Breast Cancer – Race for the Cure Austin, Texas

In women, breast cancer is the most common cancer detected, and according to the American Cancer Society, accounts for one in four cancers diagnosed.  On Sunday, November 1, 2009 at 7:30 am. in Austin Texas, the Susan G Komen Austin Foundation Affiliate will hold the Komen Race for the Cure at the Domain shopping area in Austin Texas.

If you’d like to participate you can find out the more or Register to participate in the 5k or 3.1 mile race. There is also a one mile walk available and the race will be held rain or shine.

Quick Facts about Breast Cancer:  (from the American Cancer Society)

* One in 8 women will be diagnosed with breast cancer

Risk Factors for Breast Cancer

* Age (risks normally will increase with age)

* Family History

* Early Menarche

* Late Menopause

* Breast Density

* Obesity

* Use of combined estrogen and progestin menopausal hormones

* Alcohol  Consumption

* Physical Inactivity

It is important for women to be well educated about the risks of breast cancer and how early detection saves lives. Please remember however, that statistics are only statistics, and when looking at the numbers regarding reported incidences of breast cancer, that perhaps the most important element in preventing breast cancer starts with you! Meaning, that you listen to your body and if you think there is an abnormality in your breast, even if you are not at high risk for breast cancer, that you get checked by a physician. And if you detect a lump in your breast and your physician will not send you for a mammogram, get another option, or call your insurance company and find out if you can just schedule your own mammogram directly with either a hospital or radiology clinic in your area that offers mammography services. It’s your body, and please make sure that you don’t rely only on statistics if you find a lump or are having symptoms. Get to a doctor to be checked and if the first doctor doesn’t listen to you, find another doctor.

Resources: Find a Texas Hospital, Austin, Texas Hospitals

Meet Your Patients With Their Clothes On

What You Read Here May  Surprise You – Things You Didn’t Learn In Medical School
Best Practices in Healthcare – Part II of the Series, How the Initial Patient Meeting Helps Set the Stage for Trust and Communication Between Doctor and Patient

Part II

The Mayo Clinic in Rochester, Hospital in Minnesota Case Study

In Part I of this series on 1st Impressions when Meeting Your Patient, we discussed how clean, bright, attractive offices play a part when establishing a positive first impression. In this segment, however, we’ll discuss some simple tips for helping your practice be a practice of choice with patients.

Warning: Side Effects of implementing some of these practices may result in you or your organization receiving additional referrals and business from other patients, so don’t read any further unless you could use some easy, practical tips for adding additional patients to your practice.

Here is some information you can use right away:

When you meet your patient for a discussion, give that patient the opportunity to keep their clothes on!

Let me explain. So at the Mayo Clinic in Minnesota, the offices, as I mentioned earlier, have one thing that I haven’t yet shared with you. They have a small curtain in the offices so that the office has a private area for undressing right in the exam room. Now some of you will say this is impractical or that you don’t have enough space in your offices to do this, but the one setup at the Mayo clinic didn’t take up much space, and had hooks for patients to hang their clothes up and again, was standard in every exam room I viewed.

Why, you may ask is this important? We’ll let’s take a look at the dynamics that are created with a typical office visit or facility that is not setup like the Mayo Clinic.  We’ll come back to the waiting room and check in process in another article, but for our purposes today let’s take you (put on your patient hat please) and imagine you are the patient. Ok, so you, as the patient are taken back into an exam room, that’s way too cold for comfort. It may have an overabundance of white walls and floors —who said healthcare offices had to be white and that any pictures on the walls if they are even present look like they were snatched up as a last resort at one of the discount stores close-outs. Now, there’s nothing wrong at purchasing pictures at the local discount store, and you don’t have to spend much at all, to make a pleasing environment, but you do have to put some thought into it in terms of what colors, (not white please) will be most appealing to both you, your staff and patients when entering your exam rooms. If you are design challenged hire a design student or college student to help you, but make the room visually appealing please.

Now back to the attire or clothes issue or lack thereof in most health care practices. So, you as a patient are put in this stark white room that is so cold and bright that it makes your head spin, and are then told to undress and get in this little gown, open in  the front or back depending upon which type of exam you will be getting, and then you are left to sit on the exam table usually, with the crinkly little paper sheets until the healthcare professional finally shows up to grace you with their presence. In the interim, you may or may not have some tag eared magazines to read, or you may simply try to determine how quickly you may be seen by the noise of the doors slamming or closing in every room that is near the one you are in. As the doors and commotion is heard outside the exam room in which you are sitting, you are making assumptions about the practice, the practitioners etc. In some offices, patients may wait for close to an hour or more, in these cold, uncomfortable, and annoying environments,  depending on the practice, and then when the provider comes in beaming and smiling and hurriedly glancing down at the chart saying “Hello Ms. or Mr. Smith, my name is  ________ and how are we doing today?”  Do you wonder as the provider why your patient may not be exactly in the right frame of mind to not only meet you appropriately, but feel good about this encounter?  Meeting, especially as a new patient, a provider in this type of scenario doesn’t exactly put the patient at ease, and actually, isn’t good for the provider either because if you have a patient who is comfortable, you are more apt to be able to get a more complete and accurate history.

