Health Care Reform: He Said, She Said

Because I know not all of you, or any of you for that matter, read back through comments on this blog, I thought I would highlight an exchange from Your Health or Your Wallet? The "Choice" is Yours post from a couple weeks ago. I present to you a little "he said, she said" concerning health care reform....

He said:

One thought though... For CF'ers (and others as well) you aren't really buying health "insurance." Insurance is a bet, on your part and on the part of the insurance company. They are betting that the premiums they charge you, will, on average, be a larger amount than the healthcare they are obligated to pay for. You are betting that it will be cheaper for you to pay a monthly premium, just in case some huge medical bill occurs.

For CF'ers... it ain't a bet. You and the insurance company know there is absolutely no way you could pay premiums high enough to cover the cost of your care. So bottom line... you are asking other people to pay for care you can't afford for yourself.

I would much prefer an insurance system that functions as insurance, and find the best way to provide that as cheaply as possible. And then find a way to deal with those who are un-insurable. Rather than designing all kinds of perverse incentives into an insurance system, to deal with people who insurance isn't really the appropriate means to pay for care.

Some more random comments on the post above:

Strike all pre-existing condition clauses?

We don't demand that you be able to buy fire insurance to pay for the damages AFTER your house has burned down. Or flood insurance AFTER it is filled with water. Or car insurance AFTER you've gotten in a wreck. Or life insurance AFTER you've died. If we required the above, it should be pretty obvious that what you are buying is no longer "insurance" in any sense of the word.

So why do we demand that people be able to buy health insurance AFTER they have gotten sick?

As I said above, if you have a pre-existing condition, you aren't insurable in the true sense of the word. I'm not saying I know what the solution is for those with pre-existing conditions, but I do think that basically dismantling the insurance system to deal with those issues is the wrong way to go.

More random comments:

"fair pricing despite level of health"

I assume you mean by "fair" that all people pay the same price, regardless of their health?

Once again, compare this to other insurances you buy. Do people demand "fair" pricing for car insurance for someone with a perfect 10 year driving record versus the high school student who has been in 3 accidents already? Or "fair" pricing for life insurance for the 20 year old health nut versus the 95 year old chain smoker? Or "fair" pricing for home insurance for the $100,000 home versus the 4 million dollar mansion?

So why do we demand that all people, regardless of health status, pay the same amount for health insurance?

I know, I know... people don't always have a choice in their health status, while most of the above situations are a choice. But for those who do, I'm not sure I see why their shouldn't be a consequence for health choices. For those who have no choice in their health status... like I said, I'm not sure insurance is the appropriate vehicle for paying for health care.

"My choices in my care should not be made by my pocket book, but they are, all the time."

Not trying to be offensive, so if it sounds that way, blame it on the limits of internet communication...

Why shouldn't choice in health care be made (at least in part) by money? You make choices every day based on money. Where to live, how big your house is, what kind of car to drive, what kind of job to take, what to eat, how to entertain yourself, etc. Why should health care be any different?

In my mind, part of the problem with the current insurance system is that there isn't ENOUGH decision making based on cost. With most PPO type insurances, there is very little connection between what I pay, and how much something costs. I might only pay 10%, or a $20 co-pay, for something that costs far more. Of course, I am also paying for the rest of it, but through my premiums. There is very little direct connection between the value of a health service, and how much I pay for it.

I really think the HSA route is the way to go, because it has a huge connection between cost and value. We just switched this year, and I find myself constantly asking "Is what we are going to pay for this really worth it?" (just like I do for everything else I purchase.) I NEVER recall thinking that on our PPO. If people aren't asking that question, health care is only going to get more expensive, not less. And the public option makes even MORE of a disconnect between the cost and the value.

She said:

Few things that I feel like addressing:

1. Your analogy of other types of insurance is flawed in several ways. If all insurance was ran like health insurance, then we would have a lot of problems. Say that you had a small fire in your house five years ago. It caused no structural damage, few possessions were damaged, you didn't even use insurance money for it, but called out the fire department just to make sure your house was safe. Now five years later you buy a new home and want fire insurance. If they were like the insurance company, they could deny you because of your past history of fire. Or say, you are going to get car insurance. You've never had an accident and have a perfectly clear record. You expect to be covered without a problem. However, it seems your family members seem to crash into anything on the road, and off the road, and have several tickets. The insurance company denies you because of your family history of car wrecks. Both would happen if insurance was ran anything like "health insurance".

