Monday, November 26, 2018

Diabetes Awareness

November is Diabetes Awareness Month. Let's learn something about Diabetes in order to understand it better.


Did you know there are several kinds of Diabetes? The most common are Type1, Type 2, and Gestational Diabetes. Gestational type occurs during pregnancy, so it affects less people, and usually stops after the birth of the baby. We're going to share information here about Type 2 and Type 1.

                                                         Type 2

90% of people who have Diabetes, have Type 2. Whether you develop Type 2 is mostly dependent on lifestyle and heredity: If you have a close blood relative that has it, you are at higher risk as well. Being overweight increases this risk. However, many Type 2 Diabetics are of average or slender build.



With Type 2, your pancreas is still functioning, but not at 100% efficiency. If you closely monitor the foods you eat, with Type 2 you can still keep diabetes under control to some extent. Type 2 involves an insulin resistance and sometimes a reduction in insulin production. Your body's cells do not use insulin the way they are supposed to. Sometimes people with Type 2 Diabetes are able to control their blood glucose (blood sugar) levels with diet and exercise, but often treatment requires medication. Often, medication in a pill form will help cells use insulin more efficiently, and so insulin is not necessary. However, sometimes people with Type 2 Diabetes aren't able to achieve good control of their blood glucose levels and begin to use insulin injections. When taking the pill form of medication, it's necessary to check blood glucose levels by doing a finger stick. The drop of blood goes on a test strip, and the test strip is inserted in a glucose meter which tells the level of glucose in your blood at that moment. You would check your levels before meals and at bedtime, so about 4 times each day. You gauge how many carbs you should take in if your glucose level is high, or if you are about to eat something with carbs in it, which would raise your glucose level. If you run high too often, you may need to inject insulin to help regulate the level (keep it down but not too low).  When taking insulin, much more frequent checks are needed.


The type of doctor a diabetic sees is an endocrinologist. These specialists understand the endocrine system more thoroughly than a family practice physician, and are often the only doctor a Type 1 diabetic sees. It's important to have a good relationship with your doctor, but especially with this condition.

Here is someone checking her blood glucose using a meter: The drop of blood is put on a test strip, and the test strip is inserted into the meter, which gives the blood glucose reading.








                                                                             Type 1
Type 1, or Juvenile Diabetes (also called T1D), occurs when your pancreas isn't functioning at all. In this case, you will need to give yourself insulin when you need it and monitor your food intake much more closely than with Type 2.

It was originally called 'Juvenile Diabetes' because it usually shows up in people under the age of 20-including newborns and toddlers-but can appear at any age. Type 1 is considered an autoimmune disease, or an attack from within. It does not have a connection to your lifestyle. However, it can be genetic ("runs in the family").

People with Type 1 must rely on insulin injections for treatment. Your body requires insulin at all times. Insulin works as a type of "key" that lets glucose into all your cells. Glucose is needed by your cells in order for the cells to function. Without it, glucose can't enter cells, so the cells don't have fuel to work, and your system shuts down. In Type 1, insulin must be injected so that the glucose can always enter your cells and your body can function. 


Ways to take insulin: Insulin can be carried with a person in a device that looks like a fat pen and is pre-loaded with insulin. It has a needle on the end that needs to be changed after every use.  Insulin needs to be refrigerated until it is opened. Once opened, it can be out of the fridge for 28 days and then must be thrown away. 

When you have Type 1 Diabetes, your life is much more influenced by the disease than with Type 2 (usually). A typical day for a Type 1 Diabetic includes up to 12 finger sticks/meter readings per day, with injected insulin (shots) occurring with each meal as well as long-acting insulin to get through the day. Activities that lower or raise your glucose mean more testing, as does illness (it tends to run high while fighting off an illness) while exercise usually lowers the glucose level. Having too high a level can cause nerve damage if it's left uncontrolled, and running too low of a glucose level can result in the person going into a coma. A young woman describes a day with Type 1 here: https://lyfebulb.com/2017/10/16/day-life-type-1-diabetic/




Another option for someone with Type 1 Diabetes is an insulin pump. Here is what it looks like:







The pump, as you can see, looks somewhat like a pager. It has a tendency to make security alarms go off, and can be a bother to allow for if you're wearing certain clothing; however, it does save you from several injections every day. You can take it off completely for an hour to shower or take a swim, but the pump cannot get wet. The device to your left is a Continuous Glucose Monitor. It communicates with the pump to tell it when your glucose is very low. The CGM can be worn on the shoulder as well.




