March  2018
Issue No. 90
In this issue
 

About Us 
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  A not-for-profit ministry of
Church of the Brethren Benefit Trust Inc.

Church of the Brethren Insurance Services provides the following products: dental, vision, basic life and accidental death & dismemberment, supplemental life and AD&D, dependent life and AD&D, long-term disability, short-term disability, voluntary accident insurance, and Medicare supplement for eligible Church of the Brethren employees .
 
Dental, vision, and Medicare supplement coverage may also be available for eligible retired Church of the Brethren employees.
 
For eligibility information, call Connie Sandman at 800-746-1505, ext. 3366, or contact your human resources representative.
 
Medical and ancillary plans (named above) may be available to Brethren-affiliated employer groups.
 
Long-Term Care Insurance is available for all members of the Church of the Brethren, their family and friends, and employees of Church of the Brethren-affiliated agencies, organizations, colleges, and retirement communities. 

Contact Us 
1505 Dundee Ave., Elgin, IL 60120
800-746-1505
  www.bbtinsurance.org 
  


 
There's an old saying that March comes in like a lion and goes out like a lamb, which is a simple acknowledgement that the beginning of March is often still viciously wintry and the end is mild and soft like spring. But the saying is sometimes reversed to say that March can come in like a lamb and go out like a lion. This means March is a transitional month, and anything can happen at any time.
 
Are you enjoying the softer breezes of spring or are you still coping with the cold winds of winter? Or do you live in a warm climate where there is no winter, and March is a transition to a different mix of warmth and weather? Whatever your circumstances, we hope you are enjoying the change to a different season, and that your spirits are being lifted by spring's promise of new growth.
 
March is National Kidney Month and we have chosen to focus on the kidneys in this issue. You will find a general article with information you should have to understand this remarkable organ. And because kidneys deserve our attention and are so crucial to our overall health, there is a list of things you can do to support kidney health.
 
This month's highlighted insurance product is life insurance. This kind of insurance seems obvious. Everyone should have it. But a surprisingly large number of people don't. Please take a moment to think about the coverage you already have and the coverage you might still need.
 
Finally, there are two short articles that augment our kidneys theme. Can you imagine a roller coaster helping you pass a kidney stone? Did you know something called a "paired transplant chain" can make it more possible for someone who needs a kidney transplant to find a compatible donor?
 
Blessings to you in this transitional month.
 
Consider life insurance
Have you recently thought about your life insurance policy and asked yourself if you have enough coverage? Or are you among the 41 percent of Americans who do not have any life insurance? If you are in either category, take a moment to read the information below and ask why you should have life insurance in the first place.

The reason for life insurance is to prepare your family for the unthinkable - for the possibility of life without you. If something happened to you, your life insurance would:
  • Pay funeral and burial expenses
  • Cover your family's daily living expenses
  • Pay outstanding debts, such as the mortgage, credit card balances, and car loans
  • Leave a tax-free inheritance
  • Increase your family's financial security and peace of mind
How do you know how much life insurance you need? Ask yourself these questions:
  • What would my family need at my death to meet immediate obligations, such as uncovered medical bills, funeral costs, estate costs, debts, mortgage, etc.?
  • How much future income will be needed to sustain my household?
  • What will be needed to pay for my children's education?
  • How much tax-free benefit do I want to leave to my heirs?
Further, as you move forward in your life, there are times when you should increase your life insurance - major life events that add to your obligations, such as marriage, the birth or adoption of a child, buying a new home.

