There was a couple who used to go England to shop in a beautiful Antique store. This trip was to celebrate their 25th wedding anniversary. They both liked antiques and pottery, and especially tea-cups. Spotting an exceptional cup, they asked, "May we see that? We've never seen a cup quite so beautiful."

As the lady handed it to them suddenly the tea-cup spoke, "You don't understand." It said, "I have not always been a tea-cup. There was a time when I was just a lump of red clay. My master took me and rolled me pounded and patted me over and over and I yelled out, "Don't do that. I don't like it! Let me alone", but he only smiled, and gently said; "Not yet!!"

"Then. WHAM! I was placed on a spinning wheel and suddenly I was spun around and around and around. 'Stop it! I'm getting so dizzy! I'm going to be sick!', I screamed. But the master only nodded and said, quietly; 'Not yet.' He spun me and poked and prodded and bent me out of shape to suit himself and then......

"Then he put me in the oven. I never felt such heat. I yelled and knocked and pounded at the door. 'Help! Get me out of here!' I could see him through the opening and I could read his lips as he shook his head from side to side, 'Not yet'.

"When I thought I couldn't bear it another rminute, the door opened. He carefully took me out and put me on the shelf, and I began to cool. Oh, that felt so good! 'Ah, this is much better,' I thought.

"But, after I cooled he picked me up and he brushed and painted me all over. The fumes were horrible. I thought I would gag. "Oh, please stop it, Stop it!!", I cried. He only shook his head and said. "Not yet!".

"Then suddenly he put me back in to the oven. Only it was not like the first one. This was twice as hot and I just knew I would suffocate. I begged. I pleaded. I screamed I cried. I was convinced I would never make it. I was ready to give up. Just then the door opened and he took me out and again placed me on the shelf, where I cooled and waited ---- --- and waited, wondering what's he going to do to me next?

"An hour later he handed me a mirror and said "Look at yourself." And I did. "I said, 'That's not me; that couldn't be me. It's beautiful. I'm beautiful!

"Quietly he spoke: I want you to remember, then,' he said, 'I know it hurt to be rolled and pounded and patted, but had I just left you alone, you'd have dried up. I know it made you dizzy to spin around on the wheel, but if I had stopped, you would have crumbled'. I know it hurt and it was hot and disagreeable in the oven, but if I hadn't put you there, you would have cracked.

I know the fumes were bad when I brushed and painted you all over, butif I hadn't done that, you never would have hardened. You would not have had any color in your life. If I hadn't put you back in that second oven, you wouldn't have survived for long because the hardness would not have held. Now you are a finished product. Now you are what I had in mind when I first began with you.'

The moral of this story is this:

God knows what He's doing [for each of us]. He is the potter, and we are His clay. He will mold us and make us, and expose us to just enough pressures of just the right kinds that we may be made into a flawless piece of work to fulfill His good, pleasing and perfect will.

March 15, 2005

There's another option. I'm going to turn my bully pulpit over to another expert today - one who deserves a lot of credit and our thanks for trying to help an impossible situation.

Without further ado, here's our guest columnist, Dr. Sagall:

Pharmaceutical Companies Helping Patients Get Their Medicines

By Richard J. Sagall, M.D.

It’s a choice no one should have to make – pay rent and buy food or get prescriptions filled. Yet all to often it's a choice Americans, particularly older Americans, have to make.

Over 40 million Americans have no health insurance, and millions more have limited coverage. Many Americans just can’t afford health care, and, if they can, they don’t have the money to buy their medicines.

Patient Assistance Programs

There is help available for many people who can’t afford their medicines. These programs, frequently called patient assistance programs (PAPs), are designed to help those in need obtain their medicines at no cost or very low cost.

Many, but not all, pharmaceutical companies have PAPs. The manufacturers who have programs do so for various reasons. Some believe that they have a corporate social obligation to help those who can’t afford their products. Others believe it’s a good marketing tool. As one PAP director once told me, many people who can’t afford their medicines now go on to obtain some type
of coverage. And when they get this coverage, the companies want the patient to remain on their products.

Last year, PAPs helped over 5 million people. The programs filled 14.1 million prescriptions with a total wholesale value of over $2.3 billion.

