Plan ahead for healthy school lunches – National Consumers League

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The days are getting shorter, the summer heat is cooling down, and vacations are wrapping up, all of which means one thing: back to school season is officially underway. Whether your young ones are dreading going back or eagerly looking forward to reuniting with old friends and favorite teachers, a healthy lunch will go a long way toward ensuring that first day back is a good one.

This year children will have healthier options available at school, thanks to the enactment of the Healthy, Hunger-Free Kids Act of 2010. New guidelines mean more fruits and vegetables and more whole grains at both lunch and breakfast. Additionally, schools will be substantially cutting down on salt in meals and enforcing maximum calorie limits. These options mean that school lunches will now be a healthier alternative to packing from home.

If your child buys lunch at school, view it as an opportunity to guide him or her to choose healthy options when faced with a range of choices. To help ensure that the lunch on your student’s cafeteria tray is a healthy one, consider the following tips:

Talk nutrition. If your child knows what constitutes a healthy meal, and why it is important to eat foods that are good for him/her (having energy, staying healthy, growing, etc.), it will be easier to establish an understanding of why healthy choices are important at lunchtime. Give your child some tangible markers for creating a healthy meal: including a fruit and a vegetable, choosing whole grains over white, picking a protein source, and opting for plain milk or water over sweetened beverages.

Underscore the importance of eating lunch. Particularly for younger children, the playground, friends, and other distractions can prove more compelling than sitting down to eat. Discuss with your child how eating a healthy lunch will help him/her feel good, have energy, and be able to concentrate the rest of the day.

Review the menu. Look at the daily or weekly menu with your child and discuss which items are good choices and which are “occasional” choices. Let your child choose when he/she wants to have a special treat (for example, “pizza Mondays” or “chocolate milk Wednesdays”), and come up with a game plan for making healthier choices most of the time. It is best not to create “forbidden” foods. By planning together when your child will choose a favorite, less healthy food, you increase the likelihood that your child will stay open, truthful, and guilt-free about choices made in the cafeteria. Refrain from judging your child’s less-than-ideal choices, and instead focus on doing better next time.

When possible, packing lunch for or with your child helps ensure a healthy midday meal. Whether you pack on a daily basis, or only occasionally send your child with a homemade lunch, keep these important points in mind:

Pack a safe lunch. Ensuring a safe lunch means keeping hot foods hot and cold foods cold, from the time your child leaves the house until he/she sits down to eat. Use a thermos for hot foods, such as soup, and include a cold pack with foods that need to stay chilled. If possible, pack your child’s lunch in an insulated bag. Remember not to put items that need to be hot and items that need to stay cold in the same bag. Finally, don’t forget to wash lunch bags in between uses.

Meet your child’s caloric needs. Children’s caloric needs vary greatly, depending on age, activity level, and other factors. Talk to your child’s pediatrician to get a general estimate of what his/her caloric needs are, and aim to provide one third of those calories at lunch time. Perhaps most importantly, talk to your child about whether he/she was still hungry after lunch, or had lots of leftovers. When consistently allowed to follow their bodies’ hunger signals from a young age, children have a much better chance of eating the amount they need and stopping when they are full. Include non-perishable lunch items (apples, trail mix) that can be saved for later, or even left in a backpack or locker for another day.

Pack foods your child will eat. The nutritional quality of the lunch you pack means nothing if your child refuses to eat it (or trades components away for more appealing options). Brainstorm with your child to come up with healthy options that he/she wants to eat. See if dinner leftovers, soups, or salads appeal to your child. If he/she is tired of sandwiches or more traditional lunches, think in terms of smaller “snacks” that together create a healthy meal.

  • Sample “outside the sandwich” meal: veggies and hummus, cheese cubes with whole grain crackers, and a piece of fruit provide the protein, carbohydrates, calcium, fruits and vegetables, and small amount of fat that growing children need. Be creative!

Pack healthier versions of the old stand-bys. If you have a picky eater who likes to eat the same things, day in and day out, try to up the nutritional content of lunches by making healthy substitutions that can go relatively unnoticed. Try the following swaps, and figure out the changes on which you and your child can agree:

  • Instead of high-fat lunch meats, choose lower-fat deli options such as turkey. If you face resistance, use mostly healthier deli meats with a slice of your child’s favorite for taste.
  • Swap out white bread for whole-grain bread. For picky eaters, even “white” wheat bread options are better than their white flour counterparts. When seeking out better options in the bread aisle, look for at least 3 grams of fiber per slice.
  • Substitute light mayo or mustard for full-fate mayonnaise
  • Offer baked chips, air-popped popcorn, or veggies with dip (if you can get away with it) in place of fried chips and similar snacks.
  • Offer low-fat, low-cal desserts or items with some nutritional value in place of junk. Instead of packing several cookies or a snack cake, send a favorite fruit, flavored yogurt, a small packet of fruit snacks, trail mix, or a small whole-grain muffin or cookie.

Be mindful of allergies. Check with your child’s school to ensure that there aren’t any items on the restricted list, due to other students’ allergies. Discuss with your child how food allergies make it particularly important that everyone eat the lunch that their own parent packed.