These are the important reasons for all people to consider life insurance. However, if you work for a Church of the Brethren-affiliated employer (church, retirement community, agency, camp, or district), there are good reasons for buying your life insurance through Brethren Insurance Services.
  • This employer-sponsored group insurance is less expensive than individual coverage.
  • The coverage can go as high as five times your salary up to $300,000 without answering medical questions - up to $40,000 for your spouse.
  • Coverage is available for your children as well.
  • If you die in an accident your death benefit is doubled.
  • Customer service is quick and responsive - only a phone call away.
So, take some time to review your life insurance coverage. If you do not have life insurance, consider purchasing a policy. If you work for a Brethren employer, call Jeremiah Thompson [JB1] , Director of Insurance Operations, Brethren Insurance Services, 1505 Dundee Ave., Elgin, IL 60120, 800-746-1505, ext. 3368, jthompson@cobbt.org, www.cobbt.org/.
Your kidneys - master chemists
 
Not to be taken lightly 
Not to be taken lightly Not to be taken lightly 
Not 

W hat do you know about your kidneys? And more importantly, what do you need to know? You probably know that one of their main purposes is to get rid of waste and excess fluid from your body. But did you know that they regulate your body's electrolytes? Did you know they produce hormones that affect other organs? For instance, one hormone stimulates red blood cell production. Other hormones help regulate blood pressure. The kidneys also remove drugs from the body and produce an active form of vitamin D that promotes strong, healthy bones.

When you Look at all the ways the kidneys affect the body, you realize they are essential to your health. Homer William Smith, Professor of Physiology at New York University from 1928 to 1961, wrote in Lectures on the Kidney, "It is no exaggeration to say that the composition of the blood is determined not by what the mouth ingests but by what the kidneys keep; they are the master chemists of our internal environment." So, these bean-shaped organs tucked on either side of your spine below your ribs and behind you belly should not be taken lightly. There are two of them and each is about the size of a fist, four or five inches long.

Functions

First their most obvious function. They filter the blood to produce urine which is an all-purpose waste disposal fluid. The kidneys filter about 120 to 150 quarts of blood daily to produce 1 to 2 quarts of urine, which gathers in a funnel-shaped structure, and drains down into the bladder. 
But the kidneys do so much more.
  • In the filtering process they remove toxins, excess salts, and urea which is a waste created by cell metabolism.
  • They balance the water level in the body. When water intake decreases, the kidneys keep water in the body instead of helping to get rid of it.
  • To do their blood-filtering work, the kidneys need constant pressure. When blood pressure drops too low, they increase it by producing a protein that constricts the blood vessels and sends a signal to the body to retain sodium and water until normal blood pressure is restored.
  • When the kidneys don't get enough oxygen, they send out a hormone that stimulates the bone marrow to produce more red blood cells to carry oxygen, thus regulating the red-blood cell level throughout the body.
  • The foods we eat either increase or neutralize the acids in our body. For the body to function well, these chemicals need to have a healthy balance. It's the kidneys that do this.
All this is accomplished through the filtering process, which is actually carried out by about a million tiny filters in the kidneys called nephrons. These are so good at their work that you can have as little as 10 percent of your kidneys working and you will likely not notice a problem.

Kidney failure and disease

So what can cause your kidneys to stop working? The two most common causes of chronic kidney disease (CKD) are diabetes and high blood pressure, both underlying conditions that can be treated with diet and exercise. Other conditions that can cause kidney disease are lupus; the excessive use of over-the-counter pain medications like acetaminophen (Tylenol) and ibuprofen (Advil); hardening of the arteries; and an enlarged prostate. If you have one of these conditions, you should have your kidney function monitored.

There are still more reasons the kidneys might malfunction. Bacteria from a bladder infection can cause a kidney infection. An over-active immune system may attack a kidney, causing inflammation and even damage. Minerals in the urine form crystals called kidney stones that block urine flow, producing a very painful condition. Genetically caused cysts can make 
it hard for the kidneys to work. Dehydration or 
a blockage in the urinary tract can cause the kidneys to fail. But chronic and complete 
kidney failure is usually caused by diabetes 
or high blood pressure.

As already noted, kidneys can do their job even when they are in partial failure. They are so effective that a normal person can function well with only one. But when kidneys stop working entirely, they both fail together. This is called end-stage renal disease (ESRD), and there are only two solutions. One is dialysis. The other is a kidney transplant.