Ok, so I think you get the picture. Now, let’s contrast this by how the Mayo Clinic handles their patient appointments.  When your appointment time is called you are escorted back to a nicely decorated exam room, with warm inviting colors that has the comfortable bench and a small area at the back with a rounded curtain (like the ones you sometimes see for rounded showers).  The pictures are the walls actually look like they were “chosen” to be there, and although I’m sure that there are waiting times during emergencies that would make the situation different, but in most cases, patients are seen within minutes of being placed in the exam room. Someone at the Mayo Clinic obviously has put some thought into the temperature of the room, because the feedback I received patients was that it was not too hot, nor too cold in the exam rooms. Obviously, this is somewhat subjective, but I don’t think there’s anything written in stone which says exam rooms have to be freezing! Ok, on with the process at the Mayo clinic. So the patient is in the exam room, but has not been asked to undress yet, and meets their provider fully clothed. Note: seeing the patient fully dressed can actually yield clues about the patient that you would not see if you had them disrobe before meeting them. Now who do you think will be able to get a better history? The practice that has made the patient wait – with minimal clothing, or the Mayo Clinic Practice who has setup an environment to make the patient feel comfortable and has given the patient the chance to meet the healthcare provider on equal footing. Once the patient has met the healthcare provider, the patient is asked to disrobe using the small curtain area right there in the room, while the provider sets has access  to the computer in the room and waits for the few minutes that it takes for the patient to change into the exam gown. Now, I know some of you will say but this can waste time, I need the patient to be ready when I come into the room etc. or others who would say there’s no way to minimize the wait time, there are emergencies etc. And I will say to you that’s true, there are emergencies and patients understand this, so if you’re going to have them wait longer than a certain amount of time, how about communicating this to them and/or rescheduling for another day if you’re way behind. In terms of time wasted, there are ways using the computer in a room where you can actually work on something while the patient changes, and in the visits I was viewing at the Mayo Clinic, it only took a few moments for the patients to disrobe because somehow knowing that the physician was in the room, made the process much quicker. And the patient isn’t worried that someone will open the wrong door and there they will be in all their glory, because they have a curtain giving them privacy while they quickly change.

Somehow, during my visit with more than 7 different healthcare providers at the Mayo Clinic, all of them managed to be on time, and this happened on 2 separate visits.  Just some food for thought. All of you may not be able to incorporate this into your practices but I hope I’ve given you something to consider about how you setup your interactions with patients. The one thing to remember is that when looking at your procedures for waiting room, check in, and exams, is to think like a patient and not like a provider in order to come up with best practices that will work for your office and will therefore as a side effect, bring you increased numbers of patients and more importantly, have more patients who are satisfied with the quality of their care.  It’s no wonder why the Mayo Clinic has waiting lists of patients from all over the world who wait for months to get in to see them. What lessons can be learned and implemented in your practice?

Meeting Your Patient – 1st Impressions are Everything

Best Practices in Healthcare – How the First Impression during the Initial Patient Meeting Helps Set the Stage for Trust and Communication between Doctor and Patient

Part I: Looking at the Mayo Clinic in Rochester, Minnesota 
Stay Tuned for Part II which will show you how your practice can implement some simple things which can make a world of difference in patient care and patient perception

Obviously, there are many things that need changed within our healthcare system. But what about those times when we see organizations doing things not only “right” but setting an example that is “GREAT”.  It’s important to recognize the outstanding practices within certain healthcare organizations that work well, and to emulate those if possible within our own organizations so that we can fix the things that need fixing, and make improvements in the areas that can be enhanced.

So in today’s Best Practices in Healthcare segment, I’d like to discuss how a Minnesota Health Care Organization, The Mayo Clinic in Rochester, Minnesota sets up meetings with new patients. Remember, you never get a chance to make a first impression and there’s a reason why patients travel all across the world to obtain their healthcare at the Mayo Clinic. Let’s look at some possible reasons why.

The medical offices for each clinician at the Mayo Clinic that I saw,  are standardized. This helps if you’re looking at purchasing desks or equipment, because if you’re in purchasing, buying items in bulk often makes it easier to obtain a discount on rates. And, if nothing else, having the same setup in terms of your clinician staff rooms makes it easier to standardize in terms of procedures, equipment etc.  Alright, so that’s an oversimplified view of the economics of the office setup for a practitioner. What about the dynamics of the patient’s viewpoint?

