Young Shark Blog

Archive for March, 2011

Modern medicine recognizes that many mental and emotional problems are in fact physical illnesses or related to them. So, with either Medicare Part A hospital insurance plus Medicare Part B medical insurance, or with a Part C Medicare Advantage managed care plan, participants have extensive coverage for treatment of mental or emotional illness, including depression, Alzheimer’s disease, and other forms of dementia. This includes both inpatient and outpatient care, and treatment not only by doctors but also by other Medicare-certified healthcare providers. The amount of coverage Medicare provides depends on the kind of hospital where the person receives care.

Care in a general hospital.If the inpatient care she receives is in a general, nonpsychiatric hospital that treats patients for all types of illness, the rules of coverage are the same as for any other hospital stay. That is, under Medicare Part A, she must pay a deductible, plus daily co-payments for a stay of more than 60 days within any one benefit period. If she’s in the hospital for more than 90 days in any one benefit period, Medicare Part A pays part of the cost of up to 60 more once-in-a-lifetime “reserve days”. However, there’s no lifetime limit on the number of hospitalizations that Medicare Part A will pay for. If she has a Part C Medicare Advantage managed care plan, it pays for at least this same amount of inpatient care, and some plans pay more of the cost. Care in a psychiatric hospital.If she’s an inpatient in a psychiatric hospital — meaning one that accepts patients only for mental health care — the rules of payment are the same as for a general hospital but the total amount of coverage is different. Medicare Part A covers only a total of 190 days in a patient’s lifetime for inpatient care in a psychiatric hospital.
Nursing facility care. The single most important thing to understand about Medicare and nursing facilities is that Medicare does not pay for long-term care. However, under limited circumstances and for a short time, Medicare Part Aor a Medicare Advantage managed care plan can cover a stay in a skilled nursing facility while the person is recovering from a severe mental health episode that landed her in the hospital. The nursing facility stay must follow, within 30 days, a hospital stay of at least three days. And the nursing facility stay must be medically required and prescribed by her doctor to provide her with daily skilled nursing or rehabilitation services while she’s recovering from the medical event that put her in the hospital. The coverage can last for up to 100 days, with Medicare paying the full amount for the first 20 days and your family member having to make a co-payment of $133.50 (in 2009) per day for days 21 through 100. For more details about Medicare Part A nursing facility coverage, see our article Understanding Medicare Part A (Hospital Insurance). Home care. Home care is available under Medicare Part A, Part B, or Part C (managed care) if it’s medically necessary for any illness or condition, including mental illness, Alzheimer’s, and other forms of dementia. But the rules under which Medicare coverage is available for home care are quite strict, and coverage usually lasts only a short time. The key thing about Medicare coverage for home care is that it applies only to home healthcare. That means your family member must need skilled nursing care or rehabilitation therapy while she’s confined to home because of an injury or illness. It doesn’t cover assistance with the activities of daily living such as dressing, bathing, walking, or eating unless these are provided incidentally, alongside required skilled medical care. A doctor must prescribe the home care and it must be provided by a Medicare-certified home healthcare agency. If the person in your care qualifies, Medicare pays 100 percent of the agency’s costs. But the care can continue only as long as the skilled nursing or therapy is required, while she’s actually recovering. Home healthcare is covered by Medicare Part A following a hospital stay, or by Medicare Part Bif there has been no prior three-day hospital stay. If she’s enrolled in a Part C Medicare Advantage managed care plan, that plan provides home care under the same rules, except that the home care agency must be associated with the specific managed care plan.

