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Thursday, 14 April 2016

Princess Health and Teens who talk to their parents about sex make the best choices; Clark County will offer parenting classes on sex communication. Princessiccia

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In an average Kentucky high school class of 30 students, almost 13 of the teenagers say they have had sexual intercourse at least once, but many of them have never discussed sex with their parents.

And while Kentucky parents may think their children are learning about sex in the classroom because Kentucky mandates sex education, they may not realize that the state has no set curriculum for fact-based, comprehensive sex education, and the only thing required to be taught is abstinence -- an approach that has been proven ineffective, Aaron Yarmuth reports for Leo Weekly in an in-depth article about sex education in the state.

This lack of parent-teen communication about sex has prompted a study in Clark County that will include classes to help parents become more comfortable talking about sex with their children, Whitney Leggett reports for The Winchester Sun.

The classes will be led by Shannon Phelps of Winchester as part of her research to earn a doctorate in interdisciplinary education sciences from the University of Kentucky, Leggett reports. It is funded by a $15,700 grant from the Clark County Community Foundation.

�Because the subject matter is not one that many people are comfortable with, part of the objective is to help increase parents� comfort in discussing sexual health topics so they will be more likely to address those topics with their children,� Phelps told Leggett.

"The overall goals of the program are to increase frequency and quality of parent-child sexual health communication, improve parents� comfort and confidence in their communication with their children about sexual health topics and increase openness of sexual communication between parents and their children," Leggett writes. "Topics will range from abstinence to safe sex, contraception, resisting peer pressure and communicating with potential partners, among others."

Phelps said the six week courses will promote parent-child sexual health communication, which is associated with better sexual health outcomes for young people.

�Research tells us that children, especially adolescents, who have parents who communicate with them about sexual health topics have better sexual health outcomes,� Phelps told Leggett. �That follows logic... Sometimes parents are hesitant to talk to their children for fear that they�ll go and have risky sexual behaviors, but research tells us the opposite.�

Phelps told Leggett that studies show that when parents talk to their children about sex, "it can delay the onset of sexual behaviors and reduce unintended outcomes like sexually transmitted infections and unintended pregnancies," Leggett writes.

For more information email Phelps at shannon.phelps@uky.edu, or call 859-621-1065.

A study published in the Pediatric Journal of the American Medical Association found that nearly one-fourth of youth report that they have not discussed sexual topics with their parents, and even fewer report that they have had meaningful, open conversations with them about this subject. The study attributes this poor communication to parental embarrassment, parents' lack of accurate knowledge of the subject, and poor self-efficacy.

It's a topic that needs discussion in Kentucky because almost 10 percent of the state's middle-school students have had sexual intercourse and almost one-third of its high school students are sexually active, according to the 2015 Kentucky Middle and High School Youth Risk Behavior Survey.  The survey found that overall, 41.7 percent of Kentucky's high school students have had sexual intercourse at least once.

And there is an obvious disconnect related to birth control. Kentucky ranks seventh in teen births, at 39.5 births per 1,000 females aged 15 to 19, according to America's Health Rankings. The 2015 YRBS found that 14.5 percent of high school students did not use any birth- control during the last time they had sexual intercourse.

Wednesday, 13 April 2016

Princess Health and April 13th, 2016 As Real As It Gets. Princessiccia

Princess Health and April 13th, 2016 As Real As It Gets. Princessiccia

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April 13th, 2016 As Real As It Gets

I feel like I've been in constant catch up mode over the last couple days. I think I typically do well at replying to questions or just saying thank you for a nice compliment, and replying, especially to emails, is very important to me-so it's been exceptionally challenging for me, mentally, to not be able to keep up of late. The outpouring of support after the Today Show segment has been a monumental blessing to me. As it is most of the time, it might take some time--and especially with emails to transformation.road@gmail.com, but I'll reply when I can!

This experience is an opportunity for personal growth. I believe any challenge worth the effort provides numerous opportunities for growth. I'm in that place, it seems. It feels good. It feels right. Rest assured, if you've posted something to my facebook page--or tweeted me, I sincerely appreciate you and the connection you're making.

