Top financial to-dos to end the year strong and prepare for 2023

2022-11-15T08:01:00

(BPT) – The holidays are a time full of good cheer, but not necessarily so jolly for your bank account. ‘Tis the season to stress out your budget, not to mention the anxiety many people have about the increasing cost of living and the ongoing economic uncertainty.

According to the Q4 2022 Country Financial Security Index Report, 1 in 4 Americans are looking for help with navigating today’s economic volatility. So how can you set yourself up for financial success now and into the future, especially considering so many unknowns?

Fortunately, there are some important steps everyone can take to help them have a jolly holiday season and a financially healthy 2023. You can end the year financially stronger with these helpful tips from Scott Jensen at COUNTRY Financial:

Check your financial pulse

The close of the calendar year is a worthwhile time to pause and reassess where you’re at in your financial journey. There are lots of reasons to stop, take your financial pulse and figure out if there’s a course correction needed before the year comes to a close. Some time-sensitive questions to ask yourself include:

  • What is an appropriate budget to set for the holidays?
  • Is there money in your flexible spending account that needs to be used?
  • Do you have medical needs that must take place before a new deductible period starts?

Look for gaps

It’s important to make sure you’re protected from the curveballs life can throw, like a large unexpected expense. Now is a good time to check on your insurance coverages to see if there are any gaps.

First, review your insurance products such as home, auto and life. If you had significant life changes such as a marriage, new baby, divorce, made improvements to your home or are planning a major purchase such as a vehicle or property, schedule a meeting with your insurance agent to make sure you’re covered now and to help you plan for future insurance needs.

Don’t forget to look for gaps in your financial goals, too. A financial professional can learn about your goals and help you make adjustments so you’re on the right track.

Enlist the help of a Financial Professional

If you don’t already have one, consider how a financial professional can help you keep a clear vision with a solid plan for the new year. According to the COUNTRY Financial Security Index:

  • Only 23% of Americans have a financial advisor, yet those who do feel better about their finances, including higher levels of financial security (80% compared to 53% among those who do not have a planner).
  • People with a financial planner have more confidence in their ability to pay their debts (96% compared to 76% among those who do not have a planner).
  • Those who have a financial planner are more likely to set aside money for savings or investments (71% compared to 51% of those who do not have a planner).

Don’t wait to change the course of your financial future. Now is the ideal time to assess where you are, change where you’ve strayed and make corrections for a bright 2023 and beyond.

COUNTRY Financial® is the marketing name for the COUNTRY Financial family of affiliated companies (collectively, COUNTRY), which include COUNTRY Life Insurance Company®, COUNTRY Mutual Insurance Company®, and their respective subsidiaries, located in Bloomington, Illinois.

A Well-Designed Shower Experience

2022-11-15T07:01:00

(BPT) – The bathroom has become a multi-functional space — a place to create daily experiences that cleanse, relax and rejuvenate. Designing this space provides the opportunity to select features and fixtures that bring both art and function to the bathroom. The shower, especially one with a unique waterflow, can act as a living art piece, creating an immersive experience that feels as amazing as it looks.

Indulgent Shower Experience

To maximize the shower experience, incorporate technology that brings water to life and transforms a shower from a mundane task to a serene and reviving part of the day. Carefully look at every feature when selecting a shower head — from the spray to the coverage. Each element should come together to create a shower worth looking forward to each day.

The new 14” Raincan Shower Head from the Brizo® Essential™ Shower Series features an H20kinetic® Drenching Spray that utilizes water-sculpting chips to create thousands of large droplets that pour down in alternating patterns. The shower head provides rich volume and full coverage that replicates water found in a tropical rainforest, thus creating a uniquely recharging shower experience.

Refined Luxury

To elevate the bath space and achieve a look and sense of heightened relaxation, mix textures, unexpected tile patterns and earthy colors. Select fixtures with simple, clean details that bring the space together and create a cohesive, lavish design, to provoke a feeling of serenity. Look to shapes that complement the space and bring a sense of beauty to function. The 14” Raincan Shower Head is available in a Linear Round style, bringing new refinement to timeless simplicity. It is also available in a Linear Square style that elevates the shower through striking clean lines and geometric angles. Either shape creates a breathtaking statement that can live beautifully in any bathroom.

Conscientious Style

Make design choices that are as sustainable as they are aesthetically beautiful to create a bath environment that is both functional and intentional. Select fixtures with water-saving features and high-functioning, eco-friendly products that merge technology with design. Use H20kinetic® Technology to control the shape, velocity and thermal dynamics of water, creating the luxurious feeling of a high-flow shower, using only a fraction of the water. An ideal shower experience is one that is both relaxing and kind to the environment — the epitome of luxury in the bathroom.

5 Tips for Traveling with a Chronic Disease from a Patient with Psoriatic Arthritis

2022-11-15T06:01:00

(BPT) – Sponsored by Lilly USA, LLC

Vacations present an opportunity for relaxation, spending time with loved ones and indulging in new activities. While vacation is enjoyable, many find traveling stressful and uncomfortable, especially when living with a chronic disease such as psoriatic arthritis (PsA), a condition that causes swelling, stiffness and pain in and around the joints.

Kirk is a husband, father and avid cross-country skier who has a love for year-round outdoor activities and traveling with friends and family. In addition to living with psoriasis for nearly his whole life, the last seven years have been impacted by his PsA symptoms. According to Creaky Joints, an advocacy organization providing education, support, and patient-centric research for those living with rheumatic diseases, “traveling can be a lot harder when you have chronic pain [such as PsA]”.

The joint pain caused Kirk to struggle with everyday tasks. He notes, “[The joint pain] got progressively worse to the point where I couldn’t even put my socks on in the morning without help. Something wasn’t right. I was really worried about not being able to do the things I love with my family.” With his joint pain, Kirk found it difficult to be on his feet or sit in a car for extended periods of time, which made traveling difficult.

Once he was diagnosed with PsA, Kirk tried various treatments with little success. Fortunately, with support from his rheumatologist, Kirk was able to find symptom relief with Taltz® (ixekizumab) injection 80 mg/mL, helping him continue traveling with his loved ones without as much joint pain. “Taltz is the only medication that has quickly and effectively helped me with my joint pain and my skin.”* Learn more about Kirk’s story and his experience with Taltz.

