Memory loss and aging: What’s “normal?”

Head upstairs for something and come back down without it? Find yourself struggling to remember someone’s last name or phone number? Take a wrong turn going somewhere you’ve been driving to for years? Forget to pay a monthly bill? Forgetfulness may be upsetting, but examples like these are common as we age and nothing to worry about. Yet for many older Americans, forgetting things on an increasingly regular basis may be a sign of oncoming dementia or a form of Alzheimer’s, a degenerative brain disease that affects close to one in four Americans.

Alzheimer’s disease is the sixth-leading cause of death among U.S. adults, and the fifth-leading cause among adults aged 65 to 85. In 2013, an estimated 5 million Americans aged 65 years or older had Alzheimer’s disease. This number may triple by 2050, with the costs of care already projected at over $200 billion per year, and expected to increase to more than $500 billion by 2040.

Alzheimer’s disease causes large numbers of nerve cells in the brain to die. This affects a person’s ability to remember things, think clearly, and use good judgment. It typically involves parts of the brain that control thought, memory, and language. While doctors don’t know what causes the disease, they do know that most of the time it begins after age 60.

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life, and Alzheimer’s disease is the most common. It often starts slowly. In fact, some people don’t know they have it and assume their forgetfulness is just a sign of increasing age. However, over time, their memory problems get more serious. People with Alzheimer’s disease have trouble doing everyday things like driving a car, cooking a meal, or shopping or paying bills. They may get lost easily and find even simple things confusing. Some people become worried, angry or violent.

As the illness progresses, people with Alzheimer’s disease need someone to help take care of their daily needs, including feeding and bathing. Some people with Alzheimer’s live at home with a caregiver. Other people with the disease live in a nursing home or in a facility that specializes in dementia-related illnesses.

Though age is the best-known risk factor for Alzheimer’s disease, researchers believe that genetics may play a role. Changes in the brain can begin years before the first symptoms appear, and scientists are studying whether education, diet, exercise and environment play roles in developing Alzheimer’s disease. They also are finding more evidence that some of the risk factors for heart disease and stroke — such as high blood pressure, high cholesterol, and low levels of the vitamin folate — may also increase the risk of Alzheimer’s disease.

While most changes in the brain that cause dementia are permanent and worsen over time, thinking and memory problems caused by depression, medication side effects, excess use of alcohol, vitamin deficiencies  or thyroid problems may improve when the condition is treated or addressed.

How to recognize signs of early dementia

Alzheimer’s disease is not a normal part of aging. And while memory loss affects all of us as we age, it also is typically one of the first warning signs of cognitive loss.

Different types of dementia are associated with particular types of brain cell damage in specific regions of the brain. For example, in Alzheimer’s disease, high levels of certain proteins inside and outside brain cells make it hard for brain cells to stay healthy and to communicate with each other. The brain region called the hippocampus is the center of learning and memory in the brain, and the brain cells in this region are often the first to be damaged. That’s why memory loss is often one of the earliest symptoms of Alzheimer’s.

According to the National Institute on Aging, in addition to memory problems, someone with Alzheimer’s disease may experience one or more of the following signs:

  • Gets lost
  • Has trouble handling money and paying bills
  • Repeats questions
  • Takes longer to complete normal daily tasks
  • Displays poor judgment
  • Loses things or misplacing them in odd places
  • Displays mood and personality changes.

There is no one test to determine if someone has dementia. Doctors diagnose Alzheimer’s and other types of dementia based on a careful medical history, a physical examination, laboratory tests, and the characteristic changes in thinking, day-to-day function and behavior associated with each type. It’s hard to determine the exact type of dementia because the symptoms and brain changes of different dementias can overlap. In some cases, a doctor may diagnose “dementia” and not specify a type. If this occurs it may be necessary to see a specialist such as a neurologist or gero-psychologist.

