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Tuesday, August 29, 2023

Best Health Habits That Doctors Use for Self Care



What are the habits of doctors when it comes to their own health? These simple habits used by physicians help their minds and bodies thrive.


Did you ever wonder what doctors do to stay healthy? Are they running marathons and downing supplements? Do they devote two hours to the gym every day? Are they vegans? We wondered the same things, so we checked up on our learned friends and found the answers to all our questions. So what healthy habits do docs use?

Meditation

“Every morning I pray, meditate, and stretch before I eat breakfast. For me, this helps to center me and sets the tone of the day,” says family physician Michele C. Reed. Meditation relieves stress, which in turn helps every aspect of your health. “Every morning I start the day off with meditation for 15 minutes,” says dermatologist Anna D. Guanche. Deep breathing and a mantra repetition or intention-setting for the day is key to reducing stress and staying focused. Don’t skip it! Personally, it is the most important and cherished part of my day.”

Physician Advice for Eye Health  

Don’t forget your eyeballs when you’re thinking about overall health. Ophthalmologist Vincent Hau says you should wear sunglasses daily. “Choose sunglasses that protect against 100 percent of the sun’s ultraviolet A and ultraviolet B rays, which can cause all sorts of eye damage and problems. Even on a cloudy day, UV lights still shine through and will hit and damage your eyes. More expensive doesn’t necessarily mean better protection. You can get drugstore sunglasses with just as good of protection or better than designer ones.” And fellow ophthalmologist Brian Boxer Wachler agrees UV protection is crucial. “One healthy habit is putting a 99 percent UV blocking film on my car side windows. This is based on a study I did with one of my daughters that found poor protection of most car side windows increases risk of left-sided cataracts and skin cancer on the left side of the face.”

Physical Activity

"I do some kind of exercise almost every morning," says Alex McDonald, a family and sports medicine physician. "It helps me handle stress and roll with the punches throughout the day." Dr. Subbarao Myla swears by parking far from the entrance wherever you’re going. “This helps me to add 3,000 steps just finding the car!” And if you’re really serious about your exercise, you can be like cardiac surgeon Steven Bolling, who says, “I practice what I preach. I have actually run to work basically every day for 30 years. That’s my zen moment. I really take that time out. Some of my patients know I run to work every day, and they think it’s fascinating that I’m actually doing cardio every day.” Exercising may be hard work for many when they’re just getting started, but it pays off. 

Practicing Gratitude

How in the world can giving thanks translate to better health? Negative thoughts can lead to stress and anxiety, which can have a big impact on physical health. "Every night, my family and I discuss what went well that day, and why," says family physician Brian Linh Nguyen. "Sharing what went well — and what we’re grateful for — helps us stay grounded in the positive instead of dwelling on the negative. And exploring how our actions helped those things go well helps us invite more positivity into our lives. So the more we practice gratitude, the more we have to be grateful for."

Sleeping Enough

The National Sleep Foundation recommends adults get seven to nine hours of sleep every night. “I make sleep a priority, making sure I get at least seven or eight hours of sleep a night,” says pediatrician Eric Ball. “I wake up very early (4:30 am) to exercise, so I usually am in bed by 8:30 pm or 9:00 pm.” 

Journaling Thoughts

Research studies show that writing down anxieties, joys and everything in between can relieve stress, alleviate depression and increase resilience to everything life throws at you. Cardiologist Columbus Batiste likes to write down a plan every day. "I write out what I’m seeking to accomplish that day. When and how will I exercise? What will I eat? What needs to get done at work? Physically creating this list and crossing things off helps me stay positive and productive."

Eating Well

It’s no surprise that doctors try to eat well since it’s proven to have an impact on every aspect of health, including mental health. Endocrinologist Joel Zonszein likes to eat at home rather than going out. “Eating and talking at the table with my wife and children without our cell phones, the television, or computer is important.” But doctors are picky about supplements. Cardiologist Sarah Samaan says that “doctors who strongly recommend certain supplements are often the ones selling them in their office. For primary prevention, if you’re not eating fish two to three times a week, then fish oil is probably a good idea. I also recommend vitamin D because 80 percent of U.S. adults are deficient. Those are the only two I take.” 