Psychological care. Psychological counseling is not technically medical care. But under some circumstances, Medicare Part B or Medicare Part C managed care will cover counseling by a clinical psychologist. The person’s doctor must prescribe the treatment. The psychologist must be certified by Medicare. And the psychological care must relate to a problem — such as depression or anxiety — arising out of a medical condition for which the doctor is treating her. If she’s suffering emotionally from the strain of a physical illness, suggest that she discuss the problem with her doctor. If she and the doctor believe she might benefit from psychological counseling, Medicare Part B or her Medicare Advantage managed care plan might cover the care. The office of the psychologist she’s referred to can find out in advance from Medicare whether it would cover her treatment there. Adult daycare. In general, adult daycare provides personal monitoring and attention with structured activity in a secure environment. Medicare usually considers this type of care “custodial” rather than medical and so usually doesn’t cover it. Medicare can cover services from an adult daycare center only in very limited circumstances. Medicare might cover actual mental health treatment, prescribed by a physician, provided at an outpatient mental health clinic. If this clinic is also an adult daycare center, the patient can get the benefit of the center’s other care services while receiving treatment there. Medicare will cover this kind of care only if, and for as long as, it involves actual medical treatment — administration and monitoring of medication, for example, or help with recovery from a medical crisis. Also, some Part C Medicare Advantage managed care plans offer limited adult daycare coverage as part of their comprehensive home care services. Medicare doesn’t require that these plans offer this, so the nature and extent of what they cover depends entirely on the plans themselves. Finally, Medicare partners with Medicaid to sponsor what’s called the Program of All-Inclusive Care for the Elderly (PACE). This provides comprehensive home and community care, including adult daycare, for frail elders who would otherwise require nursing home care. PACE is only available in certain states, however. And in those states, it may be available only to those who are eligible for both Medicare and Medicaid. See Medicare’s official website at medicare.gov for a list of PACE programs.

Therapeutic services for Alzheimer’s patients. For a long while, Medicare didn’t consider various therapies for people who had been formally diagnosed with Alzheimer’s disease medically necessary, and so did not cover them. This policy has changed. If the person in your care has been diagnosed with Alzheimer’s, Medicare Part B can now cover physical, occupational, and speech therapy for her, as well as psychological counseling and other mental health services. Her doctor must prescribe the treatment, however, and it must be provided by a Medicare-certified therapist or mental health provider. Medications for mental health conditions.Any medication administered to someone when she’s a hospital or nursing facility inpatient, whether or not she’s an Alzheimer’s patient, is covered by Medicare Part A. Any medication given to her at her doctor’s office or at any outpatient health facility is covered by Medicare Part B. Things get much trickier with prescription drugs taken at home. The only coverage Medicare provides for at-home medications is through a Medicare Part D prescription drug plan. Coverage for specific drugs the doctor may prescribe for mental health issues depends on the formulary — the covered list of drugs — that her plan maintains. There’s a special prohibition, however, on certain drugs that are often prescribed to cope with mental health issues. Medicare doesn’t permit a Part D prescription drug plan to cover any medication within the categories of barbiturates (certain sedatives) and benzodiazepines (certain tranquilizers), even if a physician has prescribed it. So if she’s taking one of these drugs, and she’d like to have coverage from her Part D drug plan, ask her doctor whether a similarly effective drug might be available that does not technically fall into either of these categories.

After working hard at diet and exercise, you have lost a massive amount of weight only to find you have excess skin that just won’t go away. The good news is that there are cosmetic surgery procedures that can remove that skin and tighten up what remains leaving you with a more toned appearance.

Both sexes can be benefited from a number of facial procedures that are available for addressing specific problem areas. A face lift (rhytidectomy) generally deals with the lower portion of your face. Because of weight loss or age, your eyelids may now have drooping skin. The procedure is called blepharoplasty and is done on both men and women making them look younger and refreshed.

Your surgeon may also suggest a brow lift which lifts the position of the eye brows and removes the horizontal lines that may make a person appear angry. With all facial procedures, the incisions are made as small as possible and are designed to be hidden in your hairline or where there are natural folds of your skin.

Your neck may also be showing signs of your weight loss, giving you the “turkey neck” appearance. While a neck lift (cervicoplasty) can’t reverse the aging process it can make both men and women appear more youthful. When a neck lift is done, the procedure is similar to the lifts described above with the skin being lifted, tissue and muscle being tightened and excess skin being removed.

The breast/chest area can also be a problem for both men and women. Some men may have had heavy “man boobs” and now have sagging skin left there as evidence of the weight loss. A woman on the other hand might have sagging breast tissue and skin.

A breast lift (mastopexy) on a woman will involve moving the nipple higher and rebuilding the breast tissue that remains. If a woman doesn’t have enough breast tissue or perhaps would like to enlarge her breasts she may opt to have breast augmentation done also.