As a new patient at the Mayo Clinic, when one enters the office of a practitioner, because they are standardized, what you will find are clean, bright, and comfortable offices. Each desk is connected to a seating area, similar in some respects to a built in that you would see in some kitchens which maximizes space and increases comfort. You won’t find hard, uncomfortable chairs here, but rather, padded built ins.  Making the patient comfortable is the first step in establishing a trusting relationship and giving the patient the opportunity to feel more relaxed and therefore more likely to share more easily the details that could lead to the practitioner being able to get a complete history and therefore more accurate diagnosis.

Navigating around to different areas of the Minnesota  Mayo Clinic is also easy, there are standards in terms of how signs are used, and each elevator clearly shows which part of the building you will be taken to, making it simple for all age patients to get where they need to go, on time and without much stress.  Pictures, plants, and music are strategically placed around the clinic which also helps reducing stress and making the experience more pleasant for the patient and family members who receive care in this Minnesota healthcare organization.

In the next segment of the Best Practices in HealthCare I’ll talk about one of the other practices that the Mayo Clinic uses in their initial meetings with patients and clinicians that leaves a great impression with the patients and is easy to implement, yet is not normally done in most physician offices as a standard practice. Stay tuned and thanks for reading this edition of Great Practices in Healthcare by HospitalSoup.com

Healthcare Costs – What is The Cost of your Procedure?

Buyer Beware in Healthcare – Some tips to Find out the Real Cost of A Medical Test or Health Care Procedure

Part One of our Investigative Report on Getting Pricing information in Austin Texas Hospitals and Outpatient Imaging Centers in Texas

Everyone’s talking about healthcare reform these days, but just what are some of the important healthcare issues, and which ones should you as a consumer, be concerned about right now?

One of the most crucial elements in terms of fixing our healthcare system should be to establish more transparency in terms of pricing among our health care providers.  There are discussions about pricing and discounts and you may think as a consumer that you may be offered a “cash pay” discount if you offer to pay in full or upfront for a particular test or medical procedure. But even those who consumer themselves savvy consumers may find themselves wondering what the “real” price is of a procedure.

We recently sent a reporter on an assignment to try to obtain pricing costs from different providers in the Austin Texas Area, including Texas Hospitals, Texas Outpatient Facilities and Imaging Centers in Texas.

Here’s an overview of how to try to obtain cost information for medical procedures. Note, your mileage may vary, and plan to spend much time on the phone, but here are some tips that may help you in this process.

1. Step One: The first thing you need to determine when you are having a medical test done is if you will be using insurance or not. Some of you will obviously have healthcare insurance while others may not, but there are different costs of a procedure which can vary widely, and one of the things you need to know is that some facilities will be less if you pay up front and in cash, while others may actually charge you more. And this can also vary depending upon the procedure, the facility, and the test. 

2. If you can, ask your doctor for the CPT Code, which stands for Current Procedural Terminology, and is the number that is assigned to a particular procedure or task within the healthcare community. Doctors, hospitals, and other healthcare providers and medical professionals use CPT codes for billing and reimbursement purposes.

Note: If your doctor has not provided you with a CPT code but you are interested in getting a price for a service, sometimes you can call the scheduling office first, for example, of an imaging center, or a hospital facility, and ask them for the CPT code for a particular procedure, then write this number down and use it when you are speaking to the billing department when trying to obtain the price.

2. Step Two: In order to get the cost of a procedure your best bet will be to ask to speak to the billing manager of the facility where you are considering going for your test or procedure.

3. How to Ask for Pricing Information: Tell the billing manager you are interested in finding out the price for a particular service or procedure. You may be asked to provide the CPT code, which if you have done your research in advance you will already have. The initial price you will be given will probably be the “regular price” which is not necessarily the best price.  Here’s where you will need your patience and ability to remain on the line to question further.

If you will not be using insurance, ask the billing manager if they have a cash discount option or what is the best price for a patient who will not be using insurance. You may be surprised to learn that your “cash discount” price may be higher than what your insurance company would be charged, even though you are paying in cash, at the time of service while your insurance company could take weeks or even months to pay.

If you have insurance you may have another hoop to jump through. Did you know that the providers of services are not required to disclose the prices to you, the consumer, that you would be charged if you are using your insurance company to pay for a service?  You may get that information depending on the facility and whomever you happen to get on the phone on that particular day and time, but they are not required to disclose this information to you.

According to a leading insurance company representative who wishes to remain anonymous, the providers themselves, own the rights to the actual cost amounts, or contracted amounts that they pay the insurance companies. So, as the consumer, even though most of us have lifetime limits on our insurance company policies, and it is in our best interests to know how much we would be paying on tests that are done, especially if we have the time to “shop around for healthcare”  and are not in an emergency room situation, are not being currently provided with the actual costs for our own healthcare?

