You can use Medco’s Medco By Mail two ways:
Call at 1-800-711-0926
Visit the Web site:Medco.com

Phone and Online:
Order refills, Renew prescriptions Check order status , Check mail order account status, Request mail order forms and envelopes, View prescription claims history (local and mail order)Prescription drug pricing and coverage information, Find a participating pharmacy (NC and nationwide), View summary of prescription drug benefit, Find health and wellness articles Drug information

Registration and Login for Medco.comTM
To access the above features online at Medco.com, you will first need to register and login using a login and password that you choose. The registration process will ask you for your member ID which can be found on your Blue Cross and Blue Shield ID card (enter the last 9 digits beginning with the W). Medco.com offers the following services:

Mail order transactions
Order refills. Renew prescriptions. Check your order status. Check your account status. Now you can do all these things online through Medco.com. It’s a simple way to conduct all your mail order business with Medco’s Medco By Mail.

View your prescription claims history

Need an easy way to keep track of all your prescriptions for tax purposes? Whatever your reason, now you can view your prescription claims history online. You’ll be able to review them through both your local retail pharmacies or Medco’s Medco By Mail.

Drug coverage information
Want to know how much that new prescription will cost? Check out the drug coverage feature to find out how much your prescription copayment will be at either your retail pharmacy or through Medco’s Medco By Mail.

Search for participating pharmacies:
The pharmacy search at Medco.com lets you search for participating pharmacies across the nation, not just those in North Carolina. So whether you live in areas close to our borders, in other states, or just want to know if there is a participating pharmacy in the area you may be vacationing, visit the pharmacy search on Medco.com.

Technical Support
Medco.com provides technical assistance with any problems you may experience on their Web site by sending an online inquiry or by calling their toll free number (1-800-711-0926). However, for any issues with your benefits (i.e. rejected prescription claim, paid greater than your expected copayment, eligibility inquiries, etc.) please contact BCBSNC Customer Services at the phone number listed on the back of your identification card.

* Some programs are available to members of specific plans only. Check your plan’s specific benefits to see if you are eligible.

The information above is brought to you from BCBSNC 2009, under Mail Order Drug Program.

For more information on health insurance coverage in North Carolina and how to utilize My Member Services, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

Blue Options HSA links a high-deductible health plan to a health savings account (HSA), which can be used to pay for qualified medical expenses tax-free.  Monthly premiums are as much as 50% lower than traditional health plans. The HSA is portable and any unused balance rolls over at the end of the year.Lower premiums—save as much as 50% off Blue Advantage .  Choose your own doctor from the largest provider network in the state.  Preventive care services covered at 100%

(1) An HSA is automatically included with your health plan if you select Mellon as your fund administrator

(2)  Mellon HSA includes a convenient debit card at no charge

(3)  HSA contributions and withdrawals are tax-fre

(4)  Annual contribution limit for 2010 is $3,050 for individual plans and $6,150 for family plans

(5)  Out-of-pocket maximum protects you from high-dollar medical costs

(6)  Secure access to health plan information online

(7)  Optional maternity coverage available.

*The content of this post is provided by BCBSNC.

For more information about health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents.  Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health.  Call us for details.

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A Closer Look

MYTH: Most Americans support the idea of a government-run health insurance plan.
FACT: There is simply no consensus. Where the majority stands on this issue depends considerably on how the question is phrased. If a public option is couched as simply another choice — one independent of the options they have now — of course most people say they’re for it. But when more detail is provided in evaluating the concept, opinions tend to be more negative.

For example, while a Washington Post/ABC News poll[1] did find that 57 percent of respondents supported a public option (versus 40 percent opposed), an NBC/WSJ poll[2] found that 48 percent of respondents felt a public option would “reduce access to their choice of doctors and would lower costs by limiting medical treatment options,” versus 45 percent that believed it would “help lower health care costs and provide coverage for uninsured Americans.”

Other recent polls indicate public skepticism about the direction of current health care reform proposals – particularly as they relate to a government-run health plan and health coverage costs. An October Wall Street Journal/NBC poll found that significantly more Americans think health care costs will increase under reform (47 percent) than believe reform will reduce costs (13 percent). Around the same time, a poll of likely voters conducted for the Civitas Organization[3] found North Carolinians deeply divided on this issue, with 49.3 percent of voters saying they disapprove of the health care plan being proposed by President Obama and Congress and 40.3 percent supporting it.

MYTH: Proposed health reform legislation will not tax the middle-class.
FACT: The Senate health reform bill includes indirect taxes on health care consumers, in the form of $11 billion in taxes on health insurers, drug companies and medical equipment manufacturers. Consumers will pay those costs in higher premiums. Some middle-class consumers could also see their cost impacted by the Senate’s 40 percent excise tax on “Cadillac Plans.”

If cost is the number one problem in health care, then reining in costs should be the number one priority in health care reform. New taxes and fees will increase costs for those who already have coverage.

MYTH: Private insurers hold an unfair monopoly on health insurance.
FACT: That is simply not the case in our state. According to the NC Department of Insurance, there are actually more than two dozen companies licensed to sell health insurance in North Carolina, representing competition in every line of business.[4]   Consumers can, and do “vote with their feet” and buy the insurance products of their choice. Granted BCBSNC is the state’s largest insurer, but that’s because our focus has always been on prevention, value and great customer service. And unlike most of our competitors, we’re focused solely on North Carolina, positioning us to know and best address the needs of North Carolinians.