If you go back in the archives to September 15th, 2008 and read the Day 1 post, you'll find this at the end:
"I look forward to this blog. I believe it will help me stay on track and maybe along the way it will inspire someone else to stay on track."

I've stayed true to this from Day 1. I maintain this daily blog, the MyFitnessPal logging and the accountability Tweets for me. These are "rails" of accountability and support I've installed along my path to help create stability and ultimately, consistency. I had no idea how many would follow along, relate and be affected in a positive way--and this has been a huge--and very unexpected blessing. I'm passionate about sharing what I do and how I do it--and how these things work for me.

While we're all different--and what works for me may not be what will work for you, over the last seven and a half years I've discovered that the mental/emotional and psychological dynamics are where we find the most common ground, regardless of our individual methods of losing weight. That's what makes this blog all-inclusive.

But again, I do it for me and my continued recovery and healthy weight maintenance. Someone recently suggested how I might be addicted to attention--based on all I do in these efforts. Nope! You got the wrong guy! Here's the thing: I'm going to keep on keeping on regardless of how many or who reads this blog. I'm NOT performing here. I'm being as real as it gets--and I never forget those words I wrote on Day 1.

For those who know me personally and the ones who have worked with me through the two exclusive teleconference support groups I co-facilitate with Life Coach Gerri and Kathleen Miles and the ones I've worked with one on one--they know me--they know very well where my heart and passion lives. They know why I do what I do. They've felt my emotion and heard my tears on the telephone line.

I hope you'll continue following along--and I appreciate the measure of accountability and support it provides me--and it is my sincere hope that something I express, at some point--strikes you in a monumental way.

Ultimately, it's all you, my friend. You're the one doing the work and building the fire within you. If this blog--or anything I say or do, provides a spark--and you diligently turn that spark into a burning fire for change--that, to me, is such a beautiful thing. And I know in my heart--you can do this, too. It's in you. You know how I know? Because I'm no different from you. Sure, our personal life circumstances may be wildly different--but when notes are compared on the mental-emotional elements required along the way, we're remarkably the same. I don't have special weight loss and maintenance powers! If I can choose change before change chooses me--I know you can as well.

The Today Show experience was a dream come true. Would I LOVE to do more of that type of thing?? Of course. I feel very confident and calm in that environment. But if an opportunity like that never ever comes along again, as long as I live--I'm happy, right here. And I will continue doing what I do--right here, every day. Because the bottom line is: I must always take care of me and the fundamental elements of my continued recovery and weight maintenance success...and when I do that, when I take care of me, first and foremost--everything else falls into place.

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This instantly became my favorite picture of mom. There's so much love in her heart and eyes. I wouldn't be where I am today had it not been for this amazing woman. My goodness, I love her so very much.

It was an honor to be inducted into The Joy Fit Club alongside Hope Church. In the picture below, Joy and Hope check out Hope's inspirational bracelet. After our segment was over and we all said goodbye to Joy and other Today Show staff--Hope, her husband Jeremy and I talked for about a half an hour. We concluded that our conversations could have gone on all day. When you get two people together who have experienced a massive transformation in multi-faceted ways, the commonalities seem endless. It was pure pleasure. They're amazing people. I love occasionally featuring other people's blogs--and I've provided the link to Hope's blog on her Facebook page, below the picture. You'll be inspired--I guarantee!
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https://m.facebook.com/Healthy-Happy-Hope-612967995522969/

I'm allowing the Tweets to take me the rest of the way tonight. Are we cool? Good deal. :)

Today's Live-Tweet Stream:
















































Thank you for reading and your continued support,
Strength,
Sean
Princess Health and The More Things Stay the Same - More Apparently Adulterated Heparin, This Time from Chinese Ruminants. Princessiccia

Princess Health and The More Things Stay the Same - More Apparently Adulterated Heparin, This Time from Chinese Ruminants. Princessiccia

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The story of the contaminated heparin just will not go away.  We first wrote about it in 2008 (see first post here, most related posts here, and the longer summary at the end of this post.)