With the pump, insulin is constantly being administered to the person, 24/7. This provides the person with a steady supply of insulin, since their body isn't making any insulin, and the body's cells always need it ready to dispense. The person does a blood test (finger stick) and based on that, tells the pump to deliver a "bolus" (dose) of extra insulin when they eat or when their blood sugar is running high. Since the tubing is already sitting under the skin, the pump eliminates the need for several insulin shots per day. Every 3 days a new 'set' is inserted, using  a needle and a little tool. Once the new set is inserted, the needle is then removed, leaving behind a cannula, which is a very small hollow plastic tube, underneath the skin. This connects to the insulin pump via a small plastic tube that's about 12 inches long. The pump itself is typically worn on the front of pocket of your pants. The needle is attached to your skin in the abdomen area with a large round bandage patch. The pump needs to be refilled and the infusion site (the place where the tubing was connected to the body) changed every two to three days. The insulin needs only to be infused into the fatty layer of tissue just beneath the skin. From there, it is absorbed into the body and dispersed to the cells that need it. 




How do you know if someone with diabetes might need your help? A person whose glucose level is running very low will become disoriented, may not make sense, will seem a little drowsy or shaky. If you know the person is diabetic, offer some juice or a small piece of soft candy-you don't want him or her to choke. A very small amount of soda will work, but is extremely high in sugar so don't give a large amount. Even a little milk will probably provide enough sugar to stabilize the person so he/she can decide what to do. Do not pour something down the person's throat! Your aim is only to bring the blood glucose (sugar) level up enough so the person becomes fully alert. Stay calm so the person will also stay calm, and stay close by to watch over him or her. In a few minutes, you should see an improvement. Once the blood glucose level comes back up, the person will be fine and probably will not need medical intervention. However, if you are not having success, call 911 right away. It's important to be a concerned and caring friend, but once the episode has passed, don't make a big thing of it. Your diabetic friend already probably feels self-conscious about it.

Here's a vid of a day in the life of a college student with Type 1. He is not using a pump. Notice how his vision gets blurred when he's running low. https://www.bing.com/videos/search?q=type+1+diabetic+for+a+day&view=detail&mid=956341D0FFFACD6E8DFA956341D0FFFACD6E8DFA&FORM=VIRE




Please also visit jdrf.org to learn more about Diabetes, and when you donate to charity, keep in mind people experiencing a natural disaster in their area: There are usually diabetics in need of help with their supplies and meds. 

Monday, November 19, 2018

Thank Your Farmer

Consider the role of the farmer in your Thanksgiving dinner:
  • Turkey? Farmer.
  • Or ham or beef? Farmer.
  • Milk? Farmer. Cream for whipped cream? Farmer.
  • Corn, Beans, Cranberries, Potatoes, Carrots, Yams, Apples, Pumpkin? Farmer.
  • Celery, Onion, Spices? Farmer.
  • Cucumbers for pickles? Farmer.
  • Bread for stuffing? Farmer.
  • Flour, Sugar, Butter, Eggs for pie crust, dinner rolls, or desserts? Farmer.
Have you ever thought about farming or something related as a career?

Farming can be anything from a small family farm to a major conglomerate involving several million-acre locations. If you grew up on a farm, you already know most of what's involved in running the place. You may have participated in 4-H in middle and high school. 4-H students often will raise an animal, such as a calf, lamb, or pig, and present it at the annual State Fair.



So how could more education be helpful?



Think of all the things involved in farming:

Farming crops--          Plant Science
                                    Soil Science and Irrigation:How do we rotate crops to keep nutrients in the soil?
                                    Research
                                    Farm Inspectors
                                    Biology: How can we make a plant less susceptible to disease?
                                    Meteorology: What is the weather projection for the next month or more?
                
                                            Harvesting corn: How many products can you name that have corn in them?

Farming with animals--Animal Maintenance
                                      Biology/Biomedicine
                                      Veterinary Science/Farm related
                                      Dairy Science
                                      Aquafarming--growing fish for food
       
                         
Both crop and animal farms require you to have knowledge of:

                                     Management
                                     Accounting/Budgeting/Math
                                     Machine Repair
                                     General building and maintenance skills
                                     Field Maintenance (fields needed for grazing)
                                     Biomedical Science
                                     Stock Market (what is your product
                                                        selling for-- varies day to day)



There are also careers in Agricultural Law, which deals not only with land and ownership issues, but also with pollution, price fixing, and corporate liabilities--what if an outbreak of food poisoning was traced back to food grown on your farm or by your company?



There is a constant stream of research being done on how to make plants disease-proof and yield more, as well as developing new plants (hybrids) and healthier animals, which includes genetic engineering and statistics.