Treatment of dementia depends on its cause. In the case of most progressive dementias, including Alzheimer’s disease, there is no cure and no treatment that slows or stops its progression. But there are drug treatments that may temporarily improve symptoms, and it’s important to note that other causes of dementia-like behavior – such as from head injuries, alcohol abuse and depression – can be treated.

Protecting our brains

Evidence also is growing for physical, mental, and social activities as protective factors against Alzheimer’s disease. Our brain is nourished by one of our body’s richest networks of blood vessels. Anything that damages blood vessels anywhere in our body can damage blood vessels in our brain, depriving brain cells of vital food and oxygen. Blood vessel changes in the brain are linked to vascular dementia. They often are present along with changes caused by other types of dementia, including Alzheimer’s disease. These changes may interact to cause faster decline or make impairments more severe.

We can help protect our brains with some of the same strategies that protect our heart – don’t smoke; take steps to keep our blood pressure, cholesterol and blood sugar within recommended limits; and maintain a healthy weight.

Regular physical exercise may help lower the risk of some types of dementia. Evidence suggests exercise may directly benefit brain cells by increasing blood and oxygen flow to the brain. And what we eat may have its greatest impact on brain health through its effect on heart health. The best current evidence suggests that heart-healthy eating patterns, such as the Mediterranean diet, also may help protect the brain. A Mediterranean diet includes relatively little red meat and emphasizes whole grains, fruits and vegetables, fish and shellfish, and nuts, olive oil and other healthy fats.

If you or someone you know has several or even some of the signs of increasing forgetfulness, it does not mean that you or they have Alzheimer’s disease. It is important to consult a health care provider regarding concerns about memory loss, thinking skills, or behavioral changes.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Beware hernias masquerading as stomach aches

So when the doctor says “drop your drawers, turn your head, and cough,” he or she obviously isn’t listening to your lungs – typically, it’s a simple way of diagnosing the most typical form of abdominal hernia.

Hernias are very common, and occur in different locations. A hernia occurs when an organ pushes through an opening in the muscle or tissue that holds it in place. For example, the intestines may break through a weakened area in the abdominal wall. Hernias are most likely to occur in the abdomen, but they also can appear in the upper thigh, belly button, and groin areas. Most hernias are not immediately life threatening, but they don’t go away on their own and can require surgery to prevent potentially dangerous complications.

Inguinal hernias, the most common abdominal hernia, make up about 70 percent of all hernias, and are more common in men than in women. This is because a man’s testicles descend through the Inguinal canal shortly after birth, and the canal is supposed to close almost completely behind them. Sometimes, the canal does not close properly and leaves a weakened area prone to hernias.

Hernias are caused by a combination of muscle weakness and strain. Common causes of muscle weakness include failure of the abdominal wall to close properly in the womb, which is a congenital defect; age; chronic coughing; or damage from injury or surgery. Sports-related hernias can be caused by repetitive twisting or turning, especially at high speeds.

The most obvious symptom of a hernia is a bulge or lump in the affected area. In the case of an Inguinal hernia, you may notice a lump on either side of your pubic bone where your groin and thigh meet. You’re more likely to feel your hernia through touch when you’re standing up.

Other common symptoms of an inguinal hernia include:

  • Pain or discomfort in the affected area (usually the lower abdomen), especially when bending over, coughing, or lifting
  • Weakness, pressure, or a feeling of heaviness in the abdomen
  • A burning, gurgling, or aching sensation at the site of the bulge

In some cases, hernias have no symptoms. You may not know you have a hernia unless it shows up during a routine physical or a medical exam for an unrelated problem.

Depending on its cause, a hernia can develop quickly or over a long period of time. You can’t always prevent the muscle weakness that allows a hernia to occur. However, you can reduce the amount of strain you place on your body. This may help you avoid a hernia or keep an existing hernia from getting worse. Prevention tips include:

  • Not smoking
  • Seeing your doctor when you’re sick to avoid developing a persistent cough
  • Maintaining a healthy body weight
  • Avoiding straining during bowel movements or urination
  • Lifting objects with your knees and not your back
  • Avoiding lifting weights that are too heavy for you

Other types of hernias

Incisional hernias can occur after you’ve had abdominal surgery. Your intestines may push through the incision scar or the surrounding, weakened tissue.