Taltz is approved for adult patients with active psoriatic arthritis. Taltz affects the immune system. It may increase your risk of infections, which can be serious. Do not use Taltz if you have any symptoms of infection, unless your doctor tells you to. If you have a symptom after starting Taltz, call your doctor right away.

*This article represents Kirk’s personal experiences. While Kirk saw improvement with Taltz, individual results may vary. In clinical trials more than half of people with active psoriatic arthritis taking Taltz experienced joint symptom improvement at 24 weeks. Some patients felt joint symptom relief as early as 1 week. In clinical trials up to 75% of psoriatic arthritis patients who also have plaque psoriasis saw a significant improvement of their psoriasis plaques as early as 12 weeks.

“Check List” for Traveling with Psoriatic Arthritis

The burden of traveling with a chronic disease like PsA can be lessened with a plan of action. When planning a trip, talk to your doctor about travel tips that might be best for you. Kirk recommends you consider these five tips:

1. Understand travel expectations and communicate the need for potential accommodations

Prior to traveling, discuss with family, friends and other travel companions how PsA could affect plans and activities. When managing a chronic disease, accommodations, such as blocking off extra time in the day to rest or take breaks, may be necessary. Don’t hesitate to effectively communicate these needs with your group in the beginning and as needed throughout the day.

2. Try to not over-indulge

Although vacations are typically an opportunity to enjoy plenty of food and drinks, Kirk suggests avoiding inflammatory foods such as sugar and alcohol. His biggest recommendation is to eat healthy and stay hydrated.

3. Move around when possible

On long flights or car rides, Kirk suggests getting out of your seat to walk around as much as possible to avoid feeling stiff. Whenever he can, Kirk enjoys “big reaching for the sky stretches” to loosen up his body throughout the day.

4. Pack accordingly

It is important to consider what items from home may be necessary throughout a trip. For Kirk, a lacrosse ball for self-massage and a yoga mat for his stretches are essential items on his packing list.

Individuals with PsA who are traveling may consider the following:

  • Medication, such as your monthly Taltz injection if it falls during your vacation
  • Neck and knee pillows to reduce stress on joints in the hips, knees, spine and back, especially when traveling long distances or flying
  • A heating pack to loosen joints and relax stiff muscles
  • A cooling pack to reduce swelling
  • At least one pair of comfortable, fit-for-purpose shoes to relieve joint pain in the feet, toes and back

Consult with your doctor about traveling with your injection and proper storage. Be sure to review the storage instructions, as well as instructions for use, prior to packing.

5. Take care of yourself and listen to your body

When traveling, it is important to give your body all the care it needs and to honor your limits. In addition to eating well throughout your trip and giving your body plenty of rest, it is important to check in with yourself emotionally, as battling a chronic condition can also be difficult mentally.

Ask your doctor about treatment options like Taltz

Kirk recommends talking to your doctor about available treatment options, including Taltz, if you are seeking relief from chronic joint pain due to PsA.

If you have active psoriatic arthritis, talk to your doctor about Taltz to see if it could be the right treatment for you.

Kirk was compensated for his time to discuss his condition.

INDICATIONS AND SAFETY SUMMARY

Taltz® (tol-ts) is an injectable medicine used to treat:

  • People 6 years of age and older with moderate to severe plaque psoriasis who may benefit from taking injections or pills (systemic therapy) or treatment using ultraviolet or UV light (phototherapy).
  • Adults with active psoriatic arthritis.
  • Adults with active ankylosing spondylitis.
  • Adults with active non-radiographic axial spondyloarthritis with objective signs of inflammation.

It is not known if Taltz is safe and effective in children for conditions other than plaque psoriasis or in children under 6 years of age.

Warnings – Taltz affects the immune system. It may increase your risk of infections, which can be serious. Do not use Taltz if you have any symptoms of infection, unless your doctor tells you to. If you have a symptom after starting Taltz, call your doctor right away.

Your doctor should check you for tuberculosis (TB) before you start Taltz, and watch you closely for signs of TB during and after treatment with Taltz. If you have TB, or had it in the past, your doctor may treat you for it before you start Taltz.

Do not use Taltz if you have had a serious allergic reaction to ixekizumab or any other ingredient in Taltz, such as: swelling of your eyelids, lips, mouth, tongue or throat, trouble breathing, feeling faint, throat or chest tightness, or skin rash. Get emergency help right away if you have any of these reactions. See the Medication Guide that comes with Taltz for a list of ingredients.

Crohn’s disease or ulcerative colitis (inflammatory bowel disease) can start or get worse with Taltz use. Tell your doctor if you have any of these symptoms or if they get worse: stomach pain, diarrhea, and weight loss.

You should not get live vaccines while taking Taltz. You should get the vaccines you need before you start Taltz.

Common side effects

The most common side effects of Taltz include:

  • Injection site reactions
  • Nausea
  • Upper respiratory infections
  • Fungal skin infections

Tell your doctor if you have any side effects. You can report side effects at 1-800-FDA-1088 or www.fda.gov/medwatch.

Before using

Before you use Taltz, review these questions with your doctor:

  • Are you being treated for an infection?
  • Do you have an infection that does not go away or keeps coming back?
  • Do you have TB or have you been in close contact with someone with TB?
  • Do you have possible symptoms of an infection such as fever, cough, sores, diarrhea, or other symptoms? Ask your doctor about other possible symptoms.
  • Do you have Crohn’s disease or ulcerative colitis?

Tell your doctor if:

  • You need any vaccines or have had one recently.
  • You take prescription or over-the-counter medicines, vitamins, or herbal supplements.
  • You are pregnant or planning to become pregnant. It is not known if Taltz can harm an unborn baby. Pregnancy Exposure Registry: There is a pregnancy registry to collect information about women who are exposed to Taltz during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. If you become pregnant while taking Taltz, you are encouraged to enroll in the pregnancy registry by calling 1-800-284-1695 or by visiting online at https://www.taltz.com.
  • You are breastfeeding or planning to breastfeed. It is not known if Taltz passes into breastmilk.

How to take

See the instructions for use that come with Taltz. There you will find information about how to store, prepare, and inject Taltz. Adults may self-inject after receiving training from a healthcare provider.