MYTH: Most workers aren’t happy with the quality of the health coverage they receive from employers.
FACT: Employees are generally highly satisfied with their coverage.  Eighty-one percent of insured participants in an ABC News/Washington Post poll said they were satisfied with their current coverage if they were insured.[5]   Sixty percent of employees rank health insurance as their most important employer benefit. In comparison, the second most cited response by employees was retirement plans, with only 17 percent of employees ranking those as most important.[6]

MYTH: “Health insurers make more money than any other business in America today.”[7]
FACT: That’s what Senate Majority Leader Harry Reid (D-Nev.) claims, but the facts don’t support his rhetoric about “outrageous profits.” Health insurers’ profit margins are at best in the middle of the business pack. A recent Fortune Magazine report[8] on the “most profitable industries” puts health insurers’ 2.2 percent profit margin at 35th – well behind network companies, pharmaceuticals, banks, IT, beverages and medical facilities. More heavily regulating the insurance business will only raise health care costs for working families across the country. Over the past several years, Blue Cross and Blue Shield of North Carolina has had a profit margin of between 3.6 percent and 4.6 percent. In 2008, our profit margin was 3.6 percent.

MYTH: Health insurers oppose elimination of pre-existing condition clauses.
FACT: BCBSNC and many other insurers strongly support the elimination of pre-existing conditions clauses and health-based underwriting, as long as everyone is covered. Insurers have traditionally included such clauses in insurance contracts to encourage people to be continuously covered, whether they are sick or ill. Pre-existing condition clauses and health based underwriting are simply tools to encourage people to stay covered and to maintain a broad-based pool which improves affordability for all.
If the personal responsibility requirement with sufficient enforcement goes through, it will be time to retire these types of tools. Here’s why they can be beneficial:

If someone has a heart condition that existed at the time of enrollment, they can still buy comprehensive insurance that will cover other needs unrelated to that condition. For example, treatment related to a new cancer diagnosis or emergency services would be covered – even during a temporary waiting period for the heart condition. Pre-existing condition clauses help make coverage more affordable.  Pre-existing condition clauses create a strong incentive to carry coverage all the time – not just when you’re sick. This keeps a lot of healthy individuals in the insurance pool, keeping costs down for everyone.  We want to see a health care system in which no one would be denied coverage or face unaffordable rates because of their health circumstances. We would prefer to eliminate this kind of underwriting entirely, but that can only be done if we can get everyone – sick, well and in-between – paying into the health insurance system on a consistent basis, creating a broad-based pool to spread out and absorb these costs.

MYTH: Health insurers support gender discrimination.
FACT: BCBSNC supports the elimination of rate differentials between men and women. Gender has historically been used in ratemaking because actuarial evidence shows clear gender differences in the use of medical services. For example, women have higher medical claims than men of similar age until their mid-50s.  Women’s rates can be lowered only by raising rates on men substantially, with the possibility that many young, healthy men will drop coverage. Also, unisex rating would be to women’s disadvantage later in life when claims for men surpass those of women.  While we support this change, consumers should understand that lowering rates for one group will result in premium increases for another.

MYTH: Health care costs are rising because of insurance industry profits and hefty executive salaries.
FACT: In 2007, national health care expenditures totaled $2.2 trillion. CEO compensation is a mere 0.005 percent of total spending.[9] Insurer scapegoating is a political tactic, not an answer to health care cost control.

MYTH: Government programs don’t impact the cost of private care.
FACT: The continued underpayment of providers by public programs has devastating consequences for families and employers that are struggling to afford health care coverage. Low Medicare and Medicaid reimbursements to hospitals and physicians lead to significantly higher health insurance costs for consumers and employers. Annual health care spending for an average family of four is $1,788 higher than it would be if Medicare, Medicaid and private employers paid hospitals and physicians similar rates, with total provider reimbursement unchanged.[10] Greater enrollment in a government program – or an expansion of Medicare – would make this problem far worse, raising costs for customers of private health plans even further.

MYTH: Most employees would rather have a higher salary than employer-provided health coverage.
FACT: The value employees place on health benefits exceeds the actual cost of those benefits.
Seventy-six percent of employees preferred $7,500 in employer-based health coverage to an additional $7,500 in wages.

Those preferring health benefits were asked what dollar increase in taxable income would be required for them to give up $7,500 of employer health benefits. Fifty percent said $10,000 or more; 11 percent said no increase in taxable income would be enough.[11]

MYTH: Insurers are opposed to health care reform because they want to protect their profits.
FACT: BCBSNC strongly supports enactment of health care reform this year. We also support new federal rules to require insurers to offer coverage to everyone – regardless of pre-existing medical conditions – coupled with an individual responsibility requirement and federal subsidies to make health coverage affordable. Without reform that truly works to bend the cost curve, our current system is not good for the insurance industry. At current cost trends, a large portion of our current customers will likely be priced out of the market. That’s bad for Americans AND the insurance industry. We need to reform our system to make it sustainable in the long term, but reform should not drive premium costs beyond the reach of American families.

MYTH: Insurers can drop you whenever you get sick.
FACT: Federal (HIPAA, 1996) and state laws already prohibit insurers from dropping people when they get sick. North Carolina insurers are required to issue coverage on a “guaranteed renewable” basis – meaning the decision to renew is made by the individual and not the insurer. These rules apply to coverage sold to individuals, small employers and large employers.

