TakingCare 2008 May

8/12/2019 TakingCare 2008 May

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Wheels

in motion:Biking fun

for the family

3 Make the most of your doctor visits 6Seasonal allergies

May 2008Celebrating30

YearsofHelpingPeopleStayHealthy


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recover emotionallyafter a heart attackOne-third of people whove had a heart attack have feelings of

depression during recovery. If youre one of them, these tips may help:

l Talk with your doctor. He or she will ask questions about your

symptoms and may suggest taking medicines or seeing a counselor.

l Tell your family and friends how youre feeling. Ask for their support.

l Resume your hobbies and other activities as soon as possible, or

try out some new ones.

l With your doctors consent, exercise as appropriate for your condition.

American Academy of Family Physicians

quick takes

Questions are answered by Phyllis D. Cross, M.D., M.P.H., in conjunction

with the Taking Caremedical advisory board and medical contributors.

This publication provides general information and isnt a substitute for professional health care.Be sure to discuss with your doctor any health strategies or medical treatments.

Can cracking my knuckles cause arthritis or other joint problems?

HERE ARE many different kinds o arthritis. Osteoarthritis, the most common type,

affects an estimated 21 million Americans.

Among the causes o osteoarthritis is wear and tear on the cartilage that

cushions your joints. When you lose cartilage, your bones can start rubbing

against each other. Tat can lead to pain and stiffness.

Tere is no evidence that popping or cracking your knuckles causes

osteoarthritis or any other orm o arthritis. Te distinctive sound is

caused by gas bubbles that orm in the joint when its stretched. Te

bubbles pop as everything snaps back to its original position. Although

cracking your knuckles might not cause arthritis, it potentially could

worsen a joint problem that already exists.

How to keep

your joints healthyAsk your doctor about vitamin and mineral

supplements, especially calcium and vitamin D,

that may help strengthen your bones and

joints. Also:

l Maintain a healthy weight. Excess weight

stresses your joints.

l Exercise regularly to strengthen muscles

and bones.

l If you smoke, stop. Smoking weakens bones.

did you know?Dog owners who walk their dogs are

more active and have less

body at than people who

dont own or walk dogs.American College of Sports Medicine

help teens say no

to alcohol, drugsYou may not think your teen

is listening. But, you can

be a powerful deterrent to

alcohol and drug use. Hereare some tips to get the

conversation started:

l Talk candidly about the risks

of drug and alcohol use.

l Be clear about your

expectations, and establish

consequences for breaking

the rules.

l Know how, where and with

whom your teen is spending

unsupervised time.

Partnership for a Drug-Free America

2 MAY 2008 | TAKING CARE


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youre in charge

MOS DOCOR visits are brie. But, you still can do a lot

in the time you have. Follow these tips to make the most o

your next appointment:

Plan ahead. What do you want to ask your doctor? Writedown your questions. I the visit is about multiple issues, call

the doctors office ahead o time to see i you

need a longer appointment.

Prioritize.Start with the most important

matters in case you run out o time. But,

remember to ollow up on other items later.

Be detailed.For example, describe the

symptoms or side effects youre having.

Take notes.Jot down what your doctor

says so you wont orget. Or, bring along your

spouse, a riend or your caregiver to help youremember things.

Dont be shy.I you dont understand

something, ask questions. Dont hesitate to

bring up such topics as sex or substance abuse. Also, ask when

you should call i symptoms persist or worsen. Your doctor

can help only i he or she knows whats going on.

Follow up. Feel like you didnt have a chance to take care oeverything? Ask i you can call, e-mail or schedule another visit.

Make the most of your doctor visit

WHEN NAURE calls, you know the answer. Your toddler, on the other hand, isnt so

experiencedat least not yet.Its up to you to teach your child the mechanics o going to the potty, even i, at times, the

task seems to be a losing battle. Ultimately, youll succeed, says Robert Mendelson, M.D.,

spokesperson or the American Academy o Pediatrics.

Its important to remember that toilet training is a natural thing that will happen to all

children when theyre ready, Dr. Mendelson says. Its a learning process that typically takes

about three to six months.

Here are some suggestions on how to make toilet training go as smoothly as possible:

Watch for signs of readiness.Children will let you know when its time to begin training.

You may notice that your child:lGoes a long time beore needing a diaper change or has a dry diaper afer napslAsks to wear grown-up underwearlries to hide somewhere when he or she needs to go

Be patient.Urging your child to use the toilet may be counterproductive. I you meet

resistance, wait a bit to train.

