Medicare Advantage is an all-in-one managed care plan, typically an HMO or PPO. Advantage plans provide the benefits of Part A and B, and most also include Part D, or prescription drug coverage. Some offer extra benefits not available through Original Medicare, such as fitness classes or vision and dental care.
If you opt for Medicare Advantage, you typically continue to pay your Part B premium as usual, but you will pay little or no additional premiums for your coverage. You generally have copays or coinsurance, but once you reach your out-of-pocket limit, the plan will pay 100 percent of your medical costs covered under Medicare for the rest of the year. The out-of-pocket limit does not apply to prescription drugs or extra benefits.
To keep premiums low, Advantage plans generally require you to get your care from a network of doctors, hospitals, and other providers, and you typically need pre-authorization for specialized care.
In this video, you’ll learn about what causes hyperglycemia, what symptoms to look for, and how it affects the health of people living with type 1 diabetes.
Hyperglycemia refers to an excess of glucose in the blood stream. The fact that we do not all have hyperglycemia is a tribute to the fine-tuned regulation, or homeostasis, of the normal body,
Glucose is our main source of energy especially for the brain. When we eat, our intestinal tract breaks down the complex starches and sugars we eat into glucose, which is absorbed into the bloodstream. This triggers the pancreatic beta cells to produce insulin, which allows glucose to get through the cell membrane and into our cells.
Hyperglycemia results mainly when pancreas produces insufficient insulin, or our cells exhibit insulin resistance. This can occur in diabetes, other diseases affecting the pancreas or stressful conditions which decreases insulin sensitivity.
Excess of glucose in the blood stream washes out water and salts with excessive urination, causing thirst, and drying out of the cells; the distorted vision of hyperglycemia is one such symptom thot results.
In the most common types of hyperglycemia, the cells are starved of glucose, and need to breakdown fats for energy. This produces a ketosis, or acidosis of the bloodstream, increasing the dehydration.
My wife suffered from diabetes, and had her only severe episode in Canada. She started vomiting before we discovered the high blood sugar, and couldn’t drink enough fluids by mouth. She was hospitalized in Canada and received excellent treatment with intravenous fluid and insulin.
Over the years, chronic excess of sugar attached to the protein of her cells, as manifested by excessive hemoglobin A-1 C, or glycohemoglobin, in her bloodstream. She passed away a decade ago.
A healthy lifestyle, with good sleep, diet and exercise is essential
Sugar should be considered a poison.
Regular vegetables fruits and cereal grains help avoid the excess sugar of fast foods. Exercise helps to utilize extra sugar and mitigate stress.
Please refer to the article on hyperglycemia by the Mayo clinic for a more complete discussion.
Lyme disease is high on every hard-to-diagnose disease list, because it is relatively uncommon, and can produce a variety of disturbing symptoms often classified as psychosomatic.
It is caused by a deer tick bacterial injection of the Borrelia genus, which can progress to cause widespread problems. Not every tick bite will inject the bacterium, and ticks that have been attached for less than 12 to 24 hours are unlikely to have done so.
Risk factors include living in a wooded area, particularly on the east coast. With people fleeing the cities in the wake of Covid, exposure is more common.
The NYT columnist, Ross Douthat wrote a book about his travails: “patient heal thyself“. In this day and age of overworked doctors, and with the huge variety of medical information available online, more and more people are going on a “medical odyssey”.
A painless red swelling, followed by an expanding area of red(erythema migrants), is often the best medical clue. Flu-like symptoms and enlargement of the lymph glands can accompany the “rash”. Tests are not positive for several weeks, and may be negative if and when the late symptoms of Lyme disease develop.
The earlier you get treated with a 10-day course antibiotics, the better. The problem is that not all tick bites produce infection, and so overtreatment is a real possibility.
Late symptoms can include fatigue, mental symptoms arthritis, liver problems and a variety of other symptoms. Like another bacterial disease, syphilis, lyme disease can be the great mimic.
Prevention is paramount. People living in endemic areas should wear long sleeves and pants when they go out into the woods, use insect repellent , and make sure their animals are kept tick-free.
A DWWR article on Nootkatone may be worth your time to read, since DEET and many other insecticides are toxic and have to be used with care.
Please refer to the following article by the Mayo clinic for more organized information.
Thrush is an infection of the mouth with an organism called candida albicans. It is most common in the newborn and with young children, but can occur in adults if they have an immune deficiency, use corticosteroid inhalers, are diabetic, or take broad-spectrum antibiotics.
A combined mother–child problem can occur with breast-feeding mothers in the newborn period. The mother’s nipples may become infected, giving it to the baby, and they can pass back and forth. A baby who has thrush is also susceptible to diaper rash caused by candida.
There is a sense of irritation and some pain associated with thrush in the mouth, the diaper area, and the nipples. Thrush appears as cottage cheese-like areas on the throat and tongue.
The normal immunity usually keeps thrush at bay. In a newborn, however, the immune system is not fully developed. Sometimes the hormones of pregnancy facilitate thrush in the mother. Diabetes and smoking can also allow thrush.
Sometimes the thrush infection will go down into the swallowing tube, the esophagus, and produce inflammation. This can cause pain on swallowing, and is most common in AIDS and other immunodeficiency states.
Treatment of surface candida infections like throat is usually with Mycostatin– containing mouthwashes or creams. If it spreads beyond the surface, however, you will need more potent medications. Candida albicans is everywhere, and your immunity is your main defense against it.
Keep your immunity as solid as possible naturally, with good sleep, diet and exercise.
Graves’ disease is the most common cause of hyperthyroidism. Hyperthyroidism is an over activity of the thyroid gland, and can also be produced by an overgrowth in the gland called an adenoma.
The thyroid gland is an H-shaped structure sitting astride the wind pipe. If a physician palpates the front of your neck, she is most likely trying to see if she can feel the thyroid gland. Enlargement of the grand can interestingly be produced by either overactivity or under activity.
Graves’ disease is an auto immune disease, where the antibodies produced attach to the TSH receptor on the thyroid gland, stimulating overactivity.
Many metabolic processes are regulated by the thyroid gland, and increased activity produces difficulties like insomnia, fast irregular heartbeat, shaking of the hands, heat intolerance, and irritability. Other symptoms are protrusion of the eyes, fatigue, muscle weakness, and unexplained weight loss.
The doctor suspects the disease because of the symptoms, and must do blood tests and perhaps imaging tests to make the diagnosis. Treatment consists of decreasing thyroid activity, either by radiation techniques, anti-thyroid chemicals, or surgery.
It is very difficult to reduce thyroid activity in exactly the right amount, so that thyroid administration will be necessary. This can be tricky, and requires several visits for adjustment.
The ultimate cause of Graves’ disease is unknown. The immediate cause is thyroid stimulating immunoglobulin. Graves is an auto immune disease, and is more common in people who suffer from other autoimmune diseases, such as type one diabetes, rheumatoid arthritis, or inflammatory bowel disease. The doctor will question you about some of these diseases.
Both causes of hyperthyroidism have occurred in friends of mine. The friend with the adenoma had an easier time with medication adjustment, and had no other problems. The one with the Graves’ disease has had a difficult time getting a proper dose of thyroid medication, and she has other problems with auto immunity. Women typically have more autoimmune problems.
Interestingly, the commonest cause of low thyroid activity is also an autoimmune disease. Some of the symptoms of low thyroid are the opposite of excessive thyroid activity; sleeping is excessive, there is sensitivity to cold, unexplained weight gain, and sluggishness.
Check with the doctor if you have any of the symptoms mentioned.
There is a Cleveland clinic discussion of Graves’ disease following this article.