For people under 18 years of age:

  • Weighing less than 50 kg (i.e., 110 lb): Taltz must be given by a healthcare provider.
  • Weighing more than 50 kg (i.e., 110 lb): If your healthcare provider decides that your caregiver may give your injections of Taltz at home, your caregiver should ask and receive training from a healthcare provider on the right way to prepare and inject Taltz.

Learn more

Taltz is a prescription medicine. For more information, call 1-800-545-5979 or go to taltz.com.

This summary provides basic information about Taltz but does not include all information known about this medicine. Read the information that comes with your prescription each time your prescription is filled. This information does not take the place of talking with your doctor. Be sure to talk to your doctor or other healthcare provider about Taltz and how to take it. Your doctor is the best person to help you decide if Taltz is right for you.

IX CON BS 05OCT2022

Taltz® and its delivery device base are trademarks owned or licensed by Eli Lilly and Company, its subsidiaries, or affiliates.

PP-IX-US-5717 10/2022 ©Lilly USA, LLC 2022. All rights reserved.

Ten dermatology professionals share their personal and professional experiences with acne

2022-11-14T23:01:00

(BPT) – Acne is the most prevalent skin disease in the U.S., affecting up to 50 million Americans. Most common among teenagers, acne can affect people at any age. A common misconception is that acne is due solely to one’s diet or skincare routine, but in fact the causes of acne are complex. While certain foods and even stress may exacerbate the condition, acne is often caused by hormonal changes in the body. For example, androgens, hormones that increase in boys and girls during puberty, cause sebaceous glands to enlarge and produce more sebum (oil), leading to acne breakouts. Other hormonal changes and their associated breakouts can occur throughout a person’s lifetime.

Many dermatology professionals were inspired to enter the field due to their own experiences with acne. See what 10 physicians, physician assistants and nurses who work in dermatology have to say in a new, dynamic video called My Life With Acne, which you can watch by clicking here.

More than just a skin condition

The healthcare professionals in the My Life With Acne video discuss how acne is much more than a physical disease. Its effect on one’s appearance can negatively impact a person’s self-view and mental health, regardless of their age.

“I had pretty active acne through my teenage years, even into my twenties and thirties,” says Vincent Smith, a dermatology nurse practitioner. “It was really distressing, because we all want to put our best face forward. It’s hard to do that when you’re looking in the mirror and all you see are pimples. You feel like other people aren’t looking at you — they’re just looking at your pimples.”

Acne’s potential impact on a person’s self-esteem and self-confidence means the benefits of an effective treatment are not limited to improving one’s outward appearance. “When we treat acne, we’re not just impacting their skin, we really are impacting their life,” comments board-certified dermatologist Julie Harper, MD.

Not just for teenagers

Because acne is so strongly associated with one’s teen years, adults who experience acne can have an even more difficult time coping with the condition. “I was always thinking in my mind when I was a teenager, ‘I can’t wait to get older and not get pimples anymore,’ but it’s not true,” says physician assistant Renata Block, who has been dealing with acne her entire life.

No matter your age, it’s best to consult a dermatology professional who understands acne’s causes and who can help to treat your acne successfully.

Treatment is not one-size-fits-all

Acne’s causes and exacerbating conditions are complex, and not all patients will benefit from the same treatment regimen. Approaches to acne treatment include topical prescription medications such as retinoids and retinoid-like drugs, antibiotics, azelaic acid and salicylic acid, benzoyl peroxide, and androgen receptor inhibition. Some acne medications are administered orally. Because treatments may have side effects, it’s best to consult a dermatology professional to find the best treatment options for your condition.

Treat acne early to increase your chances of success

Dr. Corey Hartman, a board-certified dermatologist who also appears in the video, highlights the importance of being treated for acne as soon as you can, for the best results. “Acne wears on your self-esteem,” he says, “and to be honest, can even interfere with your ability to excel professionally.”

If you or a loved one are experiencing acne, contact a dermatology professional to find the treatment plan that will work best for you. And don’t forget to watch the My Life With Acne video!

©2022 Sun Pharmaceutical Industries, Inc. All rights reserved.

How to travel the (wine) world, sip by sip

2022-11-14T17:33:00

(BPT) – Adventure is back in a big way. But if you’re like most of us, you don’t have enough frequent flier miles (yet) to hit every far-flung locale on your post-pandemic bucket list. Refreshing your browser for hotel deals in Reykjavik? Right there with you. Diving into a great book set in Kenya or tasting tapas at an Andalusian outpost? Sounds like it’s time to take your armchair exploring up a notch with a trip to the global wine aisle. Nothing brings you closer to the heart of a place — its people, its terrain, its story — than a handcrafted local wine.

Explore beyond the usual

It’s easy to fall into old patterns, reaching for the same wine that reliably suits your weekend take-out. No judgment here. The sea of options lining the typical wine shelf can wash over even the savviest of connoisseurs, rendering most of us incapable of making a seemingly simple decision about what to drink. Wait, isn’t wine supposed to be fun? (Yes!)

Like the exotic destinations that beckon from afar, the wine-less-traveled requires an open mind and a willingness to explore. We’ve rounded up our favorite must-pour bottles from unexpected regions in the New World, so put down that trusty bottle of Chardonnay, pack your proverbial bags, and follow us to the barrel rooms of Mendocino, Mendoza and Maipo Valley.

Discover the California region you haven’t sipped yet

When we think of New World wines, the kind made in places that have been crushing grapes for merely a few centuries — compared with the millennia-deep heritage of the Old World — California is undoubtedly the Northern Hemisphere’s crown jewel. We’ll head there first, but to an out-of-the-way spot along the North Coast that remains unconfined by convention and unfettered by throngs of tourists. Welcome to Mendocino County.

This tranquil enclave — an early pioneer of organic viticulture agriculture in the U.S. — is home to Bonterra Organic Estates, a regenerative- focused B Corp winery that has been crafting organically farmed wine since 1987. Along with a well-known collection of everyday wines made from organic grapes, Bonterra produces limited-release, single-vineyard wines from its Regenerative Organic Certified™ sites in Mendocino County.

Pour now: The Butler, Single-Vineyard Red Cuvée, Mendocino County, 2020

A shining star in Bonterra’s trio of single-vineyard offerings, this Rhone-style blend is a memorable expression of Butler Ranch Vineyard, an impossibly steep site where every grape is harvested by hand. Layered aromas of dark fruit and cedar box are woven over a complex amalgamation of black currant, pepper and herbs. $60

Travel to the edge of the earth to fill your glass

The Southern Hemisphere is no stranger to rugged adventure and off-the-grid exploring. The wines of Argentina and Chile represent the jaw-dropping topography of the Andes Mountains and the vast expanse of earth that journeys to the outermost stretches of humanity. Welcome to South America.