The Basics of the Programs

All PAPs are designed to help those in need obtain their medicines. Since each pharmaceutical company establishes its own rules and guidelines, all are different. All have income guidelines – but they vary considerably. Each company selects which drugs are available on their programs and how long a
person can receive assistance.

How PAPs Work

Although no two programs are exactly the same, most require that the applicant complete an application form. The amount of information required varies. Some programs require detailed medical and financial information, others very little. All require a doctor’s signature. Certain programs require the doctor complete a portion of the form while others only need a signed prescription.

Most send the medicines to the doctor’s office for distribution to patients, while others send the medicine to a pharmacy. A few send a certificate the patient gives to the pharmacist.

Some patients need drugs for a long time. Most programs that cover medicines used to treat chronic diseases offer refills, but not all programs.

What Medicines Are Covered

The pharmaceutical companies decide if they will have a PAP and, if they do, which of their medicines are available through the program. Some include many or all of the medicines they make while others include only a few. The reasons for their decisions are not something they reveal. None include generic medicines in their programs.

Sometimes a medicine or a certain dosage of that medicine will be on a program, then off, and then back on again. Or one dose of the medicine will be on the program while a different dose won’t be.

How To Learn About PAPs

Your doctor is not the best source of information on PAPs. Surprisingly, many doctors don’t even know PAPs exist. The same applies for pharmacists. Many social workers know about the programs. Any books in the library on PAPs are probably outdated before they are printed.

The best place to learn about PAPs is the Internet. There are a number of sites that have information on these programs. Many pharmaceutical companies have information on their patient assistant programs on their websites. Unfortunately, it’s often hard to find the page that describes their PAP.

Types of Websites

There are two types of websites with information on patient assistance programs. Three sites list information on patient assistance programs - NeedyMeds (http://www.needymeds.com), RxAssist (http://www.rxassist.org), and HelpingPatients.org (http://www.helpingpatients.org). There is no charge to use the information. These sites don’t have a program of their own nor do they help people get their medicines.

NeedyMeds is self–funded by sales of manuals and other items. The Robert Wood Johnson Foundation supports RxAssist. The Pharmaceutical Research and Manufacturers of America (PhRMA), an association and lobbying group whose members include many of the larger pharmaceutical manufacturers,
runs HelpingPatients.org, It only has information on PhRMA members programs.

Then there are a number of sites that charge to help people learn about patient assistance programs and complete the application forms. The charges vary, as does the quality of their services. Some offer a money-back guarantee if they can’t get your medicines.

How To Use NeedyMeds

I will describe how to use the NeedyMeds site – the one I know most about. RxAssist and HelpingPatients contain similar information.

There are two ways you can check to see if your medicines are available on a patient assistance program. One is to click on the drug list. This brings up an alphabetical list of all the drugs currently on PAPs. Find the medicine you take and click on its name. This will bring up the program page.

On the program page you will learn about the specifics of the PAP – the qualification guidelines, the application process, the information you need to supply, what your doctor must complete, etc. In addition, you will learn if there’s a downloadable application on the website or if you must get an application from the company. (Some companies accept copies of their application form while others require you complete an original.)

If you know the medicine’s manufacturer, you can click on the programs list. From there, you can click on the program you want to learn more about. That should bring up the information you need.

Once you get the information you need, it’s up to you to complete the applications, get the necessary signatures, and send the form to the program.

A Few Tips

The most common problem patients encounter when completing the application forms is lack of physician cooperation. Over and over I hear from people whose physicians just won’t complete the forms – or charge to do it.
I am asked what they should do.

Here are a couple of suggestions:

1. Make sure you have completed everything on the form you can. Not only should you complete the applicant’s section, but anything else you can do. This may include the physician’s name and address, phone number, etc.

2. Bring all the information your doctor may need. For example, some programs require proof of income. If so, attach whatever documents are required.

3. Bring an addressed envelope with the appropriate postage.

4. Don’t expect your doctor to complete the form immediately. A busy doctor may not have time to read the form while you are in the office.

5. If you encounter resistance, tell your doctor that without his/her help, you wont be able to obtain the medicines he/she is prescribing. Be blunt.

6. If all else fails, you may need to find a physician more sympathetic to your plight and willing to help you.

What If I Don’t Have A Computer?

