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Fixit: Seen or unseen, tiny flies bite hard

August 11, 2008 at 10:02PM

Q What exactly are no-see-ums? They take a terrible bite out of my neck and face when I am gardening. Insect repellent doesn't seem to faze them.

A A no-see-um, also known as a biting midge, is a very tiny fly (most are 1/16 inch or less). Because it is so small, it often goes unnoticed until it bites. Despite its small size, it can inflict a painful bite. It's more likely, however, that you are encountering black flies in your garden. Similar, but a little larger (1/16 to 1/8 inch), they can also administer a painful bite. Both like to bite exposed skin, but black flies tend to bite more around the head.

It is difficult to prevent either of these flies from biting. Repellents are inconsistent in their protection. You can try to avoid times when they are present; some days may not be as bad as others. Or when you know they are out, wear protective clothing, such as long pants, long-sleeved shirts and hats.

Jeff Hahn, extension entomologist, University of Minnesota Extension

Changes in living wills Q In 2003 I rewrote my living will following advice from the Minnesota Health Department. The will is signed, dated and notarized as required. Someone now tells me that it is no longer valid and that the medical profession does not follow the wishes in the will. Is this information correct?

A No. But there could be misunderstanding because of terminology.

Before Aug. 1, 1998, Minnesota law provided for several types of directives, such as living wills, durable health care powers of attorney and mental health declarations. The law changed so people can use one form, the health care directive, for all health care instructions.

A health care directive is a written document that informs others of your wishes about your health care. It allows you to name a person ("agent") to decide for you if you are unable to decide.

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For a health care directive to be legal it must:

• Be in writing and dated.

• State your name.

• Be signed by you or someone you authorize to sign for you, when you can understand and communicate your health care wishes.

• Have your signature verified by a notary public or two witnesses.

• Include the appointment of an agent to make health care decisions for you and/or instructions about the health care choices you wish to make.

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It sounds as if your form meets these requirements. Ask a lawyer or health care provider to be sure.

Even if your form was created before Aug. 1, 1998, it is still legal if it followed the law in effect when written, or meets the requirements described above.

Health care providers will follow your health care directive, or any instructions from your agent, as long as the health care follows reasonable medical practice. But you or your agent cannot request treatment that will not help you or which the provider cannot provide. If the provider cannot follow your agent's directions about life-sustaining treatment, the provider must inform the agent. The provider must also document the notice in your medical record. The provider must allow the agency to arrange to transfer you to another provider who will follow the agent's directions.

Information on how to obtain forms for a health care directive is available from the Minnesota Board on Aging's Senior LinkAge Line: 1-800-333-2433. Or go to www.mnaging.org.

Before you prepare or revise your directive, you should discuss your health care wishes with your doctor or other health care provider.

Send your questions to Fixit in care of the Star Tribune, 425 Portland Av. S., Minneapolis, MN 55488, or call 612-673-7032, or e-mail fixit@startribune.com. Past columns are available at www.startribune.com/fixit. Sorry, Fixit cannot supply individual replies.

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KAREN YOUSO, Star Tribune

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