Quick Summary

Baxter International imported the "active pharmaceutical ingredient" (API) of heparin, that is, in plainer language, the drug itself, from China. That API was then sold, with some minor processing, as a Baxter International product with a Baxter International label. The drug came from a sketchy supply chain that Baxter did not directly supervise, apparently originating in small "workshops" operating under primitive and unsanitary conditions without any meaningful inspection or supervision by the company, the Chinese government, or the FDA. The heparin proved to have been adulterated with over-sulfated chondroitin sulfate (OSCS), and many patients who received got seriously ill or died. While there have been investigations of how the adulteration adversely affected patients, to date, there have been no publicly reported investigations of how the OSCS got into the heparin, and who should have been responsible for overseeing the purity and safety of the product. Despite the facts that clearly patients died from receiving this adulterated drug, no individual has yet suffered any negative consequence for what amounted to poisoning of patients with a brand-name but adulterated pharmaceutical product.

Here We Go Again

At the end of March, 2016, per Bloomberg,

Heparin tainted with unauthorized Chinese-made ingredients may be on the market in the U.S. and the Food and Drug Administration hasn�t moved swiftly enough to prevent it, according to a congressional probe nearly a decade after hundreds of deaths were linked to sullied batches of the blood-thinning drug.

This possible contamination is different from the earlier one, when Chinese producers made crude heparin containing a deadly chemical. They may be using cow and sheep intestines to produce the raw material for heparin that is supposed to be derived only from the intestinal membranes of pigs, according to a letter the House Energy and Commerce Committee sent Tuesday to the FDA. The agency has known about the risky practice since 2007, around the time it discovered the chemically enhanced crude heparin, the panel said.

The FDA didn�t react early on 'to credible evidence of non-porcine contamination of the Chinese heparin supply,' according to the letter, only putting out testing guidelines for pharmaceutical companies in 2012. Even after the tragedy of the chemically soiled heparin, the committee said, 'loopholes and exemptions that permit part of the Chinese drug supply chain to operate outside government scrutiny still remain.'

The committee charged that nothing much as changed since the 2008 episode of deadly heparin made from Chinese pigs

The letter from the House committee said the FDA dropped the ball on many fronts and may have allowed unsafe blood thinners to remain on the market longer than necessary. Regulators didn�t properly or widely enough share information and didn�t follow up on leads about tainted heparin from other governments, according to the letter. Agency investigators failed to inform others about dodgy crude heparin makers, the panel said. It also said the FDA didn�t follow up on concerns that heparin with the chemical was recycled after the poison was removed and may have entered the U.S. market. The claims are based on documents that Baxter, Scientific Protein and FDA provided the committee as well as interviews with FDA employees, according to footnotes in the letter.

Also, efforts to investigate the 2008 problem seem to have failed,

The chemical, oversulfated chondroitin sulfate, was connected to 246 deaths and sickened hundreds of people who took the blood-thinning medicine, the FDA said at the time. Regulators never found at what point in the chain in China that the drug, sold in the U.S. by Baxter International Inc., was corrupted. The FDA closed its initial criminal investigation after it became difficult to obtain evidence in China, though it has since re-opened a related inquiry, according to the House committee. Baxter, which recalled its heparin in 2008, hasn�t sold the anticoagulant since. It said at the time it was alarmed that the contamination appeared to have been deliberate, but had no proof of how it happened.


Now the problem appears to be more bovine. It appears that French regulators first noted the problem of imported heparin derived from Chinese cows.

The French National Agency for Medicines and Health Products Safety called non-pig blending a 'critical' violation in an inspection report released in February. France cited China�s Dongying Tiandong Pharmaceutical Co. for making heparin with ruminant DNA, which includes cows and sheep. Dongying is registered with the FDA as a manufacturer of active ingredients and isn�t on the agency�s list of companies banned from importing to the U.S.

Yet, the FDA

considers heparin adulterated if it contains oversulfated chondroitin sulfate or non-pig material, according to an FDA document for the pharmaceutical industry on monitoring heparin quality. Material from cows could pose a risk because of possible contamination with mad cow disease.
Oddly enough, the Bloomberg article did not mention any criticism by the committee of the US based manufacturers who outsourced their heparin production to China.