Hiatal hernias occur when part of your stomach protrudes up through the diaphragm into your chest. This type of hernia is most common in patients over 50 years old. If a child has the condition, it’s typically caused by a congenital (birth) defect. Hiatal hernias almost always cause gastro esophageal reflux, which is when the stomach contents leak backward into the esophagus, causing a burning sensation. Symptoms of a hiatal hernia include acid reflux, which is when stomach acid moves backward into the esophagus causing a burning sensation; chest pain; and difficulty swallowing.

Umbilical hernias can occur in children and babies under six months old. This happens when their intestines bulge through their abdominal wall near their bellybutton. You may notice a bulge in or near your child’s bellybutton, especially when they’re crying. An umbilical hernia is the only kind that often goes away on its own, typically by the time the child is one year old. If the hernia has not gone away by this point, surgery may be used to correct it.

Other factors that strain your body and may cause a hernia include being pregnant, which puts pressure on your abdomen, and persistent coughing or sneezing. Other factors include a personal or family history of hernias, being overweight or obese, a chronic cough, chronic constipation, or smoking, which can trigger a chronic cough.

If your hernia is growing larger or causing pain, your doctor may decide that it’s best to operate. Repairing a traditional hernia typically involves sewing or closing the hole in the abdominal wall during surgery. This is most commonly done by patching the hole with surgical mesh, and often can be done through laparoscopic surgery, using a tiny camera and miniaturized surgical tools. Not all hernia surgeries can be conducted this way, however.

If you detect what you believe may be a hernia from straining yourself, exertion or genetics, a quick visit to your physician can help determine the easiest course of action.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Engage Employees in Monthly Health Awareness Activities

Somewhere in Washington, DC, bureaucrats are hard at work reviewing requests for new awareness recognition months, weeks, and days. There already are a slew of these, many designed to raise awareness for serious diseases and illnesses like heart disease, high blood pressure, most types of cancer, diabetes, traumatic brain injury, oral and mental health, and dozens of chronic illnesses.

There also are recognition periods for lesser-known or rare diseases, social causes, and special events like Great Outdoors Month, and Fruit and Vegetables Matter Month. Then, it expands widely from there, with recognition for everything from National Red Meat month, to Don’t Fry Day, Dump your Boyfriend Week, and months dedicated to condoms, grapefruits, biking, and riptide awareness.

The point isn’t to question whether or not these are important and worthwhile tributes, but to acknowledge that there’s something for everyone – and that represents opportunities for small businesses to embrace days, weeks, and months dedicated to loving dogs, drinking wine, eating chocolate, or disease prevention and staying healthy through improved nutrition and exercise.

Employees embrace a wide range of personal interests and activities. If your goal is to help improve workplace health and wellness, enhance teamwork, boost morale, and increase employee involvement, tapping into awareness recognition is an easy, fun, and interactive way to engage employees.

Many organizations create voluntary health and wellness committees tasked with identifying causes that appeal to employees, and then determining how education, outreach, and interactive activities will be coordinated. Some employers tie their activities to local events, charities, and parks. Program suggestions cover the gamut from inviting guest speakers and fitness experts, hosting healthy eating activities, running screening clinics for blood pressure, cholesterol, blood sugar and flu shots, swapping recipes, participating in walks, runs, and bike races, losing weight, quitting smoking, and just about anything creative, enthusiastic people can think about.

This month alone, here are just some of the more serious national health observances taking place:

  • Skin Cancer and UV Awareness Month
  • Mental Health Month
  • National Blood Pressure Awareness Month
  • Healthy Vision Awareness Month
  • Arthritis Awareness Month
  • Lyme Disease Awareness Month
  • Celiac Disease Awareness Month

There are plenty more, too – pick the ones that work for you and your team.

