John W TInder, Consultant

small business management, digital marketing strategies, social media management, web developer, search engine optimization, advertising and marketing

small business management, digital marketing strategies, social media management, web developer, search engine optimization, advertising and marketing

What You Should Know for the 2016-2017 Influenza Season


It appears Flu season this year sucks, really sucks, and nobody told me; at least with all the politico hubbub and doomsday clamoring, I did not hear anything about it.
On January 11, 2017, Kori Miller (Self) released an on-line article, after the CDC quietly released a report, basically telling us so: “According to the CDC, there has been a “slow but steady” increase in reported flu cases in November and December, with numbers expected to increase still.”¹ And, apparently, the strand of Flu is once again (was back in 2015 too) one of the most outrageous strands of flu out there.
Although “Flu Season” basically starts as early as October, it can go past January and into February or later. The Weekly Reports from the CDC show that the flu has been widespread this Winter and outbreaks have been on the rise across the U.S. that last few weeks.² (as evidenced by the my wife, my children, and a number of you on Facebook the past few weeks)
The number of Flu tests have been on the rise each week (See the CDC Dashboard if you have time; it’s cool; taxpayer dollars hard at work here, at least)

Do I have the flu?

So if you don’t want to be sick for another month; I suggest you go to the doctor and get some anti-viral drugs, and, maybe the flu shot.
What should I do if I get sick?
Most people with the flu have mild illness and do not need medical care or antiviral drugs. If you get sick with flu symptoms, in most cases, you should stay home and avoid contact with other people except to get medical care.
If, however, you have symptoms of flu and are in a high risk group, or are very sick or worried about your illness, contact your health care provider (doctor, physician assistant, etc.).³

Certain people are at high risk of serious flu-related complications (including young children, people 65 and older, pregnant women and people with certain medical conditions). This is true both for seasonal flu and novel flu virus infections. (For a full list of people at high risk of flu-related complications, see People at High Risk of Developing Flu–Related Complications). If you are in a high risk group and develop flu symptoms, it’s best for you to contact your doctor early in your illness. Remind them about your high risk status for flu. CDC recommends that people at high risk for complications should get antiviral treatment as early as possible, because benefit is greatest if treatment is started within 2 days after illness onset.

What’s new this flu season?
A few things are new this season:
• Only injectable flu shots are recommended this season.
• Flu vaccines have been updated to better match circulating viruses.
• There will be some new vaccines on the market this season.
• The recommendations for vaccination of people with egg allergies have changed.
• A generic version of the flu antiviral drug oseltamivir has become available as a pill.

If you get the vaccine, you have to do a state survey and vaccine consent form before the shot. Luckily, all the websites below give you the option of filling out the paperwork ahead of time and then going down there, presumably, to save you time waiting in line.
Get Flu shots from:
1. Walgreens -
2. RiteAid -
3. CVS (HEB pharmacies too) -
4. Walmart -
5. Target -
6. Vaccine locator tool:

That was my public service announcement, in case you were wondering ….
John Tinder

Footnotes -

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Solutions for Small Businesses to High Deductible
The rising cost of health care is routinely (every year) one of the top problems facing small businesses.¹ The trend has been for major medical health insurance companies to raise their rates in response to the rising health care costs. This trend is not going anywhere.²
There is a solution. In response to higher rates, most companies and individuals are opting for high deductible plans. Does this work? Yes. And no. It works, but if you have several major health events a year, then you may end up paying more for that year.³ Thus high deductible plans create a large “risk bubble” that if you are injured you would be out a large amount of money which you usually do not have.
I have had voluntary benefit plans like Accident insurance for many years now, even before I retired from the practice of law and started (among other things) selling Colonial Life Insurance. (I made them available to employees as part of a benefit package) The Accident Policy (or “injury” policy) provides you dollar for dollar benefits when you or a covered family member are injured. (yes, it’s like Aflac, but Colonial has been around longer and has faired better in customer satisfaction surveys) Other plans like Medical Bridge, Specified Disease and Cancer policies provide benefits when you are seriously ill.
These plans are surprisingly affordable. The price for this year is around $21 per employee per month for the Preferred plan and around $40 per month for Employee plus spouse plus children. You also get $50 per covered person health screening benefits for reporting your usually free annual wellness checkups. You only need 3 lives to apply for coverage if the premiums are taken as payroll deduction or 10 lives if the premiums are paid by the individual employees. You can do individual plans at the basic level but the benefits are lower and may not cover dollar for dollar out of pocket expenses with high deductible plans. (With the money you get back with the health screening benefit, the cost comes out to one high priced coffee per week that you would be giving up to have this protection in place.
My injury policy basically pays for itself. Yes, I pay $480 per year, but I get $100 back in health screening benefits and I save a lot more in monthly premiums on my health insurance. My children get injured often, as children are apt to do, and even my wife and myself have made claims on the policy. (like when I stuck myself with a knife on turkey-day or when my wife kicked the door jam chasing the 3 yr old).
These voluntary benefit plans used to only be available to large corporations or large groups. In the last decade, insurance companies have been making a push to make these plans more affordable and more available to small businesses and direct sales to individual consumers. With rising health care costs and higher premiums the trend of the now and the future, Voluntary benefit plans, or “gap” insurance is the only solution in my book. I couple it with a health savings plan for additional tax savings.
Call me to confer on this critical topic.