This is absurd and absolutely needs to be changed. What other service or product that we would purchase would we have to pay for or have deducted from our “limits” on payments when we don’t know or can’t get the amount that a service costs?  In part two of our series on Healthcare costs we will share with you the actual variances that we received on pricing for the cost of a CAT scan in Austin Texas. Note:  the range was between $250.00 and $1650.00 for the same test. So it does pay to do your research up front, and to understand the real costs of healthcare. 

Note: as I mentioned in the article above, one of the things we discovered was that if using a “negotiated” or contracted rate which would be your insurance company discount, that facilities are not “required” to provide you with that information. Because this is not currently a law that there would be transparency in making pricing information available to consumers, one of the ways that some of our colleagues are dealing with this now is by refusing to use any facility that does not offer at least a range of pricing or attempt to be helpful to a consumer seeking price information. Now, granted, it is impossible for a facility to be “exact” with some amounts of testing, because, let’s say for example, the patient arrives at the testing facility and the radiologist on staff determines that there needs to be more than one view or picture taken of a certain area. Or perhaps the price that was obtained was given “without contrast” which means that the exam was initially supposed to be done without having the patient drink or receive fluids which would illuminate certain areas for testing, but it is later decided that the exam needs to be done with contrast or adjusted in some other manner. Of course, the pricing in these situations would need to be changed, but it is our opinion, that the consumer should be given at least a base price range up front if they ask for it, and there should not be a veil of “secrecy” behind health care pricing which is the way that our current system has existed for years.

What are your thoughts? Have you tried to obtain pricing information for a procedure and could not? Have you found out that certain procedures have huge differences in costs depending upon the facility?

Note: We are not saying that it is wise to make health care decisions based solely on costs. There are some tests and procedures that are highly specialized or in some cases use better equipment or machines where it may make more sense to pay more and obtain the best quality care. But, in certain instances, where the machine and equipment are the same, and you can get good quality radiologists or practitioners reading your exam results (that’s another issue for a future article) where you, as the consumer, should be aware that there are certain tests that you may be charged way over and above what you could have paid, and that information should be available to you, so that you can investigate your choices like you would any other important purchase in your life. 
Do you think we should take the Secrecy out of Healthcare pricing and Procedures? What are your thoughts?

Handwashing – Do you Know How to Wash Your Hands?

Handwashing: most of us think we know how to properly wash our hands. We’ve been doing it for years, and our mothers have been telling us to remember to wash our hands since the first day we can remember.  But many of us don’t wash our hands correctly or  understand that proper handwashing  takes a certain amount of time.  Did you know that washing your hands correctly is one of the most important things you can do to prevent infection? Diseases like e-coli,  salmonella, and other food handwashing techniques will help you and your family protect against illnesses borne illnesses can be prevented in many cases if proper handwashing is done. And, as the flu season approaches this year knowing and practicing good like the cold or the flu. 

Here are 10 Tips for How to Properly Wash Your Hands

1. Gather needed supplies

2. If using a public restroom (where the paper towels require you to touch a knob or button to advance the paper, go ahead and advance the paper before your hands are wet so that you do not have to touch anything  after your hands are washed.)

2. Turn  on warm water

3. Wet your hands

4. Apply liquid soap if available or use a clean bar soap.

5. Wash, scrub all surfaces of your hands including front and back of the hands, in between the fingers, underneath the fingernails and the wrist area.

6. Wash for a full 15-20 seconds

7. Tip:  To help your kids know how long to wash their hands have them sing happy birthday out loud twice to themselves. By the end of the song, the 15-20 seconds has passed

8. Rinse very well, again rinsing all surfaces that you washed

9. Dry your hands using a clean towel or air dryer if in a public bathroom. Don’t use your hands to touch anything after leaving the restroom including door handles or the air dryer. I use my shoulder to turn on the air dryer

10. When leaving the bathroom, use a clean, dry towel to open the door so that your hands are not recontaminated with any germs.

Knowing proper handwashing technique is useful for everyone in your family. Especially with the H1N1 flu outbreak along with the regular colds and flu that circulate during the fall and winter months, NOW is a great time to learn and practice good handwashing hygiene.

Plan on Spending Hours to Cancel Your Boingo Account

Signing up for Boingo service could be hazardous to your wallet..cancellation policies make customers jump through hoops.

I like to give companies the benefit of the doubt, but in this case after repeated attempts to get our account cancelled with the Boingo service, here is an update on the number of steps that it took to finally get someone to supposedly cancel the account.