You might focus on only dairy products (or, only milk); only turkeys, only certain vegetables like corn and soybeans, or products like honey, apples, or plants to be used in landscaping, including sod, trees, shrubs, and garden plants.
                                                                      Turkey Farm


You may want to pursue organic farming--farming done with no pesticides or engineered growth chemicals. These farms tend to be smaller and require a lot more hands-on maintenance.






You may want to work as a county extension agent, who is someone who helps advise and guide farmers.



Last, while farming is a very valuable career, many times farmers find they need a second job to provide a steady income. Their income level varies year to year and is not only dependent on good weather, but also the risk of diseases in plants and animals. The machines they use are very expensive to buy and to maintain. It is very physical, demanding, tiring work, and with animals, it's rare that you can leave them and take a day off. However, most farmers will tell you they find their jobs very rewarding: Working the land and/or with animals, producing food, and enjoying the outdoors, are reasons they love what they do.





Take a few minutes to consider how your Thanksgiving feast arrived at your table and give thanks for those farmers this year.

Check out some turkey growing stats and lots of other stuff about farming in Minnesota, at the University of Minnesota Farm Extension Program: http://news.extension.umn.edu/
                            
                                    

Tuesday, November 13, 2018

How to Adult: Making a Doctor Appointment

Once you're on your own, whether away from home at college or starting life as an adult, you'll eventually need to tend to your health; namely, you're going to need to see a doctor for some reason, or at least get to a pharmacy for some help to feel better.
 
First, how to know you are 'sick enough' to be seen by a doctor. Here are some guidelines, but truly: if you feel incredibly sick, then you're sick enough.

  • Do you know how to take your temperature? You can get a digital thermometer at a pharmacy, they're easy to use if you follow the directions. Normal is usually 98.6. If it's more than 100, it might indicate you're fighting something.
  • A bad cough may indicate a respiratory infection
  • Vomiting and/or diarrhea that just won't stop after 24 hours and laying off food, should be checked out
  • If your chest aches, you may have any number of respiratory issues
  • A very raw sore throat may be strep. However, strep doesn't always cause a sore throat. It also can be shown by feeling nauseous, headaches, and a rash.
  • For women, if you are not sure whether you have a yeast infection, you should see a doctor.
  • You also should be seen if you are having depression that won't ease up. Don't feel like it's not important enough, it is.

While you wait for your appointment, here are some things to try that may help:
Cold/Cough/Chest/Sore Throat - Lots (Lots) of liquids, particularly water; cough drops or anything to suck on that soothes your throat; salt water gargle; ice pops; keeping warm; sleep. Tylenol or ibuprofen for aches and pains (have a little food with ibuprofen as it upsets the stomach)


Vomiting, stomach upset - flat or sometimes fizzy soft drinks, especially clear ones; nothing but clear liquids for 24 hours and then bland foods like soda crackers, bananas, applesauce, plain cooked rice. Have small amounts at a time and see if it stays put.


For any illness, you may want to try products OTC (over the counter) to see if they help-ask a pharmacist for suggestions.



How do you make an appointment?
It doesn't matter if you are at home or away at college, it's the same procedure: First, you call the clinic. Have an idea what time you'll be able to come in. If you prefer a certain doctor or nurse practitioner, say you want to make an appointment with her. Otherwise, just say you need to be seen. They will ask what your symptoms are. This is so they are prepared for possible lab tests or anything else they commonly do, and to gauge how long an appointment you will need. They will tell you what times are available. You can choose the time you want. Write it down so you don't forget.
 
They will ask what insurance you have. Be sure you can answer that one. They will likely want a copy of your insurance card when you come in for your appointment.
 
Show up on time or a bit early for your appointment, and have your debit card with you for the copay. Go to the checkin desk and tell them who you are, and that you have an appointment at 9:00  with Mary Jones, for instance. They'll ask for your insurance card and possibly a co-pay. Get a receipt for that and keep it in a safe place.
 
When they call your name to go to your exam room, answer the doctor's questions as well as you can. It's hard to diagnose when you're not being clear. She will listen to your heart and lungs, look in your ears and at your throat, examine your lymph glands (below your ears), and may have you lay down so she can palpate (feel) your belly, and will need to examine anything that might indicate what the problem is. She may want to do lab tests such as a white blood count. That will indicate if you are fighting an infection. If there is anything at all you don't understand, ask the person to explain.


It's possible your doctor will determine that you have something viral, and antibiotics won't help.

