• Food is fuel. Your body is a complex machine that needs the right combination of nutrients to keep it strong. Eating hot, nutritious food all winter will keep the cold at bay.
• Check your medications. Many prescription and non-prescription drugs can impair judgment, making it difficult to realize just how cold you really are. Of particular concern are sedatives, hypnotics, tranquilizers, and antihistamines.
• Sweet dreams. If you are tired, your resistance to practically everything is lower, so get plenty of rest.
• Don’t smoke. You may feel warmer when you smoke a cigarette, but as with alcohol, it’s not real warmth. Smoking actually narrows your blood vessels so that less blood circulates through your body.
• Dress for the weather. It is just common sense to keep your feet and hands warm during the win­ter, but do you ever think about your head? You can lose about 20 percent of your body’s heat through your head because of all the blood flow­ing through your neck and brain. So always wear a hat, scarf, or earmuffs to keep your head warm. Make sure they’re made of wool, acrylic, or the new “outdoor” materials. And remember to layer your clothing, even when you’re indoors.
• No singin’ In the rain. A wet chill can be more dangerous than dry cold, so always have a water­proof jacket available if you’re going to be outside. Take special care if you participate in outdoor winter activities around water.
• Set the thermostat. Winter is not the time to skimp on your heating. You should keep your house at a temperature of at least 65°.
• Stay active. Indoors or out, you should keep mov­ing. Avoid sitting too long at that park bench, and break up TV time with a few light chores or an errand. In this way, you can generate your own source of heat.

 Hypothermia comes, just like the fog, on little cat feet, and, more often than not, will leave you unaware that your physical and mental abilities are shutting down. Practice good preventive wintertime habits and you won’t get caught in the cold.

It’s time to see your doctor if you have arm, elbow, or shoulder pain and:

• Chest pain
• Lightheadedness, fainting
• Sweating
• Nausea
• Shortness of breath

 These are the warning signals of a heart attack, but not every heart attack has all these symptoms. If you notice several of them, don’t wait. Get help immediately.

•  You’ve injured it within the past 24 hours
• The injured area is misshapen
• You’re unable to move it

 It’s possible you have a fracture, dislocation, or serious injury. Get medical treatment at once.

•  Wheezing
• Chest pain
• Unexplained weight loss
• Weakness and fatigue
• Persistent coughing

Together, these symptoms could indicate lung can­cer.

•  Fever and chills

 You may have an infection that needs immediate medical care. Lyme disease is one example of a bacterial infection that affects the joints.

•  Morning joint stiffness
• Limited movement and dexterity

 This could mean osteoarthritis, a condition where the cartilage in your joints gradually breaks down. Usually, you will feel an aching pain when you move or put weight on your joints.

•  Tenderness and limited movement
• Worse pain when joint is bent
• Fever (sometimes)

 Bursitis is an inflammation of the soft tissue around your joints. Rest, along with aspirin or aspirin substitute, should clear up the problem in a few weeks. But if the pain persists, see you doc­tor.

•  Swelling
• Warmth In affected area
• Muscle pain or tenderness that Increases with motion

 If you have these symptoms, you may have ten­dinitis, an inflammation of one of your tendons. It is often caused by an injury, or by repeating the same motion over and over.

Many times our ankles will swell for simple, easily explained reasons.  If you have just ridden for several hours in the car or on an airplane, you may find your feet and ankles are swollen.  In this case, there is no medical problem. Next time you travel, simply try to move about more frequently and elevate your legs if possible.  The problem should not last for more than 48 hours. But sometimes, ankle swelling can mean something more Serious.

It’s time to see your doctor if you have ankle swelling and:

Joint pain / Redness and warmth in the joint

These could be the warning signs of arthritis, an inflammation of the cartilage and lining of the joints. Because the foot and ankle region has so many joints (33 to be exact), it is particularly vulnerable to arthritis. And remember, people over 50 are at higher risk. Don’t put off seeing your doctor.  Although arthritis cannot be cured, it can be treated; but if left unattended, the disease can become disabling.