Also, not having fire insurance, I take a financial risk if something happens. Not having car insurance, I take a fiscal and legal risk. Not having health insurance? Not only is there a huge financial risk, but you are also risking your life. No other insurance is that true of.

2. Making decisions based on pocket book. Yes, I decide where I live, what I spend descresionary funds on, and how much I drive based on pocket book. But I can live in a cheaper house, not buy that shiny new computer, and drive a 10+ year old car... it's not going to kill me. But not getting drugs, going to the doctor, and millions of other things that are involved in health care very well could kill me.

3. I think of health insurance, or how I think health care should be paid for like the police, or the fire department, or like countless other services that my tax dollars go to. I haven't needed police help in years, but I'm very happy they are there if I need it, and I know that my community is a better place for it. My neighbor had a garage fire this week, that without the quick reaction of my neighbor and the fire department, I would have lost my own home. Again, something I pay for, rarely use, but am very glad they are there when I need it. I don't have kids, but I know that my community is better by tax dollars that go into their education, removing them from abusive situations, and helping them get vaccinated if they can't afford it. I've never been on food stamps, but I know that my community is better if everyone has something to eat. The same thing could be said about healthcare. Yes, I use it often, and many people out there wouldn't, but everyone's lives are made better by everyone having a chance at health. I don't understand how anyone could think differently.

4. HSAs are a crock. Spend a single day in a hospital and the $6,000 bill will eat through nearly every HSA account I've seen. Let's hope you don't need surgery, ongoing medication, or more than one day in the hospital... because not only is your healthcare money gone, but you also can't be insured again.

He said:

1) Sure, the analogy isn't perfect. But it is true that people are demanding things of health insurance that we don't demand of any other insurance we buy. And those demands transform it into something that is no longer insurance.

2) Again, I'll agree health care is somewhat different than other things you buy. Although where you live or what you drive could also kill you. My point was more that your comment implies you should be able to decide on your health care options regardless of cost. That isn't reality, just as you don't make any other decision regardless of cost. Which is why people argue that public healthcare always leads to rationing. Because when we don't pay for it directly (ie we make healthcare decisions with little regard to the true cost) we end up demanding far more healthcare than if we paid for it directly. We demand more healthcare than we can collectively pay for. And since the gov't controls the public option, they end up deciding based on the collective pocketbook. Which is exactly what many people are opposed to.

3) So did your neighbor have fire insurance, or did the fire department pay for all the damage caused to his house by the fire? The police only come to collect the evidence after the crime. They do nothing to reimburse you for the ongoing effects of the crime. The fire department shows up to put out the fire. They do nothing to pay for the damage your house suffers (in fact, that is why you buy fire insurance.) I would argue the healthcare equivalent to the police or fire department would be EMTs, which, oddly enough, already exist.

4) Our HSA is working just fine, thank you. And yup, one day in the hospital (which my wife already had this year) will wipe out your HSA account for the year. Which is exactly why you have an insurance policy connected to it. After her hospital stay, we had paid our deductible, and the insurance covers 100%. If I desire, next year I can switch back to the PPO that my employer offers, although I see no reason to do so. HSA's provide an incentive for me to actually attempt to save money, to consider whether the value of the service is actually worth what I am paying for it. It works exactly like insurance should... I pay for the little day to day stuff, but have insurance in case of an emergency. It's not a crock for us, and is actually working quite well so far, even with a major hospital stay.

Here's a great article in the WSJ with some excellent suggestions for how to reform the system, without going to single payer...

http://online.wsj.com/article/SB10001424052970204251404574342170072865070.html

So, who do you think wins this one? The "he" or the "she"?

I love that they both took this opportunity to share their opinions. Thanks guys! If you'd like to share your thoughts and opinions on Health Care Reform please contact me for the opportunity to write a guest post.

The First Time CF Rocked My World

The date was 1990 (my best recollection) and I was playing outside in my front yard. While I was running around in my own little world, I heard the phone ring. As I sprinted to go inside, I heard my mom yell "I got it", so I stopped just short of the front door. I then heard little bits and pieces of my mom's conversation with the mystery man or woman on the other end of the phone.

The following is how I believe the conversation went, with what I actually heard bolded and the rest from what my mom told me the doctor said.

Doctor: Hello, is Christine there?

Mom: This is she.

Doctor: Hey Chris, this is Dr. CF

Mom: Hi, Dr. CF

Doctor: I have some unfortunate news to share with you.

Mom: Ok

Doctor: I'm under the impression that Ronnie and Robbie were good friends, would that be correct?

