This is the first in a series of short articles intended to help you better understand your nutrition options.

By Donna Paquette

Today it seems we need to have a degree in nutrition in order to decode the content of a product. Does anyone control what’s placed on a label? Who decides the difference between whole and reduced fat? And, just how “reduced” is it? If you’re like most people you know that the language of labeling is overly complicated needing a decoder ring to decipher it all. Let’s see if I can help break the code and having a general understanding.

To begin with, the Food and Drug Administration (FDA) is responsible for food labeling. In 1990 congress enacted the Nutrition Labeling and Education Act (NLEA). This act allowed the FDA to govern the labeling of products as they are today. Light, reduced, free and low-fat are all terms defined in NLEA.

Let’s consider a refrigerator staple, Light Cottage Cheese.  What does “light” mean? How much fat is really in it? Let’s shed some “light” on the mystery. These are the definitions per serving:

• “Fat-free” must be either no fat or a very small amount; less than 1/2 of a gram.
• “Low-fat” is any product with a fat content of less than 3 gram.
• “Reduced fat” means the product has 25% less fat than the original.
• “Light” means the product will have 50% less fat than the original.

Another common dairy product- milk:

• 1% milk contains 1% fat content or 1 grams (1/4 tsp) per 8 oz serving.
• 2% milk contains 2% fat or 2 grams (1/2 tsp of fat) per 8 oz serving.
• Whole milk has 3 1/4 % fat or 3.25 grams (just shy of 1 tsp) per 8 oz serving.
• Skim milk contains 0-.5 grams (an insignificant amount) per 8 oz. serving

What does this mean in terms of fat needed in the diet? Let’s back up a moment and explain “nutrients”. Nutrients are what fuels the body. They come in several varieties; fats, carbohydrates, and protein. Our body needs them in certain percentages from our daily diet. Roughly speaking, 15% of our total calories should come from protein, 55% carbohydrates and 30% fats, with no more that coming from 10% from saturated fats. For the average person, this translates into 65 grams of fat with no more than 6 grams saturated based off of 2000 calorie diet. It’s that easy.

By the way, why do we need fat? Most people cringe when they hear the word fat but our body must have a certain amount to fuel systems, repair and maintain our cells and continue with good brain function. Fat is healthy in the right amount and the right kind. It isn’t necessary (or even healthy) to maintain a fat-free diet. Keep saturated fat low, trans-fatty acids at zero and your total dietary intake at no more than 30% for a healthier you.

Donna Paquette is a nutritionist for the Women, Infants and Children program (WIC) for the state of Connecticut. You can write to her in care of customerservice@vidacura.com.

If you’re in the age group that is just now beginning to regret listening to those loud rock concerts of your youth, you’re in good company. About one in six boomers have a hearing loss according to the Better Hearing Institute, a non-profit educational group financed by the hearing aid industry. The AARP reports that there are more people between the ages of 45-64 with hearing loss than those over age 65.

If you or someone close to you believes they may need hearing aids, your first stop should be to a physician to get a medical exam. They might refer you to an audiologist who would perform a more comprehensive evaluation. If they conclude that hearing aids are recommended, it’s especially important to become an educated consumer. We’ll tell you here what you need to know.

First, the basics
There are three types of hearing loss. Conductive hearing loss generally results from wax blockage, punctured eardrum, infection, or damage to the inner ear that prevents normal functioning of inner ear structures. Many conductive hearing problems can be improved or corrected with medical treatment. Sensorineural (“nerve”) hearing loss is most commonly caused by aging, exposure to loud noises or trauma such as a blow to the head, or damage to areas of the brain that work with the ear to interpret sound. This type of loss may be treated with a hearing aid.  Mixed hearing loss is a combination of conductive and sensorineural types and is treated accordingly. If a hearing aid is called for, two general styles of hearing aids; behind the ear (BTE) and in the ear (ITE). There are variations, advantages and disadvantages of each.

Some initial signs of hearing loss to watch for include ringing in your ears or “tinnitus”, increasing inability to hear well in groups or in areas with background noise, and frequently turning up the T.V. volume. Many people don’t even realize they are experiencing hearing loss until a family member recognized the symptoms. By the way- tinnitus can be caused by other medical conditions and medications- that’s why we recommend you check in with your physician as a first step.

Preventing hearing loss is a life-long process. The easiest way to protect your hearing is to reduce or avoid exposure to noise. Heavy machinery, loud music, engines, or even exposure to a one-time extremely intense noise can cause hearing loss. It’s most common for hearing loss due to noise to occur slowly over time as long-term exposure causes destruction of inner ear mechanics. If you live or work in a high noise area, use ear protection. Basic ear plugs used to reduce noise (say, if your sleeping partner snores) won’t protect your ears while using landscaping equipment or other high-decibel machinery.