• Take a prescription or non-prescription drug
• Consult a doctor on possible side effects or reactions to any drugs you are taking.
• A recent injury to your ankle
• Pain or tenderness
• Bleeding or bruising
• You can’t put weight on your ankle
• Numbness, tingling or paralysis in your foot
• No pulse in your foot

It is possible you have fractured a bone in your ankle or upper foot. As you age, your bones become thinner and more brittle. Even a slight injury can break one of the small bones around the ankle joint. Don’t delay seeing a doctor, especially if you are experiencing numbness, tingling or loss of pulse in your foot.  If you break a bone, setting it becomes more difficult after several hours.

Pain and a persistent itch in the affected area Distended veins in your ankles

You may not be experiencing an actual problem with your ankles, but rather a condition called varicose veins. This occurs when veins, usually in the legs, become swollen and twisted. They will appear larger and much bluer than normal. There are various causes of the condition, but few cures besides surgery.

• Pain in the ankle, calf or thigh which does not go away with rest.
• Tenderness and redness in the leg/foot area
• Pain when walking, raising your leg or flexing your foot
• Fever
• Rapid heartbeat

Sometimes after a long period of bed rest due to surgery or illness, blood pools in your veins, especially in the legs. If a clot forms within the veins of the lower legs and restricts blood flow, you may develop deep-vein thrombosis. Being overweight, smoking and taking estrogen increase the risk of this condition. You can help prevent it by giving up cigarettes, especially if you are taking estrogen; losing any extra pounds; and staying as active as possible even if confined to your bed.

• Shortness of breath or difficulty breathing, especially when lying down
• Fatigue or weakness
• A cough that is worse when you are lying down
• Wheezing
• Rapid or irregular heartbeat
• Low blood pressure
• Swollen neck veins
• Enlarged liver

These symptoms could mean you have developed a heart complication, called congestive heart failure, as a result of another disease or illness. High blood pressure, heart attacks, emphysema, or various infections can cause the heart to stop pumping as strongly as it should. Blood backs up into other organs, especially the lungs and liver, and these symptoms appear.

• Moderate to severe pain following an ankle injury
• Redness or bruising
• Difficulty moving ankle
• Difficulty putting weight on injured foot

You may have one of the most common injuries to the ankle: a simple sprain. This means you’ve stretched or torn your ligaments, the strong tissues attached to your bones. A sprain can happen any time the joint is stressed, usually if weight is placed on it at an awkward or unnatural angle. Sprains can range from mild to severe, and the pain can be slight to intense. If you find the discomfort is still quite strong, even after a couple of days, you should see a doctor or physical therapist.

Luxury Hospitals

When you first enter the Rancho Mirage suite you will see a bed in one room and a sleeper sofa in another.  There are fine linens, a flat-screen TV and original artwork — and is serviced by a private chef but guess what?  This is no hotel room.

It’s one of 24 luxury hospital suites at Eisenhower Medical Center — and a prominent example of how local hospitals are borrowing pages from the hospitality industry’s playbook to keep their customers happy.

Eisenhower also offers free valet services and a concierge to patients in the suites in the Greg and Stacey Renker Pavilion.  The Desert Regional Medical Center in Palm Springs also offers free valet, and its cancer center offers free tai chi sessions and chair-side massages.

The American Hospital Association doesn’t keep statistics on how many hospitals offer luxury-style amenities, but their spokeswoman Elizabeth Lietz said the association has heard about similar services across the country. “It’s more to accommodate not just their physical needs but their psychological and emotional needs, as well,” she said.

In the past few years, hotels have started making guest rooms and lobbies more like living rooms, said David Renker, who worked in hospitality marketing for 25 years before becoming a marketing specialist for Eisenhower.

“It’s the same concept in health care,” he added.

Denise Burkett, who worked on the design of the Renker Pavilion, said the design of health care facilities increasingly resembles that of hotels and resorts.

“You’re creating an experience for people who are staying in a hotel as well as people in a hospital environment,” she said. “(The latter) is more important because people are at their most stressed in this kind of environment.”

Renker said Eisenhower built the pavilion, named after his brother and sister-in-law, in response to patient demand for more private rooms and more space.