MYTH: Insurers raise premiums when someone becomes sick.
FACT: Federal and state laws prevent employers or health insurers from increasing a consumer’s premiums if they get sick or incur costly medical claims. While medical inflation is causing rates to increase annually, we do not raise the rates of a customer when they become sick. We have long supported prohibitions against raising premiums because a customer’s health changes.

MYTH: Health insurers oppose a government-run health plan out of fear of competition.
FACT: Health insurers are no strangers to competition, which is strong even among companies with large market shares. Employers and individuals can – and do – change companies if they can save even a few dollars on premiums. There are at least two dozen companies offering health insurance in North Carolina. BCBSNC faces competition in every line of business. [12]   The problem with a government-run plan is that it can dictate prices to hospitals, doctors and vendors. For all their reported market clout, private sector insurers can’t. That’s why Medicare and Medicaid now reimburse doctors far less than market rates, leading to higher charges on private insurers to make up the difference. This “cost shift” would get much worse if tens of millions more Americans get their coverage from a government plan. It wouldn’t take long for private coverage to become so much more expensive that the government plan would push them out of existence.
The government’s ability to manage its current health care responsibilities is subject to question, given the questions about Medicare solvency and news reports of widespread fraud, as noted in a 60 Minutes story.
There are serious concerns about Medicare financial solvency. Growing annual deficits are projected to exhaust the program’s reserves in 2017.[13]

MYTH: Industry anti-trust exemptions give insurers an unfair advantage and lead to monopolies and higher rates for insurance.
FACT: Insurers are only exempt from anti-trust to the extent they are closely regulated by the states, so removing these exemptions won’t make insurance any more affordable. The Congressional Budget Office issued a report[14] stating repeal of the McCarran Ferguson anti-trust exemptions “would have no significant effect on the premiums that private insurers would charge for health insurance.” Robert Laszewski, an Alexandria, Virginia-based consultant said “Either the people who are proposing this are really naïve about how insurance is regulated, or they are just playing political games with the voters.”[15]

MYTH: Health insurer political contributions give the industry too much influence.
FACT: Health insurers control the political debate? Hardly! See this analysis of “heavy hitters” in the political world, courtesy of the nonpartisan Center for Responsive Politics:

http://www.opensecrets.org/orgs/list.php?order=A. Of the top 20 influential segments, labor unions take 12 slots.

At BCBSNC, we believe we have a responsibility to our customers and our state to be engaged in this debate and to provide policymakers with information that will help them evaluate the likely impact of various reform approaches — particularly cost implications. Health care reform that drives up health care costs is ultimately bad for everyone.

MYTH: The Federal government has a strong track record in running health plans and can certainly handle a vast expansion in its role.
FACT: Medicare, the federal insurance program for the elderly and disabled, and Medicaid, the federal-state program for the poor, are popular with beneficiaries, many of whom would have few other options. But costs for these plans have run many times higher than initially projected, and fraud remains a significant problem. The Medicare program, which spends more than $400 billion a year, reviews only 3 percent of claims. Medicare reported that it improperly paid more than $10 billion in claims in the fiscal year that ended Sept. 30, 2008.[16] The solvency of Medicare remains in question, with its hospital program reserves projected to be depleted in 2017. [17]

*The content of this post is provided by BCBSNC.

For more information about health insurance coverage in North Carolina, please visit our website at http://www.nchealthplans.com/ or call our toll free number 888-765-5400 and speak with one of our qualified agents.  Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health.  Call us for details.

————————————————————————————-
[1] NBC News/Wall Street Journal Poll, October 2009 http://firstread.msnbc.msn.com/archive/2009/08/18/2033674.aspx
[2] Washington Post ABC News Poll, August 2009
http://www.washingtonpost.com/wp-dyn/content/article/2009/10/19/AR2009101902451.html
[3] http://www.nccivitas.org/media/press-releases/civitas-poll-support-health-care-bill-continues-decline
[4] http://www.ncdoi.com/me/annualdatafiling/2007/enrollment%20data/enrollment%20by%20plan%2012-31-07.xls
[5] http://abcnews.go.com/PollingUnit/story?page=1&id=7910801
[6] EBRI Health Confidence Survey, 2004
[7] Politico, October 14, 2009 http://www.politico.com/news/stories/1009/28276.html
[8] Fortune 500 2009 Top Industries: Most profitable http://money.cnn.com/magazines/fortune/fortune500/2009/performers/industries/profits/
[9] www.factcheck.org
[10] Milliman report, “Hospital & Physician Cost Shift – Payment Level Comparison of Medicare, Medicaid, and Commercial Payers,” December 2008
[11] EBRI Health Confidence Survey, 2008
[12] http://www.ncdoi.com/me/annualdatafiling/2007/enrollment%20data/enrollment%20by%20plan%2012-31-07.xls
[13] A SUMMARY OF THE 2009 ANNUAL REPORTS — Social Security and Medicare Boards of Trustees (http://www.ssa.gov/OACT/TRSUM/index.html)
[14] CBO Cost Estimate on H.R. 3596, Health Insurance Industry Antitrust Enforcement Act of 2009 – October 23, 2009 http://www.cbo.gov/ftpdocs/106xx/doc10673/hr3596.pdf
[15] Bloomberg News 10/23/2009
[16] Wall Street Journal 10/28/09
[17] A SUMMARY OF THE 2009 ANNUAL REPORTS — Social Security and Medicare Boards of Trustees (http://www.ssa.gov/OACT/TRSUM/index.html)

 Ruptured Anterior Cruciate Ligament (ACL), Torn ACL, Torn ligament.