Examples of other factors leading to or predisposing a person to hearing loss include having family members with hearing loss, taking medications that can be toxic to the ear, recurrent ear infections, and a previous history of damage to your ear drum.

Insurance doesn’t usually pay for hearing aids
Hearing aids require a prescription. Audiologists often sell hearing aids or partner with a licensed hearing aid retailer.  Unless you’re a veteran or in the case of certain states, if you’re a child under age 13, expect to pay for your own hearing aids as most insurance plans don’t cover them. Prices often range from $1,000 to $7,000 or more depending on the type of hearing loss you have and the hearing aid you select. But you might not need anything nearly so costly. In our research consumers often pay more than necessary or may be victimized by unscrupulous dealers.

Why are hearing aids so expensive?
As with many other areas of healthcare, high hearing aid prices can be attributed to monopolistic pricing and regulations that discourage competition. A hearing aid consists of a small microphone that amplifies weak sounds through a small speaker. Unlike the routine price decreases that we’ve come to expect from other electronic devices like cell phones, computers and televisions, the price of hearing aids have actually increased. Surprisingly, its own industry trade association has concluded that hearing aid manufacturers could help more people, sell many more hearing aids and make more profit if prices were reduced.

There are some hearing aid-type devices that like reading glasses, don’t require a prescription and offer benefit at substantial savings. These devices are made by companies including Maxisound, Nexear and Songbird. Prices for these types of aids range from $80 to $500 each. They can generally only be purchased online, but all are sold with money-back guarantees. So for mild to moderate hearing loss, they’re worth a try and may be a good bet for your money. (VidaCura carries Nexear brand products, Click here to see them.)

Here’s an interesting tidbit that can help you understand the hearing aid industry better. A study conducted and reported on in a recent issue of the American Journal of Audiology concluded that these over-the-counter type hearing aids “don’t work well and could potentially damage a persons hearing”. The kicker is that study was funded by the Oticon Foundation, manufacturer for Oticon brand hearing aids. We suspect the eyeglass industry said many of these same things about reading glasses when they first began to be sold over the counter.

Be a smart shopper
Following a principle you’ll hear us frequently refer to; you will get the best care if you do your research and ask the right questions. It’s especially important for hearing aids since in addition to dealing with your hearing, it’s also likely you’re spending your own money. When the results of your exam indicate that you might benefit from a hearing aid, consider the following factors: Hearing aids are sold (“dispensed”) by licensed audiologists and by retailers who have relationships with audiologists. That opens the door wide to potential kickbacks, and referral fees in exchange for recommending higher priced models. This can result in your paying prices higher than you should.

Five important rules to follow when shopping for a hearing aid:

1. Rather than relying on the yellow pages, ask friends and family for recommendations as to where they’ve purchased hearing aids.
2. Beware of suspect advertising claims such as “Thousands of dollars off” a digital hearing aid, “25 people needed to participate in hearing study”, “buy one get one free” and “We offer Medicare discounts”. Unfortunately, all are common gimmicks
3. Keep the medical recommendation from your medical practitioner or audiologist separate from their brand, model and style recommendations. Rather, ask what features and specifications they recommend in a hearing aid for you. Then, shop based on your own price, service and style preferences.
4. Insist on at least a thirty day trial period. Some dealers may charge a 5-20% service fee on returns. If you are a Costco member, the hearing aids they sell fall under their standard “if you’re ever dissatisfied for any reason, we’ll take it back” policy.
5. Some dealers charge a fee for creating the custom molds into which the electronics of the hearing aid goes so that it fits properly in your ear. Others don’t.

One final thought… If hearing aids can help you hear better, please consider them. The stigma associated with wearing a hearing aid is largely gone. Well-known celebrities who have been helped by hearing aids include President Bill Clinton, actors Lou Ferrigno and Richard Thomas, and U.S. Army General Norman Schwarzkopf. These days, it’s so common to see people with earpieces plugged into one ear, who knows whether they’re talking on the phone or just improving their hearing.

Larry Berk and Delaney La Rosa, RN,  are a husband and wife team; healthcare and insurance professionals with over 25 years of combined experience. Larry is the President of VidaCura, Inc. Delaney spent several years’ performing healthcare fraud investigations and is a registered nurse in Connecticut. This article also appears in The Hartford Courant’s online edition of CTWatchdog

Last November, my wife and I had to make a trip to the emergency room of a local hospital. I’d like to tell you about our experience there and what happened after they gave us a bill without delivering any service. This is exactly what happened to us as reported in yesterday’s (3/8/09) Watchdog column of the Hartford Courant written by George Gombossy.

