Disrespect

Last month, while working an urgent care shift, I caught a bug from one of my patients which progressed very quickly from a viral upper respiratory illness to a bacterial infection. Because I was so congested, the infection also seeded in my upper airways, and I developed bronchitis. Whenever bronchitis sets in, I am in for a world of hurt, because the coughing jags are so violent that I almost pass out from them since I can’t get a breath in.

In an effort to keep social media world happy, I posted my health status just so people would know why I sort of backed off from social interaction during that time. I felt horrible, and my voice was reduced to a strange, congested baritone mumble.

What irritated me was that several people jumped onto social media with health advice. I understand that people were concerned and trying to be helpful. However, there were two facts which kept floating through my head, and which left me scratching my head over how people thought it was appropriate to post advice.

FACT #1: I never asked for any advice from anyone. I was merely posting facts about my condition.

FACT #2: I am a board-certified family practice physician who works regularly in the urgent care setting. Don’t you think I would KNOW how to take care of myself? Why would anyone offer unsolicited health advice to a physician?

I couldn’t help but be bothered by the influx of posts suggesting things like, “drink tea with honey”, or “take zinc”. As an urgent care doctor, I am just as likely to give general, common sense advice about upper respiratory infections as I am to give prescriptions for medications and order in-office nebulizer treatments. I know all about zinc, tea with honey, vitamin C, salt water gargles, etc.

Besides, I ended up needing a course of antibiotics, two prescription inhalers, two prescription cough medications, and three over-the-counter decongestants. No amount of tea with honey, zinc, or salt gargles would have fought off the infection and reactive bronchitis I had developed. One person on Facebook hounded me via Messenger, and when I said I couldn’t chat, sent me a bizarre set of instructions for a concoction which included red wine. I became irritated and berated him for giving me health advice, whereupon he took the opportunity to insult me for no good reason. His disrespect was so blatant that I blocked him. I don’t need that kind of hostility in my life.

Sorry, but I think it is presumptuous and insulting to attempt to give health advice to doctors. In the age of Google, so many people fall under the assumption that they are suddenly experts when it comes to just about everything. Don’t trust everything you read on Google!

When I really think about it, I doubt that people would give automotive advice to an auto mechanic, or financial advice to their CPA’s. So why insult someone with 7 years of medical training and 14 years of experience as a practicing physician?

I believe I have made my point.

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Understanding The Costs Of Diabetes Treatment And Planning For The Future

Original post can be found at:
https://www.thesimpledollar.com/understanding-the-costs-of-diabetes-treatment-and-planning-for-the-future/


by DeVonne Goode
Updated on 06.05.18

Diabetes is a prevalent disease. However, it can still take many by surprise, and leave them struggling to pay medical bills.
With the complexities of the condition and the wide range of costs involved with treatment, having a financing plan is necessary. Health insurance is obviously one of the primary methods of assistance. But not everyone has the adequate coverage to cover
the costs – let alone the out-of-pocket cash to put on the counter every time out.

Opening a savings account, particularly one with high interest, could be a worthwhile investment toward consistently managing the disease today and into the future.

Diabetes at a glance
Type 1 Diabetes

A condition that keeps the body from producing enough insulin. Insulin shots are used to control blood glucose levels. Most diagnosis occur among children and young adults, which is why it is also referred to as juvenile diabetes.

Type 2 Diabetes

The most common form of the condition where the body doesn’t properly use insulin to convert sugar, starches and other food into energy.

Gestational Diabetes

Occurs when women experience high blood glucose levels during pregnancy. It’s usually easily managed and goes away after pregnancy.
Prediabetes

When blood glucose levels are higher than normal, but not high enough to be diagnosed as Type 2 diabetes. A large number of Americans are living with prediabetes (1 out of 3 adults). But taking early action to manage glucose levels can prevent diabetes from forming.

People who have diabetes are at higher risk of developing the following health conditions:
Blindness
Heart disease
Stroke
Kidney failure
Blindness
Loss of lower appendages (toes, feet, or legs)

Keep in mind – these conditions occur in the case of severe complications with the disease. With consistent attention to diet and other medical treatments (like most living with type 1 or type 2 diabetes undergo), these conditions are avoidable.
Diabetes by the numbers

According to a recent report from the Centers for Disease Control and Prevention (CDC), more than 100 million U.S. adults are now living with diabetes or prediabetes. Of that, only 12% were aware that they had it. And with approximately 1.5 million new cases being diagnosed every year, the need for education and financial support is clear.