Affected Animals: Commonly, dogs and humans; less commonly, cats. Obese animals are at greater risk for suffering this injury. In addition, certain breeds of dogs are more susceptible than others to developing a ruptured cruciate ligament. Most commonly, these breeds include the rottweiler and cocker spaniel. The Labrador retriever, German shepherd, mastiff, golden retriever, miniature and toy poodle, Lhasa apso, and bichon frise are likely to suffer from the problem as well.

Overview:
A normal dog’s knee joint works like a hinge, keeping the animal’s leg stable as it bends. When the knee has a ruptured cruciate ligament, the “hinge” becomes loose and no longer functions as effectively. This looseness prevents the knee from maintaining stability of motion. As a result, the dog suffers pain, inflammation, and eventually develops arthritis. This is a very common orthopedic disease in dogs.
When a knee injury occurs suddenly — as it usually does among humans who suffer from injuries to the cruciate ligament due to a skiing, football, or other sports-related accident — the ligament will tear rapidly. But usually with dogs, the tearing is partial and occurs gradually, resulting in low-level lameness that may improve initially over time. However, progressive injuries can be quite damaging; because of the trauma to the ligament, the knee joint becomes inflamed, leading to arthritis, which only grows worse with continued weight bearing.

Trochlea of Femur - Tibia; Fibula - Cranial Cruciate Ligament - Caudal Cruciate Ligament- Lateral Meniscus - Medial Meniscus

In more severe chronic cases, the “shock absorbers” of the knee — quarter-moon shaped sections of cartilage called the medial and lateral menisci — tear or become crushed because of exposure to abnormal stress that occurs when the knee is loose. Animals with this condition often are severely lame and may not be able to put any weight on the affected leg.

Both surgical and non-surgical methods for treatment are available. Generally, dogs have a good chance of recovering normal, or almost normal, movement after surgery, but the arthritis that has occurred already will not be reversible. Additionally, dogs that have ruptured the cruciate ligament on one side are more likely to tear the ligament in the other knee.

Obesity is a major risk factor for this injury and certain breeds of dogs are more likely than others to rupture their ligaments.

Clinical Signs:
Clinical signs include acute non-weight bearing lameness; chronic progressive lameness; crepitus; pain; decreased range of motion; presence of medial buttress; presence of meniscal click; stifle effusion; thickened joint capsule; positive cranial drawer test; positive tibial compression test; reluctance to sit with normal flexed stifle tucked under the body; and inability to rise or walk if the condition is bilateral.

Symptoms:
Rear limb lameness, sudden onset lameness that either improves slightly and remains chronic or worsens again. The affected knee may feel thicker than the normal one. The dog may sit with its injured leg held out to the side, rather than tucked up underneath. The lameness should worsen with exercise. The knee may sound “crunchy” when put through a range-of-motion test.

Description:
Found in every joint of the body, ligaments are bands of tough, fibrous tissue that hold two or more bones in proper position. One of the ligaments that stabilizes the knee joint when the leg bends and moves is called the cranial cruciate ligament. When this cruciate ligament becomes loose, it is no longer able to ensure stable movement, and damage to the cartilage in the knee joint, leading to arthritis.

Ligaments are very strong tissues, but once they are damaged, they tend to heal slowly and incompletely. In people, cruciate ligament tears are often the result of rapidly occurring trauma, such as injuries resulting from skiing, football, soccer, and other sports accidents. Although this type of injury can also occur in dogs — jumping up to catch a Frisbee, for example, can cause rapid trauma — ruptured cranial cruciate ligament injury in the canine usually occurs progressively, over a period of time. There is often a partial tearing, which may show up as a low-level lameness and appears to improve in days to weeks. This partial tearing sets up inflammation within the knee joint, and the weakened ligament is further damaged with continued weight bearing. Eventually, this leads to complete rupture.

Due to a possible genetic component, some breeds, such as the rottweiller and cocker spaniel, are very prone to this disease. They may have some underlying genetic, conformational, or inflammatory disorder that predisposes the ligament to rupture; their susceptibility to the injury is a topic of research at many veterinary institutions. Obese animals are also at increased risk for this disease. However, dogs of all sizes and breeds can develop ruptured cranial cruciate ligaments.

Dogs with a ruptured cranial cruciate ligament in one knee have a 20 to 40 percent chance of injuring the other side, making a full recovery less likely.

Diagnosis:
The diagnosis of a ruptured cranial cruciate ligament usually can be made upon physical examination. Two tests, the positive cranial drawer test, and the positive tibial compression test, will confirm the diagnosis. The positive cranial drawer test, in which the dog’s knee is bent slightly and pressure is applied to the bones comprising it, is performed to check for instability within the joint. A positive tibial compression test also assesses the stability of the knee joint; this test may be more sensitive in detecting looseness in heavily muscled dogs. It may be necessary to sedate large dogs before performing the test. When the injury is chronic, the cranial drawer and tibial compression tests may be less effective assessments because their results will be more difficult to evaluate, since the body will have built up scar tissue in the joint capsule in an attempt to limit the abnormal motion.