Mendoza may have put Argentina on the world wine map, but it’s Luján de Cuyo — a sub-region of Mendoza where the vines rest at altitudes close to 3,500 feet — that draws us in. Italian immigrants, awed by the soaring terrain, powerful winds and pure water from mountain snowmelt, planted the first Malbec grapes here over a century ago. Today, Bodega Trivento crafts its Golden Reserve Malbec from 60- to 100-year old vines tended by generations of family farmers.

Pour now: Trivento Golden Reserve Malbec, Luján de Cuyo, Mendoza, 2020

A vivid interpretation of Luján de Cuyo’s legendary vineyards, this hand-harvested Malbec is aromatic and full-bodied, with enticing notes of strawberry, raspberry, blackberry and plum. Don’t miss the soft tannins and plush, velvety finish. $20

On the other side of the Andes, we venture into Chile’s Maipo Valley, home of Cabernet Sauvignon royalty. Visionary winemaker Don Melchor Concha y Toro first planted vines from Bordeaux here in 1883. More than a century later, the inaugural vintage of his namesake Cabernet Sauvignon from Don Melchor Vineyard in Puente Alto delivered an unequivocal benchmark for Chilean wine.

Pour now: Don Melchor Cabernet Sauvignon, D.O. Puente Alto, Maipo Valley, 2020

Steeped in heritage and brimming with elegance and power, this quintessential Chilean Cabernet is intensely aromatic, with bursts of red fruit balanced by floral notes of violet and rose. Consider this a splurge-worthy luxury that will age well for another 35 years. $150

As we all dream of our next great adventure, these wines bring the world’s most intriguing destinations a little closer to home.

Fueling your business with your fleet

2022-11-14T11:31:00

(BPT) – For owners of small- and medium-size businesses, there are so many elements to be handled that finances often do not get the attention required to drive a sustainable and growing business. It is widely reported that 82% of small businesses shut down due to poor cash flow management, and CB Insights reports 39% ran out of cash or failed to raise new capital. This is especially tricky for businesses with company vehicles.

Business owners can tap financial tools and make strategic decisions to make running and growing their vehicle fleets more efficient. As demand for their goods and services increases, business owners can be better prepared to improve their fleets’ capabilities, productivity and efficiency while paving the way for growth.

These tips to evaluate use, budget and finance can help business owners manage their fleets efficiently and determine the right time and right additions for their company’s success and growth.

Think MAST

A good first step is to understand how a company’s vehicles are utilized. Just think MAST.

  • Miles – How many miles are anticipated per year?
  • Application – Does the company have the right vehicle for the job? In other words, are fleets hauling feathers or cement?
  • Specifications – What vehicle equipment is needed: towing and hauling, custom storage, onboard power?
  • Term – A good replacement cycle plan will save fleet costs in the long run.

Understand the company’s fleet finances

One important job for business owners is identifying realistic budgets. Here are steps to help steer a company in the right direction.

  1. Plan and set goals – Take stock of the current vehicles and expected replacement cycle. Don’t wait until a vehicle is needed. Business goals should include plans for future changes.
  2. Review past expenses – Past expenses can provide a reference point for what to include in a fleet budget and highlight areas that need attention.
  3. Forecast – There are various techniques, including simply increasing a previous year’s budget by a flat percentage or starting from scratch, to forecast potential costs for your fleet.
  4. Track results – It’s essential to make this a routine part of your business processes.

Determine the best financing options

Next, business owners with fleets need to examine the best financing for their budgets — and for the long haul. Here are a few things to consider.

  • Lease or own – There are advantages to both options, so comparing them is key. Leasing benefits may include more affordable payments, allowing funds to be invested in other areas. However, owning fleets allows for less frequent vehicle turnover and flexibility on mileage.
  • Fleet financing – One option is a commercial fleet financing partner. In addition to expertise in fleet financing, Ford Pro FinSimple offers a Commercial Line of Credit (CLOC) that helps fleet owners save time. A CLOC provides businesses with easy and transparent financing with flexible terms that is ready to be used any time throughout the year.

Andrew Comrie-Picard, the founder of ZipTire, a Los Angeles–based mobile tire business, is a customer of Ford Pro FinSimple, which provides easy fleet financing for small- and medium-size businesses. He says, “I financed my first truck through Ford Pro FinSimple financing. And now as we’re growing, I’m really excited to work with Ford Pro FinSimple in order to build out our fleet, get more vehicles and to be able to upfit them.”

Find a commercial-centric partner

When shopping for a new fleet, it is important to find a dealership that will partner with you throughout both the purchasing process and the life of your vehicle.

  • Establish a relationship – Look for a dealership that has experience in commercial vehicles. This will ensure you receive help for your business-specific needs and that when you’re ready to finance, they’re ready to deliver.
  • Service is key – Good vehicle service can help business owners avoid downtime with streamlined maintenance, repairs and parts to keep their fleets in good working order. Some dealerships even provide 24/7 mobile service.

To learn more about how Ford Pro FinSimple can serve as a resource for commercial financing needs, please visit https://fordpro.com/en-us/financing/?bannerid=MAT_release_fin_CLOC.

Epilepsy: One Student’s Journey to More Seizure-free Moments

2022-11-14T07:31:00

(BPT) – November is recognized as National Epilepsy Awareness Month in the US. Epilepsy is a brain disorder involving recurrent, unprovoked seizures. The CDC reports that about 3.4 million Americans live with epilepsy today [1].

For anyone living with epilepsy, coping with the challenges of the disease involves more than just physical health. Many living with the neurological condition may experience emotional challenges, like worrying about when their next seizure will occur or feeling overwhelmed when it comes to choosing the right treatment options.

One student’s journey

Isla Ritchie, a university student from Texas, began having seizures at age 11. Isla experienced multiple seizures weekly, which affected her entire body and left her feeling sore and fatigued for days. At first, doctors prescribed her a variety of anti-seizure medications, but nothing controlled her seizures until she was introduced to VNS Therapy™ when she was 12.