Many people without a computer can still use the information available on these websites. Nearly everyone knows someone with a computer – a family member, a neighbor, or a friend. Most public libraries have computers for public use and people who can help those not familiar with their use.

Summary

Patient assistance programs are not the best solution to the problem of inability to pay for medication. However, it is the best solution for some people. Millions of people use PAPs to get the medicines they need but can’t afford. If you can’t afford your medicines, a patient assistance program may be able to help you.

* * *

Richard J. Sagall, M.D., is a board certified family physician. He co-founded NeedyMeds and continues to run the site. He can be reached via the website, http://www.needymeds.com. Currently he practices occupational medicine in the Philadelphia area.

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Progress might have been all right once, but it's gone on too long.
-- Ogden Nash


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Is It A Stroke?

Would you be able to identify the signs that someone is having, or has had, a stroke? The sooner a person gets treatment, the better chance there is of recovery. "Clot-busting" drugs need to be administered within only a few hours of a stroke event to be effective. Time is of the essence with stroke.

Doctors are saying that non-medical individuals can recognize a possible stroke by asking the person they are concerned about to do three simple things:

1. Ask the person to smile;

2. Ask the person to raise both arms and hold them up;

3. Ask the person to say a simple sentence.

If the individual has trouble with any of these actions, call 911 immediately and describe the symptoms to the operator.

For more information on the research behind these recommendations see the American Heart website at
http://www.americanheart.org/presenter.jhtml?identifier=3008841

The life you save may be that of someone you love.

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Elder CareTip

The Creator didn't include handles or grab bars on people. When we're trying to assist someone with getting up from a chair, or we're trying to walk with someone whose balance isn't good, a reliable handle would do wonders for both our backs and the safety of the person we're helping. Lifting under the shoulders is bad for everyone. Belt loops break at the most inconvenient times. There's the very real risk that the person we want to help may bring us down, too, if there's a bad fall.

One possible answer is a gait belt. These are the soft woven belts you see physical therapists and nurses put around the waist of a patient they want to safely assist. The gait belt gives you something sturdy and safe to hold on to. If it's loose enough to put two fingers behind (no looser) the "patient" can wear it all day without discomfort.

This is one piece of equipment that's not expensive. You can get increased safety for both you and your loved one for around ten dollars - a real bargain these days. Gait belts are available at most any medical supply store, or on the web at
http://www.vitalitymedical.com/VitalityMedical.storefront/EN/Product/
POS6524?AID=10273944&PID=1247687

I receive no compensation for this recommendation - I just think it's a doozy of a good product for the price and what it can do.

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Formerly, when religion was strong and science weak, men
mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic.
-- Thomas Szasz

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Just a quick reminder for those of you who have been meaning to get yourself or a loved one enrolled in one of the Medicare Drug Card programs - you have until the end of this month to do so without possibly losing some amount of coverage. It's a complicated matter at best. Try using the interactive planner at http://www.benefitscheckup.org

By the time we meet again, Spring will have officially sprung. Here's a cyber package of chocolate bunny ears for everyone who's so inclined. If you don't want yours, pass them along to someone who could use a hug.

See you on April Fool's day. Until then, don't keep us a secret. If you know other people who should be reading this too, then do them and us a favor by telling them about Elder CareTips™. Just send them this link:
http://eldercareteam.com/resources/newsletter.htm

Until next time,

Molly

© 2005 Molly Shomer, All rights reserved. You are free to use material from Elder CareTips: Mastering The Eldercare Maze™ as long as you include complete attribution, including live web site link and email link. I would appreciate it if you would let me know where the material will appear.

To subscribe, send a blank email to eldermatters@aweber.com

Molly Shomer
Head Coach
The Eldercare Team
http://www.eldercareteam.com
molly@eldercareteam.com
(972) 395-7823

One day, a poor boy who was selling goods from door to door to pay his way through school, found he had only one thin dime left, and he was hungry.

He decided he would ask for a meal at the next house. However, he lost his nerve when a lovely young woman opened the door.

Instead of a meal he asked for a drink of water. She thought he looked hungry so brought him a large glass of milk. He drank it slowly, and then asked, How much do I owe you?

You don't owe me anything, she replied. "Mother has taught us never to accept pay for a kindness."