Outsourcing Continues Unabated


In 2012 we noted that outsourcing by big multinational drug companies based in the US and other developed countries of active pharmaceutical ingredient (API) production to dubious manufacturers based in countries with much less robust regulation was continuing.  I wrote then

To put it more directly, most so called pharmaceutical companies in the US and other developed countries have outsourced the actual manufacturing of drugs. Thus, most companies that appear to be pharmaceutical manufacturing companies are really just pharmaceutical marketing and development companies. (And not so much the latter, look here:  Light DW, Lexchin JR. Pharmaceutical R&D; what do we get for all that money? Brit Med J 2012; 345: 22-25.  Link here.) Pharmaceutical companies appear to be abandoning their core essence, but are content to market drugs  under their logos without telling the patients who take them the real source of these products.  This would appear to be a big scandal, but one that stays curiously anechoic.

In 2016, outsourcing of drugs by big multinational corporations with prestigious names seems to be continuing at a rapid pace.  Per Bloomberg,

The U.S. depends heavily on China for medicine. Along with India, the country is one of the top two producers of base ingredients for drugs in the world, according to the National Academies of Sciences, Engineering, and Medicine.

There is still no clear way for US patients or doctors to identify outsourced medicines, and efforts to better regulate them seem feeble. Thus the danger that patients may be getting ineffective, adulterated, even deadly outsourced medicine in bottles with the logos of big, famous pharmaceutical companies seems to be ongoing.

The More Things Stay the Same

In 2012, we wrote

I have yet to see any discussion with pharmaceutical executives about why their companies hardly make drugs anymore. In the absence of such discussion, I can only speculate that most likely, this is first a product of financialization. Drug company executives, like most organizational leaders, have fallen under the spell that says their only goal should be to increase short-term revenues. It may be cheaper to buy drugs from perhaps dodgy outsourced suppliers rather than manufacturing them them themselves. Continuing stories like those above, and that of the contaminated Chinese heparin suggest that these outsourced drugs are cheap for a reason. It appears that to save money short-term, pharmaceutical executives may be abandoning their most central mission, to provide pure, unadulterated drugs.

The continuing story of outsourced pharmaceutical manufacturing provides yet more evidence that current management dogma may be literally toxic. Once again, I suggest that true health care reform requires leadership of health care organization who put patients' and the public's health ahead of short-term revenue (and the personal enrichment that may result).

It is likely that a number of policy changes will be needed to reduce the threats posed by contaminated or adulterated outsourced pharmaceuticals.  There is one simple step that ought to be taken quickly to at least make the problem more transparent.  In the US, most manufactured products have a label disclosing the country of origin.  In parallel with that, all pharmaceutical containers, and all pharmaceutical labels and marketing materials ought to disclose the country in which the active pharmaceutical ingredient was manufactured, and the name and location of the company responsible for that manufacture.

There seems to be no need to rewrite or update this.

The fact that this problem has been known for 2008 year, but not clearly addressed, shows the pitiful state of American health care dysfunction.  But those with vested interests in preserving the current system remain fat and happy, like the pigs of China.

 Appendix - Heparin Case Summary

- We have posted several times, recently here about the tragic case of suddenly allergenic heparin. Although heparin, an intravenous biologic anti-coagulant, has been in use for over 70 years, serious allergic reactions to it had heretofore been rare. Starting late in 2007, hundreds of such reactions, and 21 deaths were reported in the US after intravenous heparin infusions.All the heparin related to these events in the US was made by Baxter International.

- We then learned that although the heparin carried the Baxter label, it was not really made by Baxter. The company had outsourced production of the active ingredient to a long, and ultimately mysterious supply chain. Baxter got the active ingredient from a US company, Scientific Protein Laboratories LLC, which in turn obtained it from a factory in China operated by Changzhou SPL, which in turn was owned by Scientific Protein Laboratories and by Changzhou Techpool Pharmaceutical Co. Changzhou SPL, in turn, got it from several consolidators or wholesalers, who in turn got it from numerous small, unidentified "workshops," which seemed to produce the product in often primitive and unsanitary conditions. None of the stops in the Chinese supply chain had apparently been inspected by the US Food and Drug Administration nor its Chinese counterpart. (See posts here and here.)