Isla has drug-resistant epilepsy (DRE) – a diagnosis given to patients after two anti-seizure medications fail to control seizures when used for an adequate period of time as determined by a patient’s physician. According to the Epilepsy Foundation, about one-third of adults with epilepsy and 20-25 percent of kids with epilepsy have DRE [2].

VNS Therapy™ has been FDA approved since 1997 [3] and is indicated for use as an adjunctive therapy in reducing the frequency of seizures in patients four and older with drug-resistant epilepsy who have partial onset seizures. It is a unique, implantable medical device that works by delivering mild pulses of stimulation through the left vagus nerve to areas of the brain known to be associated with seizures. It’s placed under the skin of the chest and connects to the vagus nerve in a short, outpatient procedure that takes one to two hours.

Through a combination of one medication and a VNS Therapy™ device, Ritchie has been able to keep her seizures under control. Now 19, she has more seizure-free moments and recently started studying entrepreneurship and international business at a university.

Understanding treatment options beyond medication

A new survey of 200 VNS Therapy™ patients and caregivers, conducted by Wakefield Research on behalf of LivaNova, highlights the importance of considering VNS Therapy™ as an alternative option if anti-seizure medications alone are not effectively controlling seizures. In the survey [4], 94% of patients and caregivers reported they wish they had known about VNS Therapy™ sooner, and 86% say they worry less about seizures because of their VNS Therapy™ device.

“Advocacy allows those touched by epilepsy to receive the best possible care and achieve the highest quality of life and independence,” said Angus Wilfong, MD, Pediatric Neurologist practicing in Phoenix, AZ. “Understanding all the latest epilepsy treatment options is important and surveys such as this highlight how these treatments affect overall well-being, beyond simply reducing seizures. Treatment options like VNS Therapy™ that may reduce the frequency and severity of seizures can make huge quality of life improvements for those living with drug-resistant epilepsy, and their families.”

VNS Therapy™

More than 125,000 patients, including over 35,000 children, have been treated with VNS Therapy™ worldwide. VNS Therapy™ can lead to fewer seizures, shorter seizures and better recovery after seizures.

Common side effects include hoarseness or change in voice tone, shortness of breath, sore throat, and coughing. These side effects generally only occur during stimulation and usually decrease over time. Implant site infection is the most common side effect of the procedure and can often be resolved with medication.

While individual results may vary, VNS Therapy™ can help patients like Isla manage seizures and thrive.

“VNS Therapy™ has given me the seizure control I need. I can now confidently talk to friends, be social, stay alert in class, and network,” said Ritchie. “It’s a part of me that I’m grateful I have. I can study, achieve my goals, and chase my dreams again.”

When a patient has epilepsy, they should be seen by an epilepsy specialist who can help them get control of their seizures.

Find out more about VNS Therapy™ at www.VNSTherapy.com.

References:

1. https://www.cdc.gov/epilepsy/about/fast-facts.htm

2. https://www.epilepsy.com/treatment/medicines/drug-resistant-epilepsy

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5961632/

4. A survey of 500 U.S. epilepsy patients and caregivers, 100 U.S. respondents using VNS Therapy and 100 parents or caregivers of a child (defined as over the age of four and under the age of 18) with epilepsy using VNS Therapy was conducted by Wakefield Research on behalf of LivaNova and Red Havas.

Isla Ritchie is a Patient Ambassador for LivaNova’s VNS Therapy™ system, for which she receives modest compensation.

About VNS Therapy for Epilepsy

1. INDICATIONS

The VNS Therapy System is indicated for use as an adjunctive therapy in reducing the frequency of seizures in patients 4 years of age and older with partial onset seizures that are refractory to antiepileptic medications.

2. CONTRAINDICATIONS

Vagotomy The VNS Therapy System should not be used (is contraindicated) in people who have had the left vagus nerve cut to treat another disorder (a left vagotomy).

Diathermy Inform anyone treating you that you CANNOT have any short-wave diathermy, microwave diathermy, or therapeutic ultrasound diathermy (hereafter referred to as “diathermy”) anywhere on your body because you have an implanted VNS Therapy System (sometimes referred to as a “Vagus Nerve Stimulator” or “Vagus Nerve Stimulation”). Injury or damage can occur during diathermy treatment whether your VNS Therapy System is turned “ON” or “OFF.” Diagnostic ultrasound is not included in this contraindication.

3. WARNINGS

Avoid excessive vagus nerve stimulation Excessive stimulation of the vagus nerve can be produced by frequent magnet activation or more than 4 hours of continuous stimulation due to repeated magnet activations.

Unapproved uses The safety and efficacy of the VNS Therapy System have not been established for uses outside its approved indications for use. The safety and efficacy of VNS Therapy have not been shown for people with these conditions: history of previous therapeutic brain surgery or brain injury, dysautonomias, lung diseases or disorders, including shortness of breath and asthma, ulcers (gastric, duodenal, or other), fainting (vasovagal syncope); irregular heartbeats (heart arrhythmias) or other heart abnormalities; other concurrent forms of brain stimulation; pre-existing hoarseness; under 4 years of age; progressive neurological diseases other than epilepsy.

Swallowing difficulties Difficulty swallowing may occur with active stimulation, and aspiration may result from the increased swallowing difficulties. Use of the magnet to temporarily stop stimulation while eating may mitigate the risk of aspiration.

Shortness of breath Shortness of breath may occur with active VNS Therapy, especially if you have chronic obstructive pulmonary disease or asthma.

Obstructive sleep apnea Use of the VNS Therapy device can cause or worsen pre- existing obstructive sleep apnea (episodes where breathing stops for short periods of time while sleeping). You should see your physician if you show any signs or symptoms of obstructive sleep apnea or worsening obstructive sleep apnea.

Device malfunction Device malfunction could cause painful stimulation or direct current stimulation. Either event could cause nerve damage and other associated problems.

Device removal Removal of the VNS Therapy System requires an additional surgical procedure. When a device is removed, the surgeon may leave part of the lead behind. This may pose certain risks.

Device manipulation Do not manipulate the generator and lead through the skin, as this may damage or disconnect the lead from the generator and/or possibly cause damage to the vagus nerve.

Device trauma Blunt trauma to the neck and/or any area of the body beneath which the lead is implanted could possibly cause damage to the lead.