If the dog’s meniscal cartilage — the knee’s “shock absorbers” — has been torn, the veterinarian may feel a “meniscal click.” Thirty to 50 percent of dogs that have knee joints with chronically ruptured cruciate ligaments will experience damage to their cartilage, resulting in arthritis. X-rays can help confirm the diagnosis and give an indication of how much arthritis already is present. This information may be important for determining prognosis. X-rays can also rule out diseases such as rheumatoid arthritis and fractures that may display similar symptoms.

Occasionally, the veterinarian will obtain and analyze a sample of joint fluid in an attempt to rule out other types of arthritic diseases. However, this procedure usually will not be performed unless there is suspicion that an underlying disease is causing the ruptured cruciate ligament.

Prognosis:
The prognosis depends on a number of factors. The longer the injury has been present, the more arthritic the joint and the more guarded the prognosis. If the meniscal cartilage is torn, the prognosis is more guarded as well. Obese animals tend to recover more slowly than animals in good shape. Animals with torn cruciate ligaments on both sides take longer to recover than animals with an injury on only one side. Dogs with underlying diseases such as rheumatoid arthritis, lupus, or immune mediated polyarthritis have a decreased prospect for a full recovery.

In general, animals stabilized with any surgical technique will require three to six months of rehabilitation. After that time, depending on how arthritic the joint was before surgery, they should return to fairly normal activity levels, although they are unlikely to regain 100 percent of their pre-injury function. These dogs may be sore after heavy exercise and occasionally may require pain medication. Athletic animals will have some decrease in function and will be unlikely to return to competition. Hunting dogs may not be able to hunt as frequently or for extended periods of time as they did prior to injury. The TPLO- surgery is purported to be able to return animals to performance levels; however, definitive objective studies have not been published to date.

Transmission or Cause:
The cause can be traumatic, or can occur as a result of chronic inflammation in the knee joint. There may be no known cause to the inflammation. However, the ligament may rupture as a result of the following diseases: medial patellar luxation, a disease in which the kneecap pops in and out of joint; rheumatoid arthritis; lupus; immune mediated polyarthritis; septic arthritis, an infection in the joint; osteochondrosis, which is a cartilage development problem; and problems related to the animal’s build or body conformation.
Dogs that are obese are much more likely to develop this disease than dogs that are of normal weight. In addition, certain breeds are more prone to developing the disease, especially the rottweiller and cocker spaniel.

Treatment:
The treatment for this disease can be surgical or non-surgical. Non-surgical management consists of exercise restriction, anti-inflammatory medications, physical therapy and weight loss. These therapies can be effective in very small animals such as cats and dogs weighing less than 15 pounds, although these animals will develop some arthritis, they may regain almost normal function.

Most veterinarians will recommend surgery for treatment of a ruptured cranial cruciate ligament. The many surgical procedures that are available for treatment can be organized into three basic categories: intracapsular stabilization, extracapsular stabilization, and a patented procedure called the Tibial Plateau Leveling Osteotomy® (TPLO).

Intracapsular ligament replacement involves either transplanting tissue from other parts of the dog’s body, such as the patellar ligament or fascia lata, into the knee joint. Other options for ligament replacement include a synthetic graft made from materials such as Gore-Tex® or ligament from a tissue bank. The goal of intracapsular ligament replacement is to position the replacement ligament in an anatomically correct configuration.

Extracapsular stabilization stabilizes the knee joint, using materials such as fascia lata, which is a strong fibrous sheet of tissue surrounding the muscles in the outside of the leg, monofilament nylon or other suture material, or stainless steel wire. Fibular head transposition is an extracapsular technique that allows another ligament in the knee joint, the lateral collateral ligament, to replace the function of the cranial cruciate ligament. These techniques are not performed inside the joint; rather, they function to counteract the instability in the joint by acting in a manner similar to an intact cranial cruciate ligament.

Tibial Plateau Leveling Osteotomy® (TPLO) is a technique that utilizes a different approach to treating cranial cruciate ligament injury. Rather than trying to oppose the forces acting on the cranial cruciate ligament in the normal knee joint, a TPLO® eliminates these forces — and thus the need for a cranial cruciate ligament — by changing the anatomy of the knee joint. This procedure requires that a bone cut be made in the tibia, which is then stabilized with a specialized bone plate. Only veterinarians that have been trained and licensed by the developer of the technique are permitted to perform this surgery. In general, dogs weighing less than 40 pounds are too small for this procedure.

There are advantages and disadvantages to each of these techniques. The results of these procedures are generally very good; however, some surgeries are more promising than others for complete return to function. There also can be substantial differences in cost and recovery time. A veterinarian can detail these surgical options and further explain the various procedures. Although cruciate ligament surgery can be very demanding, many veterinarians have a great deal of experience and success with these procedures.
Rehabilitation regimens vary, but most veterinarians recommend range-of-motion exercises, gradual return of activity, swimming, weight reduction, and pain medication.