What health care reform means for young adults – National Consumers League

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The historic health reform battle ended in March, with the signing of the Affordable Care Act of 2010. While many of the law’s programs and benefits will be rolled out over the next 5-10 years, there will be several, more immediate, benefits that we will begin to see in the coming months.

You can actually see – state-by-state – which benefits have already been made available. It is now easier than ever to get access to health insurance.   Everyone will begin to see the benefits of the expanded access to affordable care – whether young adults, Medicare recipients, small business owners, or those just seeking additional preventive services.

What reform means for young adults

The new health care law enacted in March of 2010 has numerous provisions that will impact young adults. This demographic, though sometimes referred to as the ‘invincibles’, faces numerous health issues. The Department of Health and Human Services reports one in six young adults has a chronic illness and 30% are uninsured; young adults also have the lowest rate of access to employer-sponsored health insurance. The new law contains numerous provisions to cover young adults, whether through insurance provided through their employer, their parents’ health insurance, Medicaid changes, or the new Health Insurance Exchanges. Although many of its parts will not take effect until 2014, some major changes will occur in 2010.

Coverage

Before the law was passed, insurers could drop young adults from their parents’ health care plan when they turned 19, or upon graduation from college. The new law eliminates these practices. Starting in September 2010, dependent children up to the age of 26 will be eligible to remain on their parents’ plan, whether they are in college or not, living at home or residing in another state, or are single or married. The remaining exception, however, is that young adults offered coverage through their own job or if their parents’ existing plan does not qualify.

By 2014, all American citizens, including young adults, will be required to purchase insurance, with the threat of a fee for those who do not. There are various provisions in the new law, which make it easier to obtain coverage. Unemployed young adults with income up to approximately $15,000/year can look forward to an expansion of Medicaid for their health coverage. Individuals who make less than about $43,000 and who work at a place that does not provide affordable coverage can receive tax credits to help pay for insurance through new Health Insurance Exchanges. These exchanges will give consumers choice among plans and in a standardized format to help them find which is best for their needs. According to the Kaiser Family Foundation, prices each year will be capped at $5950 for individuals and $11,900 for families, excluding premiums.

The new law also intends to make obtaining insurance easier for young adults who work for small businesses. Many young adults work for small businesses. According to Kaiser Family Foundation, 36 percent of working uninsured young adults were employed in a small business with fewer than 25 workers. Incrementally over the next four years, small businesses with less than 25 employees will be eligible to receive tax credits to help make health insurance more affordable for their employees. If the small business has fewer than 100 employees, they also will be able to purchase insurance through the new Health Insurance Exchanges.

Preexisting conditions

Starting in September 2010, insurers can no longer deny coverage to children up to 19 with preexisting conditions such as asthma and high blood pressure. However, young adults over the age of 19 will not have this protection until 2014. In the meantime, adults with preexisting conditions who have not had insurance for a six–month period will have the option to either enter a temporary national pool for high-risk individuals or join pools set up by their state. You can find more information about whether your state is covered by this national plan here.

Preventive care

Under the new law, young adults can also take advantage of the many expansions to preventive care.  New health plans must cover certain preventive services without having the consumer share the costs.  Consumers will not need to pay a deductible, co-pay, or coinsurance when receiving preventive care. The preventive services covered include blood tests, many cancer screenings, and counseling for a wide array of issues.

Get off to a healthy start this school year – National Consumers League

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It’s back to school season for much of America. There are many ways – for the health and well-being of the entire family – that parents and their families can start the year off right.

Check-ups, screenings, and immunizations

It’s important that your child have routine exams and screenings to help track their development and identify (and treat) any potential problems. Make sure vision and hearing are among the routine screenings your child receives.

In addition to the routine trip to the primary care office, it is important that your child visit the dentist every six months. Mouth troubles and dental-related conditions account for the #1 reason kids miss school.

Check with your local school and your health care practitioner about vaccine requirements and recommendations, and what is best for your child. If possible, take advantage of being in the doctor’s office and schedule your child’s flu vaccine for October or November.

In order to avoid trips to the doctor throughout the school year, remind your kids to wash their hands. Send them with a bottle of hand sanitizer for those times they can’t suds up in a sink.

Sleep

It is important for children to get several hours of quality sleep. They need the z’s in order to have energy, enthusiasm, and the capacity to learn.

Children ages 6-9 should aim for roughly 10 hours of sleep a night. Their older counterparts, the pre-teens, should get just over 9. All kids are different, however, and you should adjust their sleep schedule to suit them.

Backpacks

The American Academy of Pediatrics advises that kids not carry more than 10-20 percent of their body weight in a backpack. You should also double check that the weight in their bags are distributed evenly, and remind them to carry the backpack with both (ideally padded) straps.

Your child’s mental health: stress and anxiety

Anxiety and stress are normal feelings at the start of the school year – for both kid and parent. Remember that it should pass within the first few weeks of school. If children remain anxious, you should talk with your health care practitioner.

Stomp out stress and anxiety by showing enthusiasm for the start of school. Talk with your kids about what happened each day, and get involved in with school activities. In addition to watching your child’s physical development, you should also keep tabs on their social and emotional changes.

