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December 19, 1997     Cape Gazette
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December 19, 1997

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34 -.CAPE GAZETTE, Friday, December-19 - December 25, 1997 HEALTH & FITNESS Diabetics seek uniform insurance coverage Lawmakers face push for new legislation By Rosanne Pack Those touched by diabetes are hoping for a new law in the new year that might give a new lease on life to some. With the opening of the Delaware General Assem- bly in January, proponents of House Bill 175 are pushing for adoption of legislation that would provide uniform insurance cover- age for those who are diabetic. "We are getting positive reac- tion from those on the Economic Development, Banking and Insur- ance Committee," sad Don Post. "We feel like we've got impres- sive facts and figures that are go- ing to hit home with a lot of peo- ple. "In the long run, what we are asking for will save money for in- surance companies,, tax payers and employers. And, the bottom line is that it can mean saving lives." Post lives in Milton and he is the special events coordinator for the Sussex County affiliate of the Delaware American Diabetes As- sociation (ADA). He is one of many active with ADA who are contacting legislators and sup- porters on behalf of the proposed legislation. Introduced last spring and now in the banking and insur- ance committee, the bill would expand and define the extent of insurance coverage for diabetic supplies, education and services. It would make coverage uniform for those who are otherwise fully covered by insurance, regardless of tlieir insurance provider. Uniform coverage needed Post said that, currently, the de- gree of coverage is not dictated by law and it varies greatly from one insurance company to another. He said some cover supplies for blood sugar testing, but not the equipment to read the tests. Some provide coverage for only a month's supply of medication or supplies with no provision for an emergency backup. Milton resident Patt Wagner. joins Post in sharing the combined story of medical facts and the hu- man faces of the issue as they drum up support for HB 175. Wagner is a registered nurse and the coordinator for the regional Diabetes Care Center. As a certi- fied diabetes educator she said that she regularly hears concerns from diabetics and their families regarding confusion and inconsis- tency in insurance coverage. Wagner thinks that HB 175 is a strong move in the right direction and that the legislation is deserv- ing of support from the general public and all who are touched in one way or another by the disease. She points out that diabetes has a tremendous impact on society as a whole, and that any move to make the disease more manageable will benefit all. Post and Wagner are armed with statistics that show how per- vasive diabetes is, and yet, how those who properly manage their health can lead full, productive lives. Deadly complications "If people are equipped to man- age their health and therefore avoid complications they can continue to be productive work- ers, effective parents and con- tributing members of society," Post said. "But when we talk about dia- betes, we also have to face the fact that it is presently the second leading cause of death in children; it is the second lead- ing cause of death among women. More women die an- nually from POST complications of diabetes that from breast cancer," said Post. Post and Wagner said that the impact of diabetes is not always realized because the complica- tions that eventually lead to a death are often seen as the sole cause rather that the result of the primary disease. "This disease attacks almost every system in the body in one way or another if it is not man- aged," Post said. "So often you hear someone died of heart failure or kidney failure, and you don't know that the initial cause was di- abetes that weakened or damaged the failing organ. "And when you look at those who lose their vision or have to undergo amputation because of diabetes, it makes supporting the cause of insurance coverage and proper health management even more important." Rep. George Carey (D-Milford) is one of the sponsors for HB 175. He expects the insurance agency to cite added costs and perhaps to mount opposition to the bill. Cost-effective care "I can see that they will say that it will cost them and maybe push insurance costs up initially, " Carey said, "but, in the long term, I think it might be a case where we spend a dollar and then it makes us two. "If we can spare diabetics the loss of their eyesight or their legs, they can continue on with their lives. Then you're a provider and not a burden. No one wants to be a burden; we need to give them the means to control the diabetes and lead a better life." Carey said he cannot predict the progress of the bill. It was intro- duced last spring and referred to the banking and insurance com- mittee. The representative said that he knows that supporters 'hope to see it released from com- mittee as early as possible so it might make it through the house and the senate before the General Assembly adjourns in June. "Patt Wagner has kept me in- formed on the bill," Carey said. "There is supervision built into it so that education and medication and equipment will only come un- der insurance