Imperfection

That’s right – doctors know they are never going to be perfect. Like eating well. You should eat a plant-based diet with plenty of fruit, veggies, fish, and olive oil. “If your health is generally good, there’s no reason for any foods to be strictly off-limits,” says McDonald. “My personal goal is to eat healthy 90 percent of the time."






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Monday, August 28, 2023

Make Your Giving Tax-Efficient



Don’t wait until tax season to find ways to benefit both yourself and your favorite charities. 


If you are charitably inclined, you may send a check to organizations you support or give money via monthly automatic deductions. But did you know that there is a better way to give, one that will benefit you by reducing your taxes and possibly send a larger chunk of money to the charitable institution as well? Let’s look at five tax-savvy strategies for giving that you may want to implement now or put on your calendar for future donations.

2023 Tax Brackets and Standard Deduction

Marginal Rates: For tax year 2023, the top tax rate remains 37% for individual single taxpayers with incomes greater than $578,125 ($693,750 for married couples filing jointly).

The other rates are:
  • 35% for incomes over $231,250 ($462,500 for married couples filing jointly)
  • 32% for incomes over $182,100 ($364,200 for married couples filing jointly)
  • 24% for incomes over $95,375 ($190,750 for married couples filing jointly)
  • 22% for incomes over $44,725 ($89,450 for married couples filing jointly)
  • 12% for incomes over $11,000 ($22,000 for married couples filing jointly)
 
The lowest rate is 10% for single individuals with incomes of $11,000 or less ($22,000 for married couples filing jointly).

The standard deduction for married couples filing jointly for tax year 2023 rises to $27,700, up $1,800 from the prior year. For single taxpayers and married individuals filing separately, the standard deduction rises to $13,850 for 2023, up $900, and for heads of households, the standard deduction will be $20,800 for tax year 2023, up $1,400 from the amount for tax year 2022.

  1. Itemize. If you have more itemized deductions than the current standard deduction, itemizing is worth it. You can deduct charitable contributions of money or property made to qualified organizations. In general, the IRS allows you to deduct up to 50 percent of your adjusted gross income (AGI), although lower percentages apply in some cases. If you struggle to meet the threshold for itemizing, you can bundle, or bunch, donations from two or more years into one year so that you qualify. 
  2. Donate stocks or bonds. If you normally make cash donations or pull out a credit card, consider the benefits of donating appreciated securities directly to your chosen charities. Neither you nor the charity will have to pay capital gains tax, and you’ll be eligible for an income tax deduction equal to the fair market value of the stock or bond, up to 30 percent of your AGI.
  3. Qualified Charitable Distributions. You may want to donate directly from your traditional IRA. As a qualified charitable distribution (QCD), the gift will count toward meeting your RMD for the year. While the money won’t qualify as a charitable deduction, it reduces your taxable income, potentially lowering Medicare premiums as well as overall taxes. It also counts toward meeting your required minimum distribution. You must be at least 70 ½ to use a QCD and meet other requirements.
  4. Donor-Advised Funds. If you are a substantial giver, you may want to create your own charitable giving fund. Using a donor-advised fund (DAF), you can claim the tax deduction that year and then distribute the money over the coming years. Assets in the fund can be invested, and any resulting growth is tax-free. You can even use appreciated securities to make the initial investment.
  5. Charitable Gift Annuities. Large institutions and charities often offer charitable gift annuities to donors with as little as $5,000 to give. You make a donation, which is kept in an account where it is invested. This funds a monthly or quarterly payout to you, the annuitant, for as long as you live. Upon your death, the charity gets whatever is left in the account. Your initial donation can be made in the form of cash, securities, or personal property. Annuitants may be able to deduct a portion of the original gift, and a portion of the payments they receive may be tax-free, based upon life expectancy.

Be sure to sit down with your financial consultant or tax advisor now to strategize your giving for years to come. One plan may be right for you now, while another could be most beneficial in the future. It’s worth consulting a professional to make sure you are meeting all requirements while still getting the maximum return for your giving.


 


This article is not intended to be a substitute for professional financial advice from a qualified financial advisor.

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Blog posting provided by Society of Certified Senior Advisors



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Sunday, August 20, 2023

Pre-Paying for (or just Planning) Burial and Cremation



You want to make it easy for your family when you die. But is it wise to pre-pay for a funeral or cremation?