More safety tips

Double check with your child’s school to ensure that the emergency contact information, as well as information about medications your child may take (at home or at school), known allergies, and physical limitations are current.

Depending upon how your child will get to school, remind them of safety tips. If they ride the bus, for example, they should know to keep out of the street and to keep a safe distance from the bus at all times; they should also know to wait for the bus driver to signal before crossing the street. If walking or bike riding, they should use a buddy system, wear reflective gear, obey traffic lights and street signs, and always wear a helmet. For those traveling by car, remind children to stay in their safety seats or seat belted at all times.

Encourage your kids to get active after school. Ideally, children and teenagers should get 60 minutes of physical activity most days of the week.

Remind kids to practice good hygiene. In addition to washing their hands, remind them not to share combs/brushes or beverages.

Eating right on a budget – National Consumers League

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It takes planning and willpower to make healthy food choices, regardless of one’s financial situation, but for those on a tight budget, getting healthy food on the table proves even more difficult. 

No matter your financial constraints, however, it IS possible to create healthy, delicious meals – all it takes is foresight, creativity, and a bit of effort! To make your food budget stretch further in the healthy choices department, follow these tips:

Plan ahead and make a list

Plan a menu for the week, using grocery store sale ads as a guide and incorporating main ingredients into several meals. Make a list of items you need, and stick to your list at the store. Don’t forget to check the pantry before planning meals or buying staple items – you may already have key ingredients to put to good use. Good planning, and shopping only once a week when possible, will enable you to reduce waste, save time, and save gas money.

Buy the right fruits and vegetables

Fruits and vegetables can be incredibly expensive, but they don’t have to be. Seek out produce that is in season in your area, as it generally costs less (and tastes better!). Stay away from pre-chopped, pre-sliced fruits and vegetables, which save time but cost far more than their whole counterparts. Frozen fruits and vegetables are always a great choice, as they are affordable, always ripe (they are flash-frozen at peak ripeness), and can be used in small or large quantities without waste.

Choose whole grains

Whole grains are far more healthful than their refined counterparts and add an affordable nutritional boost to any meal. They have a long shelf life, and many stores sell whole grains from bulk bins, enabling you to purchase only the amount you need. Try using brown rice instead of white, choosing whole wheat bread instead of white, and experimenting with quinoa, barley, and buckwheat. Making whole grains and vegetables the main part of a meal – and serving meat, poultry, or fish as a “side dish” – creates a cheaper, and healthier, plate.

Eat more beans, less beef (and poultry)

Beans are an inexpensive source of protein and fiber, with the added bonus of a long shelf life. Dried beans will give you the most bang for your buck, but canned beans, which are still fairly cheap, are easier to use. Serve beans in salads, pasta dishes, soups, burritos, and chili, or make them the main component of a quick, healthy, meatless, and inexpensive meal.

Bring a brown bag

Although it takes a few extra minutes, packing a brown bag lunch is nearly always cheaper – and healthier – than buying a midday meal during the work or school day. Before you take your weekly shopping trip, plan out packable lunches for the week. Leftovers also make great lunches!

Purchase fewer packaged and processed foods

Meal replacement bars, snack packs, and other packaged, processed foods tend not only to be expensive but to contain ingredient after ingredient that one cannot pronounce. Whenever possible, substitute whole foods for these products (an apple with peanut butter, yogurt and fruit, homemade trail mix), for a healthier diet that saves serious cash. For an added boost to your wallet, buy larger bags of snacks instead of 100-calorie packs, and make your own single servings with plastic bags after you arrive home.

Buy in bulk

When done right, buying in bulk can save both time and money. Focus your bulk purchases on products that you use frequently enough that you will consume them before they spoil or pass their “use by” date. Make a bulk-buying trip with a friend who enjoys similar foods, and split items that you both use, but that are too large for your household’s use before expiration.  Remember that not all bulk items actually save you money, so check the unite price and ensure that you’re getting a good buy before making a purchase.

Find the store brand

Grocery stores sell their own brand of many of the name brand products they offer. These store brands are almost always less expensive and are usually exactly or almost the same as the pricier name brands. Check next to, below, or above the name brand products you usually consume to see if a cheaper alternative exists.

Grow produce in the garden

It doesn’t require a large plot of land, a lot of effort, or more than a few dollars to grow a few fruit or vegetable plants, but the payoff is significant. Plant tomatoes, lettuce, cucumbers, or other favorites, and reap the nutritional and cost-saving rewards of your labors all summer long.

Don’t let foodborne illness ruin summer celebrations – National Consumers League

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With temperatures heating up, many of us are heading outdoors to celebrate summertime with picnics, cookouts, and other gatherings. While warm weather creates the perfect atmosphere for family reunions, company picnics, and general merriment, it also increases the likelihood that foods served outdoors will spoil and sicken consumers.

To protect yourself, your family members, and your guests from foodborne illness, follow these simple rules:

Prep your food for safety

Wash hands with soap and warm water for 20 seconds, both before and after handling food items. Take special care when handling raw meat.

Keep raw poultry, meat, and eggs away from other foods to avoid cross-contamination.

Thaw and marinate meat, poultry, and seafood in the refrigerator, and not at room temperature.