In yesterday’s installment, we mentioned that we had called the company several times to cancel but the very long waiting times when calling during our workday made us resort to trying to use the email address published on the Boingo website to try to cancel the service. We received a response back after one day saying that due to security concerns the company couldn’t cancel our service via email. Note: the company allows the customer to sign up automatically via their website and provide the credit card number for immediate access without any security concerns, but apparently does not extend the same courtesy to customers to allow them to login to their secure, online account and cancel their service. Instead , Boingo makes the customer call an 800 number and spend  long times on hold. You may need a good speaker phone once you are connected,  and  if you’re lucky enough to be connected after waiting, will find yourself jumping through more hoops in trying to cancel the service, then it takes to get a loan these days.  And in this economy, that’s saying something.

Our other attempt to reach an agent without long waiting times was as we had previously posted, done in a call placed during the middle of the night in the US, and going this route, we were able to speak with an agent right away. However, the agent after verifying our account information and finding out that we wanted to cancel, and running through multiple options of how we could remain a customer, then informs us that her system is “updating” and she cannot accept cancellations. This, keep in mind readers, after she was supposedly able to pull up the account and verify it etc. So at least part of her system was working, but obviously not the part that accepted cancellations. The agent, took down all of our information and said that she would cancel the account when her system came back up again, and she would email us a confirmation number. We waited for yet another day, no confirmation number came. So, again, we tried emailing the support email address saying that we had called and cancelled our account directly with an agent, and did not receive a cancellation number and could they please email us a confirmation number. We were then given options about responding back using email giving confidential information via email to “confirm” our account, or calling one of their customer service agents again 24/7 according to the company to process our cancellation. (Which, note, we had already done..we had already cancelled the account…Boingo just didn’t process it apparently, as we were not given a confirmation number.)

Ok, so we called again today and reached a customer service agent after about 13 minutes on hold. The agent then proceeded to “confirm” our information and retrieved our account. We then asked to cancel the account, and the agent said that she’d email the cancellation number. “Oh, no, we want a cancellation number right now we told the agent.”  We actually cancelled our account several days ago and were told we would receive a confirmation number for the cancellation which never came.  We asked the agent for her name and for the cancellation number. Keep in mind we were at work and had some patient appointments to attend to, so our patients were waiting. We were then placed on hold for another 8 minutes, before the agent came back on the line and then said she had to verify some additional information with us before she cancelled our account like the last 4 digits of the credit card that was used to sign up.

What do you mean…you need the last 4 digits of the card we used to sign up? We gave that to you when we were purchasing your service.  Right now all we want to do is CANCEL. We have corporate cards and to find out the exact number that was used almost 30 days ago would require us to spend even more time on this issue that was getting to be a huge pain in the “you know what” this point.  After telling the agent that we wanted to cancel NOW, and we wanted our cancellation number NOW, she finally provided the number we had asked for so many times and spent so many hours to try to get.   Talk about wasted time and frustration. This is a really bad idea of how to make your customers angry and how not to do business.

Needless to say when traveling for health care reasons, we would not recommend that anyone use this service or company. There are enough frustrations involved with managing one’s healthcare, especially if being away from home is a necessity and you don’t need a website or company that touts “cancel at anytime” yet makes it almost impossible to cancel a service that’s supposed to help improve your productivity not hinder it.

Boingo Review Online Access While Traveling

Boingo Service – Not a Good Option for Our Health Care Travelers

If you have a health condition that requires seeking treatment from a facility away from home, it may be useful to have a resource that allows you to stay connected and use an online service for Internet Access while traveling. Staying in touch with friends and concerned relatives with updates on your medical condition can help if you need to journey away from home for medical treatment. Also, having online access can be very helpful so that if you need to research additional information on your condition while out of town and give you flexiblity to work remotely, even if you’re away. While many hospitals today offer online access while in the facility, sometimes it can be useful to have internet access while in airports, hotels, and or train stations while you travel. Because some of our staff recently took a trip away from the office and used one of the heavily advertised services called Boingo, which is marketed as a way to utilize Internet hotspots in airports and selected locations worldwide, we thought we would review this service for our readers.

The Positives:

Signup was fast, easy, and no hassle, and the locations where service was available was easily found and utilized.

Pricing seemed actually very reasonable: 9.95 per month in the US

Global Service was advertised for 59.00 a month

The website states that the service is available in 500+ airports worldwide and 20,000 + hotels

Additionally, if you are a coffee drinker or McDonalds fan, there are 14,000 McDonalds locations along with more than 70,000 coffee shops and cafes where one can supposedly connect to a hotspot to utilize their internet access.

Using the service once signed up was easy and the software that was provided made it a no-brainer to connect to any hotspots that were in the vicinity. We actually had one of our writers use the service while on a trip to Europe and it worked surprisingly well.

