Events
July is UV Safety Awareness Month
ULTRAVIOLET RADIATION
We are exposed to ultraviolet radiation through the sun, and some man-made resources like welding and tanning beds. UV rays are a moderate-frequency radiation which can damage the DNA, or genetic material, in cells which may lead to cancer or damage to the eyes.
THERE ARE 3 TYPES OF ULTRAVIOLET RADIATION:
UVA rays have the least energy and can cause skin cells to age, mainly exhibited by wrinkles, and can lower your body’s immune defenses. They are also suspected to play a role in some skin cancers. About 95% of the ultraviolet rays from sunlight are UVA rays.
UVB rays have a bit more energy than UVA rays and can directly damage the DNA of skin cells. These are the rays that cause sunburns and believed to be to source of most skin cancers. They too contribute to skin aging and decreasing your body’s immune defenses, and cause snow blindness (a sunburn to the cornea). About 5% of the ultraviolet rays from sunlight are UVB rays.
UVC rays have the most energy of the ultraviolet rays. They react with the ozone in our higher atmospheres and don’t typically reach the ground and are not normally associated with risk for skin cancer. These rays are the ones which come from man-made sources such as arc welding torches, UV sanitizing bulbs and mercury lamps.
DIFFERENT FACTORS AFFECT ONE’S EXPOSURE TO UV RADIATION:
Time - UV rays are strongest between 10 am and 4 pm.
Season - UV rays are stronger during the spring and summer months.
Latitude - UV exposure is less as you move farther from the equator.
Altitude - More UV rays reach the ground in higher elevations.
Clouds - Exposure may vary when the skies are cloudy, but it is important to know UV rays can get through to the ground despite the lack of visible sunshine.
Reflection - UV rays can bounce off of surfaces like water, sand, snow, pavement, and even grass. This can increase UV exposure.
Air - Ozone in the upper atmosphere filters some of the UV radiation.
UV RADIATION AND SKIN CANCER:
There is a direct link between basal and squamous cell skin cancers and melanoma to sunlight exposure. Some studies have shown possible links of sunlight exposure to Merkel cell carcinoma and melanoma of the eye. People who use tanning beds/booths have been shown to have a higher instance of melanoma and basal and squamous cell skin cancers, especially when they started tanning before the age of 25. Fortunately, when discovered early enough basal cell cancer and squamous cell cancer are almost always curable. Sunburns play a strong role in the development of melanoma and this is the most dangerous of the skin cancers because it has the ability to spread to other organs very rapidly if it is not treated early.
UV RADIATION AND YOUR EYES:
UV rays can damage all structures of the eye. The front surface of the eye absorbs 99% of UV radiation. Cataracts, corneal damage, macular degeneration and eye cancers take years to develop and each time we are enjoying the sunshine without eye protection, we increase our risks of eye disease leading to a decrease in or loss of vision. Additionally, those who have spent long hours in the midday sun, such as farmers, skiers, swimmers, surfers and fishermen, are more likely to develop growths on the conjunctiva of the eye called pterygium. The eyelid skin is the thinnest skin on our bodies and UV damage can leave us with dryness, wrinkles, loss of skin elasticity and mottled pigmentation, as well.
WHAT YOU CAN DO TO REDUCE YOUR RISKS:
When outside, try to stay in the shade, especially during midday hours.
Wear UV-blocking sunglasses; choose 100% UV or UV400 protection, or glasses that block both UVA and UVB rays.
Protect your skin with clothing which covers your arms and legs, and a hat to protect your head, face and neck.
Use sunscreen to help protect exposed skin.
SUNLIGHT AND YOUR HEALTH:
Healthy exposure to sunlight can have positive effects on our overall health as long as we protect ourselves against the damaging effects of UV radiation. In fact, our bodies require some natural light every day to help maintain good and restful sleep. There are light-sensitive cells in our eyes which play an important role in the body’s natural wake-sleep cycles, which can be important as we age and become more prone to insomnia. Your body also makes Vitamin D when it is exposed to the sunlight. Vitamin D helps to promote strong bones and may help to prevent some cancers.
Resources:
American Cancer Society - Ultraviolet Radiation
American Cancer Society - Be Safe in the Sun
EPA - UV Radiation and Sun Exposure
American Academy of Ophthalmology - The Sun, UV Light and Your Eyes
June is Alzheimer's and Brain Awareness Month
Everyone who has a brain is at risk for dementia. Worldwide, 55 million people are living with dementia. Alzheimer’s dementia is the most common form of dementia; it is a degenerative brain conditions which is not a specific disease, but an overall term which describes a group of symptoms. More than 6 million Americans are living with a diagnosis of Alzheimer’s dementia. By 2050, this number is projected to rise to nearly 13 million. Statistically, 1 in 3 seniors succumb with Alzheimer’s, or another dementia. In 2023, dementia will cost the nation some $345 billion.
While your memory often changes as you grow older, memory that disrupts daily life is not a typical part of aging; it may be a symptom of Alzheimer’s or another form of dementia. There are 10 early warning signs and symptoms you should become familiar with. If you notice any of these, please schedule a visit with your physician for further evaluation.
Memory loss that disrupts daily life - One of the most common signs of Alzheimer’s dementia, especially in the early stages, is forgetting recently learned information, important dates or events, asking the same question over and over, and an increasing need to rely on memory aids, such as reminder notes, electronic devices or family members, for things you once handled independently.
What’s a typical age-related change? Sometimes forgetting names or appointments, but remembering them later.
Challenges in planning or solving problems - Changes in your ability to develop and follow a plan, or work with numbers, such as following familiar recipes or keeping track of monthly bills. You may also find increasing difficulty with concentration and tasks taking a longer time to complete than before.
What’s a typical age-related change? Making occasional errors when managing finances or household bills.
Difficulty completing familiar tasks - Persons with dementia may often find it hard to complete daily tasks, such as driving to a familiar location, organizing a grocery list or remembering the rules of a favorite game.
What’s a typical age-related change? Occasionally needing help to record a TV show or operate/change the settings on a washing machine.
Confusion with time or place - You may find you are losing track of dates, seasons and passage of time; having increasing trouble understanding something if it is not happening currently or in the immediate future; and/or forgetting where you are or how you arrived there.