We’re all going to die, and many of us prefer to have everything in order before we go, including a service and arrangements for burial or cremation. Paying for it all may seem like a no-brainer. But there is actually quite a lot to consider before handing over your credit card or check.

To Plan, to Pay or Both?

The Funeral Consumers Alliance is a strong advocate for planning your service without paying for it unless you must do so to qualify for Medicaid. They warn that many states still lack laws to protect funds in pre-paid plans, putting the money at risk. 

How to Obtain an Economical Burial or Cremation

The average funeral runs between $7,000 and $10,000 these days. For many people, that is more than they are willing to spend. But how can you cut costs? We consulted the Cremation Institute for their best ideas.

First, they suggest that you shop around when using a funeral home. They are not all the same, nor do they charge the same prices for the same services. You can also get a feel for the individual homes to determine which one might be a good fit. Establish a budget before you go and negotiate costs. Some homes are willing to work with you on price, and having a predetermined budget will keep you from getting “upsells”, such as buying the mahogany coffin instead of the perfectly fine pine one. 

You can also elect to skip embalming, which is not only bad for the environment but drives up funeral costs. Burying or cremating right after death eliminates the need to embalm. You might consider direct cremation, when your body is cremated upon death and returned as ashes. They can be scattered or kept in an urn, which you can shop for online. 

Caskets can be very pricey. Save money by renting a casket for a viewing or funeral, or by using a simple, eco-friendly casket. Finally, you can also consider direct burial and hold a memorial service at home.

Veterans’ Benefits

Veterans are entitled to many benefits on death, including a plot in a national cemetery  without charge for a gravesite or marker if they meet certain requirements. Someone will still need to foot the bill for embalming, burial and transporting the body. But even if they choose to be buried elsewhere, the Department of Veterans Affairs (VA) will provide death benefits, including:
  • Up to $2,000 in burial costs for a service-related death.
  • Up to $807 for a plot and $300 in burial expenses if the death was not service-related.
  • Up to $807 in burial costs and $807 for a plot if the death was not service-related but the death happened while the veteran was in a VA hospital.
Be sure to check the VA website for details on benefits. You can also check if you are eligible for military funeral honors.

Ask These Questions Before You Buy

If you are still considering pre-paying funeral costs after reading this article, make sure to get answers to each of these questions https://www.lhlic.com/consumer-resources/how-pre-paid-funeral-plans-work/ first:
  1. Do the payments seem reasonable?
  2. How long will I be making payments?
  3. What if I die before I have paid in full?
  4. What exactly does the plan cover?
  5. What will happen if I move?
  6. What will happen if the cost of my funeral goes up before I die?
  7. Who gets the interest earned on my payments?
  8. If I change my mind, can I cancel and get a full refund?
  9. If there is money left over, who will get it?
However, go ahead and prearrange by comparing prices from different funeral homes – there are often wide variations in cost for what are essentially the same services. Visit several to see which one you like the best. Some will let you fill out a form, specifying what you’d like at your service without paying a dime in advance. 

Economical cremations can be pre-arranged as well, although loved ones can also make a phone call upon death to contract the service. These range in cost from about $500 to $1,200 for what seems to be the same service. 

Then tell your family what you have chosen. Give them a copy of your plan or contract. Do not put your plan in a file or lockbox. Do not just say, “Everything is taken care of”. People can forget what you have told them, forget where to look for important papers, and even forget if you wanted burial or cremation, especially in the emotionally-charged time surrounding your death. 

Make sure your plans are carried out by providing written instructions to your siblings, children, a member of the clergy, your financial planner … whoever may need to help guide the process after your death. If having a religious ceremony is important to you, make that clear. 

Prepayment Pros and Cons

Why might you want to prepay? Sometimes, the funeral home will give you a discount. You can avoid inflation (although your money is tied up). You may be able to pay in installments, avoiding a large lump sum. Prepaying can give you peace of mind and ensure that you are in control of your exit. 

However, you should first consider why prepayment may be a bad idea. If the service provider loses your agreement, your plans will go awry. You can be overcharged if you don’t compare prices. Your chosen provider may be out of business, overbooked, or refuse to honor your agreement for any number of reasons, leaving no recourse for family members. The provider’s services could change over time, making them unable to fulfill your wishes. Or you may forget to adequately inform family members of your agreement, leading them to make different arrangements that they pay for. 