Mom: Yeah, they're in the hospital often together.

Doctor: Well, Robbie recently underwent a surgical procedure to fix a problem that he was having.

Mom: Ok

Doctor: During surgery, Robbie's lungs unexpectedly started to fill up with fluid.

Mom: Oh no!

Doctor: All Robbie had to do was cough to clear his lungs, but we just couldn't get him to do it. He was in a lot of pain and probably lost much of his strength to muster up the cough.

Mom: And?

Doctor: Robbie died on the operating table. I'm sorry. I thought that you and Ronnie would like to know.

Mom: Well I'll tell Ronnie what happened.

Doctor: We're very sorry.

Mom: That's ok, I'll go speak with Ronnie.

So as you can see, I didn't actually witness most of the conversation had between my mom and the doctor (which by the way could have been a CF nurse). After my mom said "Oh no" I knew it wasn't good and started to walk away from the door. I'm not sure if I knew about Robbie's surgery or not, but I just knew that Robbie was dead. It wasn't common for any medical professional to call the house and my mom's reaction kind of tipped me off. I remember walking towards the street, already feeling a deep sense of sadness for my loss of a great friend. Robbie was my first CF friend and one that I spent a lot of time with in the hospital (this was before they kept us separate). I started walking back towards the door and heard my mom say that she would talk to me and hang up the phone.

My mom came outside and broke the news to me. "Ronnie, your friend Robbie was having a surgery and something went wrong. He died during the operation." Boom. The weight of a thousand bricks felt like they had just been thrown on me. There I was, a little 10 year old boy, being told that my 12 year old friend will no longer be there to hang out with in the hospital. The one guy at the time that "really got" what I was going through would never be able race me down the hall on our IV poles. Some one who I looked up to as the older "cool kid". I can still remember his smile and how it lit up a room when he walked in. He was always happy and never complained. He always "looked out" for me and treated me like a little brother. His laugh was infectious and bright teeth would glow as he cackled. Robbie was my first of many CF friends that I have lost but it still feels like yesterday that it happened.

Of course there were a million questions running through my head after my mom told me the full story. It never once made me question my own mortality, but I just couldn't understand how he could die. I knew he was "sicker" than I was, but I didn't think he was that sick. Why did he have to go into surgery? Was he in pain? What if his mom didn't smoke inside the house, would he still be alive (yes, you read that right, she smoked in the house)? The biggest question I had then is still the biggest question I have now...

Why didn't you just cough Robbie?

I lost Robbie almost 20 years ago, but as I write this, I realize how much I still miss him.

Went to the Grammy's!!!

Here's what I'm thankful for on this great Thursday....

- Home. There's just nothing like being home. It's not that I don't have a great time on a vacation (thus my need to take many of them) but I must say, I relax WAY MORE at home. I'm a big routine kind of a guy. When I'm on vacation, my routine gets completely thrown off and I feel like I'm constantly playing catch up. I explained it this way to a friend recently: Being at home feels like a vacation and a vacation feels like work. Am I the only CFer who feels that way?

My home may be smaller :)

- Grammy. As in Mandi's grandma. She was actually willing to put up with me this last week and make me feel like one of her own. She has such a warm soul and an open heart that it is pure pleasure being around her. She also has one of the best memories ever. She can recall stories from 1947 while I have a hard time remembering what happened in 2007. And as a bonus, she makes some of the best goulash (not Hungarian, grammy style) ever!

Get it?

- Tylenol. I woke up with a headache behind my eyeballs this morning. One of those "head in a vice" and my eyes are going to pop out kind of headaches. I tried the whole rubbing the temple thing. No luck. Squeezing the muscle between my thumb and my pointer finger? No dice. I then just started to press on my eye balls hoping that making them bleed would let me forget about the head pain. Then Mandi reminded me that they actually made little white pills that help these sorts of things go away. Thank you Tylenol (the generic brand, whatever your name is).

I only took 3, don't worry.

