Ah, now that we’re in the thick of the winter—albeit unseasonably warm in many places—it’s time to talk about what you can do to arm yourself to fend off the cold and flu. Not only do these infections leave you feeling lousy, they can sideline you for a week or longer, negatively impacting your life and productivity.
Believe it or not, the flu leads to an average of $10.4 billion in direct medical costs, and the annual projected lost earnings due to illness and loss of life amount to $16.3 billion. All in all, the total annual economic burden of the flu is estimated to amount to $87.1 billion in the US alone.
According to the Centers for Disease Control and Prevention (CD), the cold and flu viruses are spread mainly by droplets made when people with the cold or flu cough, sneeze, or talk. These droplets can land in the mouths or noses of people who are nearby. Also, a person may be exposed to the cold or flu by touching a surface or object that has a virus on it and then touching their own mouth, eyes, or possibly their nose.
Just because you have been exposed to the virus doesn’t mean that you’ll “catch” it. If your immune system is running full-throttle, it can protect you from these viruses, as well as other germs. What we do and eat affects immunity on several different levels. For instance, those with a poor diet will get sick more often and more severely than a person who eats a healthier, more nutrient-dense diet.
Along those lines, let’s explore some of the common dietary and lifestyle factors that can impair your immune system, making you more susceptible to getting an infection, getting hit harder, and keeping you out longer.
Too Little and Too Much Exercise. The relationship between exercise and upper respiratory tract infections (URTI) looks like a “J” curve, with both being sedentary and over-exercising increasing one’s risk of getting sick. On the other hand, moderate exercise can enhance immunity and decrease one’s risk of getting sick.
Too Much Stress. Chronic stress decreases the body’s immune response to a single acute stressor. In other words, the body builds up a tolerance and becomes resistant to the signal. Since it’s been inundated over time, it just doesn’t recognize it as a big deal, which leads to suppression of the immune system, which can leave one more susceptible to infections. On the other hand, stress management techniques (such walking outdoors in nature, meditation, and yoga) bolster the immune system and help you ward off infection.
Overeating. Consuming enough calories is important to optimize immune function, but consuming too much can compromise your ability to fight off illness. Excess body fat secretes inflammatory chemicals that can serve as “false alarms” for the immune system. Over time, these signals can result in the body dialing back its immune response, leaving you more susceptible to getting sick. Not surprisingly, studies show that obese individuals are more likely to get sick, as well as develop more serious complications from common infections.
Sugar and Refined Carbohydrates. Research suggests that heavily processed, refined carbohydrates and sugars reduce the capacity of white blood cells to fend off foreign pathogens. What’s more, overconsumption of sugar also increases levels of inflammatory cytokines, much like obesity and overeating as described above. Not only that refined sugars feed the “bad” bacteria of the gut, and a diet high in refined carbohydrates and sugar leads to gut dysbiosis, an unhealthy imbalance of gut bacteria. Why is this so important? The digestive system houses over 70% of our immunity, and it relies on a healthy balance of gut bacteria.
Artificial Sweeteners. Multiple studies have shown that consumption of artificial sweeteners (e.g., sucralose, saccharin) reduce the number of “good” gut bacteria and lead to gut dysbiosis, which, as mentioned above, can hamper immunity. Even more, there’s also evidence suggesting that sucralose may suppress the immune system and make one more prone to viruses.
Not surprisingly, many of the very same dietary and lifestyle factors that seem to contribute to so many health-related issues also impair immunity, leaving you more susceptible to getting sick and increasing the frequency and severity of infection. Not only will eating better, exercising regularly, and managing stress help you look, feel, and perform your best, that combo can also fortify your internal armor against getting sick.
To Good Health,
If you have Medicare as your primary insurance, and other health insurance or coverage, or what is called a “true secondary,” each type of coverage is called a “payer.” The “primary payer,” in this case Medicare, pays what it covers on your bills first, and then sends the rest to the “secondary payer” for payment. In some cases, there may also be a third payer as well.
Medicare pays up to the limits of its coverage. For example, with chiropractic coverage, Medicare will only pay for billing that contains certain manipulation codes. Exams or anything that falls under physical therapy is not a covered benefit when performed by a chiropractor.
Medicare in most cases will then submit its “Explanation of Benefits” (EOB) to the secondary payer. This is what is called a cross-over. Although it should, this is doesn’t always happen this way. There are instances where the billing department will have to wait to receive the EOB from Medicare, and then submit a paper claim to the secondary payer. The secondary payer will then pick up uncovered costs. This is only if you have what is called a “true secondary.” It is important to note that this coverage is very different from supplemental insurance.
