011, that really hit home. I had not really thought about diabetes this way, but she is so right that I must add my thoughts as a Type 2 and with heart disease.
Yes, diabetes does make life simpler in so many ways. I go shopping for groceries with my wife and by myself. I do look for something to change the menu, but I seldom get past the label. It is easy to pick up fresh vegetables and some fresh fruits as from experience I know that the carbohydrate count is within the range I am looking for. Once in a while, it is easy to select a few of the higher carbohydrate fruits as we both like them and I can limit the portion size that I will eat.
Then we come to the packaged products. If it isn't the carbohydrate content, then it is the sodium content that rejects them. Most canned fruits and vegetables are ruled out because of the sodium levels or the carbohydrate levels. Some canned fruits and vegetables can be made acceptable by rinsing them and then soaking them in clear water and draining this liquid, thereby eliminating the liquid they were canned in.
Catherine says it very well that we would not choose to have diabetes, but it can be a blessing in disguise (I say it is a large blessing) as we eliminate many foods we would not otherwise reject. I add sodium because of heart disease which eliminates other foods. Now with the American Heart Association issuing their call to the public, health professionals, the food industry, and the government to increase efforts to lower the amount of sodium that we consume on a daily basis, we have more hope.
The AHA has issued their statement to get people to limit their sodium intake to 1500 milligrams of sodium per day. This is down from the 2300 milligrams that was their standard. Anyone concerned about heart disease and high blood pressure, the standard now is 1500 milligrams. Thank you to the AHA for their revision. Therefore, I now feel much safer with my personal upper limit being at 1200 milligrams of sodium intake.
Everyone should read their release published in Science Daily here. Now if the American Medical Association and other professionals organizations will follow their lead, we can all be healthier.
Yes, diabetes does make life simpler in so many ways. I go shopping for groceries with my wife and by myself. I do look for something to change the menu, but I seldom get past the label. It is easy to pick up fresh vegetables and some fresh fruits as from experience I know that the carbohydrate count is within the range I am looking for. Once in a while, it is easy to select a few of the higher carbohydrate fruits as we both like them and I can limit the portion size that I will eat.
Then we come to the packaged products. If it isn't the carbohydrate content, then it is the sodium content that rejects them. Most canned fruits and vegetables are ruled out because of the sodium levels or the carbohydrate levels. Some canned fruits and vegetables can be made acceptable by rinsing them and then soaking them in clear water and draining this liquid, thereby eliminating the liquid they were canned in.
Catherine says it very well that we would not choose to have diabetes, but it can be a blessing in disguise (I say it is a large blessing) as we eliminate many foods we would not otherwise reject. I add sodium because of heart disease which eliminates other foods. Now with the American Heart Association issuing their call to the public, health professionals, the food industry, and the government to increase efforts to lower the amount of sodium that we consume on a daily basis, we have more hope.
The AHA has issued their statement to get people to limit their sodium intake to 1500 milligrams of sodium per day. This is down from the 2300 milligrams that was their standard. Anyone concerned about heart disease and high blood pressure, the standard now is 1500 milligrams. Thank you to the AHA for their revision. Therefore, I now feel much safer with my personal upper limit being at 1200 milligrams of sodium intake.
Everyone should read their release published in Science Daily here. Now if the American Medical Association and other professionals organizations will follow their lead, we can all be healthier.
January 14, 2011
Calling for More Testing for Diabetes
A lot more needs to be done. It seems many educational institutions are jumping on the band wagon of encouraging more testing for diabetes. But calling for more testing is not getting the job done. Unless this call is turned into action, nothing will change. And this is all to often the case. Calls go out, but no one follows through to see that doctors are doing this and often the insurance companies are discouraging them.
If these institutions would encourage their medical schools to spread the word and talk to their graduates, more good might happen. What might assist if pressure on the medical insurance industry to request doctors do this to remain on the approved list. Doubt insurance would consider, but it could save them big bucks in the long term.
In addition they would actually be doing some excellent preventative medicine and developing customer relations. What is it going to take to get everyone on board and taking action. I suspect it is a task for people in a position to call investigations and enact legislation that might force this stalemate.