How to Prepay

You may think that by setting money for your funeral aside in your will, you have avoided many potential pitfalls. Since wills must go through probate, your body likely will have already been dealt with long before a will goes into effect. There are other ways to prepay that may be better.

A payable on death (POD) bank account, sometimes called a Totten trust, is an account held solely by you until your death, when the named beneficiary presents a death certificate to the bank and immediately gains access to the funds without waiting for probate. It works well if your beneficiary does not predecease you, and if that person can be trusted to spend the money as you wish, not on a one-way ticket to Hawaii. 

A regular savings account will also work if you set it up as a joint account with a trusted individual. When you die, this person will automatically own the account and can use the money to pay for your funeral. Again, this person must have your complete trust. As an account co-owner, he or she could withdraw funds at any time and use them for anything.

Three kinds of insurance may be used to cover funeral expenses. A life insurance policy may pay a lump sum upon death. Burial insurance can pay death-related costs, and pre-need insurance will cover a set amount for a funeral. It’s important to note that the Funeral Consumers Alliance, a watchdog group, does not recommend burial or pre-need insurances. 

Planning your funeral is a smart move, as long as you let several people know what your plans are in writing. But the benefits of paying in advance is a much more nuanced topic, and one you would do well to explore thoroughly. You want to make sure that the money is available as soon as you die to a trustworthy individual who will follow your plans to the letter. That done, you can check it off your list and concentrate on getting the most out of life.

 



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Tuesday, August 15, 2023

Should a Robot Do Your Surgery?



Robotic surgery does have advantages, but they may not be the ones you think it has.


As more and more medical centers are investing the $2 million or so needed for a robotic surgery system in an operating room, patients are often faced with a choice: Should I have my surgery done by a surgeon alone, or in concert with a robot?

A common misconception is that “robotic surgery” involves allowing a pre-programmed robot to carry out a surgical procedure. In fact, a trained surgeon is in control at all times, using a high-definition, 3D camera and miniaturized instruments inserted via one or more small incisions to make intricate moves guided by the surgeon’s hands at a console. The robotic equipment does not “think” on its own at any time. 

While robotic technology is not currently used in every situation, it can be employed in the following types of surgery:
  • Colorectal 
  • General
  • Gynecologic
  • Heart
  • Endometriosis
  • Head and Neck
  • Thoracic
  • Urologic

Traditional surgery is either laparoscopic, performed through small incisions, or open, performed through one large incision. Either way, the surgeon needs room to manipulate instruments with his or her hands. Robotic instruments take up less space, reducing the need to push muscle and tissue aside.

Advantages

Surgical centers cite a long list of advantages to using a robot, starting with more precise surgery due to the enhanced visualization the camera provides, and the range of motion achieved in tight spaces. Surgeons can perform more steps of an operation inside your body, when traditional surgery would have them making a larger incision to work outside of your body. Benefits also include:
  • Fewer complications during surgery
  • Reduced risk of infection
  • Shorter hospital stay
  • Fewer blood transfusions and less blood loss
  • Reduced pain during recovery
  • Quicker recovery
  • Smaller scars

Disadvantages

The equipment to perform robotic surgery is very expensive, in part because it is dominated in the US by a single company, Intuitive Surgical. Surgeons need special training on the equipment, and robotic surgery fellowships are becoming more common, but these surgeons are limited in number. There are also dangers to the patient, which include:
  • Your surgeon may need to switch to a large incision and traditional surgery if there are complications. This can include scar tissue from previous surgery. 
  • Nerve damage and compression. 
  • Longer time spent in surgery.
  • Robotic malfunction. This is extremely rare. There are a variety of safety measures - to prevent this from occurring. 

Another downside to robotic surgery is the higher cost. One recent study found an average total hospital cost of $15,319 for patients in a robotic surgery group versus $8,955 for patients getting traditional laparoscopic surgery. However, patients may benefit financially from the reduced cost associated with a shorter hospital stay.

Surgical Outcomes

Robotic surgery is often perceived as “better” than traditional methods. Surgeons often assume that the shorter recovery time and other benefits result in a better outcome for patients. However, according to a recent review of 50 randomized control trials for abdominal and pelvic procedures published in the Annals of Internal Medicine, outcomes for both are nearly identical. 