In male breast lift, incision is made at the fold under the breast area; any excess tissue and fat are removed via liposuction with the incisions being closed with fine sutures.

Considering the arm area, the most likely place with excess skin is the underside of the arm. Arm lift,(brachioplasty) can be done by making an incision near your arm pit, liposuction follows to remove fat from the under arms and then the excess skin is pulled towards and the incision is closed.

You might find that you have excess skin and tissue drooping around your abdominal area (both above and below the belly button) along with sagging skin in the buttocks area. During your consultation with your surgeon, various procedures may be discussed such as tummy tuck (abdominoplasty). Great care is given to hide incisions in natural folds of the body. The length of this horizontal incision depends on the amount of excess skin to be removed.

As with most procedures, the muscles are tightened through the incision and liposuction maybe used to remove fat and contour to your abdomen. Depending on how much skin and tissue you have remaining, your surgeon may suggest a body lift which is a combination of tummy tuck and butt lift.

Thigh lifts (thighplasty) are done to change the appearance of specific portions of your thighs. Liposuction may be used to define your thighs and remove any excess skin.

With any of these or other cosmetic surgery procedures, you should make sure your surgeon is certified by The American Society of Plastic Surgeons (ASPS). When you meet your surgeon for the first consult you want to ask what their experience level is, with the specific procedure you are considering. Better to find out before you go through surgery than afterwards.

Prices for each procedure vary by geographic area and some surgeons have “packages” for multiple procedures. Financing is available for plastic surgery through several financing companies although you should explore all your financial options.

People who are unlucky to experience erectile problems run across a lot of ads for ED medications. You have certainly the experience of having your inbox full of spam emails suggesting great prices for these drugs. It has come to the point that erectile dysfunction is already an open topic and people discuss it on TV and magazines. Of course, there’s nothing wrong with talking about a health condition, even if it was a taboo not that long ago. However, the main catch is that the large public believes that the widely advertised ED drugs are the only way to overcome ED and there’s nothing else you can to about it. Fortunately for a lot of men out there, treating erectile dysfunction is not limited to only taking pills. In fact some improvements can be done with effective lifestyle changes.

Yes, lifestyle changes have become the recent fad in the world of medicine, being hailed as the most effective proactive treatment for many health conditions, including erectile dysfunction. And there’s a reason for that – by changing your lifestyle you can effectively minimize the risk of certain conditions even those you are prone to. But what it has to do with erectile dysfunction? Well, let’s take a look at the cause of the problem.

As you probably know, erectile dysfunction is primarily caused by such physiological conditions as diabetes, hypertension, high cholesterol, alcohol abuse, obesity, smoking, heart diseases as well as use of certain medications. It’s logic that if you manage to prevent the development of the aforementioned conditions there will also be a lower risk of experiencing erectile dysfunction. So what can be done to prevent it in terms of lifestyle?

If you do not want to depend on Viagra at a later stage of your life you should change your habits and employ a healthy lifestyle. This involves becoming more physically active and following a specific regimen. Physical activity is a must for preventing numerous health problems including hypertension, heart diseases, high cholesterol and obesity. By exercising at least 30 minutes three times a weak you will be able to keep your cardiovascular system and the body in general in good shape. If you have weight problems, you might want to intensify your physical activity in order to get rid of the excessive weight. It doesn’t really matter what kind of physical activity you’re engaged in – working out, swimming, jogging, aerobics, yoga – as long as you manage to keep your body in tone and give your heart a good pump.

In terms of diet, there’s nothing really special you’ll need to get the Viagra effect, so put those oysters away. By simply eating normal healthy food you will lift the pressure from your body and minimize the risk of developing numerous diseases. Healthy food means anything that is non pre-processed, fast, junk, too salty, fat or hot. Keep your regimen rich with vegetables, fruits, red meat, fish, poultry and seeds to have a good balance of vitamins and minerals. And speaking of vitamins and minerals, you might as well want to take supplements of Vitamin A, E and zinc in order to minimize the risk of needing Viagra in the future.