What’s a typical age-related change? Getting confused about the day of the week but figuring it out later.
Trouble understanding visual images and spatial relationships - For some, visual problems can be a sign of dementia. This may lead to difficulty with balance, trouble reading, problems with judging distance, and/or difficulty in interpreting color and contrast which can place you at increased risk for injuries or present issues with driving.
What’s a typical age-related change? Vision changes related to cataracts.
New problems with words in speaking or writing - You may find you are having increased difficulty in following or joining a conversation; this may result in stopping in the middle of a conversation having no idea of how to continue, repeating yourself, struggling to find vocabulary to name a familiar object or using the wrong name for an object (e.g. calling a “watch” a “hand-clock”)
What’s typical age-related change? Sometimes having trouble finding the right word.
Misplacing things and losing the ability to retrace steps - Persons with dementia may put things in unusual places, lose things and be unable to trace back their steps to find misplaced items, and even accuse others of stealing their misplaced things, especially as the condition progresses.
What’s a typical age-related change? Misplacing things from time to time and retracing steps to find them.
Decreased or poor judgement - Individuals may develop changes in judgement or decision-making, such as paying less attention to grooming/hygiene.
What’s a typical age-related change? Making a bad decision or mistake once in a while, like neglecting to change the oil in the car.
Withdrawal from work or social activities - A person with dementia may experience changes in the ability to hold or follow a conversation, or have trouble keeping up with a favorite team or activity, resulting in withdrawal from hobbies, social activities of other engagements.
What’s a typical age-related change? Occasionally feeling uninterested in family or social obligations.
Changes in mood or personality - You may find increasing mood and personality changes such as becoming confused, suspicious, depressed, fearful or anxious, or even being easily upset at home, with friends or when out of your comfort zone.
What’s a typical age-related change? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.
EARLY DETECTION MATTERS! If you find one or more of the above signs in yourself or another person, it can be difficult to know what to do. It is natural to feel uncertain and guarded about discussing these changes with others. Personally, voicing your concerns about your own health makes them seem more “real”, but bringing these to others’ attention about what you have seen may not be received well. Keep in mind, these are serious health concerns that should be evaluated by a health care provider so action can be taken to slow progression and minimize potential risks. Why get checked?
WHAT’S NEXT? If you’re concerned that you or someone you know is displaying any of these signs, take action: Talk to someone you trust. It can be helpful to confide in a friend or family member. For tips on how to have a conversation, visit alz.org/memoryconcerns. See a doctor. Get a full medical evaluation to determine if it’s Alzheimer’s or something else. Early diagnosis gives you a chance to plan for the future, access support services and explore medication that may address some symptoms for a time. Visit alz.org/evaluatememory to learn what an evaluation may include. Get support and information. Call the Alzheimer’s Association 24/7 Helpline (800.272.3900) or visit alz.org/10signs.
Here are some additional resources:
Alzheimer's Association - Alzheimer's and Dementia
NIH Alzheimer's Disease Fact Sheet
Alzheimer's Association - How is Alzheimer's Disease Diagnosed?
May is Healthy Vision Month
Eyes and Overall Health
Taking care of your eyes should be a priority just like healthy eating and physical activity; it can also benefit your overall health. Older adults tend to have more vision problems as a whole, but people with vision problems are more likely than those with good vision to have diabetes, poor hearing, heart problems, high blood pressure, lower back pain and strokes. They are also at increased risk for falls, injury and depression. Statistically, among those who are 65 and older, 54.2 percent of those who are blind and 41.7 percent of those with impaired vision report that their overall health is fair or poor, as opposed to 21.5% of those without visual deficits. Some of the more common eye conditions that can result in vision loss, and lead to blindness, are cataracts, glaucoma, diabetic retinopathy and macular degeneration.
Healthy vision can help keep you safe each day. To keep your eyes healthy, get a comprehensive dilated eye exam: an eye care professional will use drops to widen the pupils to check for common vision problems and eye diseases. It’s the best way to find out if you need glasses or contacts, or are in the early stages of any eye-related diseases. If you haven’t had an exam for some time, schedule one this month.
In addition to your comprehensive dilated eye exams, visit an eye care professional if you have:
Decreased vision;
Eye pain;
Drainage or redness of the eye;
Double vision';
Diabetes;
Floaters (tiny specks that appear to float before your eyes);
Circles (halos) around light sources; or
If you see flashes of light.
For this Healthy Vision Month, take care of your eyes to make them last a lifetime!
Ways you can help protect your vision:
Get regular comprehensive dilated eye exams.
Know your family’s eye health history. It’s important to know if anyone has been diagnosed with an eye disease or condition, since some are hereditary.
Eat right to protect your sight: In particular, eat plenty of dark leafy greens such as spinach, kale, or collard greens, and fish that is high in omega-3 fatty acids such as salmon, albacore tuna, trout, and halibut.
Maintain a healthy weight.
Wear protective eyewear when playing sports or doing activities around the home, such as painting, yard work, and home repairs.
Quit smoking or never start.
Wear sunglasses that block 99 percent-100 percent of ultraviolet A (UVA) and ultraviolet B (UVB) radiation.
Wash your hands before taking out your contacts and cleanse your contact lenses properly to avoid infection.
If you are still working, practice workplace eye safety.
Source: Centers for Disease Control and Prevention
Additional Resources:
April is Defeat Diabetes Month
Although there are multiple types of diabetes, most of our CCM patients with a diagnosis of diabetes have type 2 diabetes. With type 2 diabetes your body does not use insulin properly; it is the most common form of diabetes and is often referred to as adult-onset diabetes. Today, one in every 11 people, globally, has diabetes; this is projected to rise to one in every 9 by 2045. Some may be able to manage their diabetes through diet and exercise, while others may need medication or insulin to help manage it. Understanding what diabetes is, what your risks are, and what you can do to help reduce the risks is an essential part of learning to live with diabetes.
Diabetes explained . . .
When we eat, food is digested in the stomach and intestines where it is broken down into glucose and then absorbed into the bloodstream. The body (pancreas) produce insulin which removes sugar from the bloodstream and delivers it to the cells of the body where it is needed for energy, mainly muscle. It also regulates the production of glucose by the liver, turning it off when blood glucose levels are high. In people with type 2 diabetes, the cells don’t respond to the insulin as it should, disrupting blood glucose levels. This leads to insulin resistance and prediabetes which can lead to type 2 diabetes. Type 2 diabetes begins gradually, and results from lifestyle choices. Since it is a gradual onset, it is typically seen in older adults.
