This is the first of several posts on the health care plan. Love it, or hate it, the health care reform finally passed at the end of march. This is a bill that has been written, re-written, fought over, negotiated, trashed, then brought back so many times that one could have made a job out of keeping track of the changes over the past year. Luckily, one of my good friends works for a congress woman and was kind enough to send me up to date information on the bill. There are many pieces to the final bill. Some will kick in as soon as ninety days after the bill was passed, and others will not come in until 2014 with the full expression not being seen until 2020. Here are some of the changes that we will see over the next six months:
For those Uninsured:
Young adults can remain on their parents' insurance up to the age of 26 (effective 6 months after enactment)
Immediate assistance will be provided to those who are uninsured due to pre-existing conditions. Assistance will be provided through a temporary high risk pool until the Exchanges (see future post) are up and running in 2014 (effective 90 days after enactment)
For those with private insurance
Health care plans are prohibited from denying coverage to children with pre-existing conditions (effective 6 months after enactment, this will apply to adults in 2014)
Health care plans are prohibited from dropping people when they get sick
Health care plans are no longer allowed to place life time caps on coverage
Free preventative care under new plans: preventative services will be exempt from deductibles and will be provided with no copay (effective 6 months after enactment)
Consumers in new plans will have access to internal and external appeals process to appeal decisions.
Insurance companies are required to put more of your premium toward benefits and less toward profits. Insurers that do not meet thresholds will be required to reimburse policy holders (Effective Jan 1, 2011
New Group health plans are prohibited form discriminating in favor of employees with higher wages.
Additional Changes
Increase funding for community health centers with the goal of doubling the number of patients served by 2015
Funding for training programs for primary care doctors, nurses, and public health professionals
Provides funding to states in order to establish offices of health insurance consumer assistance where consumers can file complaints and appeals
The details on the above changes are still being ironed out. Next post: long term health care changes.
Hi All! I am currently hard at work researching the health care reform. I am fortunate enough to have a friend who spent the summer in DC answering questions about the reform and who now works for a congress woman in NYC. He has been kind enough to provide me with a plethora of information. It turns out that some of the details are still not quite ironed out in terms of policy. I will hopefully have this post up in the next few days. Stay tuned!!
Spring is here!While many may rejoice at the arrival sunshine, longer days, and spring blossoms, others of us see spring as both a blessing and a curse.Sunshine and flowers mean drier air filled with allergens to attack our sinuses and make us suffer. The warm weather brings people out from the woodwork.We are more social, we date, we frolic in the park, and we spread germs.Enter Cold and Flu season the sequel.Being sick is never fun, but it is especially annoying when you are a dancer.Either you are too sick to take class, or you drag yourself to the studio only to feel like moving death the entire duration from pliés to grande allegro.
I finally lost my battle last Sunday against the flowers and the germs after a stress-filled week and a fun filled weekend.Finally, on day five of feeling like my sinuses have been taken over by a colony of slime monsters, I called out of work and dragged my feverish, coughing, aching, sneezing self to the health center at NYU.I have what, it seems, half of New York City has: a cold/flu with a side of spring allergies.Turns out I had been doing a lot of the right things but not enough.If one is going to wage war against the disgusting spring combo of virus and pollen one must do it properly.I left the nurse practitioner with a bag of goodies and a sheet (fully explained and hi-lighted) of remedies.After a day of rest and using the recommendations of my new friend, Mike, RN, I am already feeling like I can enjoy the sunshine, blossoms, and ballet once again. Here is what was recommended to me:
1. Gargle (with an antiseptic mouthwash)
5 times/day for recovery, 2-3 times/day for maintenance.
Gargling with an antiseptic mouthwash helps to kill the germs in your mouth (Which is huge in preventing the spread of your illness to others) and is soothing at the same time.An added bonus, If you get a minty one, it helps open your sinuses as well.
I bought the Walgreen’s brand antiseptic mouth rinse ($2.79).It comes with a free smaller 8.5 oz bottle that is perfect to carry throughout the day.
2. Drink lots of clear fluids
Do this throughout the day.The more the better
Water, tea, chicken broth, and juice are all great.
No, coffee does not count.
3. Saline Nasal Spray
5 times per day for recovery, 2-3 times per day for maintenance
The spray helps get the saline into your upper sinuses.It will moisten irritated tissue and help relieve inflammation.
I also use a neti pot.Neti pots are great for clearing out the nasal passages but to not get the upper sinuses.
A combo of the neti pot in the morning and evening, and the nasal spray throughout the day works wonders.
4. Steamy showers
Taking a steamy shower in the morning when you wake up and in the evening when you go to bed will help open your sinus passages.
Take the saline nasal spray into the shower with you.The steamy shower makes it more effective.