Dialysis

There are two kinds of dialysis. In hemodialysis, you are hooked up to a machine. An access point into your blood vessels is made, usually in your leg or arm. The machine pumps your blood into another machine called a dialyzer. This works like a kidney and does the filtering. Then the clean blood is sent back into your body. The process takes about four hours and typically must be repeated three times a week. It can be done in a hospital or a dialysis center or at home, depending on your medical condition.

With peritoneal dialysis, your blood is cleansed inside your body. Your doctor will do surgery to place a plastic catheter in your abdomen. During the dialysis a liquid called the dialysate is sent through the catheter into your abdominal area, called the peritoneal cavity, slowly filling it. Though blood stays in the arteries and veins lining the peritoneal cavity, extra fluid and waste products are drawn out of the blood and into the dialysate. With this kind of dialysis, there two options. One, you can put a bagful of dialysate, about two quarts, into the peritoneal cavity and leave it there for about four hours, then drain it back into the bag, which is thrown away. Meanwhile, you can go about your daily business. With the second option you use a machine called a cycler, and the exchanges are done throughout the night while you sleep.

Depending on your medical condition, you can survive on dialysis for many years. The average life expectancy is 5 to 10 years, but many people on dialysis have lived for 20 or more years. So that brings us to the other way to deal with kidney failure, and that is to have a kidney transplant. Many people feel this gives them more freedom and a better life than dialysis.

Transplant

The National Kidney Foundation cites studies showing that people live longer with a transplant than those on dialysis. A kidney can be donated by a living donor or it can come from someone who has died; it can come from a family member or a stranger. Three tests are done to see if the donor and recipient are compatible. Generally, a kidney from a living donor will begin to function sooner and may last longer. When you have been cleared for a transplant, you are put on a waiting list. It can take many years for a good donor kidney to be found. So, finding someone who will volunteer to give you a kidney is a great blessing. Transplant surgery takes about four hours. Afterwards, it may take a while for the kidney to begin working. Interestingly, during a transplant, the old kidneys are not usually removed. Instead the new kidney is put in the lower abdomen where it is easy to hook it up to blood vessels and the bladder.
 
Importance of kidneys

Why do you, as an ordinary citizen, need to know all this about your kidneys? Well, according to the American Kidney Fund, kidney disease is the 9th leading cause of death in the United States. It's estimated by the Centers for Disease Control that 30 million people (15 percent of the adult population) have chronic kidney disease. Here's a sobering statistic: most people (96 percent) with kidney damage or mildly reduced kidney function don't know they have chronic kidney disease. Even among those with severe CKD, 48 percent don't know it. CKD is estimated to be more common in women than in men, though men are more likely to have ESRD. Some racial and ethnic groups, according to the American Kidney Fund, are at higher risk: African Americans almost 4 times higher than whites; Native Americans 1.5 times higher; Asians 1.4 times higher; Hispanics 1.5 times higher. Diabetes causes 44 percent of all new cases of kidney failure, and high blood pressure causes 28.4 percent.

Let's return to our 20th century physiologist, Homer William Smith, who had this to say about the importance of the kidneys - "Our glands, our muscles, our bones, our tendons, even our brains, are called upon to do only one kind of physiological work, while our kidneys are called upon to perform an innumerable variety of operations. Bones can break, muscles can atrophy, glands can loaf, even the brain can go to sleep, without immediately endangering our survival, but when the kidneys fail to manufacture the proper kind of blood, neither bone, muscle, gland nor brain can carry on."

So, don't forget about your kidneys. Pay attention to them. Keep them healthy.
Caring for your kidneys
Here are some things you can do to keep 
your kidneys  in good working order:

1. Keep your blood pressure normal at 120/80.
Have it checked regularly. Blood pressure higher than 120/80 is considered elevated, and means you should change your lifestyle and diet. You should not allow your blood pressure to go above normal levels.
 