Why is it significant . . .
Sustained high blood glucose levels can cause damage to both small and large blood vessels, placing one with a type 2 diabetes diagnosis at higher risk for heart attack, stroke and kidney failure. Excess blood sugar decreases the elasticity of blood vessels causing them to narrow and impede blood flow. This can lead to a reduced supply of blood and oxygen, increasing the risk of high blood pressure and damage to the large and small blood vessels. Damage to the large blood vessels is known as macrovascular disease and damage to the small blood vessels is known as microvascular disease. Diabetes and heart disease often go hand-in-hand and management of cardiovascular disease in diabetic patients has become a great challenge for healthcare providers.
Let’s look a bit further at what can happen . . .
Macrovascular disease is disease of any large blood vessel in the body, including but not limited to coronary arteries, aorta, sizeable arteries in the brain and limbs. Complications from macrovascular disease include heart attack, stroke and peripheral artery disease. Diabetics are more likely to have comorbid conditions which raise the risk for heart attack, stroke and peripheral artery disease – high blood pressure, as well as, elevated LDL and triglycerides.
Microvascular disease is disease which affects the walls and inner lining of the tiny vessels which branch off from the larger coronary arteries. Complications from microvascular disease includes neuropathy, retinopathy, and nephropathy. Those are big words. . . so let me help you understand this further.
Over time, high blood glucose levels and high levels of fats in the blood can damage the nerves, or neuropathy. Peripheral neuropathy is the most common presentation; it generally affects the feet and legs and affects 1/3 to 1/2 of diabetic patients.
The retina is the light-sensitive layer of the tissue in the back of the eye. Retinopathy can lead to macular edema, which is the leading cause of blindness for diabetic adults in the US. Having diabetes also makes one 2-5 times more likely to develop cataracts and nearly doubles their risk for open-angle glaucoma.
The kidneys contain millions of tiny blood vessel clusters called glomeruli that filter waste from the blood. Over time, high blood glucose levels can cause damage to the glomeruli and lead to diabetic nephropathy, decreased kidney function and kidney failure.
Who is at risk . . .
Those who are overweight (BMI >25)
Those over the age of 35
Those who have a family history of diabetes
Those who are not physically active
Those who have high blood pressure
Those who have had gestational diabetes (diabetes during pregnancy)
What you can do to improve your outcomes . . .
It is important to understand that lifestyle changes such as losing weight, eating healthy, and engaging in regular exercise may reduce the progression of insulin resistance, prediabetes and type 2 diabetes. Being consistent about what and how much you eat is important, and healthy food doesn’t always mean boring food! NovoNordisk, a leading manufacturer in a wide range of diabetic medications has a free and helpful web-based resource for patients diagnosed with diabetes. You do not have to be taking a NovoNordisk product to take advantage of their platform and I encourage anyone, whether you have diabetes or not, to visit NovoCare Education and Resources for helpful information on healthy lifestyle tips and recipes, as well as ideas to keep physically active. We also have resources for one-on-one education for patients who need motivation and accountability in working toward productive diabetic self-management. Houston Methodist Hospital, in particular, has diabetic education and medical nutrition therapy for those seeking a more individualized experience. As far as activity, most professional platforms recommend 150 minutes of moderate aerobic activity per week. Aerobic activity is any activity that increases your heart rate and oxygen demand. This allows more oxygen to make it to the muscles to help them burn fuel (calories) and move more efficiently. . . this is what most of us call “cardio” or cardiovascular conditioning. While 150 minutes a week does seem to be very cumbersome, if you are not physically active currently, please start with 20 minutes of aerobic activity 3 days of the week and gradually build up your tolerance. As is the case with your diet, being consistent is important. For some additional and more specific guidelines for staying active and tips on activities which you can benefit from please see American Heart Association’s recommendations for physical activities in adults and Centers for Disease Control and Prevention's recommendations for physical activity. The benefits of aerobic exercise include, but are not limited to reduction of heart rate and blood pressure, elevation of your HDLs or “good” cholesterol, improvement in cardiovascular conditioning, reduction in your risk of heart disease, better management of your blood sugars, weight loss and weight management, improved mood and cognition, slowing of bone mineral loss which leads to osteoporosis, increase of fluid to the joints to relieve pain associated with arthritis.
Living with diabetes can be overwhelming and exhausting, frustrating and confusing and difficult to handle at times. You can live normally with diabetes, and you have a healthcare team who wants to help you to be the best you possible. It is important to understand the impact diabetes can have on your overall well-being and developing a strategy to manage your diabetes and reduce your overall risks can be daunting; talk with your care coordinator today - let’s make sure you understand fully what diabetes is and what your risks are, we understand what your values are, and together we can work on setting small, incremental goals to help you in your journey to defeat diabetes!
Centers for Disease Control and Prevention - Diabetes Basics
January is National Mental Wellness Month
What is Mental Wellness? According to the World Health Organization, mental wellness is defined as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” This doesn’t mean that your are absent of any mental health issues, and it also doesn’t mean you just have great coping skills. In a nutshell, mental wellness refers to the positive characteristics that allow you to thrive, even during stressful times. Typically, those with a good sense of mental wellness have some of these traits in common:
Contentment refers to feeling secure no matter what your circumstances. Those with high levels of contentment are able to laugh and enjoy life.
Resiliency means that you can stand up to stressful situations, effectively deal with them, and return to a sense of normality. Resilient individuals can adapt to changing situations and life events.
Work/life balance is healthy. Having this balance means that you can separate your home and work life. Those with balance in this area make sure to allow time for both work and play.
Ability to build/maintain relationships refers to your social abilities and confidence. Those who are good at managing their relationships adhere to the concept of give and take. They understand the importance of other people in their lives.
Self-confidence refers to high self-esteem. These individuals have a strong sense of self, use their strengths to their advantage, and learn to overcome any weaknesses.
An unwavering sense of purpose can help with all of these characteristics, even when times get tough. When you have meaning in your life, you tend to take more positive steps to accomplish your goals.
