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Preventing-HIT or Heparin Induced Thrombocytopenia

8/29/2013

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Heparin, which is given intravenously is a medication that prevents the blood from clotting. The pill form of that medication is called Coumadin or it's generic is known as Warfarin. These medications are categorized as anticoagulants and are often called blood thinners. Some people may consider these medications as the diet pill for blood since it prevents thickening and the subsequent accumulation of platelets in the blood that may cause a clot to form in an artery. Blood clots generally lead to strokes and heart attacks which can cause death.

The problem with blood thinners or medications that regulate the blood in such a way to reduce instances of coagulation is that there is a delicate see saw between the blood being too thin and the blood being able to clot easily. If the blood is too thin, irregular bleeding or hemorrhage can occur. Other problems include: cholesterol embolism-fast lipids(pardon the pun), which is when the blood begins to release cholesterol from the badly damaged and clogged arteries as a result of the blood being suddenly thinned by the heparin or coumadin, warfarin. When the cholesterol is released into the blood stream, it ultimately damages other blood vessels and thus leads to kidney, renal and spinal failure. Yes, this can also lead to death.

With such a delicate balance to maintain, blood thinners have to be practically designed for the body in order for them to work properly. Many patients who begin to have problems with anticoagulant medications require hospital treatment or several doctors visits to regulate their medications, along with the problems of cholesterol. Tissue necrosis can also be a negative drawback by taking Heparin, Coumadin or Warfarin. This is caused by a deficiency known as a Protein C  deficiency. Protein C is a anticoagulant. Someone who lacks the proper amount of Protein C may develop blood clotting issues. Such conditions are called DVT, or deep vein thrombosis or PE, Pulmonary Embolism. When a blood thinner or anticoagulant is given the interruption of free blood flow causes the clots to travel elsewhere and prevents blood supply to the tissues and skin which causes gangrene and thrombosis.

To test how effective Coumadin, Heparin and Warfarin is in the body, a test called the PT/INR or international normalized ratio is used. This test is a measure of how long it takes for blood to clot. A high PT/INR means that a person is at risk of bleeding severely. A low PT/INR means that a person is at a high risk for developing blood clots.  The APTT test or Partial Thromboplastin Time test is used to monitor the effects of the Heparin, Coumadin or Warfarin. This is a reason why the PT/INR is tested on patients prior to surgery. Heparin's of a smaller molecule are considered LMWH or Low Molecular Weight Heparin that is measured in molecules of 4,000-6,000 daltons. These medications are given by injections and are not measured by PT/INR testing. The Heparin anti-Xa test is used to monitor Low Molecular Weight Heparin or a physician may order a CBC or complete blood count.

Heparin Induced Thrombocytopenia or HIT is caused by a low platelet count from taking Coumadin, Heparin or Warfarin. The antibodies in the blood then create new blood clots resulting from the platelets clumping or binding together or by attaching themselves to existing clots in the arteries or veins.

Regarding medications, there is Heparin, Coumadin or Warfarin and then there is this Low Molecular Weight Heparin. Coumadin and or Warfarin can be taken orally in pill form. The Low Molecular Weight Heparin is given by injection. The choice would depend on the person if they want to visit a doctor or hospital, inject themselves or would they just rather take it in pill form? People tend to treat their bodies like tanks with all these injections and IV's. Coumadin, Heparin and Warfarin can cause a person to hemorrhage, while LMWH or Low Molecular Weight Heparin can cause Thrombocytopenia. So now you have  a choice for the blood in your body  to either start or stop. The Heparin anti-Xa is not done as a routine or monthly test- so how do you know if the LMWH stuff is working? Which could be a problem especially if the insurance company will not pay for it because it does not meet medical necessity criteria. Ok, a platelet count will help, I guess. Hopefully, you won't be just another tank in the hospital or worse by then. 

Perhaps, if Coumadin and Warfarin were made in extended release medication form, this could possibly maintain or assist in regulating the amount of Coumadin or Warfarin the body recieves in the bloodstream on a daily basis. It may stabilize the blood so that it does not thin too quickly thus preventing hemorrhage and will stay in the body long enough to prevent thrombocytopenia,clotting or HIT by keeping anticoagulation levels consistant. Yes, this seems like another alternative to the medications and it's something you don't have to fast for!
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Is Neoclassical Economics Outdated?