Heartburn is definitely an annoying thing to deal with. The unpleasant burning sensation in the chest can make any tasty meal feel not so pleasant and give you a bad mood. Heartburn is mainly caused by increased acidity in the stomach and reflux of food back into the esophagus. There are different medications that help you minimize the chance of such a reflux. But not always synthetic medications are well tolerated on their own and you need an effective yet natural solution for heartburn. Fortunately, there are several ways you can calm down the fire in your chest without needing any medications. Here are some tips you will definitely find helpful:

1. Diet

It’s evident that the things you eat directly affect the acidity in your stomach and can cause the esophagus to flare up if you’ve eating something wrong. There are foods that are known to provoke acidity and heartburn more than others, and these foods include citrus fruits, tomatoes, chocolate, coffee (and caffeine drinks), salty foods, saturated fats, processed foods, alcohol and hot sauce. Keeping these foods to a minimum in your regimen will significantly reduce the likelihood of dealing with heartburn.

2. The way you eat

Besides the actual food you consume, the way you eat it is also very important. First of all, you should avoid eating large portions if you’re prone to having heartburn. Eat less food but more often, if you feel hungry throughout the day, in order to avoid too much food filling up the stomach and making a part of it to reflux into the esophagus.

The timing is also important. If you’re looking forward to exercising, leave at least a 2 hour window between your meal and physical activity in order to avoid reflux. And don’t eat in less than three hours before going to bed, otherwise you risk having your sleep disturbed by heartburn.

3. Water

Heartburn may be a sign of dehydration, especially after exercising. So make sure to consume an adequate amount of clean water every day – about 8 glasses. If you have heavy physical activity then your water intake should be increased. However, make sure that you’re drinking water not soft drinks. Drinks high on sugar and caffeine may increase your energy for some time but they will surely provoke heartburn.

4. Garlic

Garlic is certainly not a good choice when it comes to good breath but it sure is effective for heartburn. Moreover, if you have problems with the stomach flora and are prone to ulcer, garlic’s antiseptic and antibacterial abilities will help you minimize the chance of suffering from serious stomach conditions. So you get Nexium and antibiotics in one natural package with a small amount of fresh garlic every day.

5. Oxygen

In many cases heartburn is caused by a weak LES (lower esophageal sphincter) – the muscle connecting the stomach and the esophagus and preventing the food from flowing back up from the stomach. And like with any muscle, the way it gets its oxygen is very important for keeping it in a good shape. Sometimes heartburn can be caused by improper breathing that doesn’t give your body the oxygen it needs. So try to breathe slowly and deeply in order to give all your muscles the oxygen required for normal functioning. It sure is a good alternative to pills like Nexium.

Condition of your hearth is a good indicator of your health in general. And if you start losing hair it’s a clear sign that there are some health problems that you don’t know about yet. There are many health conditions that can trigger hair thinning and hair loss, such as nutritional problems, hormonal imbalance, surgery side-effects, medication and substance abuse, and thyroid problems.

The problem of hair loss has become quite common in the US. The American Academy of Dermatology’s Data indicates that by the age of 40 nearly a half of all Americans will experience hair loss problems to a different degree. But if you have thyroid problems, hair loss might take place even earlier.

There are three major kinds of thyroid issues:

1. Hyperthyroidism – Over-activity of the thyroid gland
2. Hypothyroidism – Under-activity of the gland
3. Benign thyroid disease and thyroid cancer

When speaking about hair loss issues, they are usually connected with over and under activity of the thyroid gland and respective hormone production.

Where is the thyroid gland exactly?

The thyroid gland is located at the base of the neck, surrounding the voice box (larynx) from both sides.

What should you do if thyroid problems cause hair loss?

Get a medical evaluation

If you have hair loss problems and suspect them being caused by thyroid functions, you should get an evaluation from a dermatologist and endocrinologist. Dermatologists usually take a set of tests in order to find any signs of infections and health problems other then the thyroid gland functions. Endocrinologists will evaluate the condition of your thyroid and tell you what the problem is exactly if that’s the case.

Can it be the drug you’re taking?

In many cases hair loss can be caused by the use of particular medications. If you are currently taking Synthroid, Unithroid, Levoxyl, Levothroid or any other similar medications there’s a risk of experiencing hair loss problems. If that’s the case, consult with your doctor in how to minimize the effects of these drugs.

Avoid being undertreated

Not taking the right medications for the right medical condition can also cause serious side effects including hair loss. Make sure that your doctor has issues the right treatment course by consulting with another specialist.