Yes, why even have elected officials if they cannot act on behalf of their constituents. The Alzheimers Association has a national plan. What can't the American Diabetes Association have a national plan. Probably because it is not part of their 2011 priorities.
Many of the Type 1 people are talking about talking to their elected officials and are doing this, but it is not even on the agenda for the ADA. This is another reason those of us with Type 2 need a new organization that will advocate for 90 to 95 percent of the people with diabetes.
Using the HbA1c test as a screening test is somewhat practical, but both tests should be preformed. If getting this started requires giving up one test, then so be it. In the January 2011 issue of the American Journal of Preventive Medicine, a study reports that the A1c test can be administered in the physician's office and will identify pre-diabetes.
If they can identify more individuals with pre-diabetes in the physicians office, it will give an opportunity to stop the progression of the disease and possibly delay diabetes for many years. This would be a win for the people in terms of healthcare and even a win for the medical insurance industry with less expenses.
If you are considering being tested, learn the signs for risk for diabetes. They are high blood pressure or heart disease, being overweight or obese, or a family history of diabetes, over the age of 45, and are a woman with a past gestational diabetes, get yourself tested to determine if you have prediabetes. If you are diagnosed as having pre-diabetes, loosing as little as 10 to 15 pounds through exercise and diet will cut your chances in half of developing diabetes. This will improve your health dramatically if you treat it as serious and keep working at it.
Read the article on the study here and good luck. For those of us already with diabetes, if you can work this in with a friend that shows the above probabilities, do it politely and explain how it can help.
This article appeared on January 13, 2011. It is not a total shock that they say that nearly one-half of the people with Type 2 diabetes do not manage it. From the persons I know locally, I thought the percentage would have been nearer 60 percent.
Don't get me wrong, nearly 50 percent is horrible, and coming from the Centers for Disease Control, I can trust these numbers a lot more that my own observations. This public health initiative is between the doctors of endocrinology and two large pharmacological companies.
This may be a lofty project, but at least some of the people in a position to do so are involved. Now the problem will be if we can get them behind the screening for diabetes and pre-diabetes.
If these institutions would encourage their medical schools to spread the word and talk to their graduates, more good might happen. What might assist if pressure on the medical insurance industry to request doctors do this to remain on the approved list. Doubt insurance would consider, but it could save them big bucks in the long term.
In addition they would actually be doing some excellent preventative medicine and developing customer relations. What is it going to take to get everyone on board and taking action. I suspect it is a task for people in a position to call investigations and enact legislation that might force this stalemate.
Yes, why even have elected officials if they cannot act on behalf of their constituents. The Alzheimers Association has a national plan. What can't the American Diabetes Association have a national plan. Probably because it is not part of their 2011 priorities.
Many of the Type 1 people are talking about talking to their elected officials and are doing this, but it is not even on the agenda for the ADA. This is another reason those of us with Type 2 need a new organization that will advocate for 90 to 95 percent of the people with diabetes.
Using the HbA1c test as a screening test is somewhat practical, but both tests should be preformed. If getting this started requires giving up one test, then so be it. In the January 2011 issue of the American Journal of Preventive Medicine, a study reports that the A1c test can be administered in the physician's office and will identify pre-diabetes.
If they can identify more individuals with pre-diabetes in the physicians office, it will give an opportunity to stop the progression of the disease and possibly delay diabetes for many years. This would be a win for the people in terms of healthcare and even a win for the medical insurance industry with less expenses.
If you are considering being tested, learn the signs for risk for diabetes. They are high blood pressure or heart disease, being overweight or obese, or a family history of diabetes, over the age of 45, and are a woman with a past gestational diabetes, get yourself tested to determine if you have prediabetes. If you are diagnosed as having pre-diabetes, loosing as little as 10 to 15 pounds through exercise and diet will cut your chances in half of developing diabetes. This will improve your health dramatically if you treat it as serious and keep working at it.
Read the article on the study here and good luck. For those of us already with diabetes, if you can work this in with a friend that shows the above probabilities, do it politely and explain how it can help.