- We found out that the Baxter International labelled heparin was contaminated with over-sulfated chondroitin sulfate, a substance not found in nature, but which mimics heparin according to the simple laboratory tests used in the Chinese facilities to check incoming heparin. (See post here.) Further testing revealed that the contamination seemed to have taken place in China prior to the provision of the heparin to Changzhou SPL. (See post here.) It is not clear whether Baxter International or Scientific Protein Laboratories had inspected most of the steps in the supply chain, or even knew what went on there.

- The Baxter and Scientific Protein Laboratories CEOs did not seem aware of where they got the heparin on which the Baxter International label was eventually affixed. But one report in the New York Times alleged that Scientific Protein Laboratories would not pay enough for heparin to satisfy any sources other than the small "workshops."

 - Leaders of all organizations involved, Baxter International, Scientific Protein Laboratories, Changzhou SPL, the Chinese government, and the US Food and Drug Administration, and the US Congress assigned blame to each other, but none took individual or organizational responsibility. (See post here.)  Note that SPL was recently bought out and taken private, making its current leadership even less transparent (see post here).  A 2010 inspection of an SPL facility by the FDA revealed ongoing manufacturing problems (see post here).

- Researchers (who turned out to have financial ties to a company which is developing an anti-coagulant drug that could compete with the heparin made by Baxter International) investigated the biological mechanisms by which the contamination of the heparin lead to adverse effects, but no one investigated further how the contamination occurred, or who was responsible. (See post here.)

- Hundreds of lawsuits against Baxter have now been filed, so far without resolution. (See post here.)  Efforts to make documents to be used in these cases public so far have not succeeded (see post here).

- A government report which attracted little attention warned of the dangers of pharmaceutical ingredients made in China and subject to virtually no oversight. (See post here.)

-  Despite requests from the US, the Chinese government did not investigate the production of the heparin that lead to the deaths (see post here.)

-  In February, 2011, a congressional investigation of the case was announced, but results were unavailable until now (see above)

-  In June, 2011, a jury returned the first verdict in a civil case about the contaminated heparin, awarding money from Baxter International and Scientific Protein Laboratories to the estate of a man who apparently died due to tainted heparin (see post here).

Princess Health and Peanut butter can be a healthy choice, but you have to read the labels; gimmicks to improve taste not the best for nutrition. Princessiccia

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Peanut butter has long been considered a healthy food choice, and for the most part it still is, but with the advent of low-fat brands, flavored peanut butters and companies adding preservatives to lengthen shelf life, not all peanut butters are equally nutritious, Jose Aguayo and Ryan Canavan report for the Environmental Working Group.

Originally, peanut butter was made from one ingredient: ground roasted peanuts. But now, commercial brands have added sugars, salt, hydrogenated oils and other preservatives, and some are less acceptable than others.

For example, "reduced-fat peanut butters are some of the worst offenders," the authors write. To reduce the fat calories, manufacturers will often take out the healthy monosaturated fats but then add sugar and salt to improve the taste.

Most commercial brands also add hydrogenated oils, as well as preservatives like potassium sorbate, to extend peanut butter's shelf life. The authors note that over 80 percent of peanut-butter brands have hydrogenated oils, which introduce "artery-clogging saturated and trans fats to peanut butter's otherwise-healthy fat profile."

"For a healthy heart, the American Heart Association recommends avoiding foods with hydrogenated oils, including peanut butter," the authors write. So, read the labels when choosing a peanut butter to determine which ones have the least salt, sugar, hydrogenated oils and preservatives, remembering that the healthiest peanut butters are made from just ground roasted peanuts and a pinch of salt.

It should also be noted that while peanut butter can be a healthy choice, it is high in calories and should be eaten in moderation. A standard serving of peanut butter is 2 tablespoons, which is about the size of a golf ball. This amount has about 190 calories.