Prevalence
Infogram

Rates of diagnosis for the following ethnic groups
7.4% of non-Hispanic whites
8.0% of Asian Americans
12.1% of Hispanics
12.7% of non-Hispanic blacks
15.1% of American Indians/Alaskan Natives
Breakdown among Asian Americans:
4.3% diagnosed were Chinese
8.9% diagnosed were Filipinos
11.2% diagnosed were Asian Indians
8.5% diagnosed were identified as other Asian Americans
Breakdown among Hispanic adults:
8.5% diagnosed were Central and South Americans
9.0% diagnosed were Cubans
13.8% diagnosed were Mexican Americans
12.0% diagnosed were Puerto Ricans

Underreported deaths due to diabetes

Diabetes is one of the leading causes of death in the United States (seventh as of 2015). However, studies have found that it is also among the most underreported. According to the American Diabetes Association®, only 35% of people who died with diabetes had the disease listed on their death certificate. And of that number, only 10% had diabetes identified as the cause of death.

Underreported Deaths
Infogram

There are a number of possible reasons for the underreported rate. But a lot points to the lack of ability to pay for adequate diagnosis and proper medical treatment.

What specific costs will someone with diabetes have to address?

If you or your child are diagnosed with diabetes, or you’re told that you have prediabetes, management and prevention take center stage. While a lot involves diet and exercise, medication will inevitably have an effect on your finances as well.

According to the American Diabetes Association® (ADA), medical costs for a person with diabetes averages out to $16,750 per year (a total of $327 billion nationwide in 2017). Of that amount, $9,601 is attributed to treatment specifically for diabetes. That’s more than twice the medical cost for people without diabetes.

Of the $327 billion nationally, $237 billion was attributed to direct diabetes medical costs and $90 billion was attributed to indirect costs – absenteeism and reduced productivity at work. Understanding the different forms of diabetes treatment, as well as the direct and indirect costs, is important for wrapping your head around plans for financing.


Type
Treatments

Type 1 Diabetes
Diet
Exercise
Insulin therapy
Regular blood glucose tests/monitoring

Type 2 Diabetes
Diet
Exercise
Insulin therapy
Other medication
Gestational Diabetes
Diet
Exercise
Monitoring sugar intake
Monitoring the baby
Direct Medical Costs ($9,601/year)
Indirect Medical Costs ($90 billion nationally)
Prescription medication (30% of total cost)
Loss of productivity due to mortality ($20 billion nationally)
Hospital care (30% of total cost)
Inability to work as a result of diabetes ($40 billion nationally)
Routine doctor’s office visits (15% of total cost)
Reduced productivity while at work ($30 billion)
Other medications and supplies (25% of total cost)
Reduced productivity due to increased absences and loss of employment from diabetes ($6 billion)

Insulin

Insulin injections are one of the primary forms of medical treatment used to manage diabetes. Especially for those living with type 1 diabetes, who can’t produce insulin of their own, these types of injections are vital for survival. However, the cost for insulin has skyrocketed in recent years, leaving many in the position of having to choose between going into debt or cutting back on medication.

Average cost for insulin as of 2015: $100-$200 per month
Average cost for insulin as of 2018: $400-$500 per month

WIDELY USED INSULIN BRANDS AND INSULIN INJECTION TOOLS
Insulin
Apidra, Humulin, Lantuo, Lente, Levemin, Novolog, Novolin, NPH Insulin, Regular Iletin, Regular Insulin, Velosulin
Insulin Syringes
BD Ultrafine, Levemir®, Monoject, NovoFine®, Ulticare, UniFine, UltiGaurd
Insulin Pumps
Animas, Deltec, Medtronic

Diabetes screenings and other medications

Along with your normal doctor’s visits, diabetes screenings are an important part of the process for identifying the disease. Specifically, if you have been diagnosed, testing your blood glucose levels will become a regular part of your life. Much of the costs for medications involved should be covered by your health insurance. And there are a number of home testing devices you can invest in to help make things more convenient and cost-effective.