John Tinder

1. See bizjournal: NFIB Survey.
2. See. ABC news.
3. See the SimpleDollar.
4. Links to Money Talks.

Preventive care benefits for adults

So it occurs to me while I am doing the end of the year enrollments for benefits that most people do not understand their rights under the Affordable Care Act and specifically do not understand that your doctor CANNOT charge you for your wellness preventative visit and tests. This includes more than you think.
So make sure you know under what conditions you can be charged for what tests while you are doing your well check-up.
See link:
There, I just saved you about $30. Merry Christmas. All Marketplace health plans and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible.

South Texas Indigent Defense Workshop - Effective Indigent Defense Practices

It's free CLE and it has lots of goodies, free forms and free contact information for resources. Plus, its on a Friday in Corpus Christi, so you attorneys coming from out of town can stay for the weekend, deduct half the trip and go to the beach. The event is co-sponsored by the Texas Indigent Defense Commission & Texas Justice Court Training Center and will focus on implementing efficient pretrial processes that meet Fair Defense Act requirements. Judges, court staff, public defenders, and attorneys who take court-appointed cases are invite...

Psych Congress

Patient Adherence - its what needs to happen if you want to finish a program. Dr. Saundra Jain and her husband are building a 90 day program, called the Wild 5 Wellness Program. Considering the high number of suicides, substance abuse, etc., in our profession, I think we should all take time to check it out.

John W. Tinder

Psych Congress 2016 Steering Committee Members, Saundra Jain, MA, PsyD, LPD and Charles Raison, RN, MS, NP, talk about how hypothermia can be an antidepressant. Read about it in this blog post!

Untitled Album

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Top 10 Chiropractic Studies of 2013 « Science-Based Medicine

Back health is Important and should not be ignored – tips to being healthy at the office

Whether you have a nagging back pain, strained muscles, or just want to live longer, if you sit at a desk for long periods of time, you should take care of your back. Here are some tips to achieve some level of comfort and better back pain management, and therefore better health.

First - You should make regular visits to your chiropractor and massage therapist. Link to science study: Click here.
I now use my chiropractor on a monthly basis to maintain consistent back health. It helps all other exercises and practices perform even better.
Massage has a number of therapeutic benefits in addition to general stress relief. A good massage will help increase endorphins—the body's natural painkiller—in your bloodstream, which in turn may allow you cut back on pain medications. Massage can also encourage blood flow, which in turn brings healing nutrients to the affected area and can speed healing. Click here.
Want to live longer? 10 best habits.