Clean all surfaces that come into contact with raw meat or poultry – such as cutting boards, utensils, dishes, and countertops – with hot, soapy water or a bleach solution. If outdoors without access to a kitchen, store anything that has come into contact with meat in a separate, sealed bag, and clean items as soon as possible (discard the bag).

Transport food with care

If traveling to a picnic or cookout, store cooked foods, produce, and raw meat and poultry separately, in sealed containers, to avoid cross-contamination during transport.

  • Keep hot foods hot and cold foods cold. Store hot foods in insulated containers, and keep cold foods on ice – or reusable cold packs – in coolers. In particular, mayonnaise-based foods and cut melons need to be kept cold.
  • Car trunks can exceed 150°F, so transport coolers in the passenger area of the car if at all possible.
  • After arriving at your destination, be sure to remove all food from the car. Place coolers in the shade and keep them closed until the contents are needed.

Grill safety 101

Cook meat in one step, rather than cooking partway and finishing later. Bacteria grow more rapidly in partially cooked food.

Thoroughly cook meat to kill any harmful pathogens that may be present. The only way to know that meat or poultry has reached a safe internal temperature is by using a meat thermometer. Remeber the following temperatures to ensure safety:

  • Ground beef, lamb and pork: 160°F
  • Ground poultry: 165°F
  • Hot dogs: 165°F
  • Beef roasts and steaks: 145°F
  • Poultry: 165°F
  • Pork chops, roasts, and tenderloin: 160°F

When removing cooked food from the grill, always use a clean plate. Never put cooked food – or anything else – on a plate or tray that was used to hold raw meat.

Serve safely

  • Wash hands before serving (and grilling, if applicable). If the picnic site does not have hand washing facilities, bring moist towelettes for all guests, in order to decrease the chances that food will be contaminated
  • Serve and eat grilled foods immediately.
  • Keep hot foods at a temperature between 140°F and 165°F until they are served, as harmful bacteria can grow rapidly at temperatures below 140°F.
  • Keep cold foods at 40°F or cooler until serving, as harmful bacteria can multiply quickly above 40°F.
  • Avoid the temptation to display foods on picnic tables and remove them from coolers/warming areas only right before eating.
  • Minimize handling of picnic foods – such as buns, cut watermelon, and sandwich fillings – as much as possible. The more people who touch an item, the higher the risk of contamination.
  • Refrigerate or freeze leftovers immediately. If the temperature is above 90°F, discard all prepared foods that have sat outside for longer than one hour. Regardless of the temperature, prepared foods should never be left at room temperature for longer than two hours.

Changes for asthma medication – National Consumers League

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Recently there has been important news from the Food and Drug Administration about the medications used to treat asthma. Understanding your asthma medications will help you understand your asthma and keep you healthy.

If you have asthma you should be seeing a health care practitioner and have a treatment plan in place, which may include medications. Asthma is usually treated with two kinds of medications – fast-acting inhalers (or rescue inhalers) and long-term controllers. Recently the Food and Drug Administration (FDA) made some important announcements regarding both long-term controllers and fast-acting inhalers.

Long-term controllers: long-acting beta-agonists (LABAs)

LABAs are used as long-term asthma controllers relax muscles in the airways and lungs. They can help patients breathe easier and lessen symptoms of asthma such as wheezing and shortness of breath. Because of safety concerns, FDA is requiring changes to how LABAs are used to treat asthma. Studies have shown that use of LABAs increase the risk of hospitalization and even death.

FDA is now requiring the following to appear on the label to ensure the safe use of the LABAs:

  1. LABAs should only be used by those who cannot control their asthma with other medications, and then only for the shortest possible time.
  2. LABAs should never be used without also taking an asthma controller medication, like an inhaled corticosteroid. Medications that include both a LABA and an inhaled corticsteroid are Advair and Symbicort. Single ingredient LABAs such as Serevent and Foradil, should not be used alone.
  3. Children and teens should be prescribed only the combination LABAs to ensure compliance with both medications.

In addition to the label changes, FDA is requiring the manufacturers of LABAs to study the drug’s safety when combined with other drugs, such as inhaled corticosteroids. The manufacturers must also develop risk evaluation and mitigation strategies. These include new medication guides for patients and an education plan for healthcare professionals about the appropriate use of LABAs,

Fast-acting inhalers

Recently the FDA announced the phase out of seven fast acting inhalers that use chlorofluorocarbons (CFCs). Due to concerns about how CFCs damage the earth’s ozone, which protects life from the damaging effects of the sun’s ultraviolet rays, the US has been banning the use of CFCs since the 1970s. CFCs, which make the contents of a canister spray out, have been banned in most consumer aerols, (such as hairspray) for decades. CFCs aren’t harmful to people. Medical devices using CFCs are among the last to be affected.

Many manufacturers have reformulated or are reformulating their inhalers so they don’t contain CFCs. Four of the seven inhalers that were part of FDA’s announcement are no longer being made. The three other inhalers will be phased out over the next three years, and will be banned after the end of 2013. A new way of delivering asthma medications has started replacing CFCs and is called hydrofluoroalkane (HFA). It has been used in inhalers for more than a decade and will continue to replace CFC inhalers as they’re phased out.