My Health Renovation

Guest post by Elizabeth Haran

ren·o·vate

tr.v. ren·o·vat·ed, ren·o·vat·ing, ren·o·vates

1. To restore to an earlier condition, as by repairing or remodeling.

2. To impart new vigor to; revive.

I have gone through many stages with my CF, trying to hide it as a kid for fear of being “different”, complete denial and non-compliance in my early college years, and finally an acceptance of what this disease really means for me and my future. About 6 months ago I entered a whole new stage, “renovating” my health. Yes, there are certainly parts of CF that are out of our control, but to a certain degree our health is dependent on how hard we are willing to work for it. I learned this the hard way. In the Fall-Winter of 2008 I was put on IV treatment for what I thought would be my standard 3-week clean-out. Instead I spent 10 weeks on home infusions and for most of that time extremely ill. For the most part I spent my days moving from my bed to my couch, every move I made sucked the energy out of me. I was barely able to get myself in and out of the bath tub and standing in the shower was not even an option. I ran a fever for weeks, at times reaching as high as 106 and my whole body ached. My doctor went through 6 different drug combinations during this time, never able to find one that actually seemed to make me feel better. He sent me to an infectious disease specialist who really had no other suggestions. I had an air-quality specialist come in to test my home to make sure there was no mold that could be contributing to making me sick. No significant mold levels were found.

I was feeling completely helpless and I looked my doctor in the eye and asked him if I was dying, because I was beginning to believe that was what was happening. His answer was that he did not think so, that I was just going through a rough patch. I have been treated by my CF doctor for the past 23 years; I trust him completely, but I wasn’t convinced on this one. Fast-forward to the end of that ten week period. My doctor figured out (not soon enough) that I was having a reaction to one of the meds called “drug fever.” While that could account for some of the symptoms that I had experienced, I got my PICC line pulled with an FEV1 not any better than when I started! 10 weeks of pure hell….for NOTHING!

Well now, almost a year later I can look at that experience and say that maybe it was not for nothing after all. There was something to gain and it may have been a blessing in disguise….

I continued as usual for the three months following the end of IV treatment trying to recover, only to have another PFT done in March, and blowing my all time low (FEV1 of 43%.) My fear kicked in again…it prompted me to make numerous drastic changes to my daily routine and as a result I have greatly improved my health. It was at this time when I stumbled across cf.com and subsequently runsickboyrun.com. I spent endless hours reading and researching about the tactics that other CFers use to maintain their health. I was surprised (or more like shocked and appalled) to realized how many things I was doing WRONG. I thought I did so much day to day to take care of myself, when in reality there was so much that I was not doing that I should have been. I decided that it was time for a “health renovation!”

I am so grateful to the members of cf.com and to Ronnie for motivating me to take control of my health and ultimately helping me increase my FEV1 by 23% since I became a member of cf.com!!! I had always been relatively compliant with my medications and treatments and “got by” but this was not enough anymore. I made a pact with myself to be 100% compliant 100% of the time. I have stuck to that over the past 6 months (no matter how early I have to get up to fit my treatments in, or if I am struggling to keep my eyes open to do my treatments at night)….and as I sit here typing this feeling better than I have in years…I am so glad that I have. At my last clinic visit 1 week ago I had an FEV1 of 65% and FVC of 118%. I have been on a “PFT high” ever since, and am more motivated than ever to work as hard as I possibly can to keep that number rising!!!

Here are the changes that I have made to my routine over the past 6 months…

1. I switched from using the Hil-rom 104 vest to using the Respirtech Incourage vest system. I like the features that this system offers and I personally find that it makes my vest sessions more productive.

2. For years I had been using the PariTrek portable compressor for ALL of my nebulizer treatments completely unaware that this unit is NOT supposed to be used for Pulmozyme or Tobi. I have now switched to using the DeVilbiss PulmoAide.

3. I began taking PharmaNAC Fizzy Tablets 2x/day.

4. I began taking a multi-strain Probiotic daily.

5. I began using the NeilMed Sinus Rinse with sterile water, and sterilizing the bottles after each use. I had sinus surgery as a child, and thankfully have not had many sinus problems since, however I still LOVE this rinse!

6. My doctor had been prescribing me Advair for a couple of years but I would rarely remember to actually use it. I now use it 2x/daily.

7. Over the past few years I really fell out of any sort of exercising routine. I was really getting no physical activity at all. I now have worked my way up doing 45-60 minutes of cardio 4-6 days per week. I also take 1 hour Pilates classes 2x/week. I truly believe adding exercise to my daily routine is one of the MOST IMPORTANT changes I made!!!

8. I am ashamed to say that I used to NEVER sterilize my nebulizer sets, just rinsed with soap and water and sometime even used them while they were still wet. Yikes!!! I have since started sterilizing after every use using the Phillips Avent IQ24 electric baby bottle sterilizer and the Germ Guardian for drying.

