Oh, my aching knee!

It seems that I have tried everything to get rid of that nagging pain in my knee. I have gone to a specialist, used ice packs and hot packs and tried both topical and injected pain relievers. Now my doctor is suggesting total joint replacement as a way to relieve my symptoms.

Not quite sure what I plan to do. I know of a few people who have had replacement surgery and seem to experience more pain afterwards.

Try eating breakfast!

Why do children who eat breakfast do better in school? It's because their bodies and brains need the energy that breakfast gives them! They think better and learn better if they get breakfast. The same is true for children who are not in school yet. Remember, your toddler needs breakfast too.

Breakfast can make a difference in:

* How much your child learns
* How well your child plays
* How good your child feels

Breakfast is Easy

Breakfast can be a quick bowl of cereal and milk with a glass of juice. Or it can be a slice of cheese on toast and a piece of fruit. It can be just about anything. A sandwich or some of last night's fried chicken is fine. That's my husband talking! The important thing is to make it a habit. Not having enough time for breakfast is no excuse!

No time for Breakfast?

* How about getting everything ready the night before?
* How about taking turns getting breakfast ready?
* How about taking breakfast along to eat on the way to preschool or daycare? Try a grilled cheese sandwich(love cheese!). Take milk or juice in a "to-go" cup with a straw.

Whatever you do, figure out how to get your child to eat some breakfast!

Now, let's turn to you......How about your own eating habits? Do you eat breakfast every day? If you have a hard time "getting going" in the morning, it could be because your body and your brain need energy. Do you start to sag about 10:00? You need breakfast! You might have an easier time controlling your weight if you eat breakfast too.

So in a nutshell, get in the breakfast habit at your house! It could really make a big difference.

Why should your battle be any different than mine?

Americans without health insurance and those on Medicaid are diagnosed with cancer at a later, more advanced stage than those with private health insurance, according to a new study.

Many common cancers that are treatable in their early stages, such as breast cancer and colorectal cancer, are much deadlier when diagnosed at an advanced stage. That's why early diagnosis is critical to successful treatment.

Researchers found that the greatest risk of advanced-stage cancer diagnosis involved types of cancer that could have potentially been detected early by routine screening or monitoring for symptoms in the early stages.

Researchers say the findings should have important implications for the nation's health care system and policy decisions about health care reform.

The fact is, too many cancer patients are being diagnosed too late, when treatment is harder, more expensive, and has less chance of saving lives. We must begin to remove the barriers that stand in the way of early diagnosis and timely access to medical care if we are to give all cancer patients an equal chance in the fight.

Cancer Diagnosis Linked to Insurance Status

In the study, researchers from the American Cancer Society examined the effect of health insurance status and ethnicity on cancer stage at the time of diagnosis for 12 common types of cancer. The study looked at more than 3.7 million Americans diagnosed with cancer between 1998 and 2004.

The results, published in Lancet Oncology, showed that uninsured and Medicaid-insured people were significantly more likely to be diagnosed with cancer at a later stage than those with private health insurance.

For example, the odds of being diagnosed with stage III or stage IV colorectal cancer were two times and 1.6 times greater, respectively, among the uninsured and those on Medicaid than those with private health insurance. For advanced melanoma (the deadliest form of skin cancer), the odds were 2.3 times and 3.3 times greater for uninsured and Medicaid-insured patients.

African-Americans and Hispanics were also more likely to be diagnosed with advanced cancer, regardless of their health insurance status, than whites.

Ways to lower your healthcare bills

Last night, I was watching the news and sadly a woman had to stop purchasing her mother's meds for diabetes because of the expense. Another husband and father has to decide whether to purchase his blood pressure meds and keep missing his much needed doctor visits or put food on the table. This always saddens me. Cashing out seems to be the answer these days. There are other options but let's just hope and pray it is not too late where we find ourselves having to take drastic steps as mentioned earlier.

CO-PAYS. DEDUCTIBLES. OUT-OF-POCKET EXPENSES.
It may feel like you need to empty your savings account to stay healthy. You’re not alone: One in six Americans spends at least 10 percent of his or her annual income on prescriptions, premiums, and medical care. "Many women assume these costs are nonnegotiable,” says Michelle Katz, author of 101 Health Insurance Tips.

“But it’s easy to save hundreds of dollars on your bills each year by speaking with your doctor or choosing another insurance plan.” Here, learn why you’re paying too much—and how you can put that money back in your pocket.