The asthma medication in the new inhalers is the same. Only the way the inhaler gets the medicine to your lungs is different. If you use one of the CFC inhalers being phased out, talk to your health care practitioner about using another type of inhaler that does not use CFCs

For more information on the devices that are no longer being made and whose sale will be forbidden after 2013 see the FDA’s announcement.

Patient safety starts with you – National Consumers League

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Health care is not always as safe as we would like it to be. More than 10 years ago, the Institute of Medicine came out with a groundbreaking report that found that as many as 44,000 to 98,000 people die in American hospitals each year as a result of medical errors. What can consumers do to make sure they have a safe experience when they get health care?

Medical errors happen when what was planned as part of medical care does not work out, or when the wrong plan was used in the first place.) While there have been many efforts to improve safety over the last decade, progress is slow. Medical errors can happen anywhere you get your health services: in hospitals, clinics, a doctor’s office, nursing homes, pharmacies, and even in the patient’s home.

The best way you can help prevent errors is to be an active member of your health care team. That means taking part in decisions being made about your health care. Research shows that patients who are involved with their care tend to get better results. You can get better and safer care by asking questions about your diagnosis, treatment options, how you’re being cared for, and any medications prescribed for you.

Become an informed consumer.

Before seeking care, gather information about the illness or condition that affects you. Use reliable sources (like government Web sites such as the National Guideline Clearinghouse, Centers for Disease Control and the National Institutes of Health). Research options and possible treatment plans.

Choose a doctor, clinic, or hospital experienced in the type of care you require. For example, see the website developed by the Centers for Medicare and Medicaid Services, Hospital Compare, for information on comparing hospitals.

Keep track of your own medical history and your medications.

Write down your medical history, including medical conditions you have, illnesses, and hospitalizations. Keep track of all your medications (both prescription and over the counter) and dietary supplements (vitamins and herbs). This is called a personal medication record (PMR). There are several formats for keeping a PMR, and you should pick what works best for you.  Share all this when you visit the doctor, or go to the hospital or clinic.

Be a part of the team.

It’s your job to work with your doctor or other health care providers. Clear communication between patients and those that are taking care of them is critical to improving safety and reducing the risk of medical errors.

Make sure you share your health history and medication use with your team. The PMR is a good way of doing that.

Make sure you understand the care and treatment you are going to receive. Ask questions! The Ask Me Three program from the National Patient Safety Foundation encourages patients to ask their team these three important questions:

  1. What is my main problem?
  2. What do I need to do?
  3. Why is it important for me to do this?

Follow the treatment plan agreed upon by you and your doctor. Make sure you receive the instructions verbally AND they are written down for you.

Get a partner.

Involve a family member or friend in your care. Ask a family member or friend to be with you in the hospital or come along to appointments to speak up for you if you can’t. They can help you understand care instructions and be your advocate when it’s time to make decisions. It helps to have a second set of ears, especially if you are nervous or distracted about your condition.

More tips for: hospital stays

  • Don’t be afraid to remind doctors and nurses about washing their hands before working with you. You are part of the health care team and it is okay for you to remind them. Hand washing is one of the best ways to stop hospital infections, including the MRSA infection, which can be very serious.
  • If you are having surgery, make sure that you, your doctor and surgeon all agree and are clear on what exactly needs to be done. Some surgeons sign their initials directly on the site to be operated on before surgery.
  • If you have an intravenous catheter, to prevent infection tell you doctor or nurse if the bandage comes off or there is soreness around the catheter.
  • If you have a urinary catheter, make sure it is removed as soon as possible to prevent an infection. Ask your health care team every day if it can be removed.
  • Quit smoking. Patients who smoke get more infections.
  • When you are being discharged, ask your doctor to explain the plan to you, and write it down so that you understand what you need to do. Research shows that at discharge, doctors think their patients understand more than what they really do about what they should do when they are at home.

More tips for: medications

  • Make sure ALL your health care providers know ALL the medications, both prescription and OTC, as well as dietary supplements such as vitamins and herbs, that your are taking. Keep a Personal Medication Record (PMR), make sure it is up to date, and share it with your health care provider.
  • Tell your health care providers about any allergies and adverse reactions you have to medications.
  • When your health care provider write you a prescription, make sure you can read it and know what medicines you are being prescribed.
  • Ask about your medicines when you are prescribed them and when you receive them. Ask:
    • What is it for?
    • How long do I need to take it?
    • What side effects are likely, and what should I do if I have them?
    • Can I take it with other medicines and dietary supplements?
    • Is there any food or alcohol that I need to avoid while taking?
  • When you pick up your medicine at the pharmacy, ask if this is the medicine that was prescribed. Most medication errors involve the wrong drug or wrong dose.
  • If you have questions about the directions on the medicine label – ask!  Medicine labels can be hard to understand.  For example, does “three doses daily” mean take a dose every eight hours around the clock, or just during waking hours?