coverage in the proper manner. It will cost some- thing if it passes, but the long- term benefits of the legislation should outweigh the initial cost. It will be a start to help individuals help themselves." Carey pointed out that laws governing the insurance industry underwent similar amendments regarding health issues such as mammograms and pap smears. He said there was resistance from the insurance lobbyists, but once the legislation was in place, it was shown to be cost effective over the long run. Post said that emotional, human health issues often have to be looked at in terms of dollars. He said the fact that diabetes is the costliest single disease in the United States is of tremendous significance. Continued on page 36 Dysthymia, depression mark holiday blues Matiy people experience the holiday blues. This is usually a temporary condition and should be distinguished from depression, which lasts longer and usually has more serious symptoms. Depression is persistent and normally interferes with one's work, friendships, family life and physical health. Depressive episodes usually last several months and can recur throughout a person's lifetime. Common symptoms of depres- sion include feelings of guilt, de- spair, unending misery, low self- esteem, self-destructive thoughts, irritability, helplessness, difficulty in concentrating and making deci- sions, loss of interest in life and an inability to experience pleasure. There may also be physical symptoms, such as fatigue, loss of appetite, insomnia (or sometimes overeating and oversleeping), as well as pain and other bodily com- plaints. Dysthymia, or low-level de- pression, has many characteristics in common with the holiday blues; although, again, the holiday blues are temporary. Dysthymia, by definition, is an overwhelming but chronic state of depression that lasts at least, two years. It is less disabling than major depres- sion, so many of those with dys- thymia are able to hold jobs and maintain an adequate interperson- al life. It occurs twice as often in women as it does in men, and symptoms usual!y first appear in adolescence or young adulthood. Although the symptoms are usual- ly not as severe as those of major depression, it is a serious condi- tion; if not treated, it can actually lead to major depression. In the absence of any other cause for these symptoms, the dysthymic person is one who has had at least two of the following symptoms for two years: poor appetite or overeating insomnia or oversleeping fatigue or low energy low self-esteem poor concentration or difficulty making decisions feelings of hopelessness The holiday blues can be char- acterized by any of the symptoms of dysthymia, but they are usually limited to the holiday season. The holiday blues may also bring on irritability, angry blowups, exces- sive brooding, difficulty finding pleasure in life, guilt, and avoid- ance of other people. Whenever people find them- selves feeling down and rotten over the holiday season, they may well have the holiday blues. The person with dysthymia is, of course, more prone to experienc- ing these symptoms during the holidays, but the holiday blues can hit anyone - dysthymic, de- pressed, or not. Fortunately, all three of these conditions are treatable with psy- chotherapy and other therapeutic modalities. Gaining insight into one's life circumstances, talking to a supportive and objective lis- tener, gaining the understanding of other people, changing thinking about dealing with problems, communicating differently, mov- ing from despair to finding mean- ing in life - all of these things can happen in therapy, and those suf- ferring can gain relief from these debilitating feelings. A feeling of relief may he the greatest gift of all for the holiday season. Do the holidays make you sad? Many people become sluggish and gloomy as the days of winter approach; for some, these feelings may be due to a condition called Seasonal Affective Disorder (SAD). This may have frothing to do with the holidays at all, al- though it does coincidentally oc- cur at this time of year. The prevalence of SAD increas- es the further north one lives; in Florida, only about 2 percent of the population suffers from SAD, while the incidence is almost 9 percent in Alaska. Seasonal depression seems to be related to the length of the days and changes in the availability of sunlight. Changes occur in our bodies as a response to the short- ening of days, somewhat similar to some animals who go into hi- bernation in the winter. More than three-quarters of those who suffer from SAD are women, and most are in their 20s, 30s or 40s. SAD is a serious depression that recurs each year at the same time. It starts in the fall and ends in the spring. The symptoms are similar to those of major depression: lethargy, anxiety, sadness, irri- tability, concentration difficulty, withdrawal into solitude and loss of interest in life. Some people with SAD may feel self-destructive. Also, many experience an ex- cessive need to sleep, an increased appetite and a weight gain of as many as 10 pounds. Fortunately, this condition can be treated. Those who experience SAD should call a health-care profes- sional immediately. Nobody deserves a SAD holi- day. HEALTH TOPICS Joel Vcmisd has a primte . ace in Georgetown. She is avail- abk at Brie Coumelisg CM-. ter, 856-9190 or e-mail \.