1. Choose a plan carefully

When it comes time to re-enroll this year, don’t blindly check the box next to your current policy. Re-evaluate your plan annually to ensure it meets your current needs. The first question you should ask is whether you have a favorite doctor or a medical condition that requires a specialist’s care. If you answered yes to either, your best bet may be one of the pricier preferred provider organization (PPO) or point-of-service (POS) plans, which give you the freedom to visit any physician. Generally, an in-network doctor will charge $10 to $25 per visit; out-of-network M.D.’s bill you for 30 percent of their fees. But if you only see your physician a few times a year, a health-maintenance organization (HMO) may be a better fit. These offer a limited selection of doctors for cheaper premiums and co-pays.

If you’re self-employed or your employer doesn’t offer medical insurance, check out Web sites like ehealth insurance.com, which offers price and coverage comparisons by state. Take into account your prescriptions, regular care needs, and mental health and vision expenses. Also consider if you’re planning on becoming pregnant within the year, because not all plans cover those costs. Once you’ve pinpointed all the services you’ll require, crunch the numbers with an online calculator such as money-zine.com. Don’t be scared off by policies with high deductibles, the amount you have to pay out of pocket before insurance coverage kicks in. Those plans have cheaper monthly premiums, so they may be worth it if your medical needs are minimal.

2. Question your tests

Doctors aren’t necessarily aware of what screens and exams are covered by your insurance. To avoid pricey surprises, bring a list of approved labs to your first appointment with a new physician. Also check with your insurance provider before you schedule any treatments or tests, such as X-rays, MRIs, and breast ultrasounds; you may need to get written or verbal approval beforehand. Write down everyone you talk to and the time and date you spoke. A paper trail is crucial if there are any questions or disputes later on.

3. Bargain with your doctor

If you’re paying your bills out of pocket, don’t be shy or embarrassed to ask your doctor for a discount. Explain your situation. “Say, ‘You’re not in my network, but I wouldn’t trust anyone else to handle this. Is there any way you can adjust your fee for me?’ ” The key is establishing a personal relationship with your doctor and the staff. It would be a good thing to arrive on time for your appointments and always expressing your appreciation.

4. Know what to do in an emergency

When a crisis occurs, hospital and doctors’ fees are probably the last thing you’re thinking about. That’s why it’s crucial to review your policy in advance. Check to see if you need preapproval before going to the emergency room and note which hospitals in your area are considered in-network and what constitutes an emergency(you can find this information in your insurance policy booklet or on the company’s Web site). You’ll protect yourself from an unexpected bill: Health insurance companies deny 20 percent of all emergency care payment requests that require prior authorization, according to a recent study published in the Annals of Emergency Medicine. If it’s urgent, don’t hesitate to call an ambulance. But for non-life-threatening situations, such as a broken bone or a fever below 103ºF (unless you have stomach pain, which could signal appendicitis), ask a friend or family member to give you a ride to the hospital.

5. Review your hospital bill

Most women scrutinize their credit card statements every month, yet very few even glance at their hospital invoices. But they should: Experts estimate up to 90 percent of hospital bills contain errors. Before you check out, request an itemized bill. Each treatment you receive is assigned a numerical code. “So somebody accidentally typing in the wrong code could mean a difference of hundreds or even thousands of dollars.” Before leaving, scan your bill for any unusual charges. Then, at your next appointment, ask your physician or someone on her staff to go over anything you don’t recognize.

6. Pay with pretax dollars

Less than 15 percent of Americans take advantage of a health savings account (HSA) or flexible spending arrangement (FSA), both of which are offered by employers. That means most of us are losing out on free money: These accounts allow you to pay for medical expenses with cash you set aside from your paycheck before taxes are taken out. The result: a savings of up to 30 percent on your health care costs. You can even use the accounts to pay for costs not covered by health insurance, such as doctor and prescription co-pays as well as hospital stays. Many plans also let you purchase contact lens solution, glasses, Band-Aids, and aspirin.

Most employers offer only one type of account, either an HSA or FSA. The big difference between the two is that you can roll over your HSA contributions from year to year and from job to job. But with an FSA, you forfeit any money remaining in your account if you don’t spend it by March 15 of the following year or if you switch companies. For an accurate estimate of your medical expenses, review your health-related spending over the past 12 months, then add on any additional expenses (new prescriptions, for instance) you expect to incur in the future. But do keep in mind that you have to file claim forms to be reimbursed, so if you’re horrible at paperwork or holding on to receipts, these types of accounts may not be for you.