For more on this subject

National Patient Safety Foundation

Agency for Healthcare Research and Quality (AHRQ)

AHRQ’s Questions are the Answer

Fact sheets on Health Care Associated Infections (English, Spanish, and Large Print)

Health care reform: good for consumers and America – National Consumers League

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The lack of comprehensive health care coverage is America’s albatross – it makes our businesses less competitive and our workers less healthy. We need to put partisan concerns aside and work NOW to ensure that the system is reformed. The cost of doing nothing is unthinkable.

American families are paying about $15,000 a year for health care, twice as much as we did twenty years ago, and we pay $6,500 more for health care than any other industrialized country in the world. Yet despite these high costs we have poorer health outcomes.

We need to address why we are overpaying for care that is not making us healthier. Health reform, as proposed in several current bills in Congress, will move us towards greater accountability, efficiency, accessibility, transparency, and quality. It is essential that everyone have access to affordable health care or the system will remain broken.

For consumers, health reform will translate into choice – with a greater number of options available, including keeping and supplementing your own insurance, at more affordable and competitive prices. Reform will also make it easier to compare and understand the true costs and benefits of plans. As consumers and employees, we can make choices what will help push for health insurance and benefits that are competitive, innovative, and cost-contained.

With unemployment nearing 10 percent, many Americans have lost their employer-based coverage. Further, of the nearly 50 million uninsured, close to 80 percent are working Americans. It is imperative that we not leave our most vulnerable citizens out in the cold, which is why health reform will only be effective if everyone is covered.

Experts project that families will pay $10,000 more annually on medical costs by 2016 if we DON’T fix the system Health care coverage for all Americans is a moral imperative that must not be allowed to fall victim to partisan politics.

Consumers wary of therapeutic substitution – National Consumers League

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Therapeutic substitution, known also as drug switching and therapeutic interchange, is the practice of replacing a patient’s prescription drugs with chemically different drugs that are expected to have the same clinical effect. Many times patients switch to a different drug with no problems. However, for certain medications and conditions, therapeutic substitution could cause problems.

Consumers with a few specific conditions may be more likely than others to encounter a switch. Here are some of the conditions in which therapeutic substitutions may be more common, as well as the concerns about substitution expressed by some patient groups. As always, it is important to talk to your doctor about any potential therapeutic substitution.

In the lists of medicines, the Brand Name comes first, (and generic version is in parentheses).

Antidepressants 
Antidepressants stimulate chemical changes that increase the levels of neurotransmitters in the brain responsible for a person’s mood.

Some examples of antidepressants:
Prozac (fluoxetine), Zoloft (sertraline), Paxil (paroxetine), Luvox (fluvoxamine), Celexa (citalopram), and Lexapro (escitalopram). Antidepressants are associated with drug groups known as MAOIs, tricyclics, and SSRIs and are commonly prescribed by psychiatrists and other physicians to treat depression, bipolar disorder, and other mental illness.

Substitution concerns:
The American Psychiatric Association, Mental Health America, National Alliance on Mental Illness, and the National Council for Community Behavioral Healthcare oppose therapeutic substitution based on the substantial risk of serious adverse outcomes in people with mental illness. These groups support policies that provide patient access to the medications their doctors think they need, and they encourage shared patient-physician decisions based on the unique needs of individuals.

Cardiovascular Medications
There are several classes of drugs used to protect your heart, monitor your cholesterol level and blood pressure, and prevent other damage.

  • ACE inhibitors are used for controlling blood pressure, treating heart failure, preventing stroke, and preventing kidney damage in people with hypertension or diabetes. They also improve survival rates in patients who have had a heart attack.
  • Examples of ACE Inhibitors include: Capoten (captopril), Vasotec (enalapril), Prinivil (lisinopril), Accupril (quinapril) and Univasc (moesxipril)
  • Statins are used to lower cholesterol levels in people at risk of developing heart disease.
  • Examples of statins include: Lipitor, Zocor (simvastatin), Crestor, Pravachol (pravastatin), Mevacor (lovastin).

Substitution concerns:
The American Heart Association and the American College of Cardiology oppose therapeutic substitution and believe that only the prescribing doctor is equipped to determine the best drug or combination of drugs. These organizations believe that therapeutic substitution may result in the patient receiving a drug that doesn’t work well enough, produces life-threatening toxicity, or interacts dangerously with other drugs the patient is taking.

Epileptic medications
The drugs taken by patients with epilepsy are called antiepileptic drugs (AEDs) and are designed to change the electrical signaling in the brain to stop or prevent seizures. 

Examples of AEDs include:
Dilantin (phenytoin), Luminal (phenobarbital), Tegretol (carbamazepine), Neurontin (gabapentin), Lamictal (lamotrigine), Gabitril, Keppra, and Zonegran (zonisamide).

Substitution concerns:
The Epilepsy Foundation is concerned that there are enough differences among AEDs that any kind of medication substitution, (including switching from brand-name to generic), could be dangerous, and it could result in less control over seizures. The Epilepsy Foundation says that changing from one drug formulation to another can usually be done successfully if the patient’s blood levels, seizures, and toxicity are carefully monitored, but it says any medication change must require the permission of the treating doctor and the patient.

Proton-pump Inhibitors
Patients with dyspepsia, peptic ulcer disease, or acid-reflux may be prescribed a proton-pump inhibitor (PPI), drugs that result in long-lasting reduction of gastric acid production.