9. I have become much more germ-conscious (i.e. I constantly wash my hands, try not to touch my face unless my hands are clean, I never go anywhere anymore without hand sanitizer in my bad and have bottles of it all over my house and in my car. I also make it a point to change my bedding more often than I used to.)

10. For years I have been spending a majority of my time in the basement of my house. It was our family room/office. A few months ago we had some water seep in through the basement floor during a bad rain storm. This wasn’t the first time this happened and as stated above we had recently had the house tested for mold and got a clean report, but I was armed with my new “proactive” attitude and decided that it was the end of the basement for me. I banned myself from the basement. Although there are no visible signs of mold or dampness, why should I put myself in an environment where I could possibly be at risk for making myself sick? The answer is simple…I shouldn’t. This definitely wasn’t the most convenient decision considering the layout of my house. Losing the basement meant losing a significant amount of usable living space and involved some rearranging. I now only step-foot in the basement to do laundry and when I do this I wear a mask.

11. I bought two Alen350 Hepa Air Purifiers, one for my bedroom and one for my now office/TV room where I spend most of my time while I am in the house. Also I never opened my bedroom windows during allergy season…so at the very least I could be sure I was sleeping in good clean air.

12. I have not yet decided to take Mucinex on a daily basis. However, there have been two times in the past few months that I have felt like I was starting to get sick and I have immediately started taking Mucinex for 10-14 days. My doctor’s opinion on this is that it will do very little for people with CF, but it has helped me to kick two minor colds without them turning into full on exacerbations. So in my opinion it is doing something to help and I will continue this routine when I feel I need to.

It is hard to say which of these things has specifically made the most difference in improving my health, but I plan to keep it up! And I will constantly be looking new things to contribute to my “renovation.”

Elizabeth Haran is a 26 year old, who was diagnosed with Cystic Fibrosis at 6 months. She was born and raised in Brooklyn, New York where she currently lives. She graduated from St. Joseph’s University in Philadelphia, Pennsylvania in 2005 with a degree in Marketing. Her interests include photography, reading, music, the beach, shopping, spending time with her family & friends, and of course WORKING OUT and staying healthy!!

Note from Ronnie: I just wanted to give a big thank you to Elizabeth for writing an outstanding guest post for RSR. She is a great example of a CFer who decided that "enough was enough" and to take CF head-on . She has shown that although it may take some changes, through a little bit of hard work and dedication, we CAN have some control over this disease. I encourage you to leave Elizabeth your encouraging comments as well as any questions you may have!

If you are interested in writing a guest post for RSR simply send me an email with a little bit about yourself and what you'd like to write about.

My Top Ten Favorite Cities

I love to travel. One of the few claims to fame that I have is the fact that I have been to 42 of the 50 states. The following list represents the first 10 cities to come to my mind when thinking of my favorite cities to spend time in...

10. Austin- Austin just has an overall cool vibe. I’m a huge fan of music and Austin has one of the best music scenes in the nation. The city is full of laid back artists, hippies, musicians and college kids from the University of Texas. It’s a great place to have a lot of fun.

9. Miami- Miami is another one of those cool cities. The architecture in Miami Beach is some of my favorite and people just seemed to take it easy there. It’s definitely one of the most fun places to just hang out for a week.

8. Denver- I like the state of Colorado overall, but Denver has to get the nod as my favorite city in the state followed closely by Colorado Springs. Denver has a fun downtown area and has multiple hiking trails and parks just outside of the city.

7. Atlanta- I love the Midtown area of Atlanta the most. What really stands out to me though is the campus of Georgia Tech. I LOVE red or brown brick buildings which you will see plenty of in Midtown and on campus.

6. Boston- I think Boston is the cleanest biggest city I’ve ever been too. Although it seemed to always be under construction, the city still seemed very orderly. The second best fire works show I ever saw took place in Boston.

5. Chicago- I grew up liking almost every professional sports team from Chicago. It started with the 1985 Chicago Bears and watching them play in the first football game that I remember watching (happened to be the '85 Super Bowl). I’ve only been there once but fell in love with the city immediately. I also have many friends from Chicago that can’t say enough good things about the city which only builds my affinity for it.

4. New York- I was fortunate enough to spend a couple summers in a row in “The City” around the 4^th of July. The fireworks display over the East River is the most stunning show I’ve ever seen. It truly is the city that never sleeps and there is always something to do. I couldn’t live there, but I love visiting.

3. San Diego- I like pretty much every city in California, but San Diego is the one that I’ve been to most often. I love taking the trolley all over the city and walking through the Gaslamp District. The weather is great year round and it’s tough to beat the scenery in southern California.