But the hotel-style upgrade also comes with a hotel-style price. Pavilion patients pay an extra fee ranging from $395 to $695 per day depending on the size of the room. That fee isn’t covered by insurance.

Still, hospital officials are quick to point out that while upgraded rooms are available, the caliber of medical care is the same no matter where a patient chooses to stay.

“The clinical care of patients is the same high quality here as it is throughout the entire organization,” said Lynda Sakai, the Renker Pavilion’s clinical director. “What’s different in Renker is they have these amazing accommodations.”

Renker said rooms in the pavilion include wall coverings, hardwood floors, rich textures and warm colors.

“You expect to walk into a hospital room and have a lot of white and a lot of steel,” he said. “We consciously tried to change that.”

The challenge in designing the Renker Pavilion was creating the look and feel of a resort while meeting the operational and code requirements of a hospital, Burkett said.

“Frankly, it’d be easy to take a wing of a hospital and create a Four Seasons there,” she said.

But to create a hotel-like environment that’s also a working hospital unit required designers to find materials that can support heavy medical equipment, withstand frequent cleaning by stringent solutions and the like, she said.

The combination posed some challenges for the hospital staff as well, Sakai said.

“When you walk in a normal floor, your patients are almost next door to each other,” she said. “(In the Renker Pavilion,) there’s a quite a bit of space between the rooms, so the nurses realize there’s a lot of walking going on.”

Joan Scully, 74, of Palm Desert noticed the difference when she stayed in a Renker room after emergency surgery on a broken hip last month.

She said she was reluctant to leave the main hospital after surgery, but her daughter talked her into a Renker room.

“Somehow they’d moved me into the Four Seasons,” Scully said.

In its first year, the pavilion has seen all sorts of patients and diagnoses, officials said.

“I think our biggest volume would be cardiac-related, but we’ve done orthopedics, we’ve had oncology, and we’ve done general surgery as well,” Sakai said. “Overall, it’s been a huge variety of patients.”

While the 24-bed unit hasn’t yet reached full capacity, Sakai said officials have been pleasantly surprised with the number of patients who have stayed there over its first year.

Still, not all local hospitals have decided to put on — or resemble — the Ritz.

John F. Kennedy Memorial Hospital in Indio does not have valet parking or other luxury- style amenities, said Linda Evans, the hospital’s public relations director.

“We don’t need that since we have plenty of close-by patient parking,” she said. “What we emphasize is our customer service and our quality of care.”

Doctors that are licensed to practice in Illinois can be easily researched by going to the web site of the Illinois Department of Financial and Professional Regulation (www.IDFPR.com). Just by pulling up this site, users will have access to all of the information they need to make an informed decision about selecting a doctor. 

The site is very user friendly and explains the steps necessary to search out a doctor. You are not required to log in or register in any way. Seekers can search by the doctor’s name if checking on a specific doctor. The site also allows searching by city, county or by medical specialty.

Once you have the doctor’s name, you can open their profile page to read a host of information. You can select from several tabs to view the doctors years of practice, schools they’ve attended, hospitals they are affiliated with, and much more.

Users will also be able to view any malpractice suit information, or disciplinary action that is available for the physician. Whether you’d like some background information on your current physician, or you need to find a different doctor in your area, this would be a good place to start.

Having access to this information will help Illinoisans make an informed decision, when it comes to something so important, as selecting a physician. Sometimes you are even referred to a physician by your own doctors, when specialized services are needed. You don’t know anything about this stranger, but you are supposed to basically “put your life in his or her hands.”

Searching out this doctor’s profile and getting to know him or her a little better, will add to your piece of mind. Patients have the right to this information, and now it’s readily available with just a few clicks of the mouse.

Medical malpractice suits have skyrocketed in Illinois alone. According to the National Practitioner Data Bank, $362,000.00 was paid out by physicians in 2003, due to malpractice suits. Because of this, the insurance doctors pay has also went up. Many long time and trusted doctors have had to leave the area, and set up their practice in states where costs are not as high.

Some Illinois residents have been left searching for a new doctor to trust their health to. Finding and trusting a new doctor can be an overwhelming decision, especially if your former doctor has been treating an ongoing condition. Having easy access to the information about the other doctors in your area can relieve some of the stress when faced with choosing a new doctor.