Not a cure The VNS Therapy System does not stop all seizures. Continue to avoid activities that can be hazardous to you and others, such as driving and swimming alone.

Before having any MRI performed Call your doctor, so your VNS Therapy System can be discussed with the MRI personnel. In many cases, an MRI can be performed safely under certain conditions. However, for a few other cases, surgery may be required to remove the VNS Therapy System prior to an MRI. Before undergoing an MRI scan with your VNS Therapy System, the VNS system diagnostic information will be collected and the current turned off. The current will be turned on again after the scan is completed. Your doctor has access to detailed MRI-related information in the physician’s manual.

Patient Magnet is MR Unsafe Do not carry the patient magnet into the MR scanner room. The magnet could become a dangerous flying object if attracted by the strong magnetic field of the MRI scanner.

Pain or other sensation during MRI scan If, during an MRI scan, you have any pain, discomfort, heating, or other unusual sensations, notify the MRI operator, so the MR procedure can be stopped.

Cardiac Arrhythmia (Model 106 or 1000 only) If you have a cardiac arrhythmia, the Automatic Stimulation feature of the Model 106 is not suitable for you. This includes heart conditions or treatments that do not allow necessary changes in your heart rate, such as atrial fibrillation, pacemaker dependency, implantable defibrillator, or cardiac medications such as beta blockers.

4. PRECAUTIONS — IMPLANTABLE DEVICE: GENERAL

Use during pregnancy The safety and effectiveness of the VNS Therapy System have not been established for use during pregnancy.

Laryngeal irritation may result from stimulation Patients who smoke may have an increased risk of laryngeal (commonly called the “voice box”) irritation.

AutoStim Devices (Model 106 and 1000)

Use during exercise Exercise or physical activity may trigger Automatic Stimulation if the feature is ON due to heart rate changes detected by the device.

Heart Rate Changes Not Associated with Seizures Situations, including but not limited to exercise or physical activity, that cause rapid increases in heart rate may trigger Automatic Stimulation if the feature is ON. If this is a concern, talk to your doctor about ways to stop stimulation during these situations. This could include using your magnet or having your doctor turn the AutoStim feature OFF.

Battery Drain If your doctor has turned on the AutoStim feature, there will be a greater impact on battery life than if the feature is turned off, which may require more frequent generator replacements.

AutoStim follow-up visits — Use of the AutoStim feature will reduce battery life. Once the AutoStim feature has been activated, your doctor will work with you to determine a treatment plan to get to the most benefit.

Time-based Features (Models 1000 only) Optional time-based features (e.g., Day-Night Programming, Scheduled Programming) do not automatically adjust for Day Light Savings Time or time zone changes. If you are using one of these features, you will need to go back to your doctor for reprogramming of the generator for any time changes.

5. PRECAUTIONS — IMPLANTABLE DEVICE: ENVIRONMENTAL & MEDICAL HAZARDS

Being close to certain types of equipment can affect the generator. Move away from or avoid equipment such as transmitting antennas.

Pacemaker Warning signs Talk to your doctor before going into places with Pacemaker Warning signs.

Small appliances Properly operating microwave ovens and other small electrical appliances, such as toasters, hair dryers, and electric shavers, should not affect the generator.

Cellular phones Cellular phones can affect some implanted cardiac defibrillators and pacemakers, but tests to date show that they do not affect the generator.

Transmitting devices Properly operating electrical ignition systems and power transmission lines should not affect the generator. Sources with high energy levels, such as transmitting antennas, may interfere with the device. Move at least 1.8 meters (6 feet) away from any equipment that interferes with your device.

Antitheft devices, airport security systems, and other metal detectors Antitheft devices and metal detectors should not affect the generator or be affected by it. As a precaution, however, move through them at a steady pace; do not linger in the area and stay at least 40 centimeters (16 inches) away from such equipment.

Electronic Article Surveillance (EAS) System tag deactivators The tag deactivators found in many retail stores can interfere with VNS Therapy when it is used near the generator. It can cause accidental activations or stop pulses. Stay at least 60 centimeters (2 feet) away from tag deactivators to avoid potential interference.

Devices with strong electromagnetic fields Electrical or electromechanical devices with a strong static or pulsing magnetic field can cause the generator to start suddenly. Such devices may include strong magnets, tablet computers and their covers, hair clippers, vibrators, antitheft tag deactivators, and loudspeakers. Keep this type of equipment at least 20 centimeters (8 inches) away from your chest. If your generator stops while you are in a strong electromagnetic field, move away from the source so the device may return to regular operation.

Medical equipment, procedures, and surgery using certain electrical instruments can affect the VNS Therapy System’s operation and sometimes damage the generator or lead.

Make sure that medical personnel know you have a device implanted in your chest.

Always call your doctor before you have any medical tests that may affect, or be affected by, the VNS Therapy System as described in this section. Precautions may be needed.

Routine diagnostic procedures Most routine diagnostic procedures, such as diagnostic ultrasound and radiography (x-rays), should not affect the VNS Therapy System.

Mammography Because the generator is in your chest, you may need to be specially positioned for a mammogram. Otherwise, the device may be seen as a shadow on the mammogram. It could make a lesion or lump in that area hard or even impossible to detect. Make sure that your doctor and the mammography technician are aware of the implanted device.

Radiation treatment Treatment with radiation, cobalt machines, and linear accelerators may damage the generator. No testing has been done to date. The effect of radiation on the device is not known. Talk with your doctor if you plan to have radiation treatment.

Other procedures External cardiac defibrillation and other procedures for heart problems, as well as extracorporeal shockwave lithotripsy, diathermy, and electrocautery, may damage the generator. If you had any of these procedures and your doctor did not know about it, have the generator checked. While diagnostic ultrasound should not affect the VNS Therapy System, therapeutic ultrasound therapy could damage the generator or inadvertently harm you.

While the generator is stimulating or being set or tested, it may briefly interfere with nearby equipment. If this happens, move at least 1.8 meters (6 feet) away from such equipment.

Radios and hearing aids The generator can interfere with devices that operate in the 30 kHz to 100 kHz range. Hearing aids and transistor radios operate in this range. In theory, the generator could affect them, but no effects have yet been reported. No detailed testing has been done, so the effects are unknown.

Other Implanted devices The generator may affect other implanted medical devices, such as cardiac pacemakers and implantable defibrillators. Possible effects include sensing problems. These could lead to inappropriate responses from the generator.