2. Phoenix- There’s not much that I don’t like about Phoenix. I love that you can live outside of the city by 10 minutes to get that “country” feel but be close to everything. It’s also nice that there are a plethora of outdoor activities year round from hiking, to boating, to four-wheeling.

1. Tucson- Tucson is (and will always feel like) home to me. I went to and graduated from the University of Arizona and will ALWAYS be a Wildcat. My favorite things that Tucson offers: my family, the mountains, the sunsets, the lightning storms, and the U of A.

So what do you think? Is there a city that I didn't list that I just have to go to? Maybe I've been there and it just didn't make an impression :)

I'd love for you to drop me a quick note about your favorite city and why I should visit....

Interesting article about Bacteria

Deep Inside Bacteria, a Germ of Human Personality

Bacteria are the oldest living things on earth, and researchers have long felt that they must lead dull, unfussy lives. New discoveries are starting to show just how wrong that notion is.

For a simple, single-cell creature, a bacterium is surprisingly social. It can communicate in two languages. It can tell self from nonself, friend from foe. It thrives in the company of others. It spies on neighbors, spreads misinformation and even commits fratricide.

"Really, they're just stripped-down versions of us," says Bonnie Bassler, microbial geneticist at Princeton University, who has spent two decades peeking at the inner lives of bacteria. Dr. Bassler and other scientists are using this information to devise new ways to fight infections and reduce antibiotic resistance.

Bacterial society is based on a chemical language called quorum sensing. To detect how many of its own species, or members of another bacterial species, are in the immediate vicinity, each bacterium secretes a certain molecule into the environment. The greater the number of molecules it can sense, the more fellow bacteria it knows are out there.

This is often a trigger to act. Some bacteria will attack a person or any other host only after establishing that there is a quorum -- a large-enough army to overcome the host's immune defenses. The strategy helps explain the virulence of a number of human ailments, including cholera, pneumonia and food poisoning.

Dr. Bassler was the first to identify the molecule that bacteria use to communicate with members of other species. She hopes the finding will lead to a new kind of drug that won't succumb to antibiotic resistance.

Resistance is a serious and growing health risk across the world. It occurs because most antibiotics are designed to kill bacteria. But some bugs survive the attack and pass on their resistant genes to their progeny, strengthening future generations and making the antibiotic less effective.

Instead of killing bacteria, Dr. Bassler wants to simply jam their communication lines -- the quorum-sensing mechanism. She figures that if the bugs can't signal each other, they can't properly assess the size of their growing army and might never attack. Another benefit: Because bacteria aren't killed, the approach could delay the onset of resistance.

To continue reading the article click here

Original article can be found at http://online.wsj.com/article/SB125236107718690619.html?mod=googlenews_wsj

Some people work (for me) on Labor Day

Wouldn’t you know it! It is my big day to chat with you and Ronnie steals my thunder. After all, I am the one writing on Labor Day, and Ronnie chooses the day BEFORE Labor Day to tell you all about it.

As a matter of fact, I should not be working at all today according to the history and information he shared with you yesterday, so I won’t. Instead of sitting down and beating out an informational tidbit, I will share with you the some of my joys about today. I can sum it up in two words, family and fun. We are in Florida and enjoying some time with some of my Mom’s side of the family and the Florida beach and sunshine. The latter is a hope for, as in Florida any day can include both sunshine and a downpour all within an hour of each other, only to have the sun pop out again and just makes things a bit steamier. Yes, that is something that is a bit hard to get used to, for Arizona is not exactly the steam bath area of the world. We have been joined here by my brother and his girlfriend, both also from Arizona, so we are all smiling and sweating together.

My Grammy's house in St. Augustine Beach, FL

The beach has been a great place to get that morning walk/run in and the scenery is just a tad different than that we see when we do our “daily” at home. Somehow it doesn’t seem so much like exercise as an adventure. We walk, jog and run on a strip of white sand that is so packed that cars drive on it as if it were a paved road. One of the nice things is…we are only two of many that are doing the same thing. Misery loves company! When the exercise portion of the morning is done we limp home wearily and wet with sweat. The latter describes Ronnie, for being the lady I am , I perspire. We head for the pool to cool off and let me tell you, that is a shocker. At home we get into a tepid if not just plain warm pool to loll about. Here, we jump in, gasp, have second thoughts an even third, but it is delightful once you get used to the feel of ice cubes surrounding you. Florida nights are getting cooler and so is the pool water. St. Augustine is in northern Florida and yes, they do have seasons, so it is not balmy breezes the year round and the temperature of the pool water is testimony to that fact.