By simply searching on the Internet for “national health awareness months,” you’ll discover a plethora of options. And when companies underwrite group activities, offer incentives, sponsor friendly competitions, and recognize participation, employers can demonstrate leadership, interest in their employees’ wellness, and their commitment to creating and maintaining a healthy workplace.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

The Message Doesn’t Get Old, but Our Skin Does

We love the sun, especially after a dreary winter and rainy spring. Whether working or playing outdoors, attending parties and picnics, enjoying trips to the beach, or just hanging on the deck or in the yard, we soak up those rays, get our vitamin D, and savor our 2017 tans. But this year, as the perennial warnings about sun exposure and the dangers of Ultraviolet (UV) rays hit the air waves, take note: Skin cancer is the most common form of cancer in the United States, and you can help minimize exposure and prevent its onset by taking simple precautions.

Unprotected exposure to UV radiation is the most preventable risk factor for skin cancer. In fact, UV radiation from the sun and tanning beds is classified as a human carcinogen by the U.S. Department of Health and Human Services and the World Health Organization. Each year, more new cases of skin cancer are diagnosed in the U.S. than new cases of breast, prostate, lung, and colon cancer combined. One in five Americans will develop skin cancer in their lifetime, and one American dies from skin cancer every hour.

Chronic exposure to the sun suppresses our natural immune system and also causes premature aging, which over time can make the skin become thick, wrinkled and leathery. Since it occurs gradually, often manifesting itself many years after the majority of a person’s sun exposure, premature aging is often regarded as an unavoidable, normal part of growing older. However, up to 90% of the visible skin changes commonly attributed to aging are caused by the sun. With proper protection from UV radiation, many forms of skin cancer and most premature aging of the skin can be avoided.

Properly protecting ourselves from UV exposure

The best way to lower our risk of skin cancer is to protect our skin from the sun and ultraviolet light. Using sunscreen and avoiding the sun helps reduce the chance of many aging skin changes, including some skin cancers. However, it is important not to rely too much on sunscreen alone. You should also not use sunscreen as an excuse to increase the amount of time you spend in the sun. Even with the use of sunscreen, people should not stay out too long during peak sunlight hours; UV rays can still penetrate our clothes and skin and do harm.

When possible, avoid sun exposure during the peak hours of 10:00 am to 4:00 pm, when UV rays are the strongest. Clouds and haze do not protect you from the sun, so use sun protection even on cloudy days.

Use sunscreens that block out both UVA and UVB radiation. Products that contain either zinc oxide or titanium oxide offer the best protection. Less expensive products that have the same ingredients work as well as expensive ones. Older children and adults (even those with darker skin) benefit from using SPFs (sun protection factor) of 15 and over. Many experts recommend that most people use SPF 30 or higher on the face and 15 or higher on the body, and people who burn easily or have risk factors for skin cancer should use SPF 50+.

Here’s how to use sunscreen to ensure the best possible protection from the sun’s damaging UV rays:

  • Adults and children should wear sunscreen every day, even if they go outdoors for only a short time.
  • Apply 30 minutes before going outdoors for best results. This allows time for the sunscreen to be absorbed.
  • Remember to use sunscreen during the winter when snow and sun are both present.
  • Reapply at least every two hours while you are out in the sunlight.
  • Reapply after swimming or sweating. Waterproof formulas last for about 40 minutes in the water, and water-resistant formulas last half as long.
  • Adults and children should wear hats with wide brims to shield from the sun’s rays.
  • Wear protective clothing. Look for loose-fitting, unbleached, tightly woven fabrics. The tighter the weave, the more protective the garment.
  • Avoid sun lamps, tanning beds, and tanning salons.
  • Buy clothing and swimwear that block out UV rays. This clothing is rated using SPF (as used with sunscreen) or a system called the ultraviolet protection factor (UPF) index.
  • Avoid surfaces that reflect light, such as water, sand, concrete, snow, and white-painted areas.
  • Beware that at higher altitudes we burn more quickly.

