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COBRA is the acronym for a health insurance portability act signed into law during the 1990’s. Thanks to COBRA, if you leave an employer who is providing your group health insurance coverage, you can keep the coverage for 18-36 months even though you no longer really qualify for the group coverage since you are not a member of the group. COBRA is a great benefit to many people-but not every employee who leaves an employer with group benefits should take advantage of COBRA coverage.

COBRA coverage is extremely expensive. If you are someone in relatively good health, who rarely goes to the doctor and has no pre-existing conditions, then COBRA coverage might not be the best use of your financial resources. Instead, you could search for low cost health insurance on an individual basis and get your own policy, not hinged on group participation, that can cover you for a fraction of the cost of a COBRA policy.

For individuals with pre-existing conditions, low cost health insurance is a pipe dream. Not only are premiums expensive for formerly ill individuals, but they may not even approve you at all depending on the risk you present. Or, they may approve you and agree to pay for your medical expenses through your policy while excluding a whole host of expenses that stem from your pre-existing condition. It is then that you are a good candidate for retaining your COBRA coverage. Even if you never go to the doctor, keeping continuous coverage through a program like COBRA is vital because it prevents another group insurance plan from declining to cover your pre-existing conditions (something they cannot do unless you’ve had a break in coverage for 63 days or longer during the past 6-12 months).

So remember, if you are young and in relatively good health, look to a low cost health insurance policy of your own for coverage after leaving a group plan. It will be much less expensive that COBRA and will allow you complete portability since its approval isn’t tied to group participation. If you have a pre-existing condition, be sure to opt for COBRA coverage immediately after leaving your job so that there is no risk of a 63 day or longer break in coverage. No matter what option you choose-make sure you always have some sort of health coverage so that you are not left to fiscally stand alone after an expensive illness or injury.

There’s this well-known line, it seems to crop up regularly in TV mystery and crime procedural shows, “There’s no such thing as a coincidence.” The detective gazes into the middle distance and then, as if my magic, manages to explain why 2 + 2 really does equal 4 this time. It’s the type of thing that ought to be true. The cause and effect of any combination of circumstances should always have some kind of logical explanation. Gastroesophageal Reflux Disease (GERD) is a classic example of this in action. If the sphincter into your stomach fails to prevent stomach acid leaking out, it’s no coincidence you find your esophagus hurting. That’s one of those night and day things. The esophagus is not designed to tolerate the presence of the acid, so… But suppose you see two men scratching their head and both are left-handed, does their preference for one hand explain why their heads itch? Obviously not. But, in all situations where two or more facts do appear together, scientists can get very interested to decide whether this is real cause and effect, or just coincidence.

So here comes the question for you to ponder. Does someone with GERD wake up more often during the night? Well, someone with the time and money decided to find out. In a sleep center set up to monitor almost every aspect of what happens when you sleep, some 40 brave volunteers with GERD agreed to be prodded and poked. This included placing a probe in their esophagus. Many might find having a piece of hardware lurking inside them a deterrent to sleep, but let’s not go there. As against all the other people monitored for sleep disorders by the center, the 40 with GERD woke three times a night. The others only woke an average of twice, even with sleep disorders. So, being scientists, these busybodies asked the poor sleepers why they had woken. Remarkably, only 15% said they had GERD symptoms. Yet when the researchers looked at the real-time feed from the metal thing in their esophagus, all the volunteers had just experienced an acid reflux episode.

This is too small a sample to be scientifically useful, but it poses a second interesting question. When trying to diagnose a problem, doctors ask their patients for symptoms. But if people are not aware of the acid reflux and it’s the cause of their waking, perhaps a lot of insomnia is caused by acid reflux. So here’s an entirely unscientific suggestion for you. If you are waking during the night and have no idea why, try taking Aciphex. Unless you have been diagnosed with GERD, this is something of a sledgehammer to crack a nut. But Aciphex cuts down the amount of acid in your stomach and makes it very unlikely any acid will leak into your esophagus while you’re lying down. Try it for a week or so. If you sleep through the night, this could be a coincidence. But it might equally be evidence you have GERD and it’s the cause of your insomnia. Of course, if you have already been diagnosed with GERD, continue taking the Aciphex and start eating less greasy and spicy food close to your bed time, and raise the head of your bed by putting blocks under the bedposts.

All of us have certainly experienced moments when the only thing that we could think of is to get some pain relief. Regardless of the cause behind pain, we simply want it to go away as fast as possible. And despite the understanding that pain is an essential signal of our bodies that made it possible for us to survive as a specie, the numerous options the medicine has for pain relief today makes us reach out for the most effective way to block pain once and for all. It is essential to know what kind of pain relief options are available out there and what cases they are used for. Because it can matter a lot when it starts to hurt.

Topical options

Topical pain relief medications usually come in the form of cr?mes, gels, balms and other substances that are easily applied to the surface of the skin. Topical painkillers are usually applied in cases of acute pain caused by injuries or physical conditions associated with chronic pain. Such substances contain active elements that are easily absorbed through the skin and don’t require internal intervention (like in the case of pills or injections). Cr?mes, balms, gels and lotions are usually effective in cases of mild pain when it doesn’t persist for long periods of time and is usually associated with internal impact on a particular area of the body.

Oral medications

Oral painkillers are probably the most common and well known forms of pain relief available on the market today. People often associate the whole concept of pain relief namely with painkiller oral medications. Fact is that this form of pain relief medications includes different types of drugs that have different methods of action and applications. For example, people often take aspirin as a painkiller for headaches, but in reality it is simply an anti-inflammation drug that helps reduce negative symptoms of associated conditions.