A relaxing stroll down the beach

Strolling down St. George’s street in the oldest community in the USA is another way of giving our new sneakers a workout. Fudge and French pastry makes those morning jogs a necessity not only for clearing the airways, but for taking off the bulge that could appear in one heck of a hurry. Because my Grammy is not in love with the kitchen and her stove, we are also walking off the effects of too many evenings of eating out and not always choosing the most lean item on the menu. Getting back in the groove when we get home will hopefully take care of that. Don’t worry about Ron’s weight dropping this week.

St. George Street in downtown St. Augustine

Since it is my day off and Ronnie has already told you everything anyone would ever want to know about the holiday, and since the beach and family are waiting, I will just say….Happy Labor Day. Enjoy the time with family, friends, and the fact that the alarm clock did not have to go off this morning for most of the working force. If you do have to work today…Thank you for being there for us.

Ronnie's getting old...

I promise to be back on the job next week and Mandi’s Monday Musings or Meltdowns will be more like the usual thing.

Now for true confessions… I will have to be very honest with you…Mandi didn’t write this at all! She is in bed sound asleep, for after all it is Labor Day, and being the loving Grandmother that I am, I am filling in for her. If it seems a bit different than her regular notes to you just factor in the difference that 57 years makes!

From left to right: Mandi, Josh, Chrissy, Susan (aunt), Grammy, Ronnie

Note from Mandi: ...when I woke up this morning, my Grammy gave me this little surprise! She is one of RSR's biggest fans and reads every day. There is no place like my Grammy's home and no one sweeter than my Grammy. This is one of my favorite places! And since we can work from anywhere, we decided we'd work from FL for a few days and then spend the holiday weekend playing with my brother and his girlfriend, Chrissy. It's been incredible to catch up on some sleep and enjoy a weekend solely relaxing...

Chrissy and Josh

Tell me what you did on your day off...

We're obviously super excited to be here :)

Girl Runs a 5k at 11% Lung Function

Here's yet another reason why I have no excuse...

A young woman who needs a life-saving double lung transplant is taking on a challenge of a lifetime today when she attempts to complete part of a five kilometre run.

Jessica Wales is taking part in the Adidas Challenge in Hyde Park, London, but has decided to walk it to ensure she has a better chance of hitting her target.

She suffered a deadly chest infection in April, and is now battling for survival.

But the brave 20-year-old is taking on this physical challenge to raise money for the transplant charity Live Life Then Give Life, known as LLTGL.

Jess, from Westgate in Thanet, was born with cystic fibrosis, the UK’s most common genetically inherited life-threatening disease.

Its devastating progression means her lungs are now useless and completely beyond repair, so a massive transplant operation is her only hope.

They are functioning at a mere 11 per cent of their capacity.

She now relies on an oxygen supply 24 hours a day and a non-invasive ventilator to keep her lungs going when they regularly start to tire.

So it will be against all the odds for her to finish the challenge, which for her will be gruelling.

Jess in unable to even wash her own hair or put on her own socks, so walking any distance will be a huge physical strain.

She is hoping to walk at least 200m per kilometre, with the total aim of walking one kilometre out of five.

LLTGL chairman Emily Thackray said: “Jessica has been waiting for her new lungs for over four years now and already doubled the two years predicted survival she was given by the doctors back in 2005.

“It is heartbreakingly sad to think that this amazing girl may well not be here to see her 21st birthday.

“The work she continues to do to raise awareness for organ donation is incredible; she is a true inspiration.”

Jess said: “A lung transplant for me will be literally life changing. It will mean the whole world to me.”

She wants to raise money for the specialist Cystic Fibrosis unit at Kings College Hospital in London, where she is a patient.

Jess said: “It is vital that cystic fibrosis sufferers receive the appropriate healthcare to ensure a better quality and length of life.

“The CF unit at Kings College Hospital provides a home from home for those frequent and often lengthy stays and all proceeds will be donated to the centre to help others like me.”

Jessica will be accompanied by a team of specialists from Kings College Hospital, to support her throughout the event.

Cystic Fibrosis is one of the UK's most common life-threatening inherited diseases which affects over 8,000 people by attacking internal organs, especially the lungs and digestive system, by clogging them with thick sticky mucus.

This makes it hard to breathe and digest food.
Each week, five babies are born with Cystic Fibrosis and three young lives are lost to the disease.