There is no better time that the beginning of a new year to take inventory of your mental wellness; determine if there are some positive characteristics that you could improve on, and even identify potential obstacles or a negative mindset that is keeping you from reaching your full potential.
Even if you have, in the past, neglected your mental wellness, it is never too late to make improvements! Here are some tips to help improve the health of your mind:
Mindfulness - This is quieting your mind with medication or prayer which can help you to stop dwelling on the past , as well as worrying about the future. Living in the present moment without judgement can help you to be more positive and to better deal with situations that arise.
Look for the positives - Are you a “cup half empty” or a “cup half full” kinda person? The good news is the cup can be filled up over and over again! Try and see the small positive things such as having a place to live, where you are warm and protected from the elements. Even in a negative situation, try to find the “silver lining”.
Take a break - Be sure to take time to relax or do something you enjoy; life can be hectic and overwhelming for your mind and body, especially if you have health problems. Even 10 minutes can do a world of good!
Spend quality time with friends and family - Socializing is important for your mental well-being. When you actively make human connections, chemicals called endorphins are released into your brain and help you to feel better.
Exercise - As little as 20 minutes a day, three times a week can increase the release serotonin which is produced by our bodies and considered to be a natural mood stabilizer; it can also help you to get a more fulfilling night of sleep!
Most of all, please know you are not alone, and it is not a sign of weakness to tend to your mental-wellness. Quite the opposite, knowing and understanding what you feel and making time to improve the way you feel is worthy of respect! If you are experiencing any uncomfortable feelings, reach out to one of our Care Coordinators, if only just to chat about how you feel.
On a final note; I would like to add an article that Sophie Letts with Meditation Help prepared for CCMS:
Don't Lose the Fight: Learn to Prevent Anxiety Attacks
Anxiety attacks can completely disrupt your life. If you find yourself battling anxiety, there are ways you can prevent attacks and live a more healthy and happy life. You need to find the right balance of taking care of your physical and mental health.
Seek a Physical Health Exam
To tackle mental health, you need to know your physical health status. Make an appointment with Chronic Care Management Solutions to learn what you need to do to live healthily. When you have anxiety, you may need to change your overall diet. Be careful about caffeine and foods high in sugar. Seek out calming teas, fruits, and vegetables for a healthy diet. For example, citrus fruits have many antioxidants and experts believe they can help people manage anxiety symptoms.
While physical activity helps your overall physical health, it can also help prevent anxiety attacks. You flood your brain with endorphins and feel-good chemicals when you work out. Additionally, working out gives you a different outlet for your anxiety. Focus on physical activity rather than giving your body a reason to continue to panic. Consider sports to reduce your stress level and prevent anxiety attacks. Try yoga, team sports, or self-defense. Working out with others can also provide a social group to rely on.
Treat Your Underlying Mental Health
Panic attacks can occur due to various mental health conditions, including:Panic disorder
PTSD
Generalized anxiety disorder
Phobias
An anxiety attack can mimic heart attack symptoms or make you fear for your life in non-life-threatening situations.
Seek professional counselors to aid you through difficult times in your life. Through therapy, you can identify the underlying cause of your anxiety. The more you know about your anxiety, the more you can battle the thoughts and feelings. You learn to confront your negative thought process and learn new ways to turn those thoughts around.
Change Your Living Space
Too much clutter at home overwhelms people with too many stimuli. Cluttered space gives off the impression that you cannot keep up with work. You may feel like work does not end because of the mess. You may feel less productive and less creative. The more guilt you feel about the mess, the more likely you will feel anxiety. Take steps to remove clutter like digitizing your paper records. Know that if you’ve compiled tons of receipts for tax purposes, the IRS now accepts scanned copies.
Prevent anxiety attacks by keeping your space clean. If you have difficulty keeping up with the chores, start by creating a chore list for yourself. You will notice a significant difference if you tidy up a little bit daily. Create a weekly plan. For example, choose one day out of the week for certain large tasks, like decluttering or cleaning the fridge. Consider making your bed every morning or putting away items after use for daily chores.
When it comes to anxiety attacks, the more time you spend with a support network, focusing on your physical health and tackling mental illness, the less time you may spend fighting off an attack. It’s also beneficial to create a more positive and organized living space. Understanding the underlying causes of your anxiety can help prepare you for the battle.
Thank you so much, Sophie for your interest and input!
Sophie Letts’ website is Meditation Help
Disclaimer: Chronic Care Management Solutions not certifying nor endorsing, and have business partnership with Meditation Help.
Happy Holidays
Wishing you all a happy and healthy holiday season, and good health and wellbeing in the upcoming year!
For many, the holidays bring much joy and happiness; for some it brings isolation and loneliness. This can be especially true for older adults. The US Department of Health and Human Services reports that 43% of senior adults experience loneliness on a regular basis; during the holidays, those feelings are amplified exponentially. Holiday fatigue (gifts to buy, cards to send, halls to deck, cookies to bake, meals to plan, parties to attend) is one reason why; the holidays are stressful and just aren’t the same as they used to be. Social isolation can be another reason. Friends and family members may have passed away or moved away, or the family has grown and have other celebrations to attend, leaving a voice that is hard to fill. Seniors who live alone may also dread going to holiday functions without a partner and end up staying at home. Physical limitations, such as vision and mobility problems, make getting out and about during the holidays a challenge for seniors. Isolation is like getting a big lump of coal in your stocking! Nearly 1/3 of people 65 and older live alone. Social isolation puts people at increased risk for heart disease, stroke, depression, cognitive decline and premature death. The health impact for someone with prolonged isolation can be as bad as smoking 15 cigarettes daily! Seasonal factors, such as the lack of sunshine and the changes in diet and routine, can also contribute to increased depression.