You have the right to know who is treating you when you visit the doctor’s office. Do your home work, and add to your piece of mind. Trusting your doctor is the first step of a good doctor/patient relationship.

In 1929, a managed care pioneer by the name of Dr. Michael Shadid began a cooperative health plan for rural farmers in Elk City, Oklahoma. The members who enrolled in his plan paid a predetermined fee and received medical care from Dr. Shadid. In the same year, the Ross-Loos Medical Group was established in Los Angeles, and it provided prepaid services to county employees and employees of the city’s department of Water and power. Its members paid a premium of $1.50 a month. In 1982, the Ross-Loos Medical Group came to be known as CIGNA Healthcare.

Also in 1929, the Baylor Hospital of Dallas, Texas initiated a prepaid system that provided medical care to about 1500 teachers. This was the birth of the health care company we know today as Blue Cross. Because Blue Cross only provided coverage for hospital services, the Blue Shield plans were created to cover doctor services, hence the name Blue Cross/Blue Shield. The premiums for this coverage were subsidized through government tax breaks, keeping them reasonably low.

Dr. Sidney Garfield and several of his associates ran a similar prepaid health plan in 1933. Together, they provided medical care to 5,000 construction workers at an aqueduct project in LA. Workers compensation insurance companies contracted with them to cover accident cases, while the construction workers contributed from their own wages for other medical services.

A few years later, Dr. Garfield set up a similar medical program for Henry J. Kaiser, providing prepaid medical care to his workers at the Grand Coulee Dam. This was the beginning of the Kaiser Foundation Health Plans, which provided comprehensive medical care to Kaiser Construction Company workers and families. After the second world war, Kaiser made his medical care plan available to the public, believing he could provide millions of Americans with comprehensive, pre-paid medical care at affordable prices. 10 years later, the Kaiser Permanente health plan had more than half a million members enrolled, and a growing network of clinics and hospitals.

Over the same period, several other prepaid group insurance plans developed, such as the Group Health Association (GHA) in Washington, DC, a non-profit consumer cooperative founded in 1937 to lower the rate of mortgage loan defaults that resulted from crippling medical expenses. Other similar organizations included the Health Insurance Plan (HIP) of Greater NY, founded in 1944 to cover city employees, and the Group Health Cooperative of Puget Sound, in Seattle, WA, formed after the war in 1947 by 400 families, each contributing $100.

With the 2nd world war raging in the 1940’s, labor was in short supply, and the government imposed wage controls. To deal with this situation, employers begun to offer health insurance as a fringe benefit to attract more workers. The government sought to encourage this new development, offering businesses income tax exemptions for health care related expenses. This begun the current trend of the employer as a health insurance supplier.

Initially, Blue Cross charged the same premium to everyone, regardless of sex, age or pre-existing conditions. This may have been because the Blue Cross was a quasi-profit organization, created and run by hospitals whose focus was on signing up new hospital patients. This changed as more private insurers entered the market. As bottom-line driven organizations, they revamped the rating system, basing it on relative risk. In this way, they were able to charge the riskiest potential customers higher rates or avoid insuring them altogether. To survive in the changing health care market, Blue Cross adopted the same rating systems. In time, they lost their tax advantage and today, they are virtually identical to most other health insurance companies.

These early health insurance companies were indemnity organizations, reimbursing health care providers on a fee-for-service basis. However, as improved medical technology and bureaucratic inefficiencies rose, more and more non-profit health maintenance organizations (HMOs) were founded. Their goal was to achieve better management of services and to emphasize preventive care while controlling health care costs. A similar pattern played out, as the HMOs became increasingly successful. Private insurers coveted their success and soon enough, for-profit HMOs proliferated, and once again dominated the market.

The enactment of the Medicare and Medicaid legislation in 1965 was a landmark in the history of managed health care, by extending coverage to millions of additional Americans. It also hastened the end of segregation in hospitals, as segregated wards were ineligible for federal payments.