**Original article can be found at http://www.kentnews.co.uk/kent-news/Battling-Jessica-puts-her-best-foot-forward-today-newsinkent27790.aspx

Pretty awesome huh?

Why Don't We Work on Labor Day???

I wanted to do something a little different for this Spotlight Sunday. Instead of spotlighting another blog/person/article, I wanted to put the spotlight on a holiday. I bet you can't guess what day I'm referring to...ok, maybe you can. If you were thinking Labor Day, you'd be correctomundo. To be honest with you guys, I had no idea why Labor Day started, when it started or who started it, so I dug up some info and thought I would share it with you guys. I've got to assume that I'm not the only person that was confused as to why this is a holiday.

The History of Labor Day

For other Labor Day information, visit our Labor Day 2009 page.

Labor Day: How it Came About; What it Means

Labor Day, the first Monday in September, is a creation of the labor movement and is dedicated to the social and economic achievements of American workers. It constitutes a yearly national tribute to the contributions workers have made to the strength, prosperity, and well-being of our country.

Founder of Labor Day

More than 100 years after the first Labor Day observance, there is still some doubt as to who first proposed the holiday for workers.

Some records show that Peter J. McGuire, general secretary of the Brotherhood of Carpenters and Joiners and a cofounder of the American Federation of Labor, was first in suggesting a day to honor those "who from rude nature have delved and carved all the grandeur we behold."

But Peter McGuire's place in Labor Day history has not gone unchallenged. Many believe that Matthew Maguire, a machinist, not Peter McGuire, founded the holiday. Recent research seems to support the contention that Matthew Maguire, later the secretary of Local 344 of the International Association of Machinists in Paterson, N.J., proposed the holiday in 1882 while serving as secretary of the Central Labor Union in New York. What is clear is that the Central Labor Union adopted a Labor Day proposal and appointed a committee to plan a demonstration and picnic.

The First Labor Day

The first Labor Day holiday was celebrated on Tuesday, September 5, 1882, in New York City, in accordance with the plans of the Central Labor Union. The Central Labor Union held its second Labor Day holiday just a year later, on September 5, 1883.

In 1884 the first Monday in September was selected as the holiday, as originally proposed, and the Central Labor Union urged similar organizations in other cities to follow the example of New York and celebrate a "workingmen's holiday" on that date. The idea spread with the growth of labor organizations, and in 1885 Labor Day was celebrated in many industrial centers of the country.

Labor Day Legislation

Through the years the nation gave increasing emphasis to Labor Day. The first governmental recognition came through municipal ordinances passed during 1885 and 1886. From them developed the movement to secure state legislation. The first state bill was introduced into the New York legislature, but the first to become law was passed by Oregon on February 21, 1887. During the year four more states — Colorado, Massachusetts, New Jersey, and New York — created the Labor Day holiday by legislative enactment. By the end of the decade Connecticut, Nebraska, and Pennsylvania had followed suit. By 1894, 23 other states had adopted the holiday in honor of workers, and on June 28 of that year, Congress passed an act making the first Monday in September of each year a legal holiday in the District of Columbia and the territories.

A Nationwide Holiday

The form that the observance and celebration of Labor Day should take were outlined in the first proposal of the holiday — a street parade to exhibit to the public "the strength and esprit de corps of the trade and labor organizations" of the community, followed by a festival for the recreation and amusement of the workers and their families. This became the pattern for the celebrations of Labor Day. Speeches by prominent men and women were introduced later, as more emphasis was placed upon the economic and civic significance of the holiday. Still later, by a resolution of the American Federation of Labor convention of 1909, the Sunday preceding Labor Day was adopted as Labor Sunday and dedicated to the spiritual and educational aspects of the labor movement.

The character of the Labor Day celebration has undergone a change in recent years, especially in large industrial centers where mass displays and huge parades have proved a problem. This change, however, is more a shift in emphasis and medium of expression. Labor Day addresses by leading union officials, industrialists, educators, clerics and government officials are given wide coverage in newspapers, radio, and television.

The vital force of labor added materially to the highest standard of living and the greatest production the world has ever known and has brought us closer to the realization of our traditional ideals of economic and political democracy. It is appropriate, therefore, that the nation pay tribute on Labor Day to the creator of so much of the nation's strength, freedom, and leadership — the American worker.

**All information presented is from http://www.dol.gov/OPA/ABOUTDOL/LABORDAY.HTM

So did that clear things up? I hope so. Now go enjoy your extra time off.