Second - A comfortable work space is important for you to feel your best. You may need to make over your work space for optimal performance. Stand up desks are all the rage. CNN Article: Google “stand up desk for ideas” or click here.
a. If you sit behind a desk for hours at a time, you're not doomed to neck and back pain or sore wrists and fingers. Proper office ergonomics — including correct chair height, adequate equipment spacing and good desk posture — can help you and your joints stay comfortable at work.
b. Chair - Choose a chair that supports your spinal curves. Adjust the height of your chair so that you are sitting in your chair with your knees parallel or slightly higher than your hips with your back straight and buttocks touching the back of your chair. Your feet should rest flat on the floor with your weight evenly distributed. Adjust armrests so your arms gently rest on them with your shoulders relaxed.
c. Keep key objects — such as your telephone, stapler or printed materials — close to your body to minimize reaching. Stand up to reach anything that can't be comfortably reached while sitting.
d. Keyboard and mouse - Place your mouse within easy reach and on the same surface as your keyboard. While typing or using your mouse, keep your wrists straight, your upper arms close to your body, and your hands at or slightly below the level of your elbows. Use keyboard shortcuts to reduce extended mouse use.
e. Telephone - If you frequently talk on the phone and type or write at the same time, place your phone on speaker or use a headset rather than cradling the phone between your head and neck.
f. Footrest - If your chair is too high for you to rest your feet flat on the floor — or the height of your desk requires you to raise the height of your chair — use a footrest. If a footrest is not available, try using a small stool or a stack of sturdy books instead.
g. Desk - Under the desk, make sure there's clearance for your knees, thighs and feet. If the desk is too low and can't be adjusted, place sturdy boards or blocks under the desk legs. If the desk is too high and can't be adjusted, raise your chair. Use a footrest to support your feet as needed. If your desk has a hard edge, pad the edge or use a wrist rest. Don't store items under your desk.
h. Monitor - Place the monitor directly in front of you, about an arm's length away. The top of the screen should be at or slightly below eye level. The monitor should be directly behind your keyboard. If you wear bifocals, lower the monitor an additional 1 to 2 inches for more comfortable viewing. Place your monitor so that the brightest light source is to the side.

Third - Perform periodic “posture checks” regularly to ensure that you maintain a good posture position. The Cleveland Clinic recommends sitting in the same position for no more than 30 minutes at a time. You may wish to set a 30-minute reminder, stand and stretch or adjust your position to maintain good posture.
Take breaks. Better health and better employee production.


Fourth - Exercise your core to strengthen abs and back muscles.
Your core muscles—your lower back and abdominal muscles—need to be strong and supple in order to support your spine and take pressure off your lower back. Unfortunately, for most of us our core muscles are rarely

Fifth - Let your spine really rest while sleeping. While you're lying down, all the structures in your spine that have worked hard all day finally have an opportunity to relax and be rejuvenated. Sleep with a pillow placed underneath your head and a rolled-up towel or lumbar pillow under your knees to maintain proper spinal alignment when sleeping on your back. If you are a side sleeper, place a pillow between your knees.

Sixth - Your shoes need to support your spine. The shoes you wear play an important role in supporting your lower back. Good shoes provide a supportive base that helps the spine and body remain in alignment. For example, make sure the area of the shoe that fits the back of your heels is snug, but not overly tight, as a good fit in the heel prevents over pronation or supination—or too much rolling of the foot to the outside or inside. Consider using orthotics. Find your nearest foot mapping spot. Click link.

Seventh - Get more exercise period. If your back is hurting, you may think the best way to get relief is to limit exercise and to rest. A day or two of rest may help, but more than that may not help the pain. Experts now know that regular physical activity can help ease inflammation and muscle tension.

Eighth - Watch your weight. Extra pounds, especially in your midsection, can make back pain worse by shifting your center of gravity and putting strain on your lower back. Staying within 10 pounds of your ideal weight may help control back pain.

Ninth - If you smoke, stop. Smoking restricts the flow of nutrient-containing blood to spinal discs, so smokers are especially vulnerable to back pain.

Tenth - Avoid high heels. They can shift your center of gravity and strain your lower back. Stick to a one-inch heel. If you have to go higher, bring along a pair of low-heeled shoes and slip into them if you become uncomfortable.

Eleventh - Pick the right handbag or briefcase. Buy a bag or briefcase with a wide, adjustable strap that’s long enough to reach over your head. A messenger bag (like the ones bike messengers wear) is made to wear this way. Having the strap on the opposite shoulder of the bag distributes the weight more evenly and helps keep your shoulders even and your back pain-free. When carrying a heavy bag or case without straps, switch hands frequently to avoid putting all the stress on one side of the body.

John W. Tinder, II
Direct - 720-375-6829
Office: 512-291-2318
[email protected]

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