Nine things you should think about before taking a life insurance paramedical examination

By Michelle Matlock, Life Quotes, Inc.

When you apply for life insurance, you will most likely have to take a medical exam.

Individual life insurance companies have a number of tools at their disposal when it comes to rating policies, and one of those tools is medical underwriting. Since the basis of insurance involves assessing risk, health status plays a critical role in the underwriting process.

What to expect

Paramedical examiners are licensed health professionals that insurance companies hire to perform medical examinations on potential policyholders. When you apply for life insurance you will be required to answer a series of medical questions, or if you apply for a policy at an insurance website, you can fill out a questionnaire online. The second part of the application is a medical form that is completed by your examiner. Examinations are generally performed in the privacy of your home or place of business.

Most paramedical exams require examiners to collect a urine sample and blood draw. You will also be asked to provide your driver's license and social security number. Typically an examiner will accept alternative forms of identification such as a military ID, passport or state issue identification cards with a photo ID. This information will be used to fill out the lab ticket. The lab uses your complete blood count (CBC), to rule out a number of conditions such as leukemia, cancer or HIV. You may also be required to take a liver function test, or a Carbohydrate Deficient Transferrin (CDT) test, which is used to rule out alcoholism, cirrhosis and other liver diseases. Lab technicians also check your cholesterol level, which will be used to evaluate your risk for heart attack or stroke.

In addition to urine and blood samples, examiners will check your blood pressure, pulse rate, and measure your height and weight. In some cases, you might be required to take an X-ray or treadmill test. Some exams might require checking your "timed vital capacity" (TVC). This is a breathing test that determines how well your lungs are functioning. They may also require some applicants who smoke or have a history of heart disease to have an electrocardiogram (EKG), a test that records electrical changes in the heart.

Questions your examiner will ask you include:

1. Name and address of personal physician?

2. Date and reason last consulted?

3. What treatment was given or medication prescribed?

What you should do

While some folks find paramedical examinations a little daunting, the extent of a paramedical exam varies by insurance company.

Also, some companies require less information than others and have a shortened version of a paramedical exam. But be warned if you are a smoker, your mortality rate is often higher than nonsmokers, and insurance companies usually require a more thorough medical examination for tobacco users.

"If your agent isn't prepping you for your exam then they are not doing the right thing," says Ryan Pinney, a brokerage director and insurance risk specialist for Pinney Insurance Center, Inc. in Roseville, Calif. "There are so many things that can mess up your lab results that people don't consider."

Pinney offers some sage advice that will help increase your odds of doing well on an examination.

1. Don't consume alcohol for 72 hours prior to your exam.

2. Don't take your exam if you are dehydrated.

3. Don't take ibuprofen or aspirin because this will create elevated liver function.

4. If you exercise or work out regularly, take a break for a day or two prior to the exam. "When you work out your muscles breakdown and that can tweak the outcome of your lab," says Pinney.

5. Don't eat fatty foods for at least two days before your examination. "If you have an exam coming up and you must choose between a triple cheeseburger or salad, go with the salad. Even if you don't have high cholesterol, fatty foods will temporarily heighten your cholesterol levels," notes Pinney.

6. Take your exam first thing in the morning don't wait until later in the evening. "Your blood pressure is lower in the morning because you've been sleeping for 6 to 8 hours. It's never a good idea to get stressed out at work, fight rush hour traffic and then take your exam," Pinney recommends. In addition, Pinney says when you sleep your back compresses, so you are also a little taller in the morning. "This can help you when it comes to measuring your height and weight."

7. Wear your tennis shoes. "When your height and weight is measured you don't have to take off your clothes or shoes. But I discourage wearing steel-toed boots or a tool belt because depending on the item this could make you 35 pounds heavier. The examiner is not required to tell you to remove those items," says Pinney. Pinney adds that you are also not allowed to keep your high heels on at a paramedical examination.

8. Never volunteer information. "Let the examiner ask the questions," says Pinney. "When an examiner asks you if you've been diagnosed with heart disease this is not a good time to tell him you haven't and then mention you've had chest pains lately. If the insurance company wants to know more details, the underwriter will contact you."

9. When the examiner asks you a question, don't lie. "Do not try to outsmart the insurance company," says Pinney. "Any misrepresentations can be considered insurance fraud on a more serious level. If you omit information or lie, once the insurance company finds out, you will be denied coverage and your application will be rescinded."

This article was originally published at Life Quotes, Inc.

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Type 2 Diabetes Curable by Bariatric Surgery?