2. Exercise and keep yourself fit.
Extra weight raises blood pressure. Keep your body mass index (BMI) in a healthy range. Regular exercise can stave off hypertension and weight gain. Aim for at least 150 minutes every week of moderate-intensity exercise, such as walking, cycling or swimming. (Your BMI is a weight-to-height ratio, calculated by dividing your weight in kilograms by the square of your height in meters. An adult should be between 18.5 and 24.9. You are overweight if you are in the 25 to 29.9 range and obese if your BMI is over 30.)
 
3. Control your blood sugar.
The World Kidney Day website asserts that half of people with diabetes develop kidney damage, and Davita Kidney Care reports that diabetes is the most common cause of kidney failure. According to the National Kidney Foundation, high sugar levels cause the tiny blood vessels in the filtering units of the kidneys to become narrow and clogged. Without enough blood, the kidneys become damaged. So watch your sugar intake.
 
4. Eat healthy and keep your weight in check.
Reduce your salt intake. Stay away from fatty foods and bad trans fats. Use good fats like olive oil, and organic coconut oil. Avoid processed food. Stay away from sodas and other sugar-laden foods and drinks. A balanced diet ensures you get all the vitamins and minerals your body needs. Eat plenty of fruits and vegetables, and grains such as whole wheat pasta, bread and rice. When you eat meat, eat grass-fed beef and free-range chickens and eggs.
5. Hydrate. Drink enough fluids.
Drink water. Traditional wisdom says 1½ to 2 liters of water per day; that's 6 to 8 eight-ounce glasses. Fluids help the kidneys clear sodium, urea, and toxins. The right level of fluid intake varies according to gender, exercise, climate, and health (and for women, pregnancy and breastfeeding are factors). People with a kidney stone are advised to drink more, as much as 3 liters of water per day. Otherwise, there is no  evidence that over-hydration helps the  kidneys. Six to eight glasses of water  should be enough. A good measure  is  whether or not your urine remains  straw-colored. A darker color could  mean dehydration.

6. Use caution with supplements and herbal remedies.
Excessive amounts of certain vitamins and herbal extracts may be harmful to your kidneys. Talk to your doctor and do your research.
 
7. Avoid contact with toxic, harmful substances.
The following could affect your kidney: NSAIDS and statins, aspirin, Tylenol, and ibuprofen, too much fluoride in your water supply, dental mercury amalgams, toxic mold, pesticides, toxic cleaning substances, artificial sweeteners.



8. Do not smoke.
Smoking can damage blood vessels, slow the blood flow to the kidneys, and impair their ability to function properly. Smoking also increases the risk of high blood pressure and cancer of the kidneys.
 


9. Drink alcohol in moderation.
Too much alcohol can raise your blood pressure. It can have an impact on your kidneys' ability to filter your blood. Alcohol has a dehydrating effect which can affect the kidneys. Chronic drinking can cause liver damage which makes the kidneys' job more difficult.
 
10. Do not overdo over-the-counter pills like ibuprofen.
Common medications like ibuprofen and naproxen (NASAIDs) can cause kidney damage. If you have chronic pain, discuss with your doctor alternative ways to manage it.
 
11. Gluten.
If you are gluten-intolerant, you could suffer from gluten-induced kidney damage. Get a genetic test for gluten sensitivity. If you have kidney disease, ask your doctor to check your levels.
 
12. Get enough vitamin D.
People who are deficient in vitamin D  are more likely to develop kidney disease.  It is not known if vitamin D levels are a  cause or a condition of kidney damage,  but getting the  vitamin D you need will  help your kidneys.  

13. Relax.
When you are under constant stress your blood sugar can be elevated and your blood pressure can rise. Both contribute to kidney disease. So, do things that help you relax and reduce your stress levels. Disengage. Take time to pray. Talk with a friend. Do yoga. Keep a journal. Get enough sleep. Read a good book. Sit by the fire. Listen to music. Take vacations. Get exercise. Remember that being is as important as doing.
 