WIDELY USED DIABETES TESTING BRANDS AND OTHER MEDICATIONS

Blood Glucose Test Meters and Test Strips
Abbott Freestyle®, Abbott Flash, Accu-Chek Compact®, Ascensia Elite, Ascencia Breeze, Ascensia Contour, Lifescan One-Touch©, Prestige
Injectable Medications
Byetta (Exenatide) injection and Symlin (Pramlintide Acetate) injection, Victoza (lLiraglutide- rDNA origin) injection
Oral Medications
Acarbose, Avandia, Chlorpropamide, Diabinese, Glipizide, Glucophage, Glucotrol, Gylset, Meglitol, Metformin, Prandin, Precose, Repaglinide, Rosiglitazone (These drugs act in different ways to lower blood glucose levels and may be prescribed in combination with other medication.)


Diabetes health expenditures according to group

Depending on whether you or your child has type 1 or type 2 diabetes, total expenditures can vary. Those who manage their condition at home, through diet, exercise, and home testing will have different averages than those needing regular appointments with specialists. According to the American Diabetes Association®, average total healthcare expenditures for diabetes treatment differ according to gender, race, and states with the highest populations of people diagnosed.

Gender
Men: $10,060
Women: $9,110

Race
Hispanics: $8,050
Non-hispanic Blacks: $10,470
Non-hispanic Whites: $9,800
States with highest population of people with diabetes
New York: $21 billion in healthcare expenditures
Florida: $24 billion in healthcare expenditures
Texas $25 billion in healthcare expenditures
California: $39 billion in healthcare expenditures

Options for diabetes treatment financing

In a recent online survey of 500 adults with diabetes, more than half of the participants acknowledged the medical costs involved has had a negative impact on their finances. Many also admitted to going to “extreme lengths” to cover the costs. These lengths include accruing credit card debt, borrowing money from family or friends, and tapping into a savings or retirement account. Many may feel the need to take some extra financial risks because they don’t feel as supported as they’d like. Understanding your options will help you make the most informed choices.

Insurance

Government insurance, such as Medicare and Medicaid provides most of the financial assistance for diabetes care. The military also takes care of a good amount of costs for veterans. The remainder of the cost is covered by private insurance or out-of-pocket cash. According to the National Conference of State Legislatures, 46 states mandate that diabetes be covered under state insurance.

Diabetes Health Insurance Coverage
Infogram

These states require coverage for diabetes treatment as well as equipment and supplies for home use (insulin, pumps, syringes, test meters). Four states do not have that same insurance mandate, however – Ohio, Alabama, North Dakota, and Idaho. Anyone with diabetes who live in any of those four states will most likely need to deal with a private insurer or explore other methods of financing.

Coverage from private insurers usually come through employer-sponsored group plans or individual health plans. Advisors would suggest going with employer-sponsored plans, because they offer higher protections due to being subsidized. On the other hand, if you are unemployed and venturing into the individual market, it may be difficult to find affordable coverage. The reason is that diabetes is considered a “high risk” disease. Insurance companies anticipate a high amount of claims, especially from those with pre-existing conditions. So it will be reflected in the pricing.

HSA

People who have diabetes but don’t have coverage that’s comprehensible enough for their needs may utilize a health savings account (HSA). An HSA is primarily useful for people with high deductibles (at least $1,350 individually, or $2,700 for family). Also, those who are a part of low-income families or don’t live in a “mandate state” may see this as a helpful tool. One big benefit of an HSA is that you take the money with you. There’s no “use it or lose it” policy like some other savings plans. Being able to set aside pre-taxed dollars to help pay for medical expenses can go along way when trying to manage diabetes.

FSA

Another way to set aside dollars for medical expenses is through a flexible spending account (FSA). An FSA is provided through your employer with a $2,650 limit. You can also use it to cover medical expenses for your spouse and dependents. One thing to keep in mind with FSA’s is that they do have an expiration period. You’re generally required to use the funds within your plan year. But your employer may offer extensions at their choosing. The benefit is, it can be used with any type of health plan. And diabetic supplies are eligible to be paid through FSA’s.

High interest savings account

If you’re not interested in dealing with your employer for coverage or a flexible spending account, a high interest savings account could be a good option to explore. It’s just like any other savings account, only with fewer restrictions. Not only are you saving for your medical needs, but your money is also making money. High interest savings accounts are opened through online banks – which means they don’t have to worry about maintaining branches all over the country. They can offer you higher interest rates, with the benefit of accessing your money whenever you want.