The Bad Points:

* Although easy to sign up and use, don’t expect the same ease or accessibility if you want to cancel

* Read the fine print regarding unlimited access. Although we had no issues with exceeding the amounts of bandwidth, unlimited is not really unlimited, there are limits in terms of how much you can use the service, so read the small print carefully and understand that there are restrictions in terms of the services offered

* Retrieving your password if you forgot it is very difficult, if not impossible. The service asks for your user name, which can be different from your email address and then asks for the last 4 digits of your credit card billing number just to get your password. Instead of offering a way of emailing you your user name to your email address and/or giving you a way of resetting your password automatically, they make you call an agent which is next to impossible because of the wait times online. Probably the wait times are so long because their password retrieval options and the ability to cancel one’s service can not be done automatically

* Although the Boingo website promises “cancel at any time * we found that the service is very difficult if not impossible for us to cancel

* There is no ability to cancel once you are logged onto your account, the company states that if you wish to cancel you must call into one of their customer service representatives. This is easier said then done and when trying to do this I am reminded of one of the old reruns of “Candid Camera” where one gets caught in an endless loop of red tape trying to reach a real person. In this instance you have to press several numbers to get to the correct extension, then during the day wait times were frequently over 10 minutes which is hard to do when you are trying to get any work done or dealing with your own customers during busy work times. So we decided to go another route and just email the support email address that they publicized on their website right next to the toll free number where the wait times were so long. It took one day to get a message back from their “support” desk, and apparently, due to “security concerns” one cannot cancel their account via email, but has to call. Hmmm, let’s see if I get it. There’s no “security” risk to sign up online, and as a customer the company has no “security issue” with you as the customer giving them your credit card for immediate access to your account. However, the company does not provide its customers with an easy way to cancel or put their service on hold instead making you call either a number that has very long waiting times, or if you try to email them directly (we were told that it was a “security” issue and they would not accept cancellations via email. Note, that we were not transmitting any confidential or secure info via email, we were just simply asking that we not be billed for the service anymore since we couldn’t get in touch with anyone in a timely manner via the telephone numbers that were provided.

Alright, so now we were beginning to get a bit frustrated with Boingo, and decided to go ahead and attempt a call again, but this time got up in the middle of the night thinking that they would not be busy if we tried to cancel during “off peak times”. So we placed a call during the night and this time we were connected fairly quickly with a real person, however when we said we wished to cancel our service we were asked if we wanted to use pay as you go, and were given several other options to remain a customer instead of canceling. When we refused all these options and simply stated that we wished to cancel we were told that their system was “updating” but that the agent would take down our information and cancel our account when the system came back online. And the agent promised that she would email a confirmation of the cancellation when the system came back up. We waited yet another day and received no such confirmation. So we have emailed the company again, and have stated in writing that we do wish to cancel our service, have tried repeatedly to do so, and won’t be paying for any more of their automatic billing. I’ll update you all on what type of response we receive, if we receive any response from them on trying to get this company to cancel our account.

Final Thoughts: It is indeed unfortunate, that Boingo does not offer an online option for it’s customers to manage their accounts in terms of activating or de-activating service. With health care issues, many patients have travel needs that can vary from month to month and if this company offered a way to manage one’s service online easily, like activating or deactivating the service without having to call an agent and spend long times on hold, then this may be a good option. We were impressed by the actual use of the service, but felt like the company was trying to make it exceedingly difficult to cancel it’s service by it’s policies on not providing an easy way to cancel the service online.

Unfortunately, we cannot recommend this service at this time due to the issues we experienced above.

The Flu- How To tell If you have the flu

Cold or Flu – How to Tell if you have either the cold or the flu

The flu is otherwise known as influenza and is caused by a virus, not a bacteria. As such, it is not treatable with antibiotics. The flu affects the respiratory system: your throat, nose, bronchial tubes and lungs. The elderly and young children, specifically infants are more susceptible to the flu than healthy young adults although you can contract the flu at any age. Anyone with a chronic condition such as diabetes, lung or heart problems that are ongoing or those with a impaired immune function is at higher risk for the flu as well. The prime time for flu outbreaks falls between the month of October through May and flu peaks during the December – early March time period.

How to Tell if You have the Flu:

It can be difficult to distinguish between the cold and the flu because many of the symptoms are quite similar. If you have a cold it is also caused by a virus and colds target the nose, throat and airways of the lungs.

Both Colds and Flu have the following symptoms:

* Scratchy sore throat
* Runny nose or general "stuffiness" in the nasal area
* Hoarseness
* Sneezing
* Coughing
* Fever

Differences between the cold and the flu:

* Fever of 101 Degrees or above (children may have fever if affected by the flu)
* Night sweats and/or cold chills
* Severe Muscle Aches
* Strong headache
* Deep fatigue and weakness

Additionally, if you are stricken with the flu, your symptoms may appear very suddenly and overall, you may feel much more ill if you have the flue as opposed to a cold. Recovery time, however, with the flu is generally around 7 to 10 days unless you have complications.