The most common and effective painkiller medications are opiates and opioids. Opiates such as morphine are narcotic drugs that have a very strong painkiller effect and relief even the most severe forms of pain, but have negative side effects that affect the perception of reality. Opioids like Tramadol are synthetic opiate derivatives that are free from such side effects. Drugs like Tramadol work by simply blocking the nerve signals transmitted to the brain and can help in relieving both acute and chronic pain.

Other types of drugs are also applied for relieving certain types of pain. As mentioned, some anti-inflammation drugs can help in relieving mild to moderate types of pain such as headache. Anti-seizure and muscle relaxant drugs are used in cases of pain caused by motor dysfunctions or muscular injuries.

Injections

Injections are usually applied for administering painkiller medications directly into the bloodstream or the affected area in order to achieve faster and more effective pain relief in cases of acute pain. Injections are also used for relieving pain during surgeries.

Rheumatoid arthritis is one of the more depressing diseases. Starting out with low level disability and some discomfort, it slowly grows more severe as time passes. It’s the slowness of the decline that makes it so terrible. There’s little to choose between one day and the next but, when you look back over the last month, you realize you’re another inch down the slope to the joints seizing up. The problem is the slow destruction of the cartilage as the autoimmune system fails to work properly and attacks healthy tissue, generating increasingly severe inflammation. The basic strategy for treatment is to balance physical therapy to maintain some mobility while using different drugs to halt the immune system’s misbehavior and control the pain. But there’s only a certain amount you can achieve through weight loss programs and physiotherapy. At some point, the joints cannot continue to move as before. The statistics show that, after about ten years, the majority of people will have significant disability despite the success of the DMARDs (disease-modifying anti-rheumatic drugs).

One of the key indicators of the inevitable decline is called morning stiffness. As the name suggests, lying down for sleep encourages the body to stop moving. During this period of inactivity, the affected joints and surrounding musculature stiffens. When waking, the body must slowly be coaxed back into mobility again. This can be a painful process. The European League Against Rheumatism (EULAR) has been running a series of trials on a slightly different approach to current practice. The European strategy has been to use a pick-and-mix approach to the DMARDs, looking for the best results on a trial-and-error basis. This has been justified by the inevitable “truth” that “all patients are different”. So, within preset limits, doctors play with different drugs in combination and at different dosages until the best outcome is achieved.

In two trials titled Circadian Administration of Prednisone in Rheumatoid Arthritis (CAPRA), EULAR has been testing a modified-release version of Prednisone. The idea is to take a low dose before going to bed. The tablet is designed not to release the drug until about four hours into sleep with the peak concentration being achieved about two hours later. So,someone going to bed at 10 p.m. will get the maximum effect of the drug at about 4 a.m. which is judged the ideal time if pain and stiffness on waking is to be reduced. The results from the second trial have just been released and confirm the success of the modified-release system. The drug was administered over a twelve week period, with a major short-term improvement in mobility on waking. But what is really significant is the continuing improvement in mobility when participants were allowed to continue taking Prednisone for up to twelve months after the end of the formal trial. It seems clear that the use of this drug alongside the optimized cocktail of DMARDs produces the best overall outcome with morning stiffness reduced and general mobility improved during the day. Given there is no immediate prospect of any drug coming on to the market as a cure for Rheumatoid Arthritis, these trials old out hope for those who currently struggle with pain in the mornings.

If you’re considering continuing medication during pregnancy or nursing, chances are you need that drug. Chances are that without it, your quality of life will be severely impaired. Whether you need treatment for cancer, autoimmune diseases, asthma, allergies, lupus, colitis, arthritis, Still’s disease, Bell’s palsy, Chrohn’s disease, pemphigus, sarcoidosis, kidney disease, mononucleosis, Epstein-Barr, organ transplant, migraines, or many others, choosing to go off your medication is always going to be a big decision. It doesn’t make it any easier that the medical community hasn’t reached a consensus on whether pregnant and nursing women should discontinue treatment. The best you can hope for is an informed doctor to assist in your decision-making process. Below, you will find specific information on the issues concerning this corticosteroid drug, pregnancy, and nursing.

Category C

Prednisolone, the active ingredient converted by the liver, is placed in pregnancy category C by the FDA. Pregnancy category C drugs have shown bad effects on fetuses using controlled animal reproduction studies. However, these drugs have not had adequate enough testing with human studies for the FDA to approve of or warn against usage. They note that category C medications may “warrant use” during pregnancy even when the dangers are taken into account.

So where does that leave you? Nowhere really. All that says is, “See if you think it’s worth it.” So, assuming you know the benefits of continuing medication, let’s take a look at the risks.

Pregnancy

While there have not been any large studies on humans involving the FDA or meeting their standards, studies have shown that the risk of birth defects in non-human animal testing is elevated. Specifically, cleft palate may be a danger in human fetuses. This finding comes from four epidemiological studies, and one specific one in California, which showed a significant rise in the defect. However, there have been many similar studies which show no statistically significant results for any specific birth defect. The result is wide open for debate, but it seems as if there is not a danger clear enough to indict the drug, and that speaks volumes. You can see why it is pregnancy class C.

However, a Michigan study of birth defects notes that, using a database of 229,101 pregnancies from 1985 to 1992, the pregnancies in which the mother was exposed to prednisolone in the first trimester shows a “statistically significant increase” in birth defects on the whole. To be in line with the control group, there should have been six cases of birth defects. However, in actuality, there were eleven cases. To complicate matters further, there was no strong association between Prednisone, prednisolone, and any specific defect, such as cleft palate, in this study.

Nursing

Numerous tests have shown that the amount of Prednisone or prednisolone found in breast milk is at most trace. While no testing on human children has occurred, the science says that the amount found in breast milk should not be enough to cause any danger in human children. According to the American Academy of Pediatrics, Prednisone is compatible with breast feeding.