Be patient

When the cause for hair loss is identified and it’s clear that the thyroid is responsible for it, it’s time to get a bit patient. You will definitely be prescribed with hormonal treatment, and it’s a slow process that may take a couple of months. Don’t expect hair loss to stop altogether after the first week of the treatment course.

Are there any other solutions available?

Of course, you may take a chance and try Propecia, which is by far the most effective hair loss drug for men. However, it should only be used by men, while women cannot take the drug due to the hormonal effects the drug delivers. And it also requires you to find out the exact problem of your hair loss. If hair thinning and balding is caused by thyroid gland issues it’s quite likely that you won’t need Propecia.

A co-occurring disorder, also referred to as dual diagnosis, is when a person has a mental disorder, such as anxiety or depression along with a substance or alcohol abuse disorder. As if receiving or providing treatment for an addiction wasn’t enough to worry about, the very high prevalence of mental disorders among people with substance abuse problems makes treatment even more difficult.

In fact, according to the American Medical Association about 29 percent of people diagnosed with mental illnesses are also affected by either an alcohol or drug addiction as well and about 37 percent of people addicted to alcohol and 53 percent of people addicted to drugs have at least one major mental illness. Co-occurring disorders has an especially prevalence in criminal justice system. According to study printed in American Psychologist in 1991, 72% of both male and female jail detainees have co-occurring disorders.

In 2004, as reported by a survey conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), there were 4.6 million adults with both serious psychological distress and a substance use disorder of which 41.4% received treatment only for mental health problem; 5% received treatment only for substance use problems; 6% received treatment for both mental health and substance use problems; and 47.5% did not receive any treatment. These numbers are astoundingly high and seem to make it obvious that more attention needs to be paid to the proper treatment of people with co-occurring disorders.

However, the likelihood of an individual receiving the proper treatment is very low. The main reason for this is in diagnosing someone with co-occurring disorders. A diagnosis of co-occurring disorders can be difficult because you need to be able to establish at least one mental disorder and one substance abuse disorder independently of each other. The reason that the multiple disorders are to be established separately and then diagnosed together as co-occurring disorders is because the best possibility of recovery from both is when they are treated together at the same time.

There is an obvious a relationship between the mental disorder and the substance abuse disorder in co-occurring disorders and a common question whether one could possibly be causing the other. While this may seem like an important question, it is much more important to keep in mind that whether or not one caused the other, they are both there and one can cause the other’s symptoms to increase in number and intensity, so if one is treated while leaving the other unchecked treatment and recovery from both will be near impossible.

A large part of recovery from addiction, and maybe even more so with co-occurring disorders, is hope. It is important to remember that even though successful treatment and recovery of multiple disorders often takes more effort, time, and patience than just one disorder on the part of both the individual affected and the treatment provider it can and has been done. Another vital aspect of recovery and maintaining hope is to not be discouraged if a relapse occurs. Although a relapse may not be a desired part of recovery, it can happen, and most people can bounce back from them quickly, with some effort, and move on with their recovery.

Having a healthy support network is also essential to people recovering from not just addiction but co-occurring disorders. A support network can be anything from sober group of friends or family, or a self-help group such as Alcoholics Anonymous or Narcotics Anonymous. Finding a support network for someone with a co-occurring disorder can be more challenging depending on the mental disorder of the individual, but there are many resources that can and should be utilized to search for one. The Links page of this site has some of the available resources listed.

When working with individuals that may possibly have co-occurring disorders, or considering the possibility of that you, yourself, may have co-occurring disorders, it is important to make sure that an accurate and thorough assessment is performed. Some of the aspects of an individual’s life that should be taken into consideration are: family history, sensitivity to alcohol or drugs (meaning the relationship between alcohol or drug use and mental health), symptoms that appear when sober, and treatment history.

Please note: not all substance abuse or mental health facilities are capable of treating co-occurring disorders and it is essential to locate one that does if successful treatment and recovery is to be obtained. For a list of substance abuse facilities that address co-occurring disorders please visit SAMHSA’s Treatment Facility Locator or call their 24-hour helpline at 1-800-662-HELP (1-800-662-4357).