For instance, eight of the reviewed studies listed long-term outcomes of two years or more. Patients died in up to 3 percent of robotic surgeries, up to 5 percent of open procedures, and there were no deaths listed from laparoscopic surgeries. Looking at 39 studies that reported the number of surgeries that required further surgical intervention due to complications, the report found they were needed in up to 9 percent of laparoscopic procedures and in up to 8 percent of robotic surgeries. 

“Just because something’s new and fancy doesn’t mean it’s the better technique,” says lead author Naila H. Dhanani, a surgical resident at UC Health in Houston. “Yes, robotic is safe, we’ve proven that. But we haven’t proven it’s better. There were four studies that showed a benefit with robotic surgery, so that’s quite modest. Forty-six showed no difference at all.”

The study may highlight a truism that has long been held. James A. Eastham, chief of urology at Memorial Sloan Kettering Cancer Center and not involved in the study, noted that “it is far more important to select an experienced surgeon with specialization in a particular field rather than picking a technique.”




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Sunday, August 6, 2023

Are You Shrinking?



Yes, we really do get shorter as we get older. Read on for why this happens and what you can do about it.


Maybe you’ve noticed that when you get measured in the doctor’s office, you’re shorter than you were in your 20s and 30s. No, nothing has changed on the measuring tape … you really are losing height. Along with worsening eyesight and less hair, loss of height is pretty inevitable as we grow older. 

At about age 40, men lose about an inch before turning 70 and women drop twice that amount. Men have more muscle mass and their bones are stronger, while women are more subject to osteoporosis. But why do we get shorter at all?  

“A little bit of shrinking is a normal part of aging, and it happens because of three things, basically,” explains Dr. Roshini Raj. To start, as we get older, the discs between the bones in our back lose fluid, so our vertebrae "simply come together, so your spine is actually shrinking a little bit." Another thing that happens with age is the flattening of the arches in our feet. Finally, we lose muscle, causing flabbier abdomens that lead to slumping posture. 

While some of this shrinkage is inevitable, there are some things you can do to lessen the effect. They are good for your overall health, too. 

Check What You Eat
While we can’t build bone as older adults, we can do our utmost to keep what we have. Your bones and teeth hold 99% of the calcium in your body. They need calcium and vitamin D to stay strong. Eat plenty of dairy (fortified milk, yogurt, and cheeses), almonds, broccoli, kale, wild salmon and soy products like tofu.

“Research has shown that a good diet in your later years reduces your risk of osteoporosis, high blood pressure, heart disease and certain cancers,” UAMS neurosurgeon Dr. T. Glenn Pait says. “Even though you might need less energy as you get older, you still need just as many nutrients from food.”

Vitamin D helps retain that calcium, and it’s lacking in most American meals. Get it via wild mackerel, salmon, sardines, tuna, and egg yolks. Fortified milk has a good amount, and UVB rays from the sun deliver vitamin D. A half hour in the sunshine is plenty, though, since you don’t want to burn your skin. 

Vitamins C and K are also essential to bone health. Eat citrus, strawberries, raspberries, pineapple, cantaloupe, tomatoes, cauliflower, broccoli, bell peppers, and parsley for the former, and leafy green veggies, parsley, prunes, avocados and kiwi for the latter. 

If you smoke, quit. Smoking damages bones and keeps you from healing quickly after a bone injury. Chronic alcohol use interferes with calcium absorption. Keep alcohol to a maximum of a drink per day. 

Work Out

Hanging upside down is not going to restore your height, unfortunately! But keeping active, especially with activities that make your legs and feet support your weight, will help keep your bones strong. Try running, jumping, going up stairs, hiking, brisk walking, jumping rope, weight training, dancing, and tennis (think pickleball). Research found that those who continued to do moderate aerobic activity all their life lost less height than those who sat around. 

Stretch Your Back

We’re not suggesting that you can stretch your back to get taller, but stretching exercises will improve strength and lead to better posture. Yoga and pilates are excellent choices for increasing flexibility, or use a stability ball. There are plenty of great back exercise videos on YouTube, or check out exercises  recommended by the Spine Health Institute. 