Examples of PPIs include:
Prilosec (omeprazole), Prevacid (lansoprazole), Nexium.

Substitution concerns:
As with any substitution, it is important to talk to your doctor, and be aware of the benefits and risks of substitution.

Flu facts for expectant moms – National Consumers League

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Recent reports show that up to 30 percent of pregnant women who are infected with the H1N1 flu virus require hospitalization. And of the H1N1-related deaths reported in the United States, 6 percent of them – a disproportionately high percentage – are pregnant women. According to the U.S. Centers for Disease Control, “Getting a flu shot is the single best way to protect against the flu.” Yet many pregnant women are either hesitant to get a flu shot or have been unable to get vaccinated due to limited supplies.

The National Consumers League wants to make sure that expectant moms have the best information available, so they can make good decisions about protecting their health—and the health of their babies—and know where to go to get the care they need. The following is a fact-filled discussion featuring NCL executive director Sally Greenberg and, providing the answers, Dr. Annelise Swigert, a board certified Ob/Gyn and fellow of the American College of Obstetricians and Gynecologists.

Sally: What is H1N1 flu, also known as swine flu? And what is a flu vaccine?

Dr. Swigert: Every year, the public is faced with a seasonal flu which usually arrives in late fall. This year, the U.S. and many other parts of the world must deal with an additional flu called H1N1 or swine flu. H1N1 is a relatively new virus that was first detected in April 2009. It is contagious, spreading from person-to-person worldwide. Illness with H1N1 has ranged from mild to severe, including hospitalizations, and some deaths. Flu vaccines, given as a shot or inhaled through the nose, protect against contracting the disease.

Sally: Why is it important for women to be vaccinated for the H1N1 “swine flu”?

Dr. Swigert: H1N1 can cause serious complications during pregnancy. Pregnant women who are infected by H1N1 are more likely to end up in the hospital. A recent report showed up to 30 percent of pregnant women with H1N1 required hospitalization. Even if they are otherwise healthy, pregnant women who get the H1N1 virus can develop severe pneumonia and respiratory failure, deliver their babies early, or possibly miscarry. Of all the deaths related to H1N1, six percent have been in pregnant women, an unusually high percentage.

Getting the H1N1 vaccine while pregnant will continue to protect the baby after he or she is born. Studies on previous influenza vaccine use in pregnancy have shown more than a 60 percent decrease in serious illness in infants born to mothers who received the vaccine when they were pregnant.

Sally: Is the vaccine for the H1N1 flu safe for pregnant women and their babies?

Dr. Swigert: Yes, the H1N1 flu vaccine is safe for

pregnant women and their babies, and has been approved by the Food and Drug Administration. The H1N1 vaccine is the same as the seasonal flu vaccine with a slightly different strain of influenza. If H1N1 had been identified a few months sooner, it would have been the seasonal flu vaccine for 2009-2010. The seasonal flu vaccine has been safely given to pregnant women for more than 40 years. The vaccine can be given during any trimester of pregnancy and also postpartum, while breastfeeding.

As with all medication use in pregnancy, your doctor will review risk versus benefit. For most women, the benefit of getting the vaccine and preventing active infection from H1N1 far outweighs the extremely small risk of serious side effects.

Sally: Where can a pregnant woman get the vaccine?

Dr. Swigert: Pregnant women should start by contacting their Ob/Gyn or other primary health care provider if they don’t have access to an Ob/Gyn. The vaccine is available at many Ob/Gyn clinics, and those that don’t have it may be able to help their patients find it elsewhere. Community centers are now holding flu shot clinics for high-risk populations, such as pregnant women or those with certain chronic conditions, like asthma. Some employers will have the vaccine, especially those in health care fields. Always let the doctor or clinic know you are pregnant, as you’re in a high-risk group and should receive priority.

Sally: Is there any way the H1N1 vaccine could have been made more quickly?

Dr. Swigert: This year was particularly challenging because vaccine manufacturers needed to produce many millions of doses of both the seasonal flu vaccine and the H1N1 vaccine – simultaneously. As a result, production of the H1N1 vaccine is being completed in about half the time it usually takes. For the most part, pregnant women and other high-risk groups have been able to get vaccinated, and health officials believe enough vaccine will be available by the end of the year to safely vaccinate all those who wish to receive it.

In Europe, government regulators have approved the use of what are called “adjuvants,” additives that can be added to the vaccine supply to greatly increase its yield

or number of doses available. U.S. officials have not yet approved adjuvants, although many in the medical community believe they are a safe and effective way to expand the vaccine supply.

Sally: How is the vaccine delivered?

Dr. Swigert: The vaccine is available in two ways: an injection and an inhaled version. The injection contains a part of the virus that causes the immune system to make antibodies to protect the body from actual infection. The inhaled vaccine has the live virus that also causes the immune system to make antibodies. Both vaccines are safe and effective.

Pregnant women should receive the shot, and not the inhaled vaccine. Women who are postpartum or breastfeeding can receive either the shot or the inhaled vaccine. Only one injection is necessary to fully protect pregnant women from infection with H1N1.