Types of complications that may occur with the flu include bronchitis, an inflammation of the lining of the bronchial tubes, and pneumonia, another type of lung infection. As always, if you have concerns or questions about your health you should contact your doctor or health care professional. There are medications for the flu that if given quickly enough after your symptoms begin, may shorten the duration and intensity of the flu illness. So learn as much as you can before the flu season begins about flu symptoms and contact your doctor right away if you think you have the flu so that you can be given options if needed for medication to reduce your flu symptoms.

Finding Courage: Lessons from a Mountain Not a Hill

Strength comes in unexpected places, find out how a trip overseas to Switzerland gave our writer some bravery she didn’t think she had…

I used to think I was courageous in my youth. Willing to try new things, be adventurous, take risks etc. Life, however, teaches one to be careful. Especially when daily living took unexpected twists and turns and things turned out differently than what I had expected.

So, I learned to be more conservative with my choices and careful with the things I chose, particularly in the area of recreational pursuits. Making tough choices in a business setting was easy for me, but on a personal level, I think the years took a toll, and thus I learned and practiced the art of being "careful."

So it was on a recent trip to Switzerland that I started thinking about being brave– Wondering where and when I had lost my courage, and then, embarking on a journey to see if I could find it.

There was one particular mountain that loomed tall in the background in an area very close to where I was staying in Switzerland. I made some inquiries of my hosts, and they explained that the mountain was a popular place for hikers and had a beautiful view at the top. As I stared at one of the largest peaks in the area, I wondered if I would have the strength to climb the mountain. You see in Austin, Texas, we have hills, not mountains, with more gradual inclines. The bike paths around Austin, home to Lance Armstrong, are filled with road bikers who find joy every day in traveling long distances–pedaling around town and up and around the beautiful Hill Country in Central Texas near Austin every day. But mountains are different. They present unique challenges and at face level mountains are much more difficult than hills to climb.

The mountain in Switzerland that kept drawing my attention had a viewing tower on top and was well known to local hikers as a great way to spend the afternoon. Many locals would traverse the mountain peaks during the day and then enjoy a meal at the restaurant at the top before making the trip back down another route by car. I would however, try to conquer the mountain on my own, on foot both ways. Climbing mountains is not my expertise and I’m certainly not used to doing such things alone. I’m more of a social hiker, preferring to follow the known path that others set so that I don’t get lost , and steep, challenging trails are not usually my first choice when it comes to hiking. I much prefer groomed slopes or those where it is easy to see where to place one’s foot for the next step. But this day was different. The mountain beckoned to me, and I thought it was a good time to be adventurous. Very adventurous. I was in a country where I did not speak the language on a mountain trail that was not very well marked and in some places not marked at all. The path was very steep, extremely tough terrain and difficult in most places, and there weren’t any places to rest until one reached the top. My friends drew me a crude map and sent me up with their blessings to try this challenge, but only if I took a cell phone along as a backup in the event that I got into any trouble. But something happened while on the mountain that day. I enjoyed the challenge, even treasured the time alone. Looking at the ancient trees in the forest and the dark trail (it was very dark to climb up during most of the trail because of the denseness of the trees) brought time for contemplation, and important thoughts to note about life, it’s twists and turns and treasuring each moment. The route, as I’ve said before, was straight up, so it took great concentration to complete each step. I carefully placed my foot on the path where the rocks wouldn’t slide too much which would allow for a gradual climb upward. I noticed many hikers came with hiking equipment, trekking poles that would support them both on the upward and downward climbs. Since I was new to the area and this was the first time on the mountain I came with no such equipment.

Only a small bottle of water attached to my waist belt and an extra shirt for warmth in the coolness of the trees. Even though it was difficult work to climb up, there was very little sun coming through so I noticed the sweat on my chest and shoulders all the while that my legs were getting cold. One step in front of the other, don’t even think about how much farther you have to go, just keep putting your feet in front of one another and you’ll make it, I said to myself. Little did I know in my deep concentration that my friends were calling the cell phone several times during the afternoon to check on me. But I, seeing no need to have the cell phone on unless I needed it, had it turned completely off. This actually gave me several hours of blissful solitude with which to reflect as I made the climb up the mountain, one deliberate step at a time. I made it to the top as I saw the sun peering through the trees, and the area at the peak of the mountain that day revealed a glorious view. From the tower it seemed like I could actually touch part of Heaven, and I allowed myself about 10-15 minutes to rest and warm my cold legs before tackling the climb back down.