This article appeared on January 13, 2011. It is not a total shock that they say that nearly one-half of the people with Type 2 diabetes do not manage it. From the persons I know locally, I thought the percentage would have been nearer 60 percent.
Don't get me wrong, nearly 50 percent is horrible, and coming from the Centers for Disease Control, I can trust these numbers a lot more that my own observations. This public health initiative is between the doctors of endocrinology and two large pharmacological companies.
This may be a lofty project, but at least some of the people in a position to do so are involved. Now the problem will be if we can get them behind the screening for diabetes and pre-diabetes.
January 11, 2011
ADA Has Legislative Priorities?
Well, on January 6, 2011, the American Diabetes Association finally issued their 2011 legislative priorities. While reasonable, I see nothing innovative or challenging in their agenda. It is good to know that they continue to back federal funding for several established government agencies.
Since they don't wish to be specific in their priorities, this should not be a challenge since most of the Federal funding of this will probably be funded, but to a lesser degree than previously with the cutbacks necessary to rein in our bloated budget. I sincerely hope that this has some success.
Now to take the remaining list of priorities and my comments.
Health Reform Defense & Implementation – focus on access to quality, affordable coverage that provide people with, and at risk for, diabetes the tools necessary to manage diabetes and prevent its onset and complications
I have to wonder why this means defending the Affordable Care Act (ACA) which congress is under mandate from the people to repeal. Plus if they are participating in the legal defense, I think this would be wrong on so many levels. We do need affordable coverage and many people do need the tools to manage diabetes to prevent its onset and complications. This seems such a mild statement, that one must wonder what they expect to accomplish. ADA's track record is not even a fair rating in the past.
Prevention – focus on primary prevention of type 2 diabetes centered on prediabetes, physical activity and nutrition
If they follow through with this, this could be great. Again they fail to mention any specifics and this should always be a top priority, especially the way they expect the number of people with diabetes to increase.
Eliminating Disparities in Diabetes Prevention and Access to Care Act to address racial and ethnic disparities
This is an excellent goal, but hopefully will encompass financial disparities. Otherwise this priority will fail.
Gestational Diabetes Act to expand diagnosis, data collection and treatment
This does reflect the major change in policy and definition for gestational diabetes in the 2011 Care Guide. For this issue alone they get my praise for something positive.
Diabetes Screening and Medicaid Savings Act to provide screening and diabetes care under Medicaid
A good priority, but lacks support in encouraging the insurance industry and Medicare to provide necessary screening from children to the elderly.
Stem Cell Research
This is too broad a priority and should be limited to research for diabetes applications only.
Health Entitlement Programs including Medicare and Medicaid
Should include all, meaning not only Medicare and Medicaid, but the medical insurance industry as well.
Discrimination Issues
Time for ADA to act accordingly and end their own discrimination. The one area they listed is worthy, but does not address ADA's own discrimination.
Bills Related to Complications and Comorbidities of Diabetes
This is very general as it needs to be. What legislation will be introduced remains a mystery until introduction.
These are at best broad priorities for an organization that should also have some specific goals and priorities. I would hopefully think they could publish some specific goals and priorities.
The listed or published priorities are in and of themselves very discriminatory. No where is any mention made of doing anything for Type 1 diabetes. Only Type 2 is given a mention. It is small wonder that the number one complaint against the ADA is their discrimination against Type 1, yet at every chance they get they will take credit for something the JDRF accomplishes.
I agree with those that want to hold ADA's feet to the fire for their lack of attention to Type1 priorities. Even the monogenic diabetes classifications get no mention in their priorities. While Type 2 is about 95 percent of all diabetes, does this mean that the others deserve no mention. I don't think so! I also will not accept that the word diabetes means all types when one type, Type 2 is singled out.
Read their priorities here, a slightly expanded version here, and if interested a list of the officers here.
Since they don't wish to be specific in their priorities, this should not be a challenge since most of the Federal funding of this will probably be funded, but to a lesser degree than previously with the cutbacks necessary to rein in our bloated budget. I sincerely hope that this has some success.
Now to take the remaining list of priorities and my comments.