He said..... "Then I thank you from my heart."

As Howard Kelly left that house, he not only felt stronger physically, but his faith in God and man was strong also. He had been ready to give up and quit.

Many year's later that same young woman became critically ill. The local doctors were baffled! They finally sent her to the big city, where they called in specialists to study her rare disease.

Dr. Howard Kelly was called in for the consultation. When he heard the name of the town she came from, a strange light filled his eyes. Immediately he rose and went down the hall of the hospital to her room.

Dressed in his doctor's gown he went in to see her. He recognized her at once.

He went back to the consultation room determined to do his best to save her life. From that day he gave special attention to her case.

After a long struggle, the battle was won.

Dr. Kelly requested the business office to pass the final bill to him for approval. He looked at it, then wrote something on the edge and the bill was sent to her room. She feared to open it, for she was sure it would take the rest of her life to pay for it all. Finally she looked, and something caught her attention on the side of the bill. She read these words.....

"Paid in full with one glass of milk"
(Signed) Dr. Howard Kelly.

Tears of joy flooded her eyes as her happy heart prayed: "Thank You, God, that Your love has spread broad through human hearts and hands."

There's a saying which goes something like this: Bread cast on the waters comes back to you. The good deed you do today may benefit you or someone you love at the least expected time. If you never see the deed again at least you will have made the world a better place - And, after all, isn't that what life is all about?

Now you have two choices.

You can send this page on and spread a positive message. Or ignore it and pretend it never touched your heart.

The hardest thing to learn in life is which bridge to cross and which to burn.....

An attorney's advice and it's FREE! Read this and make a copy for your files in case you need to refer to it someday.

GENERATIONAL “FLOW-ON” OF POLIOMYELITIS
By Eddie Bollenbach, PhD

I'd like to give my impressions and ideas about transplacental transmission of the poliovirus.

Do you know how viruses are cultivated to produce vaccines? They must Be grown inside living tissues and a very convenient way to do this is to use chicken embryos inside eggs. The reason this is convenient for so many viruses, from influenza to polio, is that embryonic and even fetal tissue is very susceptible to infection by a wide variety of viruses. The point of this is that if a human fetus in-utero was infected by a pregnant mother, the fetus would be severely damaged and would very likely die. This is because the viruses grow inside these cell producing a "cytopathic effect". This means the cells get altered in ways which, especially in fetuses, would result in catastrophic damag.For example, large cells with more than one nucleus, cells with visible bodies inside, and other anomalies.

Dick Bruno, in his New Mobility magazine column, addressed the issue of pregnancy and fetal safety by providing the following facts. In the 1950's thousands of women came down with polio while pregnant. In Los Angeles and Illinois there was a study of 1000 such women and at birth or stillborn not one fetus showed any sign of polio. Even with the normal rate of stillbirths, on autopsy of these fetuses showed no sign of the polio virus or even a cytopathic effect. However, having polio while pregnant did pose a serious health risk for the mother as more deaths during pregnancy and childbirth occurred for them. Pregnant women were 5 times more likely to die if they had polio.

In another study addressed in the same article, babies less than six months of age, born between 1897 and 1956 were studied. 150 cases were identified. Four of these babies showed signs of paralytic polio at birth. So it seems that in very rare cases the mother's antibodies do not protect the fetus. I believe, in some of these, there was a misshapen placenta.

Let's move on to some more data: Lauro S. Halstead, MD, Director of the Post-Polio Program at the National Rehabilitation Hospital in Washington, DC, and member of PHI'S Medical Advisory Committee, stated about this question::"I know of no study that indicates there is a connection. To the contrary, we know that mothers who got polio when pregnant did not pass on the virus to their children. Some viruses cross the placental barrier, but polio is not one of them."

Following Halstead's lead, I found comments by the CDC in Atlanta, on the danger of oral live polio vaccine administration during pregnancy. The CDC reiterates the lack of evidence for fetal damage due to poliovirus but if the mother is vaccinated with live Sabin vaccine, there is a concern about SV40 which is a virus that apparently does cross the placenta and can infect the fetus. Such infections may cause an increased risk of cancer.