You can also ask the doctor to write down your instructions for when you leave; most of them will give you a printout to take home with you.


It is important to know if you have any allergies to any kind of medication. Ask your parent if you don't know. If you have seen this same doctor for a few times, he or she will likely know and will prescribe only drugs that are safe for you to take.


If you have something viral, then a prescription won't help. The doctor can suggest ways for you to soothe your symptoms.
If you get a prescription, and they don't fill it at the doctor's office, here's how you get it filled.


Some doctors will call in your prescription for you at the end of your appointment (know where you want them to send it to be filled). If you get a slip of paper, called a scrip, take the scrip to your pharmacy and give it to the person working there. If you're not in their records they may ask for your information. They'll also need to know what insurance you use. They may be able to fill it while you wait, or may have you come back.


Once it is ready, you pay the copay and they give you your medicine. Ask any questions you have, and they may tell you not to take this medication with certain foods. Pay attention to that: Sometimes if you take a medication with orange juice, for example, it wipes out the effect of the medication. There will be cautions printed on the paper you get with the prescription. If you have any questions, you can call the pharmacy and ask them.


Take the medication exactly as it says on the pill or liquid bottle, and finish it all, even if you start to feel better in a couple of days. If you finish it and still aren't better, call the doctor to see what she thinks you should do (another round of medication? Something different?).


Most of all, don't be afraid to see a doctor when you are concerned. They really want to help you feel better. And if it's something that will simply run its course, then you don't have to be worried about it anymore.


Take care of yourself!!

Thursday, November 8, 2018

Changes: New(er) Faces in Washington





The 2018 midterm elections are over, with a lot of interesting results. Some of the races still do not have a confirmed winner because voting was so close. Some facts:
https://www.cbsnews.com/live-news/2018-midterm-elections-results-polls-us-races-live-updates-today-2018-11-06/


There were some remarkable winners among women, women of color, and other minorities gaining office: the youngest woman elected at age 29, 2 Muslim women elected, 2 Native American women elected, and a number of first women governors, some of them also minorities, in several states.
https://www.usatoday.com/story/news/politics/elections/2018/11/06/election-results-2018-women-minority-candidates-history-firsts/1912048002/
After this week's election, there will be some changes in our local, state, and national government. Let's brush up on who does what at the federal level:


What is the President's Cabinet?
It is a group of people who head up different departments and advise the president as to the status of those departments. But, did you know that in theory, these department heads could take over (succeed) if the president and others were removed or died in office? Below you see all the different department heads, and the order in which they could possibly become president.

What is the order of presidential succession?

The Cabinet is crucial to the presidential line of succession that determines the order in which officials succeed to the presidency following the death or resignation of the President. The Vice President tops the order, followed by the Speaker of the House, then the President pro tempore of the Senate. The Cabinet officers succeed to the presidency in the following order: (from https://www.dummies.com/education/politics-government/what-is-the-presidents-cabinet/)
  • Secretary of State, Department of State
  • Secretary of the Treasury, Department of the Treasury
  • Secretary of Defense, Department of Defense
  • Attorney General, Department of Justice
  • Secretary of the Interior, Department of the Interior
  • Secretary of Agriculture, Department of Agriculture
  • Secretary of Commerce, Department of Commerce
  • Secretary of Labor, Department of Labor
  • Secretary of Health & Human Services, Department of Health and Human Services
  • Secretary of Housing & Development, Department of Housing and Urban Development
  • Secretary of Transportation, Department of Transportation
  • Secretary of Energy, Department of Energy
  • Secretary of Education, Department of Education
  • Secretary of Veterans Affairs, Department of Veterans Affairs
  • Secretary of Homeland Security, Department of Homeland Security

The House of Representatives now has a Democrat majority, so the Speaker of the House will change to a Democrat, Nancy Pelosi, who was Speaker of the House from 2007 to 2011. She is a representative from California (San Francisco) and, by the way, she was the first woman Speaker of the House. Here is the role the Speaker plays:
The Speaker of the House exercises duties as a Member of Congress, as presiding officer of the House of Representatives, and as leader of the majority political party in the House.
These responsibilities include voting on legislation, administrative duties such as maintaining order within the House chamber, and other tasks such as appointing special committees
                           -from Government For Dummies,


The day after the election, our Attorney General stepped down at the request of the president. There is an acting AG at present. What is the role of Attorney General?
The Attorney General of the United States is the main legal advisor to the federal government. This person provides legal advice to the various department heads, deals with litigation against the government, and also can be involved in death penalty court cases.