8/22/2013

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Problem:
Currently in dispute is the issue of minimum wage and those who want it to be increase to a paltry amount of $15 an hour. I still say that those who want a mimimum wage of $15 an hour have not exactly figured out how they can live independently off of that amount. Why? That's only $2,400 dollars a month before taxes. If you're looking for a place to live, rent along with the other utilities will take up a great portion of that check easily unless you get several roomies to bunk up with you. Including other expenses and necessities in life, means that the $15 an hour for minimum wage is not an adequate amount to be self-sufficient on.

The minimum wage is established by certain indicators of economic value regarding the supply and demand of labor, the cost of labor, business growth and cost, and inflation, just to name a few.
The fair labor standards act of 1938 included a standard of minimum wage. This act is referenced to employees and children or minors employed by way of interstate commerce or production of goods for commerce. Several years later, in the early 1960's this law was amended to include workers in schools, hospitals, and governments. Hence, this became the standard of pay for working people.

Since wages and worth are "determined" by man or woman made decisions, it may be inappropriate to place a classification of "amount" on an individual when doing work or employed in a religious capacity because the values or blessings upon such work may not compare. To to pay a worker who works in a religious capacity a salary would be a must in order to survive. But, hey what religious employer want's to be accused of persecution, really? Minimum wage, maybe not!  Sure, a civil court may determine the value or work of a person in amounts of money or what is said to be a fair amount in payment due to unfortunate circumstances. But, again that is the act of a man made court and system and not the powers of the creator who assembled this world along with workers and a myriad of people, creatures and things for the spectrum of existence.

Neoclassical economics is based on the determination of prices and income distribution by competition and equilibrium; by focusing on constraining income of employees and constraining costs of employers. This could explain how works are paid a lot less and compaines reap much of the profit. This in itself creates a society of competition by way of wealthy or poor; since wages dictate market profits due to spending in the economy. If people do not have the money to spend then the equilibrium of the economy for most will remain poor due to the low output of wages earned by the a majority of people. This would mean that for neoclassical economics to work in modern times, the wealthy would have spend more money by buying more than one blender, a few American cars, several hot item appliances(even if you never use them or take them out of your car) in efforts to keep the economy afloat by spending. Neoclassical spending only benefits other countries because the wealthy or well off often travel; so they are not around to do some serious spending or enough spending in the USA  to maintain upward equilibrium in the economy. Neoclassical  economics also further diminishes the economy by competition in profits by outsourcing work and those that become unemployed as a result eventually have to take some form of work once unemployment stops paying; these people with jobs eliminated by competition usually end up taking jobs with their wages drastically reduced. Equilibrium is established this way between rich and poor. But, definitely not suitable for an American economy and people whereby income and opportunity should be for all.

Neoclassical economics is outdated because:

It creates more low income and minimum wage earners- the less you earn the less you have to live off of and save for retirement.

It increases the cost of welfare or social service programs- with not enough money to use for the necessities you have to go to the government to get the rest.

It increases the continuance of creating more low paying jobs- golly, the job market is practically full of them which leads to that cloudy(work) and rainy(retirement) future which was once so sunny and bright.

It creates a disproportionate amount of "white collar" jobs which are jobs that are professional, administrative, managerial, corporate as compared to "blue collar" or manual labor jobs regardless of education or applicable work and experience- wow, that means that any and all intensified study went to no good, because I was just given another collar by the "man" and sent off to the fields anyway.

Solution:
What is needed is an adaptation to the theory of classical economics:

Classical economics involves the theories of value and distribution, that the value of something would depend on the cost of producing and distributing it. When the term "minimum wage" is used, there should be a value associated with the cost of producing the employee that would determine if he or she should be considered for minimum wage or exempt. This means that a person with a bachelors, masters, doctorate(and all of the other degrees or disciplines) and experience has a cost or wage associated to them because of the intellectual level of the person. An employer may hire that person for a job that was not within his or her major but the intellect obtained with a person of such credential would make them worth  a lot more than minimum wage although you are not paying them a salary of a  CFO(Chief Financial Officer). Once the USA begins to put a value on education and experience it will begin to diversify  and create "white collar" jobs in every aspect to accomodate such people and not cheapen the education and person by "blue collar" and menial, manual labor and low paying jobs. The equilibrium of the economy will balance out due to the balanced nature of decent jobs and wages that enable people to spend and depend less on the government. True, years ago people did not pursue higher education of any form and may not have completed high school since employment was based on skill; so education or intellect of, is not getting it's value in worth or salary, as pertaining to the level of the employee. The government gets involved because, it must now assist a lot more people with survival as humans because neoclassical economics negates the value of a person regardless of education or experience.