Tuesday, 12 April 2016

Princess Health and April 12th, 2016 Like Opening Gifts. Princessiccia

Princess Health and April 12th, 2016 Like Opening Gifts. Princessiccia

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April 12th, 2016 Like Opening Gifts

I needed more time tonight in order to share all I wanted to share about the New York-Today Show trip. I'll wait until tomorrow to go into detail.

The biggest difference as far as maintaining the integrity of my plan, for me, was found in the perspective I chose to embrace. It wasn't too many years ago when a special occasion, like this trip, would immediately come with a declaration of defeat. I cannot count the number of times I've said "Well, obviously it's going to be too hard to stay on plan while I'm away--so I guess I'll just do the best I can," which wasn't truthful, ever.

The key phrase here: "...the best I can..." leaves plenty of room for me to play the victim card later, as in, "I was trying to do the best I could--but you should have seen that menu--it was impossible," or "I was famished between flights--and I was trying to do the best I could, but you know how hard it is in a food court!! What's a person to do?"

The words, "I guess I'll do the best I can" is closely related to another phrase I once said all the time in regards to losing weight, the ever popular, "I'll try." Both of these phrases, for me, was always code for: Off-plan, full throttle every step of the way. Yoda said it best: "There is no try. Only do or do not."  I might be paraphrasing Yoda.

I could always formulate fantastic reasons why it couldn't work--and each one with a set of circumstances I could mentally manipulate in order for me to feel good about it all. I was letting myself off the hook. And then, I'd pat myself on the back for being kind to myself in the process. But is it valid? Was ditching my plan of taking extraordinary care and proceeding to stuff myself to excess really being kind? 

Shifting the perspective from "This can't possibly work," to "How can I prepare for this to work in harmony with my plan?" 

For me, now, it starts with my personal set of non-negotiable elements: I will maintain the integrity of my maintenance calorie budget and I will remain abstinent from refined sugar. Those two things are not up for debate. The calorie budget is certainly adjustable if the time comes and it's determined my body needs more to maintain a healthy weight. But it's not adjustable simply because I'm on a mini-vacation. The adjustable approach works well for some--and if that works for you, perfect. For me-- I know, I'd take full advantage. I simply need more structure than most. And that's ok. The abstinence from refined sugar is a super solid non-negotiable. I won't say I'm never going back to eating refined sugar. But I'll say this--I pray I never do. I just can't imagine anything being worth trading away the mental clarity, peace and calm being refined sugar free has created. 

How did I plan for this trip to work well for me? I'll go into more detail in tomorrow night's edition.

Sorry for the cliffhanger! I could seriously write all night. But I'm back on my show tomorrow morning! Sleep calls.

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In the TODAY Show studio.
--------------------------------------------
It was great getting back to the Team Radio Studios this afternoon. I slept in really well. Made it to a 1:30pm meeting and jumped into production soon after. I accomplished quite a lot before a full evening that included the weekly teleconference support group I co-facilitate with Life Coach Gerri and Kathleen Miles, preparing an amazing dinner and getting a super workout.

I'll admit, I'm still a little buzzed after the NYC experience. And I'm especially grateful for the tremendous outpouring of support that's come my way. Reading the supportive messages and comments has been like opening gifts, constantly. Thank you.

Today's Live-Tweet Stream:




































Thank you for reading and your continued support,
Strength,
Sean
Princess Health and Spring fever: If over-the-counter medicines don't quell your allergies, it's a good time to see an allergist. Princessiccia

Princess Health and Spring fever: If over-the-counter medicines don't quell your allergies, it's a good time to see an allergist. Princessiccia

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By Ann Blackford
University of Kentucky

The beauty of spring is upon us, but as lovely as it may be to look at, it can wreak havoc in your nose, throat and eyes. The higher the pollen count, the greater the misery.

Seasonal allergies are the result of a chain reaction that starts in your nose. If you are allergic to pollen, the immune system will overreact by producing allergic antibodies. The antibodies attach cells in your airway and cause release of chemicals, causing an allergic reaction.