Prevention:
While prevention of injuries is difficult, there are some factors that can decrease the likelihood of rupturing a cranial cruciate ligament. First and foremost is avoiding obesity. A veterinarian can assess the dog’s body condition and provide guidelines for a healthy diet and ideal body weight. Exercise is also important for dogs, just as it is for people, since a daily exercise regimen will lessen the likelihood of injury. Because animals with other orthopedic diseases of the knee joint, such as a luxating patella, may be more prone to cranial cruciate ligament rupture, early surgical correction of such orthopedic problems is an important preventative measure.

The above information is courtsey of PetDocksVeterinary Hospital. In June 2000, Dr. Worrell and his wife Dr. Allison Arnoult opened PetDocks Veterinary Hospital. As your other family doctor, and an AAHA-accredited hospital, their mission is to provide a cheerful, dedicated, and comfortable environment that offers the best care to all pets and meets their clients needs with exceptional patient care, compassion, and outstanding, personal customer service.

They focus on providing extraordinary care for every pet.  There will never be the reason any pet does not have the opportunity for the best care veterinary medicine has to offer.

PetDocks is committed to helping rescue organizations locally and nationally. Recently PetDocks set up a donation station for displaced pets from Hurricane Katrina. PetDocks has raised over $3000.00 towards this effort. In addition, PetDocks works with PAWS and the local Humane societies to help provide low cost spay and neuter for adopted pets.

PetDocks is Located at 5307 Hwy 70 West, Morehead City, NC 2855, call or visit 252-240-3885 www.petdocks.com

Blue Cross and Blue Shield of North Carolina is a leading health services company.  We deliver quality products, information, and services to help our customers improve their health and well-being.

History and Facts:

Blue Cross and Blue Shield of North Carolina (BCBSNC) is a leader in delivering innovative health care products, services and information to more than 3.7 million members, including approximately 900,000 served on behalf of other Blue Plans. The company offers its members discounts and information on a wide variety of health-related services at no additional cost. BCBSNC also offers dental and disability insurance products. For 75 years, the company has served its customers by offering access to quality health care at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health.

*The content of this post is provided by BCBSNC.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents.  Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC).  You may qualify for a 15% healthy lifestyle discount if you are in excellent health.  Call us for details.

When it comes to torture, we could all learn a thing or two from kids. Who knows better than they how to extract most anything they want within minutes of applying the technique? I’m talking about whining, of course — that grating mewling that causes us to do anything (anything!) just to make it go away. But you can break the habit. And the rewards of victory can be rich for both of you.
Toddlers
Why they do it: Early talkers whine like babies cry. Some experts say that whining tends to peak in a child’s development when she’s feeling out of control and overwhelmed — emotions that pretty much sum up toddlerhood. She lacks the vocabulary to articulate her frustrations, and that whimpering is the natural default noise.
Certain triggers, such as hunger and fatigue, can also cause breakdowns (true for kids of all ages), so keep that in mind the next time you take your toddler grocery shopping close to naptime.
How to stop it: Patience becomes the first rule when confronted with these early bouts of whining. When her son, Matthew, who’s almost 3, melts down because he can’t wait ten more minutes for dinner, Rae Sullivan of Durham, North Carolina, gives him a little extra attention, like five minutes of lap or snuggle time. Those five minutes are well spent if it means she can finish cooking without another whinefest. Tossing him a few crackers to eat in the meantime doesn’t hurt, either.
“A lot of toddlers don’t even know they’re whining,” says Sheila Oliveri, a mom of three and a nursery school teacher in St. Louis. So give your little complainer an exaggerated demonstration: “Whyyyyyy are you taaaalkingg like thaaaaaat?” The result will be twofold: “You’ll show her exactly how irritating whining is,” says Oliveri, “and you may make her laugh, which will make her forget why she was complaining in the first place.”
Or try recording your child. Play it back to her so she knows what she sounds like, and work with her on better ways to ask for the things she wants or needs.
Preschoolers
Why they do it: Like toddlers, the 3-to-5 set has a low threshold for frustration. Plus, they’re going through a lot of changes — such as starting school, facing a new baby sib, or graduating to a big-kid bed-that make them extra hungry for your attention, even if it’s the negative kind.
How to stop it: The great thing about preschoolers is that they can still be distracted by a clever trick. For instance, Debbie Granick of St. Louis uses a “whine” cup, or bowl or bucket or whatever’s at hand. “Whenever one of them starts, I say, ‘Here, go pour out your whine and bring me your regular voice.’ It gets a smile, or at least that ‘Oh, Mom’ look, and then they’ll usually change their tone.” She then thanks her child for using a “pleasant” voice.
Or whisper your answer back. “You may have to whisper it several times, but your child will have to be quiet to hear you, and a lot of times he’ll mimic your tone of voice,” says Karen Shaffer, a mom of three in Highland, California.
By the time they’re 4, most kids are able to understand that their behavior has consequences. So you can start using the “I can’t understand you when you whine” technique.
“When my children complain, I say, ‘I’m sorry, but when you talk in that voice, I can’t understand anything you’re saying. Use your normal voice and I’ll try to listen to you.’ Then I ignore them until they start to comply,” says Audrey Smith, a mom of two in Long Beach, California. It works, she says, but you have to be as consistent as possible.
And that’s not easy, as we all know. Who among us hasn’t caved in? Trouble is, if your child sees you can be broken, he’ll simply up the ante, and your whining problem will be worse.
Besides being consistent, look for ways to reinforce the behavior you do want, like thanking him when he repeats his request in a polite tone.
Grade-schoolers
Why they do it: Besides whining when they’re tired or hungry, kids grumble when they’re asked to do things they don’t want to do (insert your chore of choice) or when they’re bored. Whining is learned behavior, and by the time a kid is in elementary school, she’s a pro.
How to stop it: Some moms swear by sending their child to the “whine” room as soon as she starts. Sending her away-to the corner of the living room, say, and letting her vent aloud to herself-spares you from having to listen to it and may help the offender understand what she sounds like.
Shaffer has another tactic when her school-age kids start in. “Every whine costs them a nickel, to be deposited in a special jar,” she says. “Then we give the money to the charity box at church on Sunday.”
When you’re out in public, you can head off most whining by establishing some rules before you leave. My two kids know that there’s every possibility of a small candy or sticker purchase if they make Mommy’s trip to Target as pleasant as possible. They also know that the moment they start complaining in that tone of voice, the deal’s off. Sometimes my 5-year-old slips up, but my 8-year-old has this rule down cold.
It bears keeping in mind that everyone whines — moms and dads, too. But our kids model their behavior on ours, so the next time you’re griping about soccer-practice schedule, take a minute to listen to yourself and then go put a nickel in the whine jar. Your child will be impressed.