Who knows, maybe someday with all this implementation and what not people can do the caprice classic economics thing!
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Co-payments and illness

8/15/2013

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Health insurance is a necessity and not something a person can be without. People who are young or healthy may often go without health benefits because they are paying for something that they do not often use. It may be easy to get the price of lipid or CBC test and just pay for them out of pocket at a laboratory or hospital whichever is cheaper. By doing so you can then visit a physician who may contact you by phone or may ask you to pay a fee for visit to discuss your results if it is necessary. If the results are normal and nothing else is required of you but to continue in good health, I often think why would a person waste all of that money to have the physician tell them that in person? Really, a co-payment, co-insurance and paying up to your deductible for a doctor's visit, just to tell you that you are healthy at least in one area of your body. That makes no sense at all, but then again, you may have patients who make at lot of "cents" pardon the pun and like to spend it on visiting doctors for no real reason.

Co-payments do add up and if a person went to a few medical facilities for various tests including ultrasounds, x-rays, lab tests and then the visit to the doctor; the co-payments made could be well over $100 dollars for a particular month. That is certainly a lot of money to spend. The cost of a copay, may cost even more if you are seeing a specialist. When people have large families or are coping with medical illness that requires treatment or therapy, the cost of copays can mean the difference between eating and not eating. There are times when things get difficult and restaurant food is not an option, but the tremendous cost of co-payments can make eating three meals a day from home difficult also.

There are some insurance plans that do not require co-payments upfront, and these range from high end plans to managed care and government plans. With some of these plans Medicaid pays for certain types of care regarding payment. The problem in America is that health insurance is designed based on health and not illness. By this I mean, health insurance has no "illness plan" that is inclusive of the actual health insurance. Now, you're going to read this and say duh, chemotherapy is covered under many and most health insurance plans. Yes, chemotherapy may be covered, but the cost of the co-payments and or specialist copays which are much more expensive can place a person in debt as a result of all of the visits for treatment and the cost of medications. Many people and families are a budget. America, still has not either set a standard of wages for citizens to be able to afford to live here or reduce the cost of living. How else is someone supposed to live on less money? The fact that someone becomes ill and has to be able to afford medical treatment in order to survive does not help matters any. Health insurance in America does not put much of a focus on a patient who is ill when it should. A healthy person may not need to use health insurance very often except for catastrophic instances because they are healthy. The routine maintenance exams that will provide stability of health results are all they need. By not focusing on what health insurance should be needed and necessary for, it is those who become ill that suffer because health insurance is not designed to compensate for costs when people require  on going medical treatment. Unless one purchases a cancer insurance or supplemental insurance plan that will provide extra money in times of need, one will have to pay for medical visits out of pocket even if they have insurance. In all, at least in America, you need two insurance plans-health insurance and supplemental insurance in attempts to offset medical payments as a result of illness.

The government in NSW Australia or New South Wales Australia created a plan to decrease the amount of co-payments people with chronic or illnesses that require treatment were making. By providing those that qualify for assistance with what is called a concession card, co-payments for certain types of treatments including medication costs were reduced and patients only made a $6 dollar copay for each medication and treatment therapy. This seems very helpful. It would certainly enable one to concentrate on ridding the illness from their body, and not worry instead about all of the bills that they are unable to pay as a result.

How would a plan like this work in the states here?

Let's see, patient America Love is diagnosed with cancer, her insurance of PAYUP has a copy of let's say $40 for each specialist visit. America Love works and has decided to have her chemotherapy treatments done at a hospital where they can accomodate her schedule. Since America Love does not make much money she goes to apply for a illness supplemental benefits concession card under her health insurer of PAYUP. PAYUP recieves America Love's request for a concession card to defray or reduce the cost of her copayments for her chemotherapy and medications. America Love's income indicates the fact that she cannot afford the $40 copay, for each time she goes for chemotherapy treatment and the subsequent cost of the medications she now has to take each month as a result of her cancer. PAYUP approved America Love's request. America Love's physician then has her make appointments at  the Double Cross My You Know What Medical Center. It was here where she met up with the oncology team and presented her concession card, including the staff that took her co-payments each time. The first co-payment was $40 dollars, but all subsequent  payments afterwards for America Love's chemotherapy was only $6 dollars. Patient America Love was also prescribed two medications that had to be taken each day. When she showed up to the pharmacy and presented her concession card for the first time, America Love paid the initial $10 dollar co-pay and then $6 dollars each for the two medications. This amounted to a total of $22 dollars. The next month America Love returned to the pharmacy and was only charged $12 dollars each month thereafter for the two medications. The concession card was a lifeline for America Love as she was able to continue working and to save money without accumulating debt as a result of her illness. This helped America Love's health tremendously, because now that her medical bills were not too much of a worry and her health was improving America Love could concentrate on living of course... in America. The only place she would probably ever be able to travel around in.