We can’t reverse our shrinkage, but we sure can get active and eat right to improve our future height and health!



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Thursday, August 3, 2023

Famous & 65

Look who's turning 65 this month

Find out which celebrities are turning 65 this month!


Image Source: Wikipedia

August 16 - Madonna Louise Ciccone, singer, songwriter and actress 

The “Queen of Pop” moved to the Big Apple in 1978 for a career in dance and became a cult figure for feminism while eliciting accolades and admonitions for her social, political, sexual, and religious themes. Every time it looked like she was going down, she reinvented herself and popped right back up at the top of her game.

Remember Madonna in "Desperately Seeking Susan", "A League of Their Own", or "Evita"? Which songs of hers are your favs? “Like a Virgin”, “Vogue”, “Hung Up”, or “4 Minutes”? Her work spans more than four decades, and there are exemplary performances from beginning to end. She is the top female recording artist ever, having sold more than 300 million records across the globe. She retained control of her music, started fashion brands, paved the way for the resurgence of strong female lead singers, and inspired university studies. But what drove her success?

Some say it was the death of her mother in 1963 from breast cancer. Others think it was an incident in NYC when she was assaulted at knifepoint by a pair of men. Madonna was left with a fierce desire to manage her own career, to not be beholden to anybody, and to reinvent herself whenever and however she wanted. 

In her youth, Madonna says she was that "lonely girl who was searching for something. I wasn't rebellious in a certain way. I cared about being good at something. I didn't shave my underarms and I didn't wear make-up like normal girls do. But I studied and I got good grades... I wanted to be somebody." 








Image Source: Wikipedia

August 25 - Tim Burton, director

We may never know what inspired the dark streak in Tim Burton’s films, however, his mother owned a cat-themed gift shop. We can say young Burton was a quiet, mediocre student who liked artwork and watching films. Dr. Seuss and Roald Dahl influenced the boy, who found his direction early and studied character animation after high school.

Burton’s first short, “Stalk of the Celery Monster”, turned heads at Walt Disney Productions, and soon he was working for them while also developing some of his own projects. It was after one of these, “Frankenweenie”, was released that Disney fired Burton for using company money to make a film too frightening for children to see. The short centers on a boy trying to revive his dog after it has been run over.

However, that was Burton’s big break as others not so squeamish as Disney noticed the film. Burton went on to put his darkly personal, yet extremely sensitive, mark on epics such as “Beetlejuice”, “Batman” and “Edward Scissorhands“. The filmmaker returned to children’s works with a musical fantasy of Roald Dahl’s “James and the Giant Peach”. While it failed at the box office, it was hailed by critics and won an Academy Award for Best Original Musical or Comedy Score. 
Burton returned to the small screen in 2021 with a series for Netflix based on an Addams Family character, “Wednesday”. He directed four episodes during the first season and won critical accolades.  








Image Source: Wikipedia

August 28 - Scott Hamilton, skater and commentator

Figure skater Scott Hamilton embodies the classic American dream: the child who has a rough start but perseveres, and through his own determination and hard work succeeds brilliantly while being an all-around good guy. 

Adopted as a six-week-old baby, Hamilton quit growing at age two. Medical professionals were mystified, and some misdiagnosed him or put him on strange diets. Finally, he was told everything was fine and to go home and live a normal life. (Hamilton did, but he was 5’2 ½” tall and tipped the scales at 108 pounds during his amateur career, topping out at 5’4” when he reached his full height.) Much later, doctors found a congenital tumor was the culprit.

You may remember Hamilton for his gold medal at the 1984 Olympics, or for his signature move, a crowd-pleasing backflip on ice that went counter to U.S. Figure Skating and Olympic rules. The man dominated skating from 1981 to 1984, winning four consecutive U.S. and World championships. He also is the creator of Stars on Ice, in which he performed for 15 years. 

Hamilton also distinguished himself as a skating commentator on CBS for many years. Throughout his working years, Hamilton worked with Special Olympics. He founded the Scott Hamilton Cares Foundation for cancer patient support and was the inaugural Celebrity Wish Granter of the Year for the Make-A-Wish Foundation. He has also assisted St. Jude Children’s Hospital and the Multiple Myeloma Research Foundation. 











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