The sun’s rays are important to our health, in moderation, but we get more than enough just by being outdoors for normal activities like going to work and to school, and when puttering in the yard or walking the dog. Taking simple, painless steps to help protect ourselves and our children now can make a huge difference later in life.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Achy Knees? Joint Pain? What You Need To Know About Arthritis

 

Maybe it starts with stiffness in the morning when you wake up, or you notice your hands are aching as the weather turns colder. Knees giving you some trouble, or your shoulder hurting when you lift heavy bags or objects? Age catches up to all of us eventually, but if you’re experiencing stiffness or swelling in your hands and joints, and a decreased range of motion you may be suffering from common arthritis symptoms.

If so, you’re in good company: More than 50 million adults and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people get older.

Common arthritis joint symptoms can come and go. They can be mild, moderate, or severe. They may stay about the same for years, or may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities, and make it difficult to walk or climb stairs. Arthritis also can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-rays. Some types of arthritis also affect the heart, eyes, lungs, kidneys, and skin as well as the joints.

Arthritis is not a single disease — it is an informal way of referring to joint pain or joint disease. There are more than 100 different types of arthritis and related conditions. People of all ages, sexes and races can and do have arthritis, and it is the leading cause of disability in America.

Every year, arthritis and related conditions account for:

  • More than $156 billion annually in lost wages and medical expenses
  • More than 100 million outpatient visits
  • An estimated 6.7 million hospitalizations

There are different types of arthritis. Osteoarthritis is the most common type of arthritis. When cartilage – the slick, cushioning surface on the ends of bones – wears away, bone rubs against bone, causing pain, swelling, and stiffness.  Over time, joints can lose strength and pain may become chronic. Risk factors include excess weight, family history, age, and previous injury.

Arthritis can also be degenerative. A healthy immune system helps protect us. It generates internal inflammation to get rid of infection and prevent disease. But the immune system can mistakenly attack the joints with uncontrolled inflammation, potentially causing joint erosion, and may damage internal organs, eyes, and other parts of the body. Rheumatoid arthritis and psoriatic arthritis are examples of inflammatory arthritis. Researchers believe that a combination of genetics and environmental factors can trigger autoimmunity. Smoking is an example of an environmental risk factor that can trigger rheumatoid arthritis in people with certain genes.

With autoimmune and inflammatory types of arthritis, early diagnosis and aggressive treatment is critical. Slowing disease activity can help minimize or even prevent permanent joint damage. Remission is the goal and may be achieved through the use of one or more medications known as disease-modifying antirheumatic drugs (DMARDs). The goal of treatment is to reduce pain, improve function, and prevent further joint damage.

Other types of arthritis include infectious and metabolic. A bacterium, virus, or fungus can enter the joint and trigger inflammation. Examples of organisms that can infect joints are salmonella and shigella (food poisoning or contamination), chlamydia and gonorrhea (sexually transmitted diseases) and hepatitis C (a blood-to-blood infection, often through shared needles or transfusions). In many cases, timely treatment with antibiotics may clear the joint infection, but sometimes the arthritis becomes chronic.

With metabolic arthritis, uric acid is formed as the body breaks down purines, a substance found in human cells and in many foods. Some people have high levels of uric acid because they naturally produce more than is needed or the body can’t get rid of the uric acid quickly enough. In some people, the uric acid builds up and forms needle-like crystals in the joint, resulting in sudden spikes of extreme joint pain, or a gout attack. Gout can come and go in episodes or, if uric acid levels aren’t reduced, it can become chronic, causing ongoing pain and disability.