7. Be drugstore-savvy

You can save up to 30 percent on your prescription costs by going generic. Ask your doctor if there’s a proven generic version of the medication she’s prescribing. They have the same quality and safety records as brand-name medicines. If there’s not one on the market yet, ask your M.D. if there’s a less expensive but equally effective alternative to the drug she’s prescribing. Even if your physician offers you free samples of a drug, still request the generic prescription: Once the complimentary packets run out, it’s likely you’ll have to fork over more money. In fact, a study from the University of Chicago found that patients who received at least one free sample of a brand-name drug spent 40 percent more for medication over six months than those who didn’t get them, possibly because they continued to buy the pricier pills.

8. Become a pill splitter

Some drugs cost the same in high and low dosages. If you’re on medication, such as one for high cholesterol, ask your doctor if she can write you a prescription for a high-dose pill you can cut in half at home. But this doesn’t apply to all drugs. Some, such as capsules, coated pills, and time-release formulas, shouldn’t be cut. So consult your doctor or pharmacist first. To ensure you always take an accurate dose, use a pill-splitting tool, available at drugstores.

9. Find a discount pharmacy

Big chains like Target and Wal-Mart sell some generic drugs, such as antibiotics and cholesterol-lowering pills, for as little as $4 for a 30-day supply. Costco also fills prescriptions at a discount (you don’t have to be a member to use their pharmacy). You might also ask your M.D. to write you a three-month prescription, then order it through an online pharmacy associated with your insurance plan or an independent one, such as walgreens.com, drugstore.com, or cvs.com. But be sure to comparison-shop: Researchers from the Creighton University School of Pharmacy found brand-name Rx’s are cheaper when purchased by mail, but generic drugs can actually cost more.

10. Take advantage of hidden perks in your plan

Your health insurance policy may cover all sorts of nontraditional services for free or at a discount(a doctor in the network usually needs to give you authorization beforehand). Check to see if yours offers discounts on or pays for smoking-cessation programs, weight-loss or nutrition counseling, or gym memberships. A handful of insurance companies, including Aetna and Kaiser Permanente, are also starting to cover alternative treatments, such as acupuncture, massage therapy, and chiropractic care.

Yes, Cereal

Here's a smart and easy way to control your weight: Have a bowl of high-fiber cereal every morning! That's the advice from researchers at the Maryland Medical Research Institute who followed the growth and development of 2,400 teens over 10 years. The findings? Doing so cut the risk of being overweight by 13 percent! The cereal-and-milk combo taps into the feel-full power of fiber and adds the fat-burning power of calcium.

Unfortunately, the same researchers found that by age 19 more than 45 percent of women were cutting out breakfast altogether, which not only causes a metabolism slump but can lead to overeating later in the day.

Do yourself a favor and choose a whole-grain cereal with at least 3 to 4 grams of fiber per serving, little or no sugar, and plenty of vitamin content to start your day off right — all you've got to lose is the weight!

What do you think about the HPV vaccine?

The latest news about the safety of the HPV vaccine is certainly reassuring. The Centers for Disease Control and Prevention announced Wednesday that the Gardasil shot against the cervical-cancer causing human papillomavirus is "safe to use and effective in preventing four types of HPV." That's based on their database surveillance system—called the Vaccine Safety Datalink—which reviewed the medical records of 190,000 girls and young women who have received the shot. This review didn't turn up any increased risk of blood clots, seizures, paralysis, strokes, fainting, or life threatening allergic reactions" To date, we have not seen a causal relationship between vaccines and adverse reactions," says CDC spokesperson Curtis Allen.

So does "safe" mean risk free? "You'll never get us to say this vaccine is absolutely safe," Allen responded. After all, the Vaccine Safety Datalink isn't large enough to pick up rare events like anaphylaxis, which occurs in 1 out of every 2 million of those who get vaccines. Indeed, the Datalink, says Allen, didn't detect a single case of anaphylaxis. Nor did it detect an increase in fainting, which even manufacturer Merck admits "has been reported following vaccination with Gardasil." (For this reason, teens who receive the shot are supposed to wait 15 minutes before leaving the doctor's office.) Merck's clinical trial involving more than 25,000 participants has shown an increased frequency of fever, nausea and dizziness as well as pain, swelling, bruising, and rashes at the injection site compared with those who received a placebo shot.