The interesting thing about coming down off the mountain that day was that during my climb up I often thought that if I could just make it up–that would be the hardest part. It’s always easier coming down, I imagined. But I was very wrong. The steepness of the mountain and the rocks and debris on the trail, made the descent down as difficult if not more difficult than the climb up. My muscles were protesting in places that obviously hadn’t received enough attention or workouts in the correct areas previously, even though I considered myself to be in fairly decent shape. This took another kind of perseverance to get down off the mountain. I had to be patient and not rush it, otherwise, if I took the wrong step, the rocks could easily shift and I could twist anankle or take a nasty tumble down the mountain. Any my only company that day were the birds and whatever animals that may have been looming in the forest, so I had to get down off this mountain all alone. So again, during the descent I had another chat with myself about just concentrating on the next step and giving myself some pats on the back for being courageous and conquering a difficult task.

When I got back to my friend’s house that night I learned that the lady of the household had commented that "she didn’t think she would’ve had the guts to take the journey that I took on the mountain that day." She said I was very "brave" which was a word I wouldn’t have used to describe myself, especially recently. In an unfamiliar country, not knowing the language, nor the trail, and hiking on a very difficult climb all alone–I guess, this day, I gained some courage. In the states I probably would not have taken the hike because on top of all the obstacles already mentioned, one generally has to worry about being female, on a hike alone in unfamiliar places and the crime that could so easily happen in areas of the United States, so I wouldn’t recommend trying something like this on your own. It just so happened that for me it was the right time. I found the right place to challenge myself. In Switzerland it’s "different" than in the US. Especially in some areas of the country. I didn’t read or hear about one crime during the time I was there. One could leave bikes out in public places and have them still there later or even the next day. There were only a few times on the trail that I even worried about being alone–and this quickly passed when I had to think about the next place to strategically place my foot. I made some great strides that day in finding my courage and felt a deep sense of accomplishment. Courage is not the absence of fear, but having the strength to face one’s fears, and doing it anyway. Perhaps I had had this courage all along, just forgotten it or not tapped into it as often as I could have as the years had passed. And in retrospect I think not only did I want to do the hike alone, but probably needed to do it. Courage, you see, comes from deep within us, even when we don’t think we have it. And sometimes climbing mountains is just what the doctor ordered.

Flu Information – Tips About the Flu

Flu Information – Facts About Flu You Should Know

The flu, is an illness of the respiratory system caused by a virus. Flu can come on suddenly and last for 7-10 days and can make you feel very ill and weak. Avoiding the flu, therefore, becomes very important.

How can you avoid the flu:

The flu is spread when droplets from an infected person touches something like a door knob or other object or if they cough or sneeze while they are near you and you touch an item that they have handled. It is very easy to contract the flu if you are exposed to large groups of people, especially during an outbreak or during prime flu season. Any area where there are large crowds–for example, universities or schools, day care centers, large office buildings, concerts or other public events, nursing homes or public transportation. It is very easy to spread the flu to other people up to a week before you are aware that you are ill, and if you have a fever, this makes you even more contagious.

To Avoid the flu, you should stay away from large crowds, especially if there is an outbreak of the flu in your area. Hand washing, but only if done properly, is one of the most important things you can do to avoid the flu and other contagious illnesses. Practice good hand washing tips by making sure that you wash your hands thoroughly very often throughout the day and especially after touching objects such as doorknobs, shopping carts or other objects. You should wash your hands for at least 10-15 seconds and then rinse well and dry with a clean paper towel or air dry. Other tips for avoiding getting sick from the flu would include getting enough rest, keeping your body properly hydrated (i.e.: drinking enough water), making sure that you are eating healthy foods, including lots of fresh fruits and vegetables, and exercising regularly.

There are also masks that can be worn while you are in public places that can reduce your risk of contracting the flu virus. Choosing an appropriate mask for protection is important and there are many factors to take into consideration when buying a mask for flu protection. We will discuss this in a follow up article involving flu protection.

Strains of the Flu Virus:

There are three strains of the influenza virus:
Type A:
Type B:
Type C:

All cause flu, however, type A causes large outbreaks that happen every few years. Type B is involved typically in more regional occurrences and in a smaller fashion, and type C has mild symptoms and is a less common variety of the flu than either A or B.

How the Flu Virus Changes:

In the case of the type C virus, it is generally stable, however, strains A and B mutate or change each year. That is the reason why new outbreaks occur every few years. Locally, outbreaks of flu that are very strong, can happen every few years.
The flu can make you feel very weak and ill, and it is not a pleasant experience for you or your family members to contract the flu virus. But knowing some general information about the flu virus can help you and your family learn some tips for preventing the flu virus that can help you stay healthy during the entire year.

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