Give praise.Reward and encourage successes. But, dont punish your child or having

an accidentthere will be plenty o those. Instead,

keep a positive attitude and clean up messes without

making a big deal out o it.

A final hint:When your child is ready to use

the adult potty, try acing him or her toward the

back o the toilet. Your child can hold onto the tank

or support.

Toilet training:Getting down to business

answersfor those quick questionsSometimes, you can talk with a doctor without an appointment.

During your next visit, ask:

lIs it OK to contact you by phone or e-mail?lIs there a charge for this service?l

Are there certain times or days when its best to call?lIs there a nurse I can call with questions?

TAKING CARE | MAY 2008 3


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Try bicycling

WHEELS WHIR, ground blurs and a cooling

breeze brushes past your ace as you pick up

speed on the downhill slope. Ah, now this is the

lieespecially afer the rigorous pedaling it took

to reach the top. For the moment, youve recaptured a

childhood joy: bike riding. What a great way to reduce stress,

improve your health and simply have un.

Body and soul

Fitting exercise into our hectic lives is crucial or mental and physical health.It can add to an overall sense o well-being and help relieve stress, anxiety and

depression. On the physical side, exercise:lReduces the risk o heart disease, high blood pressure, stroke, diabetes, obesity,

colon cancer and other health problemslHelps control weightlKeeps joints, tendons and ligaments flexiblelImproves sleeplIncreases energy and endurance

Bike riding in particular exercises your heart and lungs while at the

same time building muscles, mainly those in the thighs, hips and buttocks

O course, or saetys sake, talk with your doctor beore significantly

increasing your activity level. Also, choose sae areas or biking, such ascommunity bike paths. And, always wear a helmet when riding.

Biking benefitsBiking alls in line with other types o

exercise we commonly prescribe,

such as walking, says Barbara

Bushman, Ph.D., a

spokesperson or the

American College o

Sports Medicine.

Wheels in



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for enjoyment and health Make your cycling safer

with the right equipmentYou dont need a ton of gear to enjoy a great bike

ride, but, in addition to a water bottle, a few things

will make your trip safer and more pleasant.

Start with a properly fitting bike helmet.The

National Safety Council says a well-designed helmet

is lightweight and fits comfortably. It should have

a stiff outer shell, a shock-absorbing inner lining

thats at least a half-inch thick, and a chin strap and

fastener to keep it in place.

Use plenty of reflectorsto make sure its easy

for other people to see you. Your bike should

have reflectors on the pedals, as well as a red rear

reflector and a white front reflector. Its also a good

idea to have spoke reflectors on the wheels.

Other safety equipmentincludes a horn or bell, a

rearview mirror and a bright headlight.

Bring along some tools,such as a pump and a

patch kit, in case your bike breaks down. And, if youll

be leaving your bike unattended, thwart theft with a

hardened-steel U-lock (a lock thats shaped like a U).

Additional equipment can make biking more

comfortable. Bike shorts, for example, add somepadding between you and the seat. Gloves help

prevent numbness and blisters and can protect

your hands in a fall. And, special stiff-soled shoes

can make pedaling easier. Ask for help with these

products at a bike or sporting goods store.

But, cycling, like swimming, has one advantage over

walking. Its not a weight-bearing activity, which makes it

easier on the joints or people with arthritis or other health

conditionsor or those who are overweight.

O course, cycling isnt just or people with health problems.

Its an activity that nearly everybody can fit into their lives

in some way, Dr. Bushman says. And, theres more than one

way to get the benefits. For example, i cycling outdoors isnt

possible or some reason, consider using a stationary bike.

How much is enough?Although any amount o exercise is better than none, an

average healthy adult should do at least 30 minutes a day o

moderately intense cardiovascular exercise, such as bike riding,

five days a week. People who would like to lose weight or

maintain weight loss may need to log 60 to 90 minutes a day.

A moderately intense workout raises your heart rate and

causes you to break a sweat, but youll still be able to carry on

a conversation.

A balanced program

Although bike riding is great on its own, its even better aspart o a balanced workout that ocuses on strength training,

flexibility and a mixture o cardiovascular exercises.

Cycling provides cardiovascular benefits, as does walking.

Strength training and flexibility should also be included to

provide a well-rounded fitness program, according

to Dr. Bushman.

I you decide to add biking to your exercise mix,

theres no need to go it alone. Its an activity

that easily can be made into a amily

outing, she says. Just enjoy.