Health Reform Defense & Implementation – focus on access to quality, affordable coverage that provide people with, and at risk for, diabetes the tools necessary to manage diabetes and prevent its onset and complications
I have to wonder why this means defending the Affordable Care Act (ACA) which congress is under mandate from the people to repeal. Plus if they are participating in the legal defense, I think this would be wrong on so many levels. We do need affordable coverage and many people do need the tools to manage diabetes to prevent its onset and complications. This seems such a mild statement, that one must wonder what they expect to accomplish. ADA's track record is not even a fair rating in the past.
Prevention – focus on primary prevention of type 2 diabetes centered on prediabetes, physical activity and nutrition
If they follow through with this, this could be great. Again they fail to mention any specifics and this should always be a top priority, especially the way they expect the number of people with diabetes to increase.
Eliminating Disparities in Diabetes Prevention and Access to Care Act to address racial and ethnic disparities
This is an excellent goal, but hopefully will encompass financial disparities. Otherwise this priority will fail.
Gestational Diabetes Act to expand diagnosis, data collection and treatment
This does reflect the major change in policy and definition for gestational diabetes in the 2011 Care Guide. For this issue alone they get my praise for something positive.
Diabetes Screening and Medicaid Savings Act to provide screening and diabetes care under Medicaid
A good priority, but lacks support in encouraging the insurance industry and Medicare to provide necessary screening from children to the elderly.
Stem Cell Research
This is too broad a priority and should be limited to research for diabetes applications only.
Health Entitlement Programs including Medicare and Medicaid
Should include all, meaning not only Medicare and Medicaid, but the medical insurance industry as well.
Discrimination Issues
Time for ADA to act accordingly and end their own discrimination. The one area they listed is worthy, but does not address ADA's own discrimination.
Bills Related to Complications and Comorbidities of Diabetes
This is very general as it needs to be. What legislation will be introduced remains a mystery until introduction.
These are at best broad priorities for an organization that should also have some specific goals and priorities. I would hopefully think they could publish some specific goals and priorities.
The listed or published priorities are in and of themselves very discriminatory. No where is any mention made of doing anything for Type 1 diabetes. Only Type 2 is given a mention. It is small wonder that the number one complaint against the ADA is their discrimination against Type 1, yet at every chance they get they will take credit for something the JDRF accomplishes.
I agree with those that want to hold ADA's feet to the fire for their lack of attention to Type1 priorities. Even the monogenic diabetes classifications get no mention in their priorities. While Type 2 is about 95 percent of all diabetes, does this mean that the others deserve no mention. I don't think so! I also will not accept that the word diabetes means all types when one type, Type 2 is singled out.
Read their priorities here, a slightly expanded version here, and if interested a list of the officers here.
January 6, 2011
National Action Plan for Alzheimer's Disease is Law
Well it was bound to happen. President Obama signed the National Alzheimer's Project Act (NAPA) into law on January 4, 2011. This provides Alzheimer's disease with its first national plan to fight the disease. According to the author this was needed to abate the threat to bankrupt the US healthcare system.
I thought from all the press about diabetes and the rate of diabetes increase, that diabetes is what will bankrupt our healthcare system. I am happy for the Alzheimer's Association as this is a big step in finding ways to stop the spread of Alzheimer's disease and I do not want to belittle this accomplishment.
Now, if you will permit me, I need to rant about the American Diabetes Association and their lack of getting anything similar done. I don't know how we as patients are going to be able to influence the leadership of the ADA to do something similar, but I feel there is a need and it is long past time that someone lit a very hot fire under their backsides.
It seems that if they are doing any lobbying, it is very ineffective and they are spending the money in unproductive activities. It seems to me that the powers of ADA are more interested in anything other than getting the recognition on a national or even world wide basis. Otherwise, we should be seeing more activity and be reading more press about the accomplishments of the ADA.
Thank goodness, the International Diabetes Federation seems to have more interest and is working with governments around the world to put forth the need for diabetes recognition. This is a lot harder than working with one government. So to the ADA, I issue a challenge to quit being so sedentary and start accomplishing something which will bring more press to diabetes.
So before I forget it, please read the short article about the Alzheimer's plan here. Wish them well and start working on ADA to get something accomplished.