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Power Solar Panel Shingle

8/8/2013

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Wouldn't it be great if energy companies built a solar plant designed to reduce the cost of energy and power for home and business use? The sun does shine enough so that many people can benefit from it, instead of using sunscreen to block it. Although, the sun may cause damage to our skin with excess exposure to it, the sun is beneficial with regards to saving on electricity. The cost of having solar panels installed is extremely costly and if you're in need of a new roof or live in a building then solar energy or the use of it is something you may not be able to do. This means that you will pay what the energy company charges you each month for electricity.

Is there a way to power major appliances with the use of solar energy without getting into trouble for illegally installing a solar panel on the roof of an apartment complex or by attempting to build a solar panel yourself, that does not save you any money because electrician 101 is not your speciality?

Answer, yes there is- with The Power Solar Panel Shingle.

By now you're probably asking, what in the world is that? Before I answer that question we must first know how solar panels work in terms of providing electricity. Photovoltaics is a method of converting sunlight or energy from the sun into AC voltage, which is the type of  voltage from electrical outlets in the USA. To do this, PV(photovoltaic) panels are used as semiconductors. These semiconductors are typically mounted on a roof or are placed in areas where there is  a lot of sunlight. The energy that is collected from the sun into the solar panel is called photons. The solar panel then takes the photons and converts them in to electricity. The photons are converted into DC or direct current electricity. This is the type of electricity used in batteries. The DC electricity or voltage is then converted to 120volts of  AC voltage electricity by using an inverter. The inverter then connects to the electrical system in a home or office and enables one to use the electricity or power generated from the solar panels by using the electrical outlets in the home or office.

The Power Solar Panel Shingle is a solar panel that can be mounted from inside any house or apartment via a window. You simply open the window and mount the Power Solar Panel Shingle. Inside of the Power Solar Panel Shingle is the inverter and electric meter that keeps track of the  electricity or energy that is collected from the Power Solar Panel Shingle and the energy that is used from appliances. Just think of it as mounting a very thin air conditioner inside your window. You can even mount it on top of your existing air conditioner to save money when you use it. The Power Solar Panel Shingle comes in various sizes. To use it, you simply take it out of the box; attach the adjustable shutters to the left and right of the power solar panel shingle device and mount it from inside your home or office by opening any window that slides up or down and placing it firmly within the window sill. The Power Solar Panel Shingle must be facing outside the window in contact with the sun. Once that is complete you close the window and adjust the shutters so that the power solar panel shingle device is enclosed within the window sill to prevent air, insects, birds ect. from coming in from the outside. Or you will have to feed and breathe them the crumbs  and air you need for yourself. The United States became the world of the crumb snatchers, since the jobs went elsewhere, like the money spent on electricity. Anyhow, The Power Solar Panel Shingle device is equpped with a 8 prong power extension strip that you plug in to an electrical outlet. Once it is plugged in, the solar panels will turn photons from the sun into DC energy and the inverter will convert the DC power into AC or alternating current power so that it can be used as electricity. There is a display meter that shows how much electricity is being produced by the solar panels and how much is being used by the appliances. With the 8 prong power extension strip you are ready to plug in your appliances. Now you can use TV's, computers, air conditioners and a whole host of other appliances without the burdening cost of electricity, by just placing the Power Solar Panel Shingle device in every room of your house, apartment or even office. The Power Solar Panel Shingle device even comes with a remote control that has a display panel so that you can adjust the solar panel shingle in order to recieve the maximum amount of sunlight.