5. Wash your hands
As much as possible
This won’t necessarily help you get well faster, but it will help prevent spreading your germs to others and will keep you from catching a different bug. (Think of all the people who are sick like you who have been touching the barre. Do you really want to touch that, then eat a sandwich? No)
6. REST (It was in all caps on my educational sheet too)
When the nurse hi-lighted this one, I laughed.He said that it doesn’t have to mean that you take a full sick day.Take the time to take care of your self during the day.Here is an example: before technique class, be sure to have your water with you, gargle some mouthwash, and use your nasal spray, then repeat after class.Maybe use your time on the subway to do some mind relaxation. Get to work (or school or rehearsal) twenty minutes early, sit, relax, and have a cup of tea then repeat the gargling, spraying and washing.
Part of resting means resting your brain as well.Remember that stress hormones suppress the immune system.The more stressed you are, the harder it is for your body to fight off viruses and deal with allergens.
7. Over the counter medications
If all else fails, over the counter medications can help take the edge off.Here is a list of helpful medications and what they do (this is from the list that was supplied to me by a health care professional.Do not take these medicines if you have a history of bad reaction.If you are unsure or have adverse side effects, talk to your doctor.)
Day
Pseudoephedrine
Best to take in the morning to drain sinuses
“used for the temporary relief of nose, sinus, and ear congestion.
“Works by decreasing swelling of nose and ear tissue”
Night
Diphenhydramine
Best to take at night because it dries out the sinuses (also because one of the side effects is drowsiness)
Spring is coming and with spring comes lighter (and less supportive) footwear. As dancers, we spend a lot of time on our feet both in and out of the studio. Usually we have little control over our footwear in the studio, but out in the world, we do. Many of us are probably transitioning from boots to flats. Here are some tips from American Podiatric Medical Association for picking healthy shoes for spring:
Flats!
The Down Side: Flats provide inadequate cushioning and support. This may result in arch or heel pain.
Try to avoid wearing flats for long periods of time. If you know you are going to be walking around the city all day (and carrying a heavy bag), maybe a sneaker or danskos (APMA approved!) would be a better option.
If you do wear your flats, try to pick a pair that have built in arch support.
Never buy flats that can bend in half or twist. These are too flimsy and will not provide enough support for your feet.
One of my most poignant memories of my ballet days is sitting around with my friends after rehearsal with our feet plunged into large buckets that contained mostly ice with water to fill in the cracks. In college, we had bags of frozen peas in the freezer. Often times I would notice my colleges icing during jumps in ballet class then dance again in modern class. Poor choice. Ice is important, it reduces inflammation to overworked bodies and helps us go on to another day of doing what we love. However, you can over do it. There is such a thing as icing too long or icing at the inappropriate time. Here are some guidelines:
How long should I ice?
Most sources recommend 10-15 minutes. At work, we ice patients for ten minutes and this is plenty.
Ice should be applied for absolutely no longer than 20 minutes. Icing longer can actually cause tissue damage or an increase in the inflammation in the area.
You can ice multiple times a day (provided that you are not dancing). The recommendation is around four times a day.
When should I ice?
NEVER NEVER NEVER NEVER ice before you dance! You risk causing more damage to your injured body part.
The recommendation is that there needs to be at least two hours in between icing and physical activity. If you have iced earlier in the day, be sure to warm up the body part really well. Tiger Balm does not count and is not a substitute for a proper warm up.
Some recommend waiting until the day is over to ice (this is my preference).
How can I ice?
Ice pack: You can buy a gel ice pack at any pharmacy or you can ask your physical therapist if they have ice packs for sale in the clinic (these are usually the heavy duty, professional grade kind. I have two, they are marvelous). Ice in a baggie will also do the trick. Be sure to put something between your skin and the ice. At work, we use pillow cases. Other acceptable barriers might include: a towel or a t-shirt. It is not hard core to put the ice directly on your skin. You can get frost bite or an ice burn (both are painful and unsightly).
Ice massage: It is usually recommended that this is done no longer than ten minutes, or until the area feels numb. Simply fill a dixie cup with water, freeze it, then peel away the paper at one end. Massage the area with the ice, but be sure to keep the ice moving.
Ice bucket: An effective way to ice an ankle is with a bucket filled with ice water. The recommended amount of time for an ice bucket is 10 minutes. If your foot is numb before then, take it out.
But I'm dancing all day, and I really want to ice on my lunch break! What should I do?
Unless your break is at least three hours long, don't ice.
A nice alternative is laying on your back with your legs up the wall. This uses gravity to get stagnated blood out of your legs (which is what ice does, except the cold constricts the blood vessels, and pushes blood out of the tissue).
This is something that is seen in many restorative yoga poses, one of the benefits is listed as "refreshing for the legs and feet."
First I would like to emphasize that I AM NOT A DOCTOR (yet). Any information on this blog is NOT a substitute for having your injury checked by a person with an MD.
Where does the information come from?
I will try my best to source any information on this blog either through a reputable medical website (ie Mayo Clinic, NIH, AAOS) or published source.
My Job: I have worked at a dancer-specific physical therapy for four years and have a wealth of information from this experience. I will try to back up any information from this source by a second written source.
Just ask. Sometimes I will just ask: a doctor, a physical therapist, an acupuncturist.... information from these sources will be indicated.
My (and other's) experience. It's always useful to share experience, especially when it comes to navigating the health care system.