On that evening of November 26th, 2008, my wife began to experience severe abdominal pain. As the pain went from bad to worse, she called her primary care physician who directed us to Manchester Memorial Hospital, a regional hospital in suburban Hartford.

We checked at the front desk around 6:30 PM after which they told us to have a seat. There were no seats. As time progressed, the pain increased. My wife is a strong woman. She has an autoimmune disorder. She often deals with pain and she can take it. This pain was something else however.

Then she began to throw up.  I checked and rechecked with the receptionist who just kept telling us to be seated. Finally, I did what any customer would do. I told my wife, “we’re leaving” and we did. We went home and I called 911.

A terrific EMT crew showed up and began treatment which was a good thing since an EKG uncovered that she had some symptoms of an irregular heartbeat presumably brought on by the whole episode. They took her to Bradley Memorial hospital where doctors determined that was most likely having an acute gall bladder attack.

All’s well that ends well, right? Not in this case. Instead of billing our insurance company, they billed us for $244.25. On January 3rd, we wrote to Peter Karl, the President of the hospital who passed my concern along to one of their Patient Care Providers. She wrote back to inform me that “unfortunately, the bill is correct”.

Our mission and that of VidaCura’s is to educate consumers. There just isn’t enough dialog. We want to encourage Americans to raise the noise level so that they can be heard above the voices of special interest groups. So we turned our story over to George Gombossy who writes the Watchdog column for the Hartford Courant and writes his own blog, “CTWATCHDOG Consumer Payback”.

In an email conversation between George and Dennis McConville, a Manchester Memorial hospital Vice President and spokesman, Mr. McConville confirmed that they bill was correct. He said that my wife had been seen by a registered nurse and had been registered in the system so that her care could be triaged given all the other patients being treated at that time.

So we got no help, no medicine, no relief, not even a chair. We did, however get a bill. And given two opportunities to correct their mistake, they concluded that they deserve the money.  What’s wrong with this picture?

I suspect that for the vast majority of Americans, we all talk a good game about civic service but as the saying goes, we don’t “walk the walk” as often as we could. This is a story about one person’s experience at helping.

My wife and I have a 21 year old son in the house who, lately has been experiencing what so many others are- a temporary lapse in employment. House rules for those “of age” and living under our roof is that you either A) must be employed and pay rent or B) you must make some other contribution to society, i.e., do some volunteer work.

I wanted to help our son out because I could just tell he was highly motivated to make his contribution. Volunteermatch turned up an amazing list of opportunities. The Mercy Corps is looking for a business mentor to help those brave enough to start a new business. Nature Abounds is looking for help studying climate changes in the area. As I began to put a list together, one opportunity caught my attention. The Hospital for Special Care is a renowned rehabilitation facility in my area. They were looking for someone to play Scrabble one evening a week with a resident. This was an opportunity I couldn’t refuse. I signed up.

A couple of email exchanges and orientation sessions later with their Manager for Volunteer Services and I was an official volunteer complete with photo ID. (Ok, so I did get a little testy when their volunteer aplication asked for my work history. “I’m volunteering to play Scrabble, for crying out loud!”, I wrote in that space on the application.)

I showed up for my first game with Phil who, it turns out is a fabulous Scrabble player and has a terrifically dry sense of humor. We ended up playing for two hours.  We talked breifly about politics, debated the acceptability of latin words on a Scrabble board and when all was said and done, he beat me soundly by about 30 points.

I left there hungry. It was way after my usual supper time but it was great and in retrospect, it was easy. I learned that volunteering isn’t always about delivering meals on wheels or unloading food at a food bank or pushing a broom on a Saturday although it can be those too.

Our new President talks about Service. With all of the comparisons I’ve heard between Barack and John F. Kennedy, I half expected his inaguration to contain at least a reference to those famous words, “Ask Not What Your Country Can Do For You…”. I’m glad he didn’t. It would have been trite. But he’s right. If you don’t do it, who will? My simple game of Scrabble doesn’t come close to measuring up to the contributions I’ve heard that others made to the people in New Orleans after Katrina or in the aftermath of 9-11. But it’s something and as an old mentor told me once, “something is better than nothing”.

Phil, I have a word for you. It’s 7 letters, 14 points, 42 if I can get triple word score. The word is “REMATCH”. Next week, same time, same place but I’m bringing a dictionary.