Bariatric procedures used for treating severe obesity has been studied as a cure for type 2 diabetes mellitus. Studies have found that more than 75% of type 2 diabetes patients who undergo bariatric surgery no longer experience symptoms and no longer require insulin or other medications. Obesity and type 2 diabetes are interrelated. Nearly 24 million Americans are affected by diabetes. About 50 percent of men and 70 percent of women who have the disease are obese; therefore bariatric surgery can have a sustained and meaningful effect on fighting both diseases. In a study published by The American Journal of Medicine, 621 patients were studied from 1990 to April 2006. The results are as follows: Study Results Complete resolution of diabetes - 78.10% Improved conditions - 8.50% No changes - 13.40% For years, researchers had assumed that weight loss alone was responsible for this benefit. However, new findings are demonstrating that hormonal and metabolic changes caused by th e surgery, were responsible. The surgery helped patients lower fasting glucose, fasting insulin, and hemoglobin level. According to the Wall Street Journal, diabetes can "quickly recede" when bariatric surgery "alters the intestinal tract and diverts food away from hormones in the small intestine that help regulate blood sugar levels". Lowering hemoglobin (A1C) to below or around 7% has been shown to reduce microvascular and neuropathic complications of type 1 and type 2 diabetes. Therefore, for microvascular disease prevention, the A1C goal for nonpregnant adults in general is 7%. On the other hand, researchers observed a progressive relationship between diabetes resolution and the weight loss operation performed: Surgery Type Laparoscopic adjustable gastric banding - 56.70% Resolution results - 46.20 Weight Loss Gastroplasty - 79.90% Resolution results - 55.50% Weight Loss Gastric bypass - 80.30% Resolution results - 59.70% Weight Loss Biliopancreatic diversion/duodenal sw itch - 95.10% Resolution results - 63.60% Weight Loss This study suggests that people with Type 2 diabetes and morbid obesity who get surgery before becoming insulin-dependent have the greatest chance for complete resolution and avoiding the progression of diabetes. However, physical activity and behavior modification are important for maintaining weight loss and for completely resolving diabetes. On the other hand, the Agency for Healthcare Research and Quality (AHRQ) recently reported bariatric surgery is safer than ever. The risk of death from bariatric surgery has declined from 0.89 percent in 1998, to 0.19 percent in 2004.6. "The severity of the diabetes at the time of surgery and the regain of excess weight loss long-term seem to be the primary determinants of long-term diabetes resolution after gastric bypass surgery," said James W. Maher, MD, professor of Surgery at Virginia Commonwealth University. Although there are a number of effective, noninvasive treatments for diabetes, the American Society for Metabolic & Bariatric surgery (ASMBS) support the idea that Bariatric surgery should be considered for treating type 2 diabetes in morbidly obese adults, specially if the diabetes is difficult to control with lifestyle and pharmacologic therapy. Finally, there is still insufficient evidence regarding the benefits of weight loss surgery in patients with BMI <35 kg/m2 as a way of treating diabetes. Therefore, it is advised that patients talk to a specialist about their particular situation.

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Upcoming Trends In Bariatric Surgery

Bariatric surgery has grown into an increasingly popular procedure in the treatment of weight gain and obesity. More than a handful of new procedures are on the horizon for individuals seeking such surgery in the coming year. Bariatric surgery has been increasingly used to help treat diabetes epidemics as well as help prevent increasingly common issues such as bone and joint damage and high blood pressure.

What's New on the Horizon for Bariatric Surgery
Some of the most common reasons consumers have and will continue to seek bariatric surgery facilities in recent years are the result of less invasive surgical techniques, and the development of incision-free bariatric surgery and single-incision procedures on the horizon.

Incision-free bariatric surgery involves a technique called Transoral Gastroplasty (TOGA). Phase III studies are currently in progress and enable surgeons to change the anatomy of the stomach in order to create a feeling of fullness after small portions of food are ingested, without making any actual incisions in the stomach itself.

Single-incision weight loss surgery is also growing in popularity, enabling bariatric surgeons to perform a gastric banding procedure through a single 8-centimeter incision rather than the current technique which utilizes 4 to 5 small incisions, resulting in even faster healing times.

Bariatric surgical procedures are also seeing an increase in the non-obese, specifically for the treatment of individuals with lower body mass indexes (standards for bariatric surgeries has specifically catered to those with a BMI of 35 plus) in individuals who have also been diagnosed with diabetes.

The number of individuals undergoing bariatric surgical procedures is expected to grow in 2010, especially due to the fact that Americans diagnosed with diabetes has doubled in recent years. According to the American Society for Metabolic and Bariatric Surgery, nearly 23 million Americans today have been diagnosed with diabetes, a number expected to double by 2034 if current trends continue. The success of bariatric surgical procedures reducing and sometimes eliminating a person's need for insulin has increased the number of bariatric surgeries for the treatment of diabetes in recent years.
Bariatric Surgery: Not Just for the Obese
Unfortunately, more children and teens in any other generation have been diagnosed as being overweight or obese in the past decade. According to the American Heart Association, teens who are overweight or obese stand an increased risk of developing some form of heart disease if steps are not taken to reduce their weight. Weight loss programs for teens are on the rise in hospitals across the country, as are bariatric surgeries. Combined with education regarding proper diet and exercise, such surgeries may potentially save thousands of lives in coming decades.

A new procedure called "corset trunkplasty" has been created to help patients who have undergone bariatric surgical procedures and lost massive amounts of weight, only to be left with large amounts of excess skin, especially around the torso. The new procedure helps reduce the presence of excess skin and according to the literature, targets f lab above the belly button, reducing the amount of excess skin left around the middle as well as 'love handles'.

Of course, popular gastric band procedures will continue, including the two most popular; the lap band and the Realize band, as well as new techniques that promote surgery-free weight loss. One such device currently in late stage clinical trials is called the endoluminal sleeve, also known as an EndoBarrier Gastrointestinal Liner. The liner, placed in the upper portion of the small intestine, focuses on treating uncontrolled diabetes in the obese without surgery.

The future for bariatric surgery and development of new techniques will continue, ever striving to achieve less invasive surgical procedures that promote long-term weight loss and maintenance, reducing the risk of devastating disease processes and encouraging individuals to lead healthier and happier lifestyles.

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