14. Have your kidney function screened regularly.
This is especially important if you have one of the following high-risk factors: diabetes, hypertension, obesity, a parent with kidney disease, or if you are of African, native American, Asian, or Hispanic descent.
Kidney stones and Big Thunder Mountain
We have all heard stories of the agony of passing a kidney stone. Maybe you have actually had that misfortune. Kidney stones are hard deposits of minerals and salts that form inside your kidneys. They afflict approximately one in 10 people. Often, they form when urine is concentrated, allowing minerals to crystallize and stick together. They can affect any part of your urinary tract.
 
To pass a stone, you may need to do nothing more than take pain medication and drink lots of water. But if a stone gets badly stuck in the urinary tract or is connected to a urinary infection or causes complications, surgery may be needed. Generally, when kidney stones are passed, they leave no permanent damage except an uneasy memory and the fervent hope you will never have another one.
 
Author and essayist Edward Abbey wrote, "One must be reasonable in one's demands on life. For myself, all that I ask is: (1) accurate information; (2) coherent knowledge; (3) deep understanding; (4) infinite, loving wisdom; (5) no more kidney stones."

B ecause of the pain caused by kidney stones, it stands to reason that people will look for relief wherever they can find it, but who would have considered looking for it on a roller coaster ride? A 2016 article in The Atlantic reports that David Wartinger, a urological surgeon and professor emeritus at Michigan State University, who had been dealing with kidney stones for years, noticed that people coming back from their spring-break trips south to Disney World in Florida sometimes reported that they had passed kidney stones during and after visiting the theme parks. One man on three occasions passed a stone after riding on the roller coaster called Big Thunder Mountain Railroad.
Wartinger studied these reports of people passing stones and found the common factor was indeed the Big Thunder Mountain Railroad. He devised an experiment with silicone model kidneys and persuaded the ride manager to let him and an associate take multiple trips on the ride, carrying the model kidneys in a backpack They discovered that there was a huge difference between the front and the rear of the roller coaster. When the model kidneys were in the rear car where there was a lot more whipping around, the stones passed 63.89 percent of the time. In the front car, the rate was only 16.67 percent.
 
Wartinger has continued his experiments, but there is enough evidence to suggest that if you have a small stone, a series of roller coaster rides could help you pass it. If you have a large stone requiring an expensive procedure to break it up, the coaster could still help you pass the tiny fragments.
 
Is it possible that the future could hold a machine in your urologist's office that can give you "a precise pattern of pitches, yaws, and rolls designed around your particular kidney anatomy and the location of your particular stone"? In this world of ongoing scientific investigation and unexpected technology, anything is possible.

Paired transplant chain - an exercise in generosity
What are you to do if you need a kidney and you have a loved one who is willing to donate, but the two of you are not compatible? One possibility is to find a recipient who is a match for your loved one's kidney, and have that recipient find someone else who is willing to donate a kidney, and continue looking until you find someone who is compatible with you. Sometimes, in this scenario, a sequence of donors and recipients develops, called a "paired transplant chain." This is especially likely if someone volunteers to donate a kidney to anyone, expecting nothing in return.
 
Such a chain became possible in 2011 when a California man named Rick Ruzzamenti simply offered to donate his kidney - to anyone. The New York Times reported in February 2012 that Ruzzamenti called his hospital and asked how to do it. Across the country in Joliet, Ill., Donald Terry needed a kidney. Terry did not receive Buzzamenti's kidney, but they were the first and last persons in a chain that linked 30 people who were willing to give up an organ with 30 people who might have died without one.
 
When the donor and recipient are not compatible, the donor can agree to donate the kidney to a stranger in exchange for an effort to find a kidney for the loved one that is compatible. With the help of donor data bases like the National Kidney Registry, non-matching pairs of patients and donors can be linked up and the kidneys shuffled around until all the recipients end up with the organ that is best for them, regardless of their relationship to the donor.
 