If your secondary payer is “supplemental insurance,” it will only pick up what Medicare covers as this type of insurance policy follows standard Medicare guidelines. All other services will be denied.
So to avoid denials of coverage after services have been provided, your best course of action is to verify your coverage with both insurance companies before starting any treatment plan!
Posted By Steven J. Atlas, MD, MPH On June 20, 2016 @ 9:30 am In Addiction,Back Pain,Behavioral Health,Health,Pain Management | Comments Disabled
Over the last year, the general public has been inundated with a steady stream of reports about the dangers of opiates — pain medicines like codeine, Percocet, and OxyContin. The harm in terms of ruined lives and death from illicit drugs such as heroin is not news. But what is new, and concerning, are the risks of prescription pain medicines — those doctors prescribe for pain due to a range of causes, including musculoskeletal problems like low back pain.
The history of using opiates for chronic pain
Back pain isn’t a new problem either, but the history of how doctors have treated it is probably new to many. A “cliff notes” version of what changed goes something like this. Studies showed that doctors weren’t adequately treating the pain of people with advanced cancer. Research also showed that pain medicines such as opiates improved quality of life for these terminally ill patients. This realization led to recommendations that doctors monitor pain as they would any other vital sign (like temperature or blood pressure) for all their patients — and that all types of pain receive aggressive treatment, including long-term (chronic) pain, such as low back pain. At the same time, drug companies promoted new formulations of opioid medications with longer duration of activity that made it easier for patients to take on a regular basis.
The problem was that this fundamental change in practice was really devoid of any proof that it would help people better manage pain and minimize its effect on their lives. Prior reviews of the medical literature have documented that there is little evidence supporting the use of opiates for chronic low back pain. The modest benefits seen were with short-term use. The practice of using these medicines for long periods of time has not been carefully evaluated. Few risks were seen in these short-term studies, but tolerance to the effects of the medicine, side effects and dependence/addiction have become clearer with longer use.
A recent study published in JAMA Internal Medicine adds to this knowledge. Dr. Abdel Shaheed and colleagues performed an updated literature review, and their conclusions reinforce that only short-term benefits have been proven and the amount of that benefit is modest. Moreover, they examined the doses of pain medicines used in these studies and found that the pain relief people actually experienced was not that great.
Opiates for chronic low back pain carry big risks with uncertain benefits
This and prior studies clearly show that the leap to widespread use of opiates for non-cancer pain was premature. We didn’t know the long-term benefits and risks. We still don’t know the benefits, but this dramatic increase in use of pain medicines hasn’t helped people return to their previous level of activity, and rates of disability haven’t gone down. What is becoming clear are the risks, specifically rates of addiction, overdoses, and the rise of deaths attributed to prescription opiates. And people who have become addicted to their prescribed pain medicines often switch to heroin, which is cheaper and more readily available.
Now this doesn’t mean that we should stop treating pain. For many, the pain is real, chronic, disabling, and they need help managing it. And it doesn’t mean that everyone prescribed opiates becomes addicted. Nor does it suggest that opiate medicines have no benefits at all. But what it should do is give all of us pause. The bottom line is that simply taking a pill (or a handful of pills) doesn’t fix low back pain — and can lead to a whole lot of trouble.
What you can do for back pain
Fortunately, there is growing evidence for treatments that can help with chronic low-back pain, but they aren’t simple fixes in the form of pills, shots or surgery. Instead, treatments should focus on getting back pain sufferers active again and learning to manage, not cure, the pain. A range of therapies including exercise, education about how to care for your back, yoga, and mind-body techniques have been shown to help control back pain.
So what do I tell my patients? For those with chronic back pain who aren’t on opiates, steer clear. For those who are already take them, you can’t go cold turkey. Your body has adjusted to these medicines and stopping them abruptly is a bad idea. With help, people on opiate pain relievers can try to wean themselves off these medicines gradually and replace them with other treatments. This isn’t easy, but for many people it starts a long process of regaining control over the pain that has taken over their lives and can help them avoid the terrible consequences of opiate addiction.
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Article printed from Harvard Health Blog: http://www.health.harvard.edu/blog
URL to article: http://www.health.harvard.edu/blog/opiates-no-solution-back-pain-201606209821