If your mother had polio during pregnancy there is a chance that during birth her shedding of virus from feces, or less likely blood, could have caused an infection. If this occurred, it might be difficult to tell, in an infant, if some motor neurons were damaged. Virus shedding occurs for as long as a month in some individuals although they are not infectious, generally, because the virus has a very high mutation rate and all virulent virus is cleared within a week or two after an active infection. But that is a possibility.

I don't know if anyone here has PPS because of a fetal infection. All the evidence on this taken since the late 1800's have been unremarkable and rare. With all the polio in the 40's and 50's one would expect positive information about fetal contraction of virus if it were a common event. We would have seen it. I do know there are a lot of physical problems that are common in our age group: fibromyalgia, chronic fatigue Syndrome, back problems, arthritic problems, lupus, MS. heart problems, chronic infections, Crones disease, and the list goes onto the point where we would all fall asleep. None of us escape all of these and many have common symptoms to PPS. Currently the guidelines at the NIH to help diagnose PPS include a history of paralytic polio. It would be pretty hard to convince them that PPS is the result of a parent's polio during pregnancy although I believe, and wrote an article in the Jan/Feb 2000 issue of the The American Journal of Physical Medicine and Rehabilitation, on Late Functional Loss in Non-Paralytic Polio. In that same issue were similar papers by Bruno and Halstead. soa history of paralytic polio, to many of us at least, is not required. In summary, I think anyone who feels they have PPS as a result of transplacental infection will have a hard road in convincing health care professionals of it unless an EMG shows typical old polio damage with resprouting. You might also show a higher titer of anti-polio antibodies for one of the three strains. Now if that happened I would be convinced. My co-author Marcia Falconer worked with live poliovirus at MIT and they did the anti-body test there but it is not generally available.
*References*

http://www.newmobility.com/review_article.cfm?id=358&action=browse

Post-Polio International (Halstead)
http://www.post-polio.org/netwkg_a.html

Improving Communication with Our Doctors

Henry D. Holland, MD,
Richmond, Virginia
(Henry4FDR@aol.com)

Why am I qualified to offer these suggestions? I have had the experience of being a patient many times in my life.

I have used a ventilator since I had a permanent tracheostomy in 1970. This treatment resulted from the damage initially caused by polio in 1950. I have an intensified interest in post-polio syndrome because I have experienced its effects since about 1990.

I have been a physician since 1966, and my specialty is psychiatry. I am currently a clinical professor at the School of Medicine of Virginia Commonwealth University (formerly the Medical College of Virginia), and each year I instruct second year medical students in the technique of interviewing patients.

There were times when I wondered if I would make it to today; but I did!
And because I did I'm going to celebrate!

Today, I'm going to celebrate what an unbelievable life I have had so far: the accomplishments, the many blessings, and, yes, even the hardships because they have served to make me stronger.

I will go through this day with my head held high and a happy heart.
I will marvel at God's seemingly simple gifts: the morning dew, the sun, the clouds, the trees, the flowers, the birds.

Today, none of these miraculous creations will escape my notice

Today, I will share my excitement for life with other people.
I'll make someone smile. I'll go out of my way to perform an unexpected act of kindness for someone I don't even know.

Today, I'll give a sincere compliment to someone who seems down. I'll tell a child how special he is, and I'll tell someone I love just how deeply I care for them and how much they mean to me.

Today is the day I quit worrying about what I don't have and start being grateful for all the wonderful things God has already given me. I'll remember that to worry is just a waste of time because my faith in God and his Divine Plan ensures everything will be just fine.

And tonight, before I go to bed, I'll go outside and raise my eyes to the heavens. I will stand in awe at the beauty of the stars and the moon, and I will praise God for these magnificent treasures.

As the day ends and I lay my head down on my pillow, I will thank the Almighty for the best day of my life. And I will sleep the sleep of a contented child, excited with expectation because I know tomorrow is going to be the best day of my life, ever!

I NEEDED TO RECEIVE THIS MESSAGE TODAY!

Do you know of others who might be waiting to receive it from you?

-Remove pine tar from hands and other body parts (be sure to wash hands
with soap and water after using WD-40)
-Penetrate stuck (removable) cleats and make replacement easier
-Clean, shine and remove pine tar from batting helmets
-Polish and remove ball marks from bats
-Help break in brand new leather mitts and batting gloves