Unlike an HSA, a high interest savings account isn’t tied to a high deductible health plan with a dollar limit. And unlike an FSA, there’s no expiration date on when you can use your money. It removes any additional stress so you can concentrate on managing your condition properly. And as you earn interest, you can still take advantage of a number of outreach resources available for people with diabetes.

This condition can be a tough one to get a handle on, but it’s not insurmountable. Let your understanding of diabetes, your knowledge of its treatments, and your strategy for tackling costs work in your favor.

Clean House, Clean Mind!

No one should have to live like this!

The phrase which I have used for the title of this post is one which always intrigued me, perhaps mostly due to the fact that I grew up in a household in which various areas were “clutter zones”. This is not to say that I grew up in a messy home. My mom was actually quite tidy, and a neat freak. But I never saw more than half the surface of the dining room table, since the other half was covered with one foot high stacks of bank statements, other financial documents, greeting cards and letters from family. In like fashion, about a third of our coffee table was piled with astrology guides, tv guides, and other books which my mom was reading. Stacks of papers and magazines sat next to our living room sofa. My mom’s bedroom had banker’s boxes instead of furniture at the foot of the bed.

I also was witness to my mom’s extensive collection of jewelry and clothing. Though we had six closets, only one was filled with my clothing, while all the rest were jam-packed with my mother’s clothing. Some of the clothing had never been worn and had the price tags still attached. I admit that I knew this behavior was unusual, but I did not know how pervasive such behavior was in my mom’s family until I went to Hawaii and saw that my aunts and uncles also practiced the same behavior. Some of my relatives were so extreme in their tendency to hold onto things that they earned the label of pack rats. In fact, when one of my uncles had a severe stroke and had to be placed in a convalescent home, my cousins discovered five-foot high stacks of newspapers throughout the house in a serpentine pattern (leaving just enough room for a person to wiggle through the house), moldy food in the refrigerator, Japanese antiques which were stuffed in a room collecting dust, and a plethora of other collectibles and junk which made it next to impossible for him to use the kitchen, toilet or sleep in his bed.

When my mom became ill in 2006 and had to be placed in a convalescent home, the task of cleaning her apartment fell upon me. The enormity of sorting through all the things my mother had collected was overwhelming, and I shut down emotionally numerous times. I was shocked to find collectibles that had never been displayed, bank statements going as far back as the 1950’s, hundreds of pairs of earrings and shoes, about 150 handbags, etc. Suddenly it was left up to me to determine what items of my mom’s were worthy of being kept. Since these items could not be stored at the nursing home, they were stored in my garage and my closet. My mom still asks about her things and becomes angry if I tell her that we had to sell or give away many of the items she had collected over the decades. I did my best to keep what she deemed most valuable, either monetarily speaking or in terms of sentimental value. It always breaks my heart when I see her upset over losing her things.

My favorite aunt, two years older than my mother, was probably the worst-stricken in the family when it came to hoarding. She never had children and was a widow for 34 years when she finally passed away in 2017 at the age of 86 from ALS. Before she became ill, I remember hyperventilating upon entering her house, because the clutter was so extreme. I used to marvel at her insistence on keeping 60 plastic Smurf miniatures in her tiny bathroom, and used to wonder why she had a collection of about 200 plastic food storage containers when she lived alone. My aunt’s collections were numerous and extensive.

If you have ever tuned into the show “Hoarders” you would get a sense of what my aunt’s environment was like. My aunt’s belongings swallowed up her living space so severely that she was unable to stretch out on her bed, and could barely get to her toilet because there was so much junk in the bathroom. My aunt didn’t have access to her front door for over ten years because she had so much junk stacked up in front of it. Instead, she used the side door leading out from the kitchen to access her residence.

In January of this year I had to move from a place I had been in for close to six years. Though I have gone through my entire adult life very successfully squashing any hoarding tendencies that may be hidden in my genetic makeup, I had still acquired many things over the years. Once I was in the new place and had to sort through everything, I was ready to enter full purge mode, and got rid of a lot of things I no longer needed, and it felt FANTASTIC. That is saying a lot since I go through the bulk of my belongings three to four times a year and perform regular purges.