6. PRECAUTIONS — MAGNETS

After your operation, your doctor will give you two magnets and accessories. The magnets contain a high-power magnet that is surrounded by a plastic casing in the shape of a watch. With normal use, they should remain powerful for approximately 3 years

Keep magnet with you Always carry the magnet with you. Show your family members or caregivers how to use it.

Other implanted devices Do not place the magnet over a pacemaker since it may affect pacemaker function and could change the pacing rate. Do not place the magnet over a defibrillator (sometimes called ICD) since it could turn the device OFF

Damage from magnet Never put or store the magnets near credit cards, televisions, computers, computer disks, microwave ovens, watches, other magnets or items affected by strong magnetic fields. Keep them at least 25 centimeters (10 inches) away.

If you are not sure how to use the magnet or have questions, ask your doctor to show you how.

7. SIDE EFFECTS

Adverse events reported during clinical studies as statistically significant are listed below in alphabetical order: ataxia (loss of the ability to coordinate muscular movement); dyspepsia (indigestion); dyspnea (difficulty breathing, shortness of breath); hypoesthesia (impaired sense of touch); increased coughing; infection; insomnia (inability to sleep); laryngismus (throat, larynx spasms); nausea; pain; paresthesia (prickling of the skin); pharyngitis (inflammation of the pharynx, throat); voice alteration (hoarseness); vomiting. Adverse events reported in clinical investigation of the AutoStim feature were comparable.

How to help loved ones hear the joy this holiday season

2022-11-14T08:49:00

(BPT) – Spending time with people you love is what makes the holiday season special. But for parents and grandparents who suffer from hearing loss, gathering with family and friends can be grueling.

One in three adults over 65 experience hearing loss, which can be exhausting. People with even mild hearing loss often withdraw from activities they love due to fatigue, frustration and embarrassment, which can lead to isolation, depression and even dementia.

Until recently, hearing aids were expensive and required a prescription from a hearing health professional. That changed in October, when the FDA authorized over-the-counter (OTC) hearing aids. Now adults with mild to moderate hearing loss can get a pair from their local pharmacy or big box store without a prescription for a fraction of the cost of traditional hearing aids and start experiencing the benefits of better hearing the same day.

How to know if someone you love has hearing loss

The average person waits seven years from the onset of hearing loss symptoms to get hearing aids, and many don’t realize for years that their hearing has deteriorated. This holiday season, you can help by watching for common signs of hearing loss in friends and family, such as:

  1. Keeping the radio or television at an uncomfortably high volume.
  2. Constantly asking others to repeat themselves.
  3. Falling or losing balance frequently.
  4. Getting easily fatigued from social activities, especially in environments with a lot of background noise.

What can you do to help?

There are several easy ways to help people with hearing loss enjoy the holidays this year:

  • Don’t ignore obvious signs. If someone you love is showing signs of hearing loss, help them take a free 3-minute hearing test online at lexiehearing.com to confirm and assess the severity of their hearing loss.
  • Create a comfortable environment. People with mild to moderate hearing loss can’t easily distinguish between conversations and background noise. Help them have quality conversations by creating a quiet space free from TV, music or excessive background chatter. If they seem tired or overwhelmed, help them take a break outside or in a separate room where they can rest their ears.
  • Try a hearing aid. If an online hearing test indicates mild to moderate hearing loss, try over-the-counter hearing aids. Many offer the same features as prescription options but cost a fraction of the price. Quality brands like Lexie Hearing sell them in pairs at pharmacies and big box stores nationwide.

What to look for in a hearing aid.

Choosing the right hearing aid is important. While most over-the-counter models come at a much lower cost than traditional hearing aids, not all offer the same quality and features.

  • FDA labeling. Be sure to get a model that meets FDA standards. Read the packaging carefully — devices sanctioned by the FDA will be labeled accordingly.
  • Generous return policies. Look for brands that have generous return policies so you can try them out when you’ll get the most benefit. Lexie offers 45-day returns on all products, including its newest Lexie B2 Hearing Aids, Powered by Bose, and encourages users to wear them for at least three weeks to adjust to better hearing.
  • Great reviews. Check out device reviews. If your hearing aid runs from a phone app, consider what current users say about the product by reading app store reviews before purchasing. Make sure there’s a track record of happy customers.

Don’t let hearing loss detract from your joy this holiday. Help your loved ones take control of their hearing and make the most of every moment together.

Get Back to a Healthy Back

2022-11-14T09:01:00

(BPT) – Do you ever have pain, numbness or tingling in your lower back, legs, or buttocks? Do you often find yourself seeking a place to sit to relieve the pain? Or have you ever leaned over a shopping cart while grocery shopping to alleviate the pain? If you answered yes to any of these questions, you are not alone. You are one in over 72.3 million Americans who are suffering with chronic low back pain (CLBP), which can be a debilitating physical condition[1].

Lumbar spinal stenosis (LSS) is a condition in which the lower spinal canal narrows and compresses the nerves causing chronic low back pain (CLBP). This compression, which, is often caused by an enlarged ligament, looks like a “kink in a drinking straw,” contributing to pain and mobility issues.

This age-related condition is the leading cause of disability and physical and emotional stress amongst those who have CLBP[2]. Often, people suffering with LSS are limited by their ability to stand or walk, often stopping them from participating in their work, hobbies and activities of daily living.

If you ever notice that you find relief by bending over, or leaning on an object, such as a shopping cart, this is a tell-tale sign that you may be suffering with LSS. The most common reason for LSS is due to an enlarged ligament and up to 78% of patients with CLBP do not know the cause of their pain could be related to an enlarged ligament[1]. To confirm the source of your CLBP, you need to speak to a spine health doctor who can assess your symptoms and order the proper diagnostic imaging tests (such as an MRI).

While there are many treatments for chronic low back pain, often these improvements are temporary. If you have tried NSAIDs, physical therapy, or even an epidural steroid injection (ESI) and find that the pain continues to return, you should speak to a spine health doctor to diagnose if you are one of the millions of people with LSS due to an enlarged ligament.