Those are mild reactions when weighed against the protection young women get against cervical cancer and genital warts. The question is: Does the vaccine pose any real danger even if only in rare cases? University of California-Berkeley Prof. Phillip Tetlock has been researching this question for months after his 13-year-old daughter, Jenny developed severe paralysis soon after getting Gardasil. It turns out Jenny probably has juvenile amyotrophic lateral sclerosis, the fatal disease that killed Lou Gehrig. Whitney Baird, 22, died in August from this disease, just 13 months after receiving Gardasil. Both were healthy before getting the shot. Yet the condition is extraordinarily rare, affecting just 1 in every 2 million people. John Iskander, the CDC's acting director for the immunization safety office, tells me that both of these cases have been reviewed by CDC researchers and that "in their expert judgment, they didn't feel that vaccines were the likely trigger."

Barbara Shapiro, an associate professor of neurology at Case Western Reserve University School of Medicine who has reviewed both Jenny and Whitney's medical records, says it's impossible to know at this point whether Gardasil was somehow to blame for their tragic illnesses. "These cases are somewhat alarming but certainly don't prove that Gardasil causes ALS," she says. But they have raised red flags, considering the rarity of juvenile ALS and certain similarities between Whitney and Jenny: They both had autoimmune skin disorders and developmental delays as young children, and both rapidly deteriorated into full-blown paralysis, which Shapiro says is unusual for juvenile ALS. She adds, however, that she doesn't know how Gardasil fits into all of this—if at all. One possibility is that the vaccination somehow triggered a reaction that started killing off nerve cells called motor neurons. Jenny was found to have a mutation in a motor neuron gene, Shapiro says, which could have predisposed her to having a reaction from the vaccine.

In the two years since Gardasil came on the market, the government's Vaccine Adverse Event Report System database has received a few dozen reports of Guillain-Barré syndrome following Gardasil vaccination. This severely paralyzing (but reversible) condition was initially thought to be the cause of Jenny's and Whitney's paralysis until their symptoms continued to worsen. Tetlock wonders if others in the VAERS database might have also been misdiagnosed with GBS. Iskander tells me he doesn't think this is the case, and the rate of GBS in those vaccinated with Gardasil—about 1 to 2 per 100,000—is what you'd expect to see in the general population. But the VAERS database is based on voluntary reporting by doctors and patients, so underreporting is rampant and filings may lack crucial information. While it's fairly good at picking up common problems, experts say, it's likely to miss a small increased risk of rare conditions.

For now, the CDC has no worries over the safety of Gardasil. Iskander puts it this way: "While there is no such thing as a completely safe medical product, the available evidence suggests that benefits of this vaccine outweigh the risks." But concerning Jenny and Whitney, he does add, "we'll certainly be on the lookout if additional cases emerge." Says Shapiro: "I suspect if they get a third case, they'll have to really take notice, and they should."

Let's talk about Herpes

Dating is tough enough, and adding an issue like herpes to the mix can create some added (and understandable) anxiety. When to bring it up? And how? What will the reaction be? Questions like these will swirl through anyone's mind as they consider starting a new sexual relationship. Getting the straight facts can help the conversation go more smoothly.

Both oral and genital herpes are the result of contact with a virus that remains permanently in the nervous system. Herpes simplex virus 1 is most often associated with oral herpes, while herpes simplex virus 2 is linked to genital herpes. However, both viruses can cause breakouts in both areas — a fact which makes it unfair that genital herpes is more stigmatized than oral herpes. "Cold sores" may come from the same source as genital herpes.

Two-thirds of the 100 million Americans with oral herpes and 45 million with genital herpes never have any symptoms. It's not usually possible to catch either of the viruses unless there is an active breakout, visible as a red rash that progresses to blisters. Abstinence (from sex and kissing) is best during breakouts. Condoms are a good idea for the times between breakouts, but even then it's still possible to transmit herpes via a process known as shedding. That risk is small, though, so abstinence during breakouts and condoms at all other times gives you the best odds of not contracting the virus.

Now, here is the ultimate step for you. Approach the herpes conversation with an open mind. Is it something you can work around? Is it a deal-breaker for the person you're talking to? Herpes still allows for a full and satisfying sex life, if both people are committed. It's important to remember that every person has some aspect of their sexuality they struggle with and a chronic STD like herpes is merely one of them. Whether you're the one telling or the one being told, knowledge is power.