When it comes to your belongings, don’t allow yourself to become encumbered by them. Don’t hold onto feelings of guilt. If you haven’t used something in a while and it is collecting dust, get rid of it. There is probably someone out there who will use it and will appreciate it. If there is something you haven’t used or worn because you are waiting for the right occasion, either USE IT or let it go! I used to frequently argue with my mom about our differing philosophies about objects. She always told me I was hard on things. Scratches on my watches and my shoes were deemed by my mom to be marks of carelessness, when in contrast, my mom sequestered similar items in boxes and tissue paper for decades, never to be worn or used, in a static, pristine state and hidden under a bed or a drawer. I will continue to use the things I possess and will not worry about wear and tear. I will also make sure that tables and all the living areas of my house serve only their intended purposes, and that my storage areas never get to the point where they are overflowing.

If you know a hoarder, please GET HELP. http://hoardershelp.org/

Sex After 40

By: Dr. Stacey Naito – Physician and IFBB Pro

The Shifting Tide

Those of you about to turn the corner and enter the 40 and over zone may be concerned about the impact that getting older will have on your sex life. You may have questions about whether you must resign yourself to becoming a dried-up old lady, with no fun to be had in the bedroom. Thankfully, the reality is that you can have more fulfilling and enjoyable sex than you had in your 20’s or 30’s.

What’s more, society has gotten wind of the idea that people want to live completely fulfilled lives into their advanced years. It’s true that 40 has become the new 20, and the concept is supported by empowered celebrities like J. Lo proclaiming their eternal youth and sexual vitality without shame. So instead of allowing the aging process to shut you down, it’s time to look forward to a new and more sexually fulfilling chapter in your life.

Why Getting Older Is Great For Your Sex Life

I don’t know about you, but I wouldn’t trade the knowledge and life experience I obtained over my 52 years on the planet to return to my 20’s, because aging has positively impacted every aspect of my life, including what happens behind closed doors. With age comes acceptance of who we are, body flaws and all. Let’s face it, we accumulate stretch marks, cellulite, scars, etc. over time, all of which could send us into a meltdown if we stressed out about them. We have become more comfortable with who we are, which translates to greater body confidence. That body confidence works to our advantage in the bedroom, because we no longer feel uneasy or ashamed of how we look sans clothing. When we are comfortable naked, we can finally relax and enjoy intimate encounters to the fullest.

A woman in her 40’s or 50’s is less likely to take desperate measures to entice her man, such as dressing up in sexy but uncomfortable lingerie, or wearing a pair of high heels guaranteed to aggravate her plantar fasciitis or her bad back. In contrast, it seems there are plenty of women in younger age brackets who follow ridiculous wardrobe guidelines to garner the attention of potential sex partners or followers on social media channels. A woman in her 40’s of beyond doesn’t have the inclination to make a fool out of herself to guarantee a romp in the bedroom. She is older, wiser, and doesn’t have time for such nonsense. She doesn’t feel like she needs to try so hard to win her partner’s favor. Her attitude tends to be more along the lines of, “This is what I got, take it or leave it.” Besides, I am willing to bet that such an attitude is far sexier to a man these days. In addition, most men tend to be more excited about the notion of getting you naked, and once you are in the buff, they aren’t scrutinizing your body for flaws.

Older women are also less selfish in bed, and bolder about declaring what they want. They know their bodies, their likes and dislikes. If single, they are more discerning about how they procure partners, so they are less likely to engage in risky activities which expose them to sexually transmitted diseases. For older women in a relationship, there is a greater likelihood that they have been with the same partner for many years, and have developed a level of intimacy which only comes from a longer term committed relationship. A 40-something woman is usually confident enough to turn to her partner and say, “I really like it when you use your hands on me more”, and not fret about whether her partner will accept her sexual preferences.

Chances are that for older women, there are far fewer household distractions which can impede the natural progression of an afternoon of flirting into a full-blown lovemaking session. Such interludes are pretty much impossible if a baby is crying, or young children are demanding attention. Once children have become old enough to be relatively independent, say from pre-teens on, there may be more opportunities to roll around in the sheets with your partner without any interruptions. That kind of freedom can result in more spontaneous sexual encounters and greater satisfaction.

For those past menopause, Aunt Flo’s monthly visit no longer interferes with any amorous advances. Furthermore, there is no concern about getting pregnant and having an unplanned family addition. It’s incredibly liberating.

Sexual Issues and Aging

Though I have painted a rosy picture of the sex life of older women, there are some issues which can interfere with optimal sexual activity. However, this doesn’t mean that all women over 40 will experience sexual dysfunction. As geriatric psychiatrist and Caring.com senior editor Ken Robbins states, “Impaired sexuality and sexual function aren’t normal consequences of aging.” (https://www.caring.com/articles/sexless-after-40).