Diagnosing and controlling arthritis

Arthritis diagnosis often begins with a primary care physician, who performs a physical exam and may do blood tests and imaging scans to help determine the type of arthritis. An arthritis specialist, or rheumatologist, should be involved if the diagnosis is uncertain or if the arthritis may be inflammatory. Rheumatologists typically manage ongoing treatment for inflammatory arthritis, gout, and other complicated cases. Orthopaedic surgeons do joint surgery, including joint replacements. When the arthritis affects other body systems or parts, other specialists, such as ophthalmologists, dermatologists or dentists, may also be included in the health care team.

When the joint symptoms of osteoarthritis are mild or moderate, they can be managed by:

  • Balancing activity with rest
  • Using hot and cold therapies
  • Regular physical activity
  • Maintaining a healthy weight
  • Strengthening the muscles around the joint for added support
  • Using assistive devices
  • Taking over-the-counter (OTC) pain relievers or anti-inflammatory medicines
  • Avoiding excessive repetitive movements

If joint symptoms are severe, causing limited mobility and affecting quality of life, management strategies may be helpful, but joint replacement may be necessary. Osteoarthritis that isn’t genetic may be reduced or prevented by staying active, maintaining a healthy weight, and avoiding injury and repetitive movements. As a general prescription, focusing on healthy eating and exercise remains the best course for limiting the onset of arthritis and for helping you control symptoms now or down the road.


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Living Life on the Sunny Side of the Street

When people are acting negatively – critical about themselves and others, pessimistic, always seeing the darker side of things, constantly questioning motives, always assuming the worst – it wears on the people around them and on them, as well.  Negative people get sick more often and take longer to recover, while optimistic people tend to be less sick and more resilient.

Research indicates that psychological factors influence cardiovascular disease, morbidity, and mortality. Persistent negative behavior such as depression, anxiety or anger, and cynical, hostile attitudes toward others have been linked as early indicators of future heart disease. On the other hand, dispositional optimism or the general feeling that good things rather than bad will resolve a difficult situation or generally prevail in the future, have been associated with reduced risk of mortality.

Published last year in the American Journal of Epidemiology, researchers found a definitive association between a positive sense of well-being and better health. This study used data from 70,021 women who were part of a long-running nurses’ health study. It gauged their level of optimism through a questionnaire originally conducted in 2004. The average age of respondents was 70 years old.

Then the researchers tracked deaths among the women from 2006 to 2012. They found that after controlling for factors including age, race, educational level, and marital status, the women who were most optimistic were 29% less likely to die during the six-year study follow-up than the least optimistic. That reduced risk was seen in cancer (16% lower), heart disease (38%), stroke (39%), respiratory disease (37%), and infection (52%).

When the researchers ran additional analyses controlling for existing health conditions such as high cholesterol, diabetes, and cancer, the risk of dying was 27% lower among the most optimistic women. When controlling for health behaviors like smoking and exercise, 14% lower. And when controlling for all those factors, the risk of dying was still 9% lower among the most optimistic women.

People who are more optimistic tend to have healthier behaviors when it comes to diet, exercise, and tobacco use. It’s also possible that more optimistic people cope better, create contingency plans, plan for future challenges, and accept what can’t be changed. This optimism may have a direct impact on improved immune function or lower levels of inflammation.

In another study, doctors evaluated 309 middle-aged patients who were scheduled to undergo coronary artery bypass surgery. In addition to a complete pre-operative physical exam, each patient underwent a psychological evaluation designed to measure optimism, depression, neuroticism, and self-esteem. The researchers tracked all the patients for six months after surgery. When they analyzed the data, they found that optimists were only half as likely as pessimists to require re-hospitalization. In a similar study of 298 angioplasty patients, optimism was also protective; over a six-month period, pessimists were three times more likely than optimists to have heart attacks or require repeat angioplasties or bypass operations.

And finally, an American study of 2,564 men and women who were 65 and older also found that optimism is good for blood pressure. People with positive emotions had lower blood pressures than those with a negative outlook. On average, the people with the most positive emotions had the lowest blood pressures.

Can we learn to be positive?

