Thursday, January 08, 2009
How to loose weight and win at board games
By Anthony Policastro, M.D

Many people give games as Christmas presents. One of the games is called Balderdash. It is a game where the players try to guess the meaning of unusual words. So, I decided to give a hint to Balderdash players. The word I will define is ghrelin. We all have ghrelin. Some of us have more of it than others. We would just as soon not have it. However, we have it whether we like it or not. Ghrelin is a hormone. It is the hormone that stimulates appetite. Before meals, the ghrelin level goes up. After meals it goes down. It serves to increase food intake. It serves to increase fat mass. Like most hormones it has some other actions as well. It appears to promote lung growth in the growing fetus. It appears to help learning and memory. The suspicion is that learning and memory are best before meals when the ghrelin levels are highest. It appears to offer some protection against depression caused by stress. Most interesting, it appears to be related to sleep duration. The longer someone sleeps the lower the levels of ghrelin. The shorter someone sleeps the higher the levels of ghrelin. The take home lesson from this is the more sleep you get, the less hungry you will feel. Therefore, not getting enough sleep is likely to increase your weight. One of the reasons that obesity surgery works is that it cuts down the levels of ghrelin in the bloodstream. Since ghrelin was only discovered in 1999, there are a lot of things yet to be discovered about its action. With the current epidemic of obesity in the United States, there will be a lot of value in learning more about it. Scientists have already been working on ways to decrease the action of ghrelin. One company is working on an obesity vaccine. The vaccine allows the body to form antibodies that will bind to ghrelin's target sites. That way even though the level is not decreased, ghrelin will not be able to stimulate appetite. It may still be a while before treatment aimed directly at ghrelin is practical. In the meantime, you can at least use your knowledge of ghrelin to play a better game of balderdash.

Blue Cross mailing misleading Insurance Commissioner Matt Denn is alerting consumers about misleading information regarding the state's involvement in health insurance rates contained in rate increase notices sent by Blue Cross Blue Shield of Delaware. Commissioner Denn said that the misleading information suggested that the State of Delaware had some ability to control the rate increases that Blue Cross was imposing on its policyholders. Many Blue Cross customers have received notices in recent weeks containing substantial rate increases, some in excess of 20 percent. The notices state that the rate increases are "subject to review by the Delaware Department of Insurance." However, under Delaware law, the Department of Insurance is not permitted to review health insurance rates for anything other than technical compliance with the law. The Department has no authority to turn down health insurance rate increases that it believes to be excessive. "This misleading statement by Blue Cross is all the more egregious because the Department of Insurance has actually been seeking permission from the General Assembly for the last four years to turn down excessive health insurance rate increases, and Blue Cross has successfully lobbied against those efforts," Commissioner Denn said. Because of time frames for notice under Delaware law, Commissioner Denn cannot schedule a hearing on this matter before he leaves office on Jan. 6. His successor will need to determine whether to take formal action against Blue Cross for this mailing.

DHSS dedicates new center Officials from the Department of Health and Social Services and the Division of Developmental Disabilities Services recently dedicated its new multipurpose medical center at the Stockley Center in Georgetown in honor of Mary Ann Coverdale, the late mother of Governor Ruth Ann Minner, who shared her love, time and experience with children who needed it most. According to Marianne Smith, the Division's director, "This new 54-bed Intermediate Care Facility is specifically designed for individuals with developmental disabilities. Some of the beds are for short-term, rehabilitative stays and some will provide medical care to individuals who live at home but whose families need brief periods of respite care. Forty-five of the beds will be for the medically fragile residents who currently receive care and will continue to receive residential care at the new facility." At its highest census, in the 1970's, nearly 700 people with developmental disabilities lived at Stockley. The "best practice" philosophy 30 years ago was for people with substantial developmental disabilities to be institutionalized. Today only 85 people live on the Stockley campus. Of that number, 45 live in the medical care facility while the others are able to live in several cottages on the grounds.

Flu shots still available It's not too late to get a flu shot. Influenza is a serious disease that affects many people, including the elderly and those with serious, long-term health problems. Nanticoke Memorial Hospital's Occupational Health will be offering flu shots to the public at Nanticoke Mears Health Campus (across from Seaford Post Office) through March 2009. The cost is $20. Medicare billing is available with proof of Medicare insurance. Pre-registration is required. Large outbreaks of influenza usually do not occur before December in the USA and reach a peak between late December and early March, and many continue into the spring. The duration of protection conferred by the influenza vaccine generally begins one to two weeks after injection and may last six months or longer. Pre-registration is required. Call Nanticoke Occupational Health at 629-6875 to schedule an appointment.

LDAF Autism Ball planned The Lower Delaware Autism Foundation's Autism Ball and Auction for Hope is Saturday, March 7, 2009 at the Bay Center in Dewey Beach. The theme encourages guests to help make dreams come true for individuals with autism. The event begins with a silent auction from 6 to 8 p.m. and is followed by dinner, a live auction and dancing from 8 p.m. to midnight. There will be an open bar during the silent auction from 6 to 8 p.m. followed by a cash bar from 8 p.m. to midnight. Tickets are $125 and dress is cocktail attire. Table sponsorships are available for $2,500 and include a table for 12 guests, full page event program ad and more. Other sponsorship opportunities are also available. Entertainment will be provided by the Big City Band. Autism affects one in every 150 children born in the U.S. each year. More children will be diagnosed with autism this year than with AIDS, diabetes and cancer combined. Autism costs the nation over $90 billion annually, a figure that is expected to double in the next decade. For more information about sponsorship or volunteer opportunities, call Mary Landon Green, program and event coordinator, at 302-644-3410 or visit

Nanticoke Prescription Fund Nanticoke Memorial Hospital's Charity Endowment Prescription Fund is a fund that assists patients who cannot afford their medications when discharged from the hospital. In lieu of a gift to a colleague, business associate, family or friends, consider a donation to the Nanticoke Health Services Prescription Drug Fund in their name. Participants receive inserts for their holiday cards, which inform recipients that a donation has been made to the Prescription Drug Fund in their honor. Over 250 individuals from the community have already benefited from the fund, and Nanticoke Hospital wants to ensure many more will be able to benefit. Imagine a family member or friend, diagnosed with cancer, being told that it could possibly be three weeks before they receive prescription coverage for their pain and anti-nausea medications. With your donation to the Prescription Drug Fund, patients are able to receive immediate access to their medications. For further information and to participate in supporting Nanticoke's Prescription Drug Fund, contact Nanticoke's Corporate Development office at (302) 629-6611, ext. 2404. You may also contribute online at

Nanticoke expands testing hours Beginning Feb. 7, Nanticoke Memorial Hospital will expand Outpatient Laboratory and Radiology services testing hours to include Saturdays from 7 a.m. to 3 p.m. Patients will continue to register in the hospital lobby registration area before testing. Monday through Friday hours will remain from 7 a.m. to 7 p.m. Mears Campus hours will also remain unchanged, Monday through Friday from 7 a.m. to 4:30 p.m.