Here is an in-depth explanation from Free Dictionary/Legal
The attorney general is head of the u.s. justice department and chief law officer of the federal government. He or she represents the United States in legal matters generally and gives advice and opinions to the president and to other heads of executive departments as requested. In cases of exceptional gravity or special importance, the attorney general may appear in person before the U.S. Supreme Court to represent the interests of the government.
As head of the Justice Department, the attorney general is charged with enforcing federal laws, furnishing legal counsel in federal cases, construing the laws under which other executive departments act, supervising federal penal institutions, and investigating violations of federal laws. The attorney general also supervises and directs the activities of the U.S. attorneys and u.s. marshals in the various judicial districts. (U.S. attorneys prosecute all offenses against the United States and prosecute or defend for the government all civil actions, suits, or proceedings in which the United States is concerned; U.S. marshals execute all lawful writs, processes, and orders issued under authority of the United States.) The Attorney General, then, represents the government, and is not the President's personal legal counsel.



The branches of government and what they do, the concept of the Constitution, the first 10 Amendments:

It's our government. We need to know how it runs and who does what.



Monday, November 5, 2018

Vote!

On November 6, a number of offices are up for election. If you are 18 or will be by election day, then you should go and vote. You can vote early, if you prefer. Check the website below for all kinds of info on voting.


Here's how to find out where to vote, and to see a sample ballot based on your location. https://www.sos.state.mn.us/elections-voting/  You can also see how to vote if you are attending college away from home.



Every city or town in Minnesota belongs to a district. Based on your district, different things can be up for a vote.




In addition, each district has a representative in the State Senate--you may see ads on TV for various candidates, but they may not be in your voting district. You need to know who is, and what they favor, to be sure which candidate matches your wishes.


People can always run on any 'ticket' they want; that is, while the major political parties are Democrat and Republican, there are others, too, such as Independent, Green, Libertarian, Grassroots, or no affiliation. You don't need to be a member of any party at all to run for office, nor to vote.


You may also see several judges on your ballot, and it's likely you don't know anything about them. They frequently run unopposed, but they are elected officials.


This election, all voters in the state will be voting for United States Senator, State Auditor, State Attorney General, Governor (Mark Dayton is retiring from office) and Lieutenant Governor (Tina Smith held that office but became U.S. Senator to fill Al Franken's role, so now she is running to be elected), as well as local offices such as City Board Members and Judges. You will see some of them are running unopposed (no one else is running for that office).




Some of the candidates will say 'Incumbent' by their names, that means they currently hold that office. They may be unopposed or opposed. You can vote for the incumbent or someone else if you want to.



You forgot? The weather was bad? It wasn't at a time you found convenient? If someone gave you months of notice there was an important concert happening on a certain date, you'd show up, right? It's stunning how many people who could vote, do not vote. Why? It's the least you can do for your country. And it's so simple!
OK, these are mostly pretty lame reasons not to vote. Unless lines are long, it should only take about 15 minutes of your time, possibly even less. You stand in line to get coffee or McDonalds, don't you?


And, did you know Uber and Lyft are offering free or half price rides to your poll? Another 'problem' solved:  https://www.nbcwashington.com/news/local/Uber-Lyft-To-Provide-Free-Trips-On-Election-Day-Vote-Polling-Place-Midterms-Elections-497528571.html




You can also write in anyone you choose if you feel like that person is better qualified than anyone else. This is, logically, a "Write In" vote.


Here's what a ballot typically looks like. You fill in the ovals with a pen or marker provided at the polling place. Be sure to turn the sheet over, usually there are more candidates and offices on the other side.








Not sure where the candidates stand on issues that matter to you? Confused by campaign ads on TV? Every candidate has a website. You can check and see if that candidate's views match yours.

                                               Really??? A bit over half of potential voters actually voted?? Belgium, we're not.
Why vote???
  • We have a democracy. That means we all decide who represents us and what laws we want passed. If you vote, you make your voice heard.
  • It's a way to honor veterans: They fought and served our country to preserve our rights. Show your appreciation by participating!
  • It shows you care about what goes on in your community and your country
  • It's the simplest and most basic way to participate in your government
  • Majority rules. If an issue or a candidate is important to you, then speak up with your vote.
  • You can't sit home and complain about what's going on if you didn't make the effort to vote.
  • Everyone 18 and older can vote. It's not just up to the older generation to vote, it's everybody's right and responsibility-don't 'let those people handle it' thereby giving up your power.
  • If you want someone in or out of office, you speak with your vote.
  • It's easy and doesn't take much of your time. Your polling place is close to home, registering is simple, go and get it done.