Sally: Are there side effects?

Dr. Swigert: Some women have mild side effects such as soreness at the injection site or mild headache or body aches 2-3 days after the shot. These are not signs of infection or an allergic reaction, but signs that the immune system is responding as it should to the vaccine.

Women who have an allergy to eggs could have an allergic reaction to the shot and should not receive the vaccine. Serious reac­tions to the vaccine are very rare and occur in only one in every million women.

Sally: Have any unborn babies been harmed by the vaccine?

Dr. Swigert: The only danger to unborn babies is if their mothers get sick with the H1N1 virus. The vaccine is not dangerous, but getting the H1N1 virus is. Studies of pregnant women and their children who received the seasonal flu shot have shown no bad outcomes.

Sally: Will pregnant women who don’t get the vaccine risk getting sick?

Dr. Swigert: Pregnant women who do not get vaccinated risk becoming acutely ill with the H1N1 virus. Many of these women will have mild to moderate illness, but they risk possible complications such as pneumonia and respi­ratory failure. These complications cannot be predicted or prevented, even once the illness is diagnosed. Risks to unborn babies can include premature delivery and respiratory distress.

Sally: Does the H1N1 flu vaccine contain any additives that could interfere with a child’s development?

Dr. Swigert: Thimerosal, a preservative, is used in flu vaccines, including the H1N1 vaccine. Although thimerosal has never been scientifically proven to be harmful to children or pregnant women, due to public perception, vaccine manufacturers have produced preservative-free, single-dose syringes for use in pregnant women. These vaccines are more costly and time con­suming to produce than vaccines with thimerosal, and may not be available in all communities. Your clinic will be able to give you information on the vaccines they have available.

Also remember that because thimerosal has never been scientifically proven to be harmful to pregnant women or the fetus, injections using this preservative should be safe for use in pregnant women.

Sally: My friend gave birth a month ago. Should she get the vaccine now?

Dr. Swigert: Yes. Infants under 6 months of age are at extremely high-risk for complications from H1N1. By getting vaccinated not only will you decrease the risk of getting sick and giving it to your baby, but if you are breastfeeding, the baby will get protection from the illness through antibodies in the breast milk.

Sally: Is the vaccine safe for women who are breastfeeding?

Dr. Swigert: Yes. It is safe to receive either the shot or the inhaled vaccine while breastfeeding.

Sally: What if your family already had the flu this fall? Should expectant mothers still need to get vaccinated?

Dr. Swigert: Yes. Even if members of your family or you have had an influenza-like illness, it is still impor­tant to get vaccinated to protect you and your baby.

Sally: How can we avoid getting the flu?

Dr. Swigert: The best way to prevent the flu is to be vaccinated. Like many viruses, it is transmitted from person to person most commonly through coughing or sneezing. Other important ways to reduce the risk include: washing your hands often and thoroughly with soap, using alcohol-based hand sanitizers, and not touching your nose, eyes, and mouth.

Sally: What are the symptoms of the H1N1 flu?

Dr. Swigert: The two main symptoms of H1N1 are a fever of 100 degrees or higher, and cough and/or sore throat. Other symptoms may include headache, body aches, chills, runny nose, fatigue, diarrhea, and vomiting. Pregnant women should contact their doctor or clinic immediately if they experience any of these symptoms, as they will need to start anti-viral medication.

Sally: What should a pregnant woman do if she thinks she has H1N1? Should she take an anti-viral medication?

Dr. Swigert: H1N1 can be dangerous for a pregnant woman and her baby. Contact your doctor or clinic immediately if you have any symptoms. Treat any initial fever with acetaminophen (Tylenol), which is safe in pregnancy. Anti-viral prescription medications, such as Tamiflu, are recommended for pregnant women and safe to use.

Medication should be started within 48 hours of the onset of symptoms. Confirmation that the illness is the H1N1 virus is not necessary to begin treatment. A pregnant woman should follow her physician’s instruc­tions and should not delay seeking treatment under any circumstances.

Emergency care is necessary if a pregnant woman experiences difficulty breathing, chest pain or pressure, vomiting, dehydration, dizziness, confusion or loss of alertness. It is also important to contact your doctor if your symptoms have improved and then get worse again.

Sally: If a pregnant woman’s child or family member becomes sick with H1N1, should she avoid contact with the sick family member?

Dr. Swigert: If a family member becomes sick, a pregnant woman should contact her doctor immediately to be treated with anti-viral medication. In addition, families should have a plan to care for each other that protects pregnant mothers from the risk of infection. If others aren’t available to help care for a sick child, pregnant mothers should try to limit exposure by washing their hands often, throwing away dirty tissues, and avoiding touching their nose, mouth, or eyes as much as possible. Pregnant mothers may also wear surgical-quality face­masks if they must care for sick family members.

Sally: If a pregnant woman gets the H1N1 flu vaccine, does she need to get the seasonal flu vaccine too?

Dr. Swigert: Yes. The H1N1 flu vaccine will not protect against the seasonal flu. The seasonal flu is also a threat to a pregnant woman’s health – and the health of her baby. The seasonal flu should be treated with the same caution, care, and preventative measures as H1N1 flu.