While the holiday blues differs from clinical depression in that the holiday blues are usually temporary, we still need to take it seriously, because they can lead to long term mental health concerns. A few tips that can help with the holiday blues:
Stick to normal routines as much as possible
Get enough sleep
Take time for yourself, but don’t forget to spend time with supportive, caring people
Eat and drink in moderation (avoid alcohol altogether if you are feeling down; it is a depressant and will only make you feel worse)
Get some fresh air and exercise, even if it is only a short walk
Make a to-do list and keep things simple
Set reasonable expectations and goals for holiday activities such as shopping, cooking, entertaining, attending events, etc
Set a budget for holiday spending and don’t overextend yourself financially in buying presents
Listen to music or find other ways to relax
Enjoy your hobbies and other areas of interest
If you are traveling or gathering with friends and family during the holiday season, please make your health and safety a priority! A few things to take into consideration during the holidays:
Wash your hands with running water and soap often to prevent the spread of germs
Make sure you are up-to-date on your vaccinations (please see the CDC immunization schedule under the “Immunizations” tab)
Stay warm and dry; wear the appropriate outdoor clothing, such as layers and waterproof boots (if it ever snows)
Give yourself a break if you feel stressed, overwhelmed and out of control
Don’t drink and drive, or ride with others who have been drinking and intend to drive
Fasten seat belts when in a moving vehicle
Don’t leave fireplaces, space heaters, burning candles or food cooking on the stove unattended
When preparing foods, wash hands and surfaces frequently and cook and store foods at the proper temperatures
Limit your portion sizes, as well as foods high in fats, sodium and sugars (which seems to be the essence of holiday foods, right?!)
Try to get physical activity for at least 20 minutes daily
Take all of your medications with your for any overnight trips
Your CCM Care Coordinators are here to help you get through the holidays, in whatever way we can. If you are alone and suffering with seasonal depression, holiday blues or social isolation, please let us know; don’t suffer through the holidays. We are your advocates and value you, as well as your challenges! If you know someone who is alone, or will be spending the holidays without family or friends, reach out to them; a little effort and communication can go a long way in making a person feel that they are not “forgotten”.
In whatever you do, or however you spend the holidays, may the peace and joy of the holidays be with you today and throughout the new year!
November is Diabetes Awareness Month
Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy. In a healthy body, food is broken down into sugar, or glucose, and releases into your bloodstream. As the blood sugar rises, it signals the pancreas to release insulin. Insulin acts like a key to direct the muscle and fat cells to take in the glucose. The glucose is used for energy, or stored as fat for long-term storage.
With diabetes, your body either does not make enough insulin, or cannot use it as well as it should. When this occurs, too much sugar stays in your bloodstream. Over this time, this can lead to very serious health problems, including but not limited to, heart disease, blindness and kidney disease.
Statistically, more than 37 million adults in the US have diabetes; 20% of them don’t even know they have it. In the last 20 years, the number of adults diagnosed with diabetes has more than doubled. Diabetes is the seventh leading cause of death in the US, and is the leading cause of kidney failure, lower-limb amputations, and adult blindness.
While there are three types of diabetes, type II diabetes is our greatest concern within the population of Medicare-beneficiaries. Approximately 90-95% of people with diabetes have type II diabetes. It is progressive, developing over many years and is most often the result of lifestyle. It is usually diagnosed in adulthood, but is becoming more and more common in children, teens and young adults. Type II diabetes can be prevented, or delayed with healthy lifestyle such as weight loss, a healthy diet, and remaining physically active.
What do the numbers mean?
Glucose - a glucose level is part of routine lab testing, included in a Comprehensive Metabolic Panel. In a healthy adult, a fasting blood glucose level should report between 70 and 100 mg/dL. A fasting blood glucose level from 100 to 125 mg/dL would indicate prediabetes and above 125 mg/dL would indicate diabetes.
Hemoglobin A1c - the A1c level reflects your average blood glucose levels over approximately 3 months; it is reported as a percentage. A1c target levels can vary with different factors, but as a general rule if your A1c levels are between 5.7% and 6.5% you are considered to be prediabetic. An A1c above 6.5% is considered to be in the diabetic range. The goal for most adults with diabetes is to keep the A1c below 7%.
There are no clear symptoms of prediabetes. Having routine exams and taking an active part in understanding your test results and risks will empower you to make lifestyle changes necessary to prevent or delay the progression to type II diabetes. Having prediabetes does not mean you will develop type II diabetes, but it is a clear opportunity to make small changes that can make a huge impact on delaying or prevention of the disease. Diabetes symptoms can take years to develop, and some people have no symptoms at all. The following are considered to be diabetes symptoms and you should discuss with your care coordinator or doctor if you are experiencing any of these:
frequent urination, often at night
excessive thirst
weight loss without trying to lose weight
extreme hunger
blurred vision
numbness or tingling of the hands or feet
lethargy or fatigue
very dry skin
sores that heal slowly
more infections than usual
Diabetes and the Cardiovascular System:
Cardiovascular disease is the leading cause of death in those with a diagnosis of diabetes, 2/3 of these are in those with type II diabetes. Additionally, people who have diabetes are two times more likely to have heart disease or suffer a stroke than people without diabetes. Excess blood sugar decreased the elasticity of blood vessels causing them to narrow and impede blood flow. This can lead to a reduced supply of blood and oxygen, increasing the risk of high blood pressure and damage to the large and small blood vessels.
Macrovascular disease is disease of any large blood vessel in the body, including the coronary arteries, aorta and sizeable arteries in the brain and limbs. Complications from macrovascular disease include heart attack, stroke and peripheral artery disease.
Microvascular disease is disease of the walls and inner lining of tiny vessels which branch off from the larger coronary arteries. Complications from macrovascular disease include neuropathy (nerve numbness or weakness), retinopathy (visual changes which lead to blindness), and nephropathy (deterioration of kidney function).
Diabetes and the Kidneys:
The kidneys are quite complex, having millions of tiny blood vessels that help to filter wastes from our blood and remove them from the body in urine. We cannot live without our kidneys. Having diabetes, as we have seen above, can affect the blood vessels and the filtering system starts to deteriorate. With the damage of the blood vessels, the kidneys will start leaking valuable protein into the urine, called microalbuminuria. Kidney disease is progressive; the kidneys slowly lose their ability to filter allowing waste products to enter the bloodstream, which can be toxic. Without good control of diabetes, the kidneys will begin to fail, leading to end-stage renal disease; the kidneys will need to be replaced by transplant or blood will have to be filtered by machine, through hemodialysis for the remainder of one’s life.