If an enlarged ligament is causing your pain, your doctor can also let you know if you are a candidate for a short, outpatient, minimally invasive lumbar decompression procedure, known as the mild® Procedure. This FDA-cleared procedure restores space in the spinal canal through a tiny incision smaller than the size of a baby aspirin to provide mobility and pain improvement. The procedure does not require general anesthesia, implants, stitches, steroids, or opioids, and patients typically resume normal activity within 24 hours with no restrictions [3]. The mild® Procedure is covered nationwide by Medicare (all ages, all plan types, including Medicare Advantage) the VA, U.S. Military & IHS. Commercial coverage varies. The procedure has an 85% patient satisfaction rate[4] and studies show that mild® continues to improve patient functionality over time[3]. Patients may be able to stand 7 times longer and walk 16 times farther after having this procedure[5]. Over one-year, the average standing time increased from 8 to 56 minutes with less pain, and the average walking distance increased from 246 to 3,956 ft with less pain[5].

When should you speak to a spine health doctor? If you can relate to the mobility issues below based on your age range, you should visit https://KnowYourBackStory.com/find-a-doctor/ to learn more about your options.

  • If you are in your 50s and have trouble standing for more than 30 minutes, are unable to walk more than a mile, or have pain daily[1]
  • If you are in your 60s with the same mobility issues above, or you are unable to jog[1]
  • If you are in your 70s, and have trouble standing for 30 minutes, going up and down stairs, have problem getting in and out of a chair, or have pain daily[1]

To learn more about lumbar spinal stenosis, or to find a spine health doctor near you, you can visit www.KnowYourBackStory.com

The mild® Procedure has a strong safety profile and has been performed on thousands of patients. Although the complication rate for the mild® Procedure is low, as with most surgical procedures, serious adverse events, some of which can occur[6]. Individual results may vary. Please learn more and view safety information at vertosmed.com/patients.

[1] A Stagwell Company , H. I. & A. L. L. C. (2022, August). Mobility index and chronic low back pain survey results. Retrieved October 13, 2022, from https://knowyourbackstory.com/wp-content/uploads/2022/08/HARRIS-POLL-EXECUTIVE-SUMMARY-RESULTS.pdf

[2] Chen S, Chen M, Wu X, et al. Global, regional and national burden of low back pain 1990-2019: A systematic analysis of the Global Burden of Disease study 2019. J Orthop Translat. 2021;32:49-58. Published 2021 Sep 10. doi:10.1016/j.jot.2021.07.005

[3] Jain S, Deer TR, Sayed D, et al. Minimally invasive lumbar decompression: a review of indications, techniques, efficacy and safety. Pain Manag. 2020;10(5). Https://doi.org/10.2217/pmt-2020-0037. Accessed June 1, 2020.

[4] MiDAS ENCORE responder data. On file with Vertos Medical.

[5] Mekhail N, Costandi S, Abraham B, Samuel SW. Functional and patient-reported outcomes in symptomatic lumbar spinal stenosis following percutaneous decompression. Pain Pract. 2012;12(6):417-425.doi:10.1111/j.1533-2500.2012.00565.x.

[6] Mild® Procedure for Lower Spinal Stenosis (LSS) | Treat Back & Leg Pain. (n.d.). Vertos Medical. Retrieved October 13, 2022, from https://www.vertosmed.com/patients/

CRNAs are the solution to delayed surgical care for veterans

2022-11-14T10:01:00

(BPT) – As we honor veterans this month, it can be easy to forget about the challenges some continue to face at home: challenges that include undergoing critical medical procedures in a timely manner.

Long wait times

Veterans have to wait too long for surgical care in U.S. Department of Veterans Affairs (VA) facilities. According to a survey by Veterans Need Care Now, a grassroots coalition committed to reducing surgical wait times, 23% of veteran households report delays in securing VA health appointments and surgical procedures.

Access to high-quality, timely care

Veterans deserve access to high-quality care without long wait times. Reports have shown a lack of access to anesthesia services in the VA, which may be a contributing factor to lengthy wait times along with other factors such as staff shortages, limited space and access to specialists. A national review of staffing shortages at the Veterans Health Administration (VHA) for fiscal year 2021 found anesthesiology shortages at numerous VHA facilities, including in Massachusetts, Rhode Island, New York, Pennsylvania, North Carolina, Florida, Tennessee, Michigan, Indiana, Illinois, Louisiana, Arkansas, Colorado, Oklahoma, Washington State, California, and Minnesota.

Two types of medical professionals are able to deliver anesthesia to patients: physician anesthesiologists and Certified Registered Nurse Anesthetists (CRNAs).

The ability of CRNAs to provide high-quality care, even under the most difficult circumstances, has been recognized by every branch of the U.S. military. CRNAs have full practice authority in the Army, Navy, and Air Force and are the predominant provider of anesthesia on forward surgical teams and in combat support hospitals, where 90% of forward surgical teams are staffed by CRNAs. “The high quality of care that CRNAs can be trusted to provide is reflected in our military, where CRNAs are allowed to practice independent of physician referral and supervision,” said AANA President Angela R. Mund, DNP, CRNA.

While CRNAs care for wounded soldiers on battlefields, and they safely and cost effectively provide quality anesthesia care to veterans here at home, many VA hospitals only allow CRNAs to provide anesthesia under the supervision of a physician anesthesiologist. Requiring an additional person for the procedure can create a backlog of access to critical procedures as well as added expenses. This federal mandate creates an unnecessary barrier to expanding care and exacerbates any provider shortages.

Finding a solution and shortening wait times

Results of a study by RTI International indicated that allowing nurse anesthetists to provide anesthesia services without supervision from a physician does not put patients at increased risk. In fact, no significant difference was found in patient outcomes when comparing the three scenarios studied: CRNAs working alone in the operating room without anesthesiologist supervision, anesthesiologists working alone, and the CRNA and anesthesiologist working together on a case.

During the COVID-19 pandemic the federal government suspended the supervision requirement for CRNAs so more patients could have access to the care they needed. And now, 22 states have opted out of the federal Medicare requirement that calls for physician supervision of CRNAs.

A study by the Lewin Group shows that a CRNA practicing without supervision is the most cost-effective method of anesthesia delivery and that increasing the number of CRNAs and permitting them to practice in the most efficient delivery models will be key to containing costs while maintaining quality care. Based on this evidence, CRNA full practice authority within the VA can increase veteran access to care, lower wait times, and decrease costs.

To learn more about the role and duties of CRNAs, visit VeteransNeedCareNow.org.