In the early ’70s, a nationwide focus on health care developed, with interest groups pushing for reforms in the healthcare system, particularly cost, access to services for the uninsured, the poor and for minorities, delivery systems and consumer rights. The result was the HMO Act of 1973, which had three main provisions:

· Grants and loans were provided for the planning and start-up of new HMOs, and for the expansion of existing HMOs
· State-imposed restrictions on HMOs’ development were overridden if the HMO was federally certified
· The dual choice provision, which required that employers with 25 or more employees offer federally certified HMOs in addition to the traditional indemnity coverage

Managed care has since grown steadily throughout the ’70s, ’80s and 90s. In 1996, more than 600 HMOs were in operation, with almost 65 million members – that is one-fourth of the country’s population! There has been a gradual transition to managed care programs, as enrollment surged from 40% in 1990, to 90% today. All indications are that this trend will continue.

Today, that region is home to 500 plus biomedical companies, including the Burnham Institute for Medical Research, which opened a new $85 million Florida laboratory in Orlando’s Lake Nona community on May 15, 2009.

If San Diego’s 40-year-old renowned life science cluster is a mature oak tree, then Orlando’s new 600-acre “medical city” in Lake Nona is a rapid-growth sapling on steroids.

Medical City in Orlando

New biotech and pharmaceutical companies are expected to sprout up around the medical facilities already planned or coming out of the ground at the Lake Nona community.  And new high speed trains will link the region to Tampa Bay.

The projected end-result: a vibrant new Central Florida research center employing more than 30,000 people with an $8 billion economic impact.

And officials aim to accomplish all this in a fraction of the time it took San Diego to build its life sciences cluster.

The key: La Jolla, California-based Burnham.

Lessons from San Diego

The coastal San Diego area — once heavily dependent on the tourism and defense industries, like Orlando — successfully diversified during the past few decades to became one of the country’s top life sciences clusters. “Now that it’s mature and the baby has grown up, it’s easier to attract companies,” said Brent Jacobs, a senior director with Cushman & Wakefield in San Diego.

It started with the University of California San Diego’s medical school and research institutes like the Scripps Research Institute, the Salk Institute and Burnham. In the 1960s, they clustered around the ocean bluffs of the city’s Torrey Pines Mesa area of La Jolla.

Much of the initial economic development was organic, with San Diego researchers starting small biotech firms, some of which eventually got bought out by bigger companies. “Things happened here not so much by revolution, as evolution,” said Joe Panetta, president of Biocom, an association representing more than 575 biotechnology and medical device companies in Southern California.

In 1985, the UCSD Connect program was founded to foster biotech entrepreneurship by connecting three main ingredients: research institutes that create intellectual property; talented people who make discoveries; and entrepreneurial venture capital and management skills to develop a discovery into a marketable product.

San Diego developed its renowned biotech cluster due to investment in research; collaboration between industry, government and academia; and the entrepreneurial spirit of business and government leaders, said a 2001 study by Harvard University Professor Michael E. Porter.

And San Diego industry leaders foresee Orlando’s biotech cluster developing much faster.

Although growing a research institute from scratch typically takes a long time, said Duane J. Roth, CEO of the UCSD Connect program, Florida jump-started that process by recruiting Burnham, an existing one.

Orlando also now can see what did and didn’t work in San Diego, said Biocom’s Panetta. “You’ve got the benefit of 20-20 hindsight.”

Collaborative cluster

To be sure, it will take a few more years for the rest of the Lake Nona medical city facilities to be completed and for partnerships to get going.

But the $350 million incentive package Burnham got from Florida in 2006, plus support from Orange County, the city of Orlando and the Tavistock Group, allowed it to acquire top talent and technology for its new Orlando facility in a year, as opposed to a decade, said Burnham President and CEO Dr. John C. Reed.

Just in the past 18 months, Burnham at Lake Nona has recruited about a dozen lead scientists and eventually will have a total of 300 employees.

When Burnham announced plans to build a facility in Lake Nona, others quickly followed suit: Nemours decided to build its new children’s hospital there and plans for a new VA Medical Center were approved.

Other medical projects in the works: the University of Central Florida College of Medicine and Health Sciences campus, the University of Florida research and academic center and the M.D. Anderson Cancer Center research center. And most of these groups plan to collaborate on research.