So if having a positive attitude can help reduce illness and prolong life, why aren’t we all happy, and what might we do to become less pessimistic and negative? The first question is the harder to answer. We are complex psychological beings, products of our upbringing, genetics, hardships, and positive and negative experiences. We’ve been shaped and influenced by many people and situations, and we learned good and bad behaviors through the years by observation and reaction, and as protection.

But there are things we can do to help move ourselves into a more positive, optimistic mindset.

For example:

  • Notice negativity. Listen to what you and others say and how negative it is. Track your own thoughts on a daily basis and notice the negative assumptions and conclusions that you draw, because identifying our own negativity is essential to change.
  • When you find yourself saying something negative, think of something positive to say.
  • Search for positive aspects of situations. Most situations can be seen in both a positive and negative light. You just have to find the positive one and keep reminding yourself of it in order to eventually believe it.
  • Think of someone you know who has a positive outlook on life and ask yourself what that person would do or think in particular situations. Then try to think that way too.
  • Give others positive feedback. Even if someone has done something poorly, there has to be some aspect of it that is good. If you can find this, your view will be more positive and the other person may feel encouraged to continue.
  • Give yourself positive feedback and notice when you discount or minimize your successes. Pessimists feel uncomfortable with good things and often fear disappointing others by acknowledging their own strengths. Learn to just say thank you if someone (including yourself) gives you positive feedback.
  • Identify why you feel negative. Does it provide protection against disappointment? Does it help you not to get hurt? Do you think that it helps you to plan for possible challenges? We often think that pessimism and worry are helpful but this is not true. We can learn to handle disappointment, hurt, and challenges if we were not bogged down by anxiety and negativity.
  • Take the risk of being positive and see how it feels. It takes a long time to learn negativity and will take a while to learn optimism.

Positive thinking and being will help you lead a longer, healthier life. It may take practice, but what do you have to lose, other than the negative attitude?


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Stress at Work Is Killing Us

Whether home or at work, at school, shopping, or driving, there’s no shortage of things to stress us out. Our ability to cope, get along with others, get things done efficiently, and be reasonable often hinges on how we manage that stress. Those coping mechanisms have a lot to do with how well our days go and how we get along with family and friends. But when it comes to work, there’s a greater price to pay. Not managing stress effectively costs employers billions of dollars annually in healthcare-related expenses, lost-work hours, and reduced productivity due to illness, depression, accidents, turnover, and worker burnout.

According to research by the American Psychological Association’s (APA) Center for Organizational Excellence, more than one-third (35%) of American workers experience chronic work stress, with low salaries, lack of opportunities for advancement, and heavy workloads topping the list of contributing factors. Stress in the workplace, researchers found, manifests itself in increased absenteeism and presenteeism (coming to work, but not achieving expectations, or working to potential), lower productivity, and increased service errors.

Stress also is a contributor to high blood pressure and other diseases. When we’re frustrated, depressed, or under tremendous pressure at work or at home, we tend to eat poorly, not exercise, and otherwise tax our bodies. Links have been established between stress and our body’s production of excess cholesterol. Stress also interferes with our normal sleep, which causes fatigue and makes us irritable and more susceptible to illness. When unchecked, stress interferes with our general quality of life, and can affect our relationships, productivity, customer service, teamwork, safety, and quality.

According to the Centers for Disease Control and Prevention (CDC), work-related stress is the physical and emotional damage that occurs due to a mismatch between work requirements and the resources, needs, and capabilities of workers. Currently, 40% of American workers say that their jobs are very or extremely stressful. At the same time, 26% of employees say they are very often burned out, or stressed at the workplace. Twenty-nine percent of workers say that their jobs are extremely stressful, and 25% report that their jobs are the leading causes of stress in their lives.