The chain from Ruzzamenti to Terry required careful coordination over four months, and involved 17 hospitals in 11 states. Several times, the chain was broken. A Long Island businessman, inspired by his daughter's illness, repaired the breaches. He was always able to find that needle-in-a-haystack match to keep the chain going. For instance, a man in Michigan agreed to donate a kidney for his former girlfriend despite a bitter breakup, for the sake of their 2-year-old daughter. The article in the Times reported, "Children donated for parents, husbands for wives, sisters for brothers. A 26-year-old student from Texas gave a kidney for a 44-year-old uncle in California whom he rarely saw. In San Francisco, a 62-year-old survivor of Stage 4 Hodgkin's lymphoma donated for her son-in-law."
 
On August 15, Mr. Ruzzamenti's kidney flew east from Los Angeles to Newark, and was given to a 66-year-old man whose 34-year-old niece agreed to have her kidney shipped to a University of Wisconsin hospital for a woman whose former boyfriend agreed to donate a kidney. That kidney went to Pittsburgh to a clerical supervisor whose husband sent his kidney to a young father in San Diego. And so it went until on December 20, at the Loyola University Medical Center in Chicago, Donald Terry received the 30th and last kidney in the chain.
 
Four years later, an even longer chain began and ended at the University of Wisconsin Hospital and Clinics, which included 34 donors and 34 recipients at 26 hospitals across the country. In addition to connecting people who need kidneys with people who are willing to give them, a paired transplant chain can help people who have an especially difficult time finding a match. A news brief on the UW Health website observes, "Because these chains can include many participants, they can be especially helpful to individuals who are highly sensitized (high antibody levels) and as a result cannot find a good donor match. Sixteen of the 34 recipients in this chain were highly sensitized."

A paired transplant chain is remarkable because of the coordination that is needed and because of the medical expertise and technology it requires. But the most extraordinary thing is the simple generosity and courage of the donors - healthy human beings who are willing to sacrifice part of themselves so that another person may regain health.

LOL - The Best Medicine
              
1. Two old men were arguing the merits of their doctors. The first one said, "I don't trust your fancy doctor. He treated old Jake Waxman for a kidney ailment for nearly a year, and then Jake died of a liver ailment." "So what makes you think your doctor is any better?" asked his friend. "Because when my doctor treats you for a kidney ailment, you can be sure you'll die of a kidney ailment."

2. A doctor apologized for keeping an elderly woman waiting so long in his office. "That's all right," she said. "I just thought you'd like to treat my kidney failure while it was in its early stages!"

3. Two men were talking about their problems while waiting to see the nephrologist. One said to the other, "Just when we learn to take things with a grain of salt, the doctor puts us on a salt-free diet!"
It's always a good time to sign up for Long-Term Care Insurance
Brethren Insurance Services offers Long-Term Care Insurance all through the year
 
If you're interested in purchasing coverage, you should know that e ligibility for benefits is determined by the inability to meet at least two of these six activities of daily living -- bathing, eating, dressing, toileting, continence, or transferring. Cognitive impairment can also trigger benefits.
 
It's difficult to think about the fact that a debilitating condition or a disabling injury might leave you unable to care for yourself, or that when you reach your twilight years, the time will come when you will need some extra care. Long-term care insurance makes sure that you will get the care you need. It helps assure that the cost of your custodial care will not eat up your savings. Finally, and this is one of the best things about LTCI, it can help protect your children and other relatives from having to use their resources to care for you.
 
Brethren Insurance Services offers Long-Term Care Insurance for all members and employees of the Church of the Brethren and their family and friends; and also for employees of Church of the Brethren-affiliated agencies, organizations, colleges, and retirement communities and their families and friends.
 
If you are interested in obtaining this coverage, contact Brethren Insurance Services at  insurance@cobbt.org or 800-746-1505 for a free, no-obligation proposal or  click here to request more information.