Women can experience symptoms of perimenopause as early as 35, and the diminishing estrogen and progesterone levels can result in vaginal dryness and thinning of the vaginal mucosa, both of which can make intercourse painful. If this occurs, make sure to obtain a pelvic exam with a physician who can diagnose and treat the condition. In many cases, a lubricant is sufficient, but hormone replacement therapy may be offered as an option as well.

Some women may experience a decrease in sexual desire as they age, but many others experience a surge in libido from the increased testosterone to estrogen ratio, which increases as estrogen levels continue to diminish. The sexual benefits of testosterone are also enhanced by regular weight training, which naturally boosts testosterone levels in the body. However, the ebb and flow of sexual desire often fluctuates more in women over the age of 40, a result of associated dips and surges in hormonal levels. In addition, the hot flashes, night sweats, and mood swings associated with plummeting progesterone levels don’t exactly make a woman feel amorous.

If you are a woman over 40 who is experiencing symptoms of perimenopause, such as hot flashes, and they are frequent enough to disrupt your daily life, seek the advice of a physician. During your visit, you may ask if the addition of hormonal support supplements like maca or dihydroepiandrosterone (DHEA) would be helpful in decreasing the symptoms you are experiencing.
Most importantly, reduce stress in your daily life, get plenty of rest, and communicate with your partner about any sexual concerns you may have.

Review of Noa’s Choice Maximum Hair Growth Formula

I’m a natural skeptic. Part of that skepticism comes from my innate need to gather facts, investigate their source, and determine what is legitimate and what isn’t. As a result, I have always been interested in the sciences, so much so that I ended up immersing myself in fact-checking by becoming a physician. So when I partnered up with a company called Maximum Slim to promote their Noa’s Choice Organic Maximum Hair Growth Healing Ayurveda Formula, I thought, fine, I’ll do it, but I am going to be very honest about my personal experience with the product.

Since I have very thick, healthy, Eurasian hair which grows rather quickly and which cascades all the way down my back, I figured that I wouldn’t use this formula to promote hair growth or treat split ends. Instead, I chose to treat the angry, persistent, dry, itchy scalp condition which has been plaguing me for the last 7 or 8 weeks. This condition has been so severe and resistant to treatments like Nizoral, hair masks, pyrithione zinc, and salicylic acid. So I decided to use the Organic Maximum Hair Growth Healing Ayurveda Formula on my scalp to see if I might get even a bit of relief.

I placed about 22 drops into a dish and heated it, then massaged the oil into my scalp. I then waited for two hours, and washed my hair with a gentle shampoo. Well, goodness gracious, this magical elixir eliminated the flaky scalp condition COMPLETELY. I honestly didn’t expect that dramatic a response, but that’s what I got.

Noa’s Choice Organic Maximum Hair Growth Healing Ayurveda Formula contains all natural ingredients which are proven to promote healthy scalp, and stimulate hair growth. Brahmi leaves, amla fruit, black castor oil, hemp, fenugreek, and coconut oil are combined in a very potent elixir indeed.

There are two notes which I would like to make on this product:

1. It has a food-like smell, probably from the fenugreek seeds, which reminded me very much of cumin. I felt like I should be making meatballs, since I use cumin in most of my ground beef dishes. I don’t think this will be an issue for anyone though, because in all likelihood, you will be at home when you use that product.

2. The directions on the label state to use 4 or 5 drops on the scalp, but if you are treating your entire scalp, I would recommend a greater quantity. I used 22 drops on my scalp, and even then, I concentrated on my hairline, which was where the condition was the most severe. I think if you treat your entire scalp, you should be using about 40 to 50 drops. Make sure to massage into scalp for several minutes to allow the elixir to penetrate fully.

3. I think this product would be an excellent split end treatment, but I always tell people who have a lot of split ends that unless they just get those ends trimmed, they will constantly be chasing the problem. I would almost rather advise people to cut those split ends, and if the ends are DRY but not SPLIT, to use this oil as a preventative treatment.

Though I am part of a paid partnership with Maximum Slim, I am honestly so pleased with the results from the treatment I did that I will happily promote this product to others.

To order this amazing product, go to:
http://www.maximumslim.com/noas-choice-organic-ayurvedic-maximum-hair-growth-oil-elixir