Stop worrying about not having the money to do things your friends and neighbors do and getting all worked up over the money they are saving as a result. With The Power Solar Panel Shingle-those that need to save money the most will be able to!
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Heart Rate Monitors for Nighttime

8/1/2013

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Heart rate monitors, show the rate of electrical activity of your heart by using a sensor and transmitter that is pressed against the skin to determine the heartbeat rate. Many people use these devices for exercise. The heart rates can vary from person to person, although there is typically a range to determine what is normal (between 60-100bpm) or what is a regular heartbeat for a person. People who are athletic can have slower heart rates, so there may be no need to panic if a person who is very active is found to have a slow heart rate. Due to constant exercise that heart rate may be considered regular for that person. What these  heart rate monitors basically do is that they take your pulse from an artery eg. from the wrist and then, it displays the rate accordingly.

Can lives be saved if the same heart rate monitors were worn during sleep and or bedtime?

Patient A is an elderly man who has a slow heartbeat due to exercise and physical activity he endured years ago and still continues from time to time. His cardiologist saw nothing unusual about his heart as indicative of his labs and EKG. However, over several months Patient A's heart rate gradually slowed to under 40 bpm(beats per minute) at times. This was during the day and with a regular routine. Patient A also complained of having no energy. Patient A was using a home heart rate monitor to obtain readings. Patient A's spouse told Patient A "You need to go see your cardiologist again, this is not right!" Patient A listened to the nagging of his spouse for quite a while and then decided to do something about it. Patient A then visited his cardiologist. The cardiologist who had been treating the patient for several years tried to reassure Patient A and his spouse that all was fine and said "Believe me if there was something wrong, he would notice." The cardiologist then checked Patient A's heart rate monitor, and then the cardiologist checked  Patient A himself, which indicated the same results as Patient A's home monitor. The cardiologist ordered an EKG which revealed at heart rate of 35bpm(beats per minute). The cardiologist  informed Patient A that he needed the usual echo and nuclear stress test for evaluation. The cardiologist began to worry because he had not paid attention to the slower heart rates during the last few visits because the patient had come to the cardiologist before and it was noted that Patient A has a slow heart rate or bradycardia. The cardiologist handed the patient's spouse a nighttime heart rate monitor. "Here" he said, "Use this, an alarm will sound if your husbands heart rate gets any slower while he sleeps or overnight. If it does I want him to go to the hospital."  "Thanks" she said.  "You expect me to know how to work this thing, with my old mind, please." "You chatted enough in the waitingroom and seemed to like to know more than anybody else. Please have those tests scheduled promptly so we can get the results." The cardiologist then walked out of the office so he could see the next patient.  "So what do we do now asked the spouse of Patient A?"

The Nighttime Heart Rate Monitor and external alarm clock

The Nighttime Heart Rate Monitor works just like a regular heart rate monitor. It can be worn on the chest or wrist and connects with a strap. The Nighttime Heart Rate Monitor has an external alarm clock. The Nighttime Heart Rate Monitor's transmitter sends the result of the heart rate to the external alarm clock. The alarm clock sounds when in distress eg. a heart rate below 40bpm or a heart rate over 100bpm. The alarm becomes louder and says "emergency" if rates are lower than 35bpm  or higher than 110bpm. This will awaken the patient or family member so that the next course of action can be taken eg. aspirin therapy or medical intervention.

Patient A took the Nighttime Heart Rate Monitor and external alarm clock home and began to use it, by following the instructions. Patient A, then chose to wear the Nighttime Heart Rate Monitor on his wrist. The external alarm clock indicated his current heart rate at 40bpm as did the monitor Patient A was wearing on his wrist. Patient A then went about his day, by making the necessary appointments and putting them off for a few weeks so that he and his spouse could go on a two week vacay. "I'll do all of this stuff when I get back, or at least that's when I made the appointments for. I really just wanna relax." The Patient A and his spouse went to bed and several hours later the alarm sounded so loud that it awoke both of them.  "What's wrong?" he asked. The patient's spouse said, "Obviously, your heart! Look it says 34bpm. I'm calling an ambulance." And so she did. Patient A, was admitted to the hospital, tests were done right then and there and thus Patient A was given a pacemaker, since his current medications were unable to regulate his heart rate to an acceptable one.

"Whew!" said Patient A, a few days later. "I'm feeling like myself again."  "I'm glad you are." said the patient's spouse. "Because, I may have cancelled those tests because you had them in the hospital, but I sure wasn't going to cancel my vacay...I was going with you or without!" "Oh really!" said Patient A. "Just don't forget to pack the Nighttime Heart Rate Monitor with external alarm clock." They both laughed.





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