By Julie Tilsner, Parenting Magazine

The information above is brought to you from www.parenting.com 2009.

For more information on health insurance coverage in North Carolina and how to utilize My Member Services, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

Pharmacists in North Carolina have been granted temporary authority to administer seasonal and H1N1 flu shots to patients 14 years of age and older beginning October 9, 2009.

The Pharmacy and Medical Boards passed an emergency amendment to the pharmacist vaccination rule authorizing pharmacists to administer seasonal and H1N1 influenza vaccines to patients age 14 and up. This authorization is expected to extend through July 2010.

Eligible members ages 14 and older may go to an in-network pharmacist or CVS MinuteClinic to receive a seasonal flu shot, as well as an H1N1 vaccine – when it becomes available.

To find in-network pharmacists, visit the Doctors, Rx and Hospitals section on our site, and search for “Pharmacist (Flu & Other Limited Injections)” under Specialty. To find a participating CVS MinuteClinic, search for “Convenience Care Center” under Specialty.

The above information is taken from a News Release from BCBSNC October 2009.

For more information on health insurance coverage in North Carolina and how to utilize My Member Services, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

Flu season is likely to start earlier and be more widespread this year. The 2009 H1N1influenza virus that triggered the April 2009 outbreak and caused only mild illness will likely be the major strain. Standard strains of the flu will also be circulating, and there is a chance that the flu (seasonal and 2009 H1N1) could cause more severe illness.

Flu symptoms include fever or chills and cough or sore throat. Symptoms may alsoinclude runny nose, body aches, headache, tiredness, diarrhea, or vomiting. It is hard to tell if someone who is sick has the 2009 H1N1 flu or seasonal flu.

Prevention will play a very key role this year. Prevention includes protecting yourself

and NOT spreading the disease to others. Here’s what you should do:

Prevent:

· A cough or sneeze may be the first symptom of illness. Therefore, every

time you cough or sneeze, cover your mouth and nose with a tissue and throw

used tissues in the trash.

· If you develop flu symptoms, make arrangements to go home as soon as

possible.

· Stay home until at least 24 hours after you no longer have fever (100

degrees Fahrenheit or 38 degrees Celsius) or signs of a fever (chills, feel very

warm, have a flushed appearance, or are sweating). Checking for absence of a

fever should be determined without the use of ibuprofen or acetaminophen.

·Hand washing protects yourself and others, so wash your hands often,

especially after you cough or sneeze, or:

o Before and after preparing food or eating.

o After using the restroom.

o Before and after touching your nose, eyes or mouth.

o After you’ve been in contact with commonly touched surfaces such as

doorknobs and handrails.

· Wash hands with soap and water for at least 20 seconds.

o Use alcohol-based hand cleaners if soap and water are not available.

· Avoid touching your eyes, nose, or mouth to prevent spreading germs.

Vaccinate:

· Get the vaccine for seasonal flu to prevent or decrease the severity of the flu.

· Also get the 2009 H1N1 vaccine when it becomes available (plan is for early to mid-October). BCBSNC will be waiving deductible and coinsurance payments for the H1N1 vaccine administration for our fully insured members that do not have immunization benefits. Members in self-funded plans should check with their plan administrator to determine if a copayment, deductible or coinsurance will apply. All applicable copayment, coinsurance and deductible payments will still apply for the seasonal flu vaccine.

· Priority groups should receive the 2009 H1N1 vaccine first. The Centers for

Disease Control and Prevention (CDC) list these groups as:

o Pregnant women

o People who live with or provide care for infants less than 6 months of age

o Health care and emergency medical services personnel

o Children and young adults ages 6 months to 24 years

o Adults ages 25 to 64 years with medical conditions that put them at higher risk for influenza-related complications

Get Well:

· Most healthy people recover from the H1N1 or seasonal flu without complications. If you get the flu, it’s important that you:

· Stay home from work or school.

· Get lots of rest, drink plenty of liquids, and avoid using alcohol and tobacco.

· Relieve the symptoms of the flu with appropriate over-the-counter medications, or as directed by your doctor. ***However, never give aspirin to children or teenagers who have flu-like symptoms, particularly fever.