Diabetes can affect every part of the body. In addition to the things discussed above, persons with diabetes can experience skin complications, increased yeast and bacterial infections, elevated blood pressure, gum infections and cavities, fatty liver, thyroid dysfunction, sexual dysfunction, as well as anxiety and depression. There have also been links to diabetes and hearing loss, noting that hearing loss is twice as common in people with diabetes. It has also been determined that people with prediabetes have a 30% higher rate of hearing loss, when compared to those with normal blood glucose levels.
People don’t always take diabetes seriously; it is often perceived as a personal failure. While type II diabetes is often a result of lifestyle, diabetes is very serious and can alter one’s quality of life tremendously. You can make the changes necessary to improve your outcome. As Theodore Roosevelt once said, “Get action. Do things; be sane; don't fritter away your time; create, act, take a place wherever you are and be somebody; get action.” While I am certain he did not have health and wellness on his mind with this quote, it seems fitting. Don’t let denial put your health at risk. You can shift from a place of worry and vulnerability to hope and optimism, if only you accept the facts, and are open to change.
Resources:
NIH study shows how insulin stimulates fat cells to take in glucose
ADA - Diabetes Complications, Cardiovascular Disease
Patient Resources:
CDC Diabetes TV - Your Health with Joan Lunden and CDC
CDC Diabetes TV - Imagine YOU Preventing Type 2, National Diabetes Prevention Program
Medicare Diabetes Prevention Program (MDPP)
Novo Nordisk - Cornerstones4Care
Cornerstones4Care - Eating Healthy
Cornerstones4Care - Staying on Track
October is Breast Cancer Awareness Month
Breast cancer has become the most common cancer, worldwide, surpassing lung cancer for the first time sine 2020! Other than skin cancer, breast cancer is the most common cancer among American women. It is the leading cause of cancer death in developing countries and the second leading cause of cancer death in American women.
While breast cancer predominantly affects women, men also have a risk of developing breast cancer. Because breast cancer is primarily seen as a “woman’s disease”, men will typically ignore symptoms which can lead to potentially worse outcomes. With more than 3.8 million breast cancer survivors in the US, it is estimated that there will be an estimated 290,500 new diagnoses in 2022, with 2,710 of these diagnoses being in the male populations.
Risk factors - A risk factor is anything that can increase your chances of getting a disease such as cancer. It does not mean you will be diagnoses with the disease, but it helps to identify things which can be changed or avoided.
Lifestyle-related breast cancer risk factors include:
Drinking alcohol - those who drink 1 alcoholic drink per day have a 7-10% increase in risk, those who have 2-3 alcoholic drinks daily have a 20% higher risk.
Being overweight or obese - after menopause a woman’s ovaries no longer make estrogen and most estrogen will come from fatty tissue. Those with more fat tissue can raise estrogen levels, thereby increasing the chance of breast cancer. For women who are obese before menopause, the risk is a bit lower than those who put on weight after menopause.
Not being physically active - it is not clear how regular physical activity reduces breast cancer risk, but the evidence is there that it does. It is thought to be due to the effects on body weight, inflammation and hormone levels, especially in women past menopause.
Not having children - women who have not had children, or who have had children after the age of 30 are at higher risk for breast cancer. Having many pregnancies, or children at a young age reduces breast cancer risk.
Not breastfeeding - most studies suggest that breastfeeding will lower breast cancer risk, especially if one breastfeeds for a year or more.
Use of birth control and menopausal hormone therapy (PHT) - some birth control methods use hormones, and which may increase breast cancer risk.
Breast implants have not been linked with an increased risk of breast cancer, but have been linked with other types of cancer, including breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).
Breast cancer risk factors you cannot change include:
Being born female - this is the main risk factor.
Getting older - as you get older your risk factor increases; most breast cancers are found in women 55 and older.
Inherited genes - about 5% of 10% of breast cancers are thought to be hereditary; the most common cause of hereditary breast cancer is a genetic mutation in the BRCA1 or BRCA2 genes. Other gene mutations which can lead to breast cancer can be found within the ATM, PALB2, TP53, CHEK2, PTEN, CDH1, and STK11 genes, but are far less common.
Having a family or personal history of breast cancer - most women who get breast cancer do not have a family history, but women who have a close blood relative with breast cancer has almost double the risk. A woman with two close blood relatives has three times the risk.
Race/ethnicity - Caucasian women are more likely to develop breast cancer than African American women, with the exception in women under the age 40 and African American women have a higher likelihood to develop breast cancer over Caucasian women. African American women are more likely to die from breast cancer at any age. Asian, Hispanic and Native American women have a lower risk of developing and dying from breast cancer.
Height - taller women have a higher risk of developing breast cancer. It is not clear why, but it is thought to do with factors that affect early growth, nutrition early in love and hormonal or genetic factors.
Having dense breast tissue - breasts are made of fatty tissue, fibrous tissue and glandular tissue. Dense tissue usually results from more fibrous and glandular tissue than fatty tissue, and it can make breast cancers more difficult to identify on mammograms.
Having certain breast conditions - those who are diagnosed with non-cancerous breast conditions are at a higher risk for developing breast cancer.
Starting menstrual cycles early and going through menopause later - these are thought to be due to a longer lifetime exposure to estrogen and progesterone.
History of radiation therapy to the chest, usually when the breasts are still developing.
Exposure to diethylstilbestrol (DES) - this was given to pregnant women from the 1940’s-1970’s to support a pregnancy; women whose mothers took took this while pregnant are also at increased risk.
Breast cancer early detection and diagnosis:
Many women with breast cancer have no symptoms which is why regular breast screening is so important. When found early, when the cancer is small and has not spread to other tissues, treatment is more successful. Having regular screenings, yearly mammograms, is the most reliable way to detect breast cancer early. New technology, digital breast tomosynthesis (three-dimensional mammography), appears to find more breast cancers and provides a more thorough exam in women with dense breasts, but it is not yet available in all breast imaging centers. Studies are being conducted to compare outcomes between the standard two-dimensional mammogram and the newer three-dimensional mammograms. Currently, both types of mammograms are in line with the current screening recommendations.
As always, it remains an important part of everyone’s habits to become familiar with their own body and tissues by self-examination. When you know what you look and feel like, you can be aware of changes and report them to your healthcare provider right away.