For more infoVisit www.bikeleague.org/programs/bikemont

Join Bike Month festivities May is National Bike Montha great time to clean up local bike trails, see

if a bike rack can be installed at work or just show off your spandex!

Its also the perfect time to discover that cycling can be a great way to commute

To highlight that fact, the League of American Bicyclists has designated Friday,

May 16, as Bike-to-Work Day. Its a special part of Bike-to-Work Week,

which runs from May 12 to 16.

http://www.bikeleague.org/programs/bikemonthhttp://www.bikeleague.org/programs/bikemonth


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allergies

IS SUMMERIME, and the living is

easy. For some o us, though, it might be

sneezyor itchy, stuffy and wheezy.

Tese are the joys o seasonal

allergies, also known as hay ever.

A weedy problemContrary to the common name,

seasonal allergies arent caused by

hay and they arent accompanied by

ever. Tey happen when people whoare sensitive to pollen breathe in these tiny

grains o plant material. As a result, nasal tissue

becomes inflamed.

One o the biggest pollen producers is

ragweed, which grows in nearly every part o the

United States. One ragweed plant can

send out a billion pollen grains

in a seasonusually mid-

August through October.

Other weeds, grasses

and trees produce pollen

in the spring or summer,so each persons allergy

season may vary. No

matter when it happens,

people with seasonal

allergies can have a runny

nose, itchy eyes, sneezing

and headache.

Allergies also contribute to

more than hal o asthma cases. And,

some people with seasonal allergies also

have oral allergy syndrome. For these people,

symptoms worsen when they eat certain resh

ruits or vegetables. Tey also may have mild

swelling and itchiness o the mouth and throat.

Enjoy your summero ease seasonal allergies, try these tips:lDont mow lawns, and avoid areas with reshly

cut grass.lKeep the windows closed in your house and car

to shut out pollen.lake a shower and shampoo your hair to wash

off pollen afer spending time outside.lUse an air conditioner.lStay inside when pollen counts are high. You

can find the pollen count in your area each

day by visiting the National Allergy Bureau at

www.aaaai.org/nab/index.cfm?p=pollen .

Taking medicine for reliefMedicines ofen help control seasonal allergy

symptoms. One thing to keep in mind is that less

expensive over-the-counter medicines may bejust as effective as prescription ones.

All medicines, however, may have side effects.

Some cause drowsiness and shouldnt be used

i youll be driving, or example. So, talk with

your doctor to determine which medicines

would be best or you and how to use them. Tis

is especially important i you have a medical

condition or i you need to use the medicine or

more than a ew days. Also, talk with your doctor

beore giving allergy medicines to your child.

Blame the catMore than half of the 20 million cases of asthma in the United States are due to

allergies. And, who claims the lions share of the blame for those cases? Look no

further than your favorite feline. In a study from the National Institutes of Health,

cats accounted for nearly one-third of allergy-related asthma cases.

That doesnt mean you have to get rid of your pets. Talk with your doctor.

It may be possible to minimize the allergens, keep your asthma under control and

still enjoy your furry friends.

Tiny pollen,bigproblems



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at your best

ONE IN three adults has high bloodpressure, yet nearly a third dont know

it. Arican Americans are particularly

at risk. High blood pressure sometimes

is called the silent killer because ofen

it has no symptoms at all. Tats why its

important to know your blood pressure.

Inside the body, high blood pressure

is a bully. It orces the heart to work

harder. Blood vessels also take a beating

and can develop small bulges, become

narrow, harden aster, and burst or bleed.

All o this damage can affect blood flow

and lead to kidney ailure, heart attack,

stroke, amputation and blindness.

Blood pressure is measured in two

numbers. Both are important.l Systolic,the top number, reflects the

orce that occurs in blood vessels when

the heart pumps blood into the body.l Diastolic,the bottom number, shows

the pressure that remains in the vessels

when the heart rests between beats.

I you have high blood pressure, alsocalled hypertension, your doctor may

prescribe medicine to control it. He or

she also may suggest that you:lLose weight.lExercise or at least 30 minutes every day.lFollow a healthul eating plan, such as

the DASH (Dietary Approaches to

Stop Hypertension) plan, which

emphasizes ruits, vegetables and low-

at dairy products.lChoose and prepare oods with less salt

and sodium.lQuit smoking.

Te goal o treatment is to keep your

blood pressure below 140/90 mm Hg

or even lower i you have diabetes or

kidney disease.

Have your doctor check your blood

pressure at least every two years. Experts

advise more requent check-ups i

you have prehypertension, high blood

pressure or other health conditions.