I thought from all the press about diabetes and the rate of diabetes increase, that diabetes is what will bankrupt our healthcare system. I am happy for the Alzheimer's Association as this is a big step in finding ways to stop the spread of Alzheimer's disease and I do not want to belittle this accomplishment.
Now, if you will permit me, I need to rant about the American Diabetes Association and their lack of getting anything similar done. I don't know how we as patients are going to be able to influence the leadership of the ADA to do something similar, but I feel there is a need and it is long past time that someone lit a very hot fire under their backsides.
It seems that if they are doing any lobbying, it is very ineffective and they are spending the money in unproductive activities. It seems to me that the powers of ADA are more interested in anything other than getting the recognition on a national or even world wide basis. Otherwise, we should be seeing more activity and be reading more press about the accomplishments of the ADA.
Thank goodness, the International Diabetes Federation seems to have more interest and is working with governments around the world to put forth the need for diabetes recognition. This is a lot harder than working with one government. So to the ADA, I issue a challenge to quit being so sedentary and start accomplishing something which will bring more press to diabetes.
So before I forget it, please read the short article about the Alzheimer's plan here. Wish them well and start working on ADA to get something accomplished.
January 5, 2011
Benefits Found for Colonoscopies
Bob Pedersen, a fellow Type 2 blogger first wrote about his experience of having a colonoscopy here (link is broken and site no longer exists). It was humorous and to the point. They put me under as well using an IV and a slow drip. I have had five of these and only one that was without polyps. All have been negative for cancer. The first was at age 55 and one polyp was considered by the physician as about six months precancerous.
Now a study from Germany offers strong evidence that they can prevent colorectal cancers throughout the colon. The study appears in the January 4 issue of Annals of Internal Medicine.
A colonoscopy is one of the most effective cancer screening and prevention exams. That being said, recent studies have raised issues that a colonoscopy may not be useful in detecting some colorectal cancers. However, the issue raising studies were done in Canada. Colonoscopies are the standard in Europe and the US and apparently are better used.
Most in Canada are performed by surgeons and primary care doctors and not gastroenterologists who specialize in the exam. This could be what has caused the problem with the studies.
We definitely have a need for the exam to be performed with the flexible fiberoptic scope with a video camera as the other exams are not as accurate and the fecal occult blood testing often did not see results until cancer was already in place and doing damage. Granted they were lower cost and while there was strong evidence that they were effective, there is still some serious questions about whether more cancer is prevented using the old tests.
There are some problems in the US because gastroenterologists are not required to document the thoroughness of the exam and many people to not receive information after the procedure showing a map of the colon and where the polyps were found. In Germany the quality assurance measures have been introduced nationwide.
I have had both types of exam where I received a complete report and map and then I have not received a complete report. Some standardization needs to be put in place and patients need this complete information.
Since most colorectal cancers take five to seven years to develop on polyps, I agree that the exam needs to take place at least every five years at a minimum. When polyps are found on a regular basis, then I agree that every three years should be normal as are mine. The recommendation is that people should have the exam starting at age 50 unless there are indications for earlier exams.
Do I dare ask questions of or about the gastroenterologist? Yes, everyone should ask at least two questions when the schedule is set for the exam. They are the detection rate for the person performing the colonoscopy and what documentation will be presented upon completion and will it be for the entire colon. If it not for the entire colon, then think seriously about finding another gastroenterologist.
Read about the article on the study here and here. Also view an excellent slide show on colorectal cancer overview here.
Now a study from Germany offers strong evidence that they can prevent colorectal cancers throughout the colon. The study appears in the January 4 issue of Annals of Internal Medicine.
A colonoscopy is one of the most effective cancer screening and prevention exams. That being said, recent studies have raised issues that a colonoscopy may not be useful in detecting some colorectal cancers. However, the issue raising studies were done in Canada. Colonoscopies are the standard in Europe and the US and apparently are better used.
Most in Canada are performed by surgeons and primary care doctors and not gastroenterologists who specialize in the exam. This could be what has caused the problem with the studies.