Resources:
Breast Cancer Research Foundation
American Cancer Society - Breast Cancer
Centers for Disease Control and Prevention
American Cancer Society - Recommendations for the Early Detection of Breast Cancer
September is National Cholesterol Education Month
Cholesterol is a soft, waxy substance found in the bloodstream and cells. The body makes all of the cholesterol it needs; it is not inherently harmful, but too much is. Cholesterol comes from two sources - the liver and foods from animals (meat, poultry, dairy products). Animal proteins are high in saturated and trans fats which cause the liver to produce more cholesterol than it would normally. This can create an unhealthy cholesterol level. Low-density lipoprotein, or LDL, is what is commonly called “bad” cholesterol. It can join with fats and other substances to build up in the inner walls of the arteries. The arteries can become narrowed and clogged, restricting blood flow. This is called atherosclerosis, and if a blood clot forms and blocks one of these narrowed arteries, a heart attack or stroke can occur. High-density lipoprotein, or HDL, is what is commonly referred to as “good” cholesterol. It carries the harmful cholesterol away from the arteries and helps to reduce risk of heart attack and stroke.
High cholesterol is one of the major controllable risk factors for coronary artery disease, heart attack and stroke. If one smokes or has high blood pressure or diabetes, the risk is magnified. Atherosclerotic plaques can develop in the arteries of the heart, brain, pelvis, legs, arms or kidneys, and can lead to conditions such as coronary artery disease, angina, carotid artery disease, peripheral artery disease and chronic kidney disease. Plaques independently pose a risk, but it a piece of plaque breaks free from the artery wall, it can be carried to carried by the bloodstream to another part of the body until it lodges somewhere else in the cardiovascular system causing a new plaque. This can cause narrowing of the wall of the artery leading to blood clot development. This can occlude blood flow altogether. If the occlusion is in an artery that supplies the brain or heart of oxygen, a heart attack or stroke occurs. If the blockage is in an artery that supplies the extremities, often the legs, gangrene, or tissue death can occur.
Atherosclerosis is a slow, and lifelong progression of changes to the blood vessels that can begin in childhood and get worse as you age. Studies have shown that plaque begins when an arteries inner lining, the endothelium, becomes damaged by elevated cholesterol and triglycerides in the blood, high blood pressure, smoking of tobacco, and diabetes. Smoke plays a significant role in the progression of atherosclerosis in the aorta, coronary arteries and peripheral arteries (arteries in the legs). Smoking makes plaques more likely to form and accelerates the growth of plaque, leading to a much higher risk of abdominal aortic aneurysm.
There are so many resources available to you; please talk with your CCM care coordinator for additional information today.
August is MedicAlert Awareness Month
The MedicAlert Foundation was started in 1956 and has continued to provide life-saving services to those worldwide. What we all know of MedicAlert is wearing an ID bracelet which identifies your diagnoses and/or medications, but it goes far beyond this.
MedicAlert IDs are used to provide an immediate recognition of any medical conditions you may have; this can in include allergies, medications and treatments that you have agreed to. If you become unresponsive, medical personnel will be able to access your information quickly, which can help to prevent errors and allow responders to better assess and treat you, to sustain your life. If you have invoked a Do Not Resuscitate (DNR) order, MedicAlert can also make the responders aware.
Who would benefit from the protection of MedicAlert? If you or a loved one . . .
Have one or more medical diagnoses considered to be chronic
Live with life-threatening allergies or asthma
Care for a loved one with dementia or autism
Have an implanted medical device, or use any mobility aids
Lead an active lifestyle and want 24/7 protection
While medical alert systems offer potential benefits to people of all ages, they are of substantially great benefit to older adults. Prompt treatment can mean the difference between life and death. Worn around the neck or as a bracelet, MedicAlert IDs offer instant two way communication and around-the-clock monitoring. With the push of a button, help can be alerted and dispatched within moments without you or your loved one struggling to reach the phone, recall phone numbers or yell for help in emergent situations. Some MedicAlert systems offer an advanced functionality designed to detect high-impact falls and automatically call for help.
Many older adults fear falling and subsequently become less active physically, which leads to a decrease in mobility and balance. This makes them more at risk for debilitating falls. Using a medical alert system will help older adults feel more confident in their mobility and help them to remain as independent as they can be.
Additionally, medical alert systems can be invaluable to families and caregivers for those with dementia. In addition to 24/7 monitoring, many devices have built-in GPS capabilities. This can be a real lifeline for someone who wanders, and offer peace of mind for caregivers. MedicAlert offers 24/7 Wandering Support, and when a member is reported missing, will distribute a bulletin to local hospitals and law enforcement, while coordinating with family to safely return their loved one home.
Disclosure - MedicAlert is a brand and we are not endorsing a specific brand of medical alert system. Please talk with your care coordinator for additional information.
June is Men's Health Month
Statistics show that men are less likely than women to seek healthcare. Culturally, men are expected to be strong and rarely show signs of weakness and our socially-driven mindset trains men to believe that going to the doctor exhibits weakness. In a survey by the Cleveland clinic, this trend was confirmed, citing that 40 percent of men go to the doctor only when they have a serious health concern, and never go to the doctor for routine and preventative exams; see the study findings here: Cleveland Clinic 2018 MENtion It Survey. Men also tend to exhibit a fear of diagnosis; it is estimated that about 21% of men admit to avoiding visiting the doctor because they are fearful of what might be found. In an article published by Rutgers, men are also less likely to be honest with a doctor about their symptoms, which may contribute to the statistical findings that men will typically die five years younger in age than women. You can read the article here: The Tougher Men Think They Are, the Less Likely They Are to Be Honest with Doctors. These statistics are worrisome! It should not be embarrassing or emasculating to practice self-care or seek out medical help. We as a whole need to create a cultural shift and turn this trend around.
Prostate cancer -
Other than skin cancer, prostate cancer is the most prevalent cancer in American men. The American Cancer Society estimates that there will be 268,490 newly diagnosed cases of prostate cancer in the US in 2022 and about 34,500 men will succumb to it. In fact, prostate cancer is the second most deadly cancer in men; the first is lung cancer. Prostate cancer is more likely to occur in older men and non-Hispanic Black men. The average age of men at diagnosis is about 66. Prostate cancer is serious, but most men who are diagnosed with prostate cancer and treated do not die from it. It is essential to lower your risk by eating right, staying active and not smoking. Routine prostate screening exams including physical examination of the prostate, and a blood test called prostate-specific antigen, or PSA, are essential to early diagnosis. Men can, and should perform monthly testicular exams to monitor for any unusual masses, but the prostate can only be examined through a digital rectal exam due to its placement inside the body. You can read more about prostate cancer at the American Cancer Society.