Do you knowyour bloodpressure?

checking your blood pressureat homeMonitoring your blood pressure at home is easy. There are different types

of monitors, and each has pros and cons. Your doctor or pharmacist can

answer any questions you may have.

As you get started, ask your doctor for your target blood pressure

range, and find out what numbers are high enough or low enough to

warrant a call. To use your monitor properly:

l Take your pressure every day at about the same time, making sure to

avoid caffeine, smoking and exercise for at least 30 minutes beforehand.l First, sit quietly for five minutes with your back supported and your feet

flat on the floor. Rest your arm on a table at the level of your heart.

l Then, take two readings at least two minutes apart. Average the results.

l Keep a dated log of your readings. Bring along the logand your

monitor to check its accuracythe next time you visit your doctor.

Although its helpful, home monitoring shouldnt replace periodic

blood pressure monitoring by your health care professional.

What yournumbers meanNormal.For adults, yourblood pressure is normal if

its less than 120/80 mm Hg.

Prehypertensive. Your top(systolic) number usually is

between 120 and 139 and/or

your bottom (diastolic) usually

is between 80 and 89. Blood

pressure in this range increases

the risk that youll end up with

high blood pressure unless you

take action to prevent it.

High. Your systolic numberusually is 140 or higher and/or

your diastolic usually is 90

or higher.



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Michael W. Rosen, M.D.National Medical Executive,

Health Solutions Group

Joseph R. Carcione Jr., D.O.,M.B.A.Medical Director, Healthcare

Services, Oxford Health Plansa

UnitedHealthcare Company

Gail Borgatti Croall, M.D.National Medical Director, Health

Care Decision Support, Optum

Phyllis D. Cross, M.D., M.P.H.Medical Consultant, Optum

Tanise Edwards, M.D.Medical Consultant, Optum

Cheryl Lewis, R.N.Medical Consultant, Optum

Virginia Lund, M.A., L.P.,C.E.A.P.Mental Health Consultant, Optum

Richard A. Zabinski,Pharm.D.Vice President, Pharmaceutical

Solutions, Health Solutions Group

Taking Careadheres to stringent clinical standards andis reviewed by the following medical professionals:

Taking CareMay 2008 | Vol. 30, No. 5

E-mail:[email protected] you have an address change, send

it directly to the entity through which

you receive the newslettersuch as

your employer or health plan.

Taking Careis dedicated to helping

people have healthier lives. However,

this publication does not replace

the necessary and individualized

medical care offered by a health

care professional. Not all treatments

mentioned in Taking Careare covered

by your health plan. Please check

with your health plan regarding

covered services.

Unless otherwise noted, all models are

used for illustrative purposes only.

2008 Optum

M-25733

O2W22083

Call OptumNurseLineSMServices

1-800-267-3907

Registered nurses are available to answer your health-related

questions 24 hours a day.

Are tanning beds safe?

MANY PEOPLE think a good tan is a sign of good health.

But, actually, its a sign of damaged skin. When youre exposed

to ultraviolet light (UV), your skin tries to protect itself byproducing melanina pigment that causes it to darken.

Unfortunately, excessive UV exposure also may:Cause skin cancerMake your skin appear leathery and wrinkledWeaken your immune systemDamage your eyes and increase the risk of cataracts

Isnt the radiation different?Tanning beds and lamps emit UV radiation that can be as

strong as, or even stronger than, what comes from the sun. So,

indoor tanning is not a safe alternative to outdoor tanning.In addition to raising the risk of skin cancer and other

health problems, UV radiation from tanning beds thins your

skin, increasing the likelihood of even more damage.

Some manufacturers claim that their tanning beds use safe

rays. Although this type of UV radiation is less likely to cause

sunburn, it actually penetrates more deeply than the suns rays

and still injures the skin.

Skin damage is cumulativeit builds over time, even if

you dont get sunburns. So, harmful effects may not show

up for years, which is why many people arent aware of thedangers of tanning.

Want that sun-kissed look?If you want to tan your skin without the risk of skin cancer,

consider trying sunless tanning products. ey produce a tanned

look with the active ingredient dihydroxyacetone (DHA), which

darkens the skin by reacting with skin cells. Its for external use

only, so dont get it in your mouth, eyes or nose.

OPTUM

NURSELINESM

SERVICES

The truth abouttanning beds

Do you have questions?Optum NurseLine registered nurses are available toanswer your questions and provide health information.

This page of your Taking Carenewsletter features

examples of the kinds of questions people askas

well as the kinds of helpful answers they receive.

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