· If you’re at risk for serious complications, consult your provider as soon as you can for recommendations for antiviral medications if you’ve been exposed to someone who likely has 2009 H1N1. You are considered high risk if you:

o Are under the age of 5 or over 65

o Are pregnant

o Have a chronic medical condition, such as pulmonary disease, asthma, diabetes, neuromuscular disorders, heart disease, or a compromised immune system

Here are the warning signs that the sick person needs urgent medical attention:

· Difficulty breathing or shortness of breath

· Pain or pressure in the chest or abdomen

· Sudden dizziness

· Confusion

· Severe or persistent vomiting

· Flu-like symptoms improve but then return with fever and worse cough

It’s important to note that the influenza virus can be unpredictable, and that the CDC’s recommendations are subject to change. To stay current, consult the following Web sites:

http://www.cdc.gov/h1n1flu/

http://www.flu.gov/

The above information is taken from a News Release from BCBSNC October 2009.

For more information on health insurance coverage in North Carolina and how to utilize My Member Services, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.

Incentives can both support and motivate participation among employees. Consider both formal or company incentives and informal or program rewards and prizes from local resources to reinforce participation in workplace wellness programs. Either way, it is important to provide incentives that are attractive and meaningful to your employees.

For example, you can provide small prizes, gift cards or cash to employees who engage in activities you want to reward – such as taking the stairs, starting a fitness program, taking a health risk assessment or making healthy food choices. On a larger scale, you can recognize measured adherence to defined wellness goals with more substantial rewards, such as a reduction in an employee’s premium contribution. (Before initiating such an incentive, be sure to check with your legal counsel to ensure compliance with state and federal requirements on insurance benefits.)

You can also make healthy choices easier for your employees. Support them by bringing in a dietitian for a “lunch-and-learn,” or by offering a fitness challenge with prizes.

Sometimes praise is the best incentive. Celebrate your employees when they take positive steps like losing weight or participating in walks and other fitness events. And don’t forget the power of one’s peers: Testimonials from employees who have succeeded in meeting health goals through your workplace wellness program will inspire others to follow in their footsteps.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents.  Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC).  You may qualify for a 15% healthy lifestyle discount if you are in excellent health.  Call us for details.

2007 Blue Cross and Blue Shield® Internal Association Data: http://www.workplacewellnessnc.com/plan-create/provide-incentives-for-employees-to-get-active-and-eat-right/

1. Make sure you remember to feed the dog and give him fresh water each day. Explain that dogs, especially puppies, need nutrition each day for energy and proper growth. If you have an outside dog, it’s especially important that his water dish is changed everyday. Standing water is a breeding place for mosquitoes. Also dirt can get flung into their dish. It is equally important for small children to be supervised when dealing with this type of responsibility. Sometimes smaller children can be too eager to help. Explain to your children why we don’t feed dog’s certain foods such as sweets. Dog food is made to meet their dog’s nutritional needs and sweets can make their dog sick.

2. Being N-I-C-E to your dog is another lesson to teach children. Younger children, particularly under the age of four, have a tendency to be rough with animals. Pulling tails and ears just comes naturally with their curiosity. With a new dog, you may not know his temperament very well or how he may react to your child’s curiosity. Lead by example. Show your child how to be kind to animals. Show them how to gently pet them on the head or back and that hitting or pulling can hurt the dog.

3. Teach your child about the importance of exercise with the family dog. In order for the dog to stay healthy he must move around and play. If the dog is not overpowering, let your child walk the dog with a leash. Another fun activity for exercise is fetch. Let your child throw a ball or stick for the pet to chase. This is lots of fun for both participants.

4. If you have a rambunctious puppy, make sure your child doesn’t leave things lying around. Puppies love to chew on whatever they can sink their teeth into. If they see your daughter’s favorite dolly on the floor, or your son’s tennis shoe, the puppy will show no reserve. They will usually dive right in. Tell your child that your puppy is too young to understand, and that until he gets older, be extra careful about leaving things lying around.

5. Keep bathroom doors shut. Dogs are notorious for drinking from the toilet bowl. Reduce the temptation for him, by teaching your child to keep bathroom doors shut.

6. If you have an indoor dog then he’s got to have potty breaks outside. Keep a schedule of bathroom breaks for your dog. This is one of the not so fun parts of taking care of a new pet. Remind your child that if the new dog doesn’t keep to the scheduled potty breaks that he may find a place in the house. In training a new dog to use the bathroom outside, the scheduled times must be strictly kept.

7. Make a chart. If you child is having problems remembering to feed the pet or take it out for breaks, it would be a great idea to make a chart of things to do each day. Let your child mark a check when the chore has been completed. The more he completes the chore, the easier it will be to remember.

Children don’t always see the bigger picture of taking care of a new dog, but with our guidance, they will no doubt become good little pet owners. It’s a good idea to applaud your child when he takes on responsibility and follows through with it. This will give them confidence to mature and take on more responsibility as they get older. Taking care of a pet is a big responsibility. Teach your kids that just as they have to be taken care of by parents, their pet has to be taken care of as well. Our pets depend on us everyday.

For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents.  Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC).  You may qualify for a 15% healthy lifestyle discount if you are in excellent health.  Call us for details.

CONTENT FROM THIS ARTICLE IS FROM I-LOVE-DOGS.COM