Mental Health -
As societal norms dictate, men are notorious for not talking about their feelings. Again, many men feel that expression of their feelings creates vulnerability and is a sign of weakness. The American Psychological Association reports that 30.6% of men in the US have suffered from depression at some point in their lifetime. Studies have shown that men who do express their feelings verbally are less likely to express them harshly. Communication is essential to maintaining good mental health; while it may be uncomfortable at first, releasing your thoughts and feelings helps to reduce negative energy, or stress, which can so negatively impact our health. For more interesting information about men and depression please visit American Psychological Association.
Let’s try to break the stigma about self-care and expression! You are important and “recognizing and preventing men’s health problems is not just an man’s issue. Because of its impact on wives, mothers, daughters and sisters, men’s health is truly a family issue.” (Congressman Bill Richardson, 1994)
For more on Men’s Health, please visit Men's Health Month.
May is National Stroke Awareness Month
A stroke, or cerebrovascular accident (CVA), occurs when an artery (a blood vessel that carries oxygen and nutrients to the brain) is either blocked by a clot, or ruptures. When this occurs, part of the brain cannot get the oxygen/blood it needs so the brain cells die. Stroke is the 5th leading cause of death in the US and a leading cause of disability. Studies have shown that 80% of strokes are preventable.
Risk factors you can control:
Hypertension - know your numbers and keep them low!
Smoking - nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system. Smoking can actually double to stroke risk in African American persons.
Diabetes - diabetes independently is a risk factor, but most diabetic patients are overweight, have high blood pressure and/or high cholesterol which can multiply your risk.
Diet - diets high in saturated fats, trans fats and cholesterol can raise cholesterol leading to plaques that cause obstruction; diets high in sodium can lead to hypertension; and diets high in calorie can lead to obesity. For additional information on healthy diet please visit American Heart Association Diet and Lifestyle Recommendations
Physical inactivity - aim for being active for at least 150 minutes a week; move more and sit less.
Obesity - losing as little as 5-10 pounds can make a significant difference in your risk.
High blood cholesterol, carotid artery disease, peripheral artery disease - fatty deposits can build up in the arteries and cause narrowing, restricting the flow of blood to your brain and vital organs.
Atrial fibrillation, dilated cardiomyopathy, heart valve disease and congenital heart defects - can lead to alteration in blood flow or formation of clots which can travel to the brain.
Sickle cell disease - the sickle shaped red blood cells are decreased ability to carry oxygen to the body and can congregate on blood vessel walls leading to restricted blood flow.
To find your risk, please take the Stroke Risk Quiz. Stroke Risk Quiz
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By learning the F.A.S.T. warning signs, you just might save a life from stroke.
Face Drooping
DOES ONE SIDE OF THE FACE DROOP OR IS IT NUMB? Ask the person to smile. Is the person's smile uneven?
Arm Weakness
IS ONE ARM WEAK OR NUMB? Ask the person to raise both arms. Does one arm drift downward?
Speech
IS SPEECH SLURRED? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue."
Time to Call 9-1-1
If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get to a hospital immediately. Check the time so you'll know when the first symptoms appeared.
For more information follow this link American Stroke Association
April is National Minority Health Month
The US has become increasingly diverse in the last century and today approximation 36 percent of the US population belongs to a racially or ethnic minority group. Gender can also place someone into a minority group as well, specifically, being a female. Though health indicators, such as life expectancy, have improved for most Americans, some minority populations experience a disproportionate burden of preventable disease, death and disability when compared to their non-minority counterparts. In fact, racial/ethnic minorities are up to 2 times more likely than Caucasians to have one or more chronic diseases, or comorbidities.
The US Department of Health and Human Services, Office of Minority Health has published population profiles for some of the most prominent racial/ethnic minority groups: Black/African American, American Indian/Alaskan Native, Asian American, Hispanic/Latino American, and Native Hawaiian/Pacific Islander.
Agency for Healthcare Research and Quality, Minority Health: Recent Findings - This report helps us to identify disparities specific to racial/ethnic groups. Specifically, we can see that some Latinas have higher rates of cervical cancer than other ethnic groups, Female and Black stroke patients are less likely to receive recurrent stroke preventive care, Black and Hispanic patients tend to have have a difficult time maintaining control of blood pressure, and the list goes on.
Through education and having deeper conversations with one another, we can better address each person’s individual needs and risks and work together to set healthy goals. Please feel free to discuss further with any of our Care Coordinators.
March is National Nutrition Month
Men and women are living longer and studies show that eating well and being active can make a dramatic difference in the quality of life for older adults. It is important to eat a variety of fresh fruits, vegetables, grains, and lean proteins. I have provided some helpful resources and dietary guidelines which can offer valuable information. Please let any one of your Care Coordinators know if you have any questions or would like additional resources or nutritional consultation with a dietician.
American Academy of Nutrition and Dietetics, Healthy lifestyle for healthy older adults
US Department of Agriculture, MyPlate for Older Adults
US Food & Drug Administration, Using the Nutrition Facts Label: For Older Adults
February is American Heart Month
February has been declared American Heart Month; a time when all of us can focus on cardiovascular health. Heart disease is the leading cause of death in the United States. “Heart disease” can be used globally for multiple heart conditions, but the most common type of heart disease is coronary artery disease, or CAD, which can lead to heart attack. Elevated blood pressure, blood sugars and cholesterol levels can contribute to coronary artery disease and increase your risk of heart attack and stroke significantly. You can greatly reduce your risk by living a healthy lifestyle which includes healthy foods/drinks, maintaining a healthy weight, getting regular exercise/physical activity and refraining from smoking. Please feel free to discuss any questions or concerns you might have with any of your Care Coordinators.
Centers for Disease Control and Prevention, Resources for Individuals and Patients
Centers for Disease Control and Prevention, Should I be measuring my blood pressure?
US Department of Agriculture, Heart Health (Various resources)