Archive for September 8th, 2008

When Is A Stress Test Not Really A Stress Test?

It’s always good to talk to people who have come through major health issues like heart attacks or cancer and have taken the bull by the horns and made life style changes that will likely add years to their lives and a bonus of quality to go with it.

Then there are those who make the life style changes and assume that they are now bomb proof and have elevated their health profile to the point of not needing medical checkups. I shared in a post some time ago about a man who had colon cancer, at the time, 14 years prior to our speaking. They did a surgical resection of about 12 inches, chemo and radiation. When I spoke to him he had never been back to the oncologist and had not had a colonoscopy since the end of treatment.

More recently I was talking to man who had suffered a heart attack about 5 years ago. He was very quick to point out that the whole thing had changed his life. He now ate the right things and had become a runner, running 8-10 miles a day and occasionally participating in marathons. When I asked him when his most recent stress test was, his answer was today. He painted a picture for himself that by running every day and surviving, he had moved beyond the need to have a medically monitored, imaged stress test as part of a post cardiac event followup.

This logic won’t win any points with life insurance underwriters since they jump all over the obvious given a chance. Yes, that 8 mile run is a stress test but it doesn’t tell you anything about potential new blockage that may be building. So, surviving his stress test may in fact mean that he is completely healthy and will never have a problem again. It might also mean that, by ignoring the medical facts that caused the first heart attack, he is just one 8 mile run away from the 2nd heart attack.

Being a runner (jogger/waddler) and always being fascinated by the guys that could really run fast, I have noticed over the years that those distance runners that have heart attacks while running don’t seem to have a very high survival rate. I’m just guessing, but I wonder if that has something to do with the attack happening when your heart is pumping hard to start with. Seems to this layman that it ought to cause more damage than if you are, say, sitting down with an average resting heart rate.

Bottom line. Lifestyle changes are to be praised. I always admire someone who has seized their life back by kicking obesity or diabetes or cancer. But life style changes should always be in combination with prudent medical followup. Underwriters will insist on it and you will thank yourself. If you find that you are right on track, it’s a great chance to share that with others and help them make healthy changes. If you find out something is sneaking back up on you, you just avoided ending a run in an ambulance.

Add comment September 8th, 2008

Why Is The hbA1c So Important In Diabetes Life Insurance Underwriting?

To me it is amazing the number of people with type 1 diabetes and type 2 diabetes who not only can’t tell you what their last hbA1c level was, but honestly don’t know what I am referring to when I am gathering information vital for finding them the best possible rate for life insurance.

Before I lay all the blame on the folks that have diabetes, allow me to spread it around just a bit. We do have a real problem with doctors who either don’t want to take the time to educate their patients, or don’t think their patients are intelligent enough to understand the importance and significance of glycosylated hemoglobin. Again, I don’t know if it’s a time thing or if doctors really do want to keep their clients in the dark so they can just keep on treating. It seems to me if you give a type 2 diabetic enough knowledge about the disease, the risk factors, how to manage and how to monitor, they might just end up cured.

But back to the other side of the coin now. Now that we know doctors aren’t taking the time, patients have to educate themselves. If you have diabetes and don’t educate yourself about it, you might never understand that there is a way off that merry go round.

So, why is you hbA1c so important to life insurance underwriters. Unlike your daily or more often glucose tests, he hbA1c can give an underwriter a clear picture of how your glucose levels have done over a 2-3 month period. Let’s face it. People aren’t out looking for high readings when they check their glucose, so they tend to take it at times when it is naturally lower. The hbA1c takes that factor out of it. If you normally check your glucose first thing in the morning and it is 120 but you never check it right after lunch when it is 250, you have kind a skewed view of your diabetes control.

Underwriters know that part of the story isn’t known or isn’t being told when an applicant says their average glucose is 140 and their hbA1c on the labs is 8.4. Somewhere in between this 140 and the next 140 are scattered some dangerously high readings. If your doctor tells you about the hbA1c or if you educate yourself about it and ask your doctor to tell you what it is each time he does a full blood workup, you can fill in those blanks and know if you are headed toward other health issues brought on by out of control diabetes.

Bottom line. Ultimately the ball is in your court. I would guess that 75% of those with diabetes that I ask about their A1c, don’t know it or haven’t heard of it. Not just for the sake of better life insurance rates, but for the quality of your life, or your life itself, it’s time to wake up and learn about your disease. Make it your goal to learn enough to manage your own diabetes right back into the closet it came from.

1 comment September 8th, 2008


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