We definitely have a need for the exam to be performed with the flexible fiberoptic scope with a video camera as the other exams are not as accurate and the fecal occult blood testing often did not see results until cancer was already in place and doing damage. Granted they were lower cost and while there was strong evidence that they were effective, there is still some serious questions about whether more cancer is prevented using the old tests.
There are some problems in the US because gastroenterologists are not required to document the thoroughness of the exam and many people to not receive information after the procedure showing a map of the colon and where the polyps were found. In Germany the quality assurance measures have been introduced nationwide.
I have had both types of exam where I received a complete report and map and then I have not received a complete report. Some standardization needs to be put in place and patients need this complete information.
Since most colorectal cancers take five to seven years to develop on polyps, I agree that the exam needs to take place at least every five years at a minimum. When polyps are found on a regular basis, then I agree that every three years should be normal as are mine. The recommendation is that people should have the exam starting at age 50 unless there are indications for earlier exams.
Do I dare ask questions of or about the gastroenterologist? Yes, everyone should ask at least two questions when the schedule is set for the exam. They are the detection rate for the person performing the colonoscopy and what documentation will be presented upon completion and will it be for the entire colon. If it not for the entire colon, then think seriously about finding another gastroenterologist.
Read about the article on the study here and here. Also view an excellent slide show on colorectal cancer overview here.
January 1, 2011
CPAP Is A Carry-on for Air Travel
If you have obstructive sleep apnea and use a CPAP (or other XPAP) machines, please know that if you travel on aircraft, this equipment is allowed as a carry-on in addition to one other piece plus a personal bag such as a purse or briefcase. This is in the Department of Transportation rules which states an allowance for medical supplies and/or assistive devices.
Please do not check it as luggage. It can be damaged or lost. If you are questioned or it is deemed that it must be checked as luggage, it would be a good idea to have a print out with you to present. This can be found here.
TSA often does not know their own regulations in detail. In the above reference it does provide an email address - airconsumer@ost.dot.gov for filing complaints. There is also a site to download forms to mail in complaints.
Also it is advisable to carry a letter of medical need signed by your doctor on his letterhead paper. This has come in handy for me.
Read the reference here.
Please do not check it as luggage. It can be damaged or lost. If you are questioned or it is deemed that it must be checked as luggage, it would be a good idea to have a print out with you to present. This can be found here.
TSA often does not know their own regulations in detail. In the above reference it does provide an email address - airconsumer@ost.dot.gov for filing complaints. There is also a site to download forms to mail in complaints.
Also it is advisable to carry a letter of medical need signed by your doctor on his letterhead paper. This has come in handy for me.
Read the reference here.
December 30, 2010
Why Do We Need New Years Resolutions?
I have never seen the need. One time I tried a couple, by the end of January they were no more.
Everyone seems to think they are needed and many are blogging about how to make them achievable. Granted, most that I hear are so grandiose that it is small wonder they can't be kept. Many are totally impracticable and impossible to keep in the first place. So why even make them. This takes all the fun out of the new year and sets a pattern of failure which many people then follow for the rest of the year.
Jen Hubley, the About Today Editor at about dot com started her newsletter for December 29, 2010 stating “New Year's Resolutions: So easy to make, so hard to keep. Unless, like me, you resolve every year to stop setting unreasonable goals. Then you can start out by not making resolutions, and you're already a winner.”
Then she had to ruin her excellent start by proposing some ways to make New Year's Resolutions. Not really, but she does link to lots of types of resolutions written by others at about dot com.
Have a Happy New Year!
Everyone seems to think they are needed and many are blogging about how to make them achievable. Granted, most that I hear are so grandiose that it is small wonder they can't be kept. Many are totally impracticable and impossible to keep in the first place. So why even make them. This takes all the fun out of the new year and sets a pattern of failure which many people then follow for the rest of the year.
Jen Hubley, the About Today Editor at about dot com started her newsletter for December 29, 2010 stating “New Year's Resolutions: So easy to make, so hard to keep. Unless, like me, you resolve every year to stop setting unreasonable goals. Then you can start out by not making resolutions, and you're already a winner.”
Then she had to ruin her excellent start by proposing some ways to make New Year's Resolutions. Not really, but she does link to lots of types of resolutions written by others at about dot com.
Have a Happy New Year!
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