Many people find relief in some very effective over-the-counter medications. If OTC medications don't provide relief, or cause significant side effects, this is a good time to visit an allergist. An allergist/immunologist is a pediatrician or internist who has spent an additional two to three years of training specifically in this field.

Allergists will discuss treatment options: typically allergy avoidance, followed by medical management, and lastly allergy injections.

Allergy shots are the only known cure to date for allergic rhinitis (nasal allergies). The concept behind allergy shots � allergy immunotherapy � is that the immune system can be desensitized to specific allergens that trigger allergy symptoms, thereby building up resistance or tolerance to the allergens.

Allergy shots generally work in two phases. The buildup phase can last from three to six months and involves receiving injections in increasing amounts of the allergen and are taken once or twice a week.

The maintenance phase begins when the most effective dose is reached. The dose can be different for each person, depending on how allergic you are and your response to the build-up injections. Once the maintenance dose is reached, there are longer periods of time between injections, typically two to four weeks.

Some people will experience relief of their symptoms during the build-up phase, but for others, it may take as long as 12 months on the maintenance dose. If there is no improvement after a year, your allergist may discuss other treatment options.

Allergy shots are a good option for people with allergic rhinitis (hay fever), allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy. Shots can be given to children as young as four to five years old.

Shots are not recommended for food allergies, but can help in patients with oral allergy syndrome. This syndrome occurs in patients highly allergic to pollens; the body reacts to cross-reacting foods, and causes itching of the mouth and tongue. Allergy shots are not started on pregnant women but can be continued on patients who become pregnant while on shots.

Recently the Food and Drug Admimistration approved allergy drops or sublingual immunotherapy for grass and ragweed allergy. However, most patients have many confounding allergens (i.e. trees, molds, mites, animal danders), which can be included in allergy shots, thus making shots much more effective.

Princess Health and Poll finds many Kentuckians continue to struggle with cost of health care, though fewer are uninsured and struggling. Princessiccia

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While having health insurance certainly eases the cost burden of health care, nearly one-third of Kentucky adults struggle to pay their medical bills whether they have health insurance or not, and two in 10 say they often delay or skip needed medical care because of the cost, according to the latest Kentucky Health Issues Poll.

The poll, taken Sept. 17-Oct 7, found that in 28 percent of Kentucky households, someone had trouble paying medical bills in the previous 12 months. This didn't vary much between those with or without insurance, and was about the same as in 2014.

However, fewer Kentucky adults without insurance said they had difficulty paying their medical bills in 2015 than in 2014: down to 31 percent from 47 percent. In 2014, the Patient Protection and Affordable Care Act was fully implemented in Kentucky with expansion of the federal-state Medicaid program to people with incomes up to 138 percent of the federal poverty level.

According to the Kaiser Family Foundation, the average annual out-of-pocket cost per person for health care in the United States in 2014 was $1,036,which includes costs for any expenses not covered by insurance, says the report.

The Kentucky Health Issues Poll also found that 20 percent of Kentucky households did not get the medical care they needed, or delayed care because of the cost, in the past 12 months. This was more common among Kentucky's uninsured (27 percent) than those with insurance (19 percent).

However, these figures were an improvement from 2009, when 58 percent of uninsured Kentucky adults said they delayed or didn't get needed care, and from 2014, when 38 percent said so.

Poorer adults, those eligible for Medicaid, were more likely to forgo health care because they can't afford it; 29 percent of them said they had in the previous year, while only 16 percent of people with higher incomes said so.

"Being able to access medical care and being able to afford that care are two important factors to improve health in Kentucky," Susan Zepeda, CEO of the Foundation for a Healthy Kentucky, said in a news release. "KHIP data indicate that fewer Kentucky adults are delaying medical care. This helps Kentuckians get and stay healthier, getting timely preventive services and early help with management of chronic conditions like diabetes and asthma and with smoking cessation counseling."

The poll was conducted by Institute for Policy Research at the University of Cincinnati and for the foundation and Interact for Health, formerly the Health Foundation of Greater Cincinnati. It surveyed a random sample of 1,608 adults via landline and cell phone, and has a margin of error of plus or minus 2.4 percentage points.
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