How is that affecting them physically? CDC statistics say that seven out of 10 workers say they experience stress-related psychological symptoms regularly, and close to eight out of 10 employees regularly encounter physical symptoms associated with stress. To avoid workplace stress, 60% of 26,000 U.S. workers surveyed said they would opt for a fresh career start. This dissatisfaction on the job is costing American employers $300 billion annually on employee healthcare and employee absence costs.

Why so much workplace stress?

If you’ve ever worked for or with other people, you probably can answer this question yourself.

Workload accounts for 46% of all workplace stress incidents, and “people issues” account for 28% of stress at work problems. Additionally, juggling work/personal life challenges accounts for 20% of stress incidents reported by American workers, while lack of job security is the fourth-leading cause of stress at the workplace.

The symptoms of worrying, anxiety, and stress at work result in back pain, fatigue, stomach ailments, headaches, teeth grinding, and changes in sex drive. It reduces immunity to disease, and leaves workers unable to sleep well at night due to worrying about their jobs. And it’s costing employers an estimated $10 billion annually in productivity losses alone.

All in all, it sounds pretty dire. Yet we have to work, we have to get along with our co-workers, bosses, and customers, and we have to remain focused on quality, service, and productivity. So how can employers help address the issues that cause this detrimental behavior and side effects, and improve outcomes?

Organizations that have implemented measures to address burnout have a staff turnover rate of just 6%, which is low compared to the national average of 38%. Additionally, in progressive-thinking companies, the rate of staff reporting “chronic work stress” stands at 19% compared to the national average of 35%. Employees at the same organizations registered higher job satisfaction scores, meaning they were unlikely to seek greener pastures elsewhere.

Tips for managing workplace stress

Humans are complicated – there are no easy answers or magic bullets. But based on research, an important first step is promoting a healthy work/life balance. Progressive organizations offer telecommuting, paid time off, and flex time perks. Employee recognition strategies including profit-sharing programs, bonuses, and cost-of-living salary raises. Organizing staff retreats, interacting with staff to learn more about their problems, and monitoring job satisfaction helps, as does providing workers with regular career growth and development opportunities.

While the work has to get done and get done on time, fatigue plays an enormous role in reduced workplace productivity. While napping in one’s car is helpful when coping with exhaustion, some employers provide rest or nap lounges with couches, reduced lighting, and soft music. Ensuring that employees get adequate time for stretching, moving around, breaks, and for lunch or dinner is critical.

Additionally, time during the day for recreation – walks, runs, athletics, bicycling, working out – helps people manage stress and keep themselves healthier. That could be as simple as having a fitness room, basketball or volleyball court at the workplace, or encouraging employees to take a walk or go to the gym at times that work best for them and fit within their work requirements.

Bringing in experts on nutrition, fitness, yoga, massage, and other forms of relaxation or wellness education is inexpensive and helpful. And engaging employees in team problem-solving, or creating and empowering recreation, communication, health and wellness, and “fun” committees goes a long way toward improving morale, teamwork and productivity.

Ultimately, we all have to find ways to deal with our own stress, and the stress that accompanies most jobs. But recognizing the signs of worker stress and acknowledging the importance of providing creative and healthy outlets for employees will help reduce some of the factors that are heavily taxing workers and costing employers a fortune, and employees their health.

Oral Cancers Are Largely Preventable

Oral health is not only important to our appearance and sense of well-being, but also to our overall health. Cavities and gum disease may contribute to many serious conditions, such as diabetes and respiratory disease, and untreated cavities can be painful and lead to serious infections. Poor oral health has been linked to sleeping problems, as well as behavioral and developmental problems in children. It also can affect our ability to chew and digest food properly.

But there’s a more insidious nature to poor oral health. While genetics can play a role, lifestyle and poor choices are major contributors to a cancer that kills approximately 10,000 Americans annually. In fact, the American Cancer Society’s latest estimates for 2017 forecast that approximately 50,000 people will get oral cavity or oropharyngeal cancer this year.

April is National Oral Cancer Awareness Month. Oropharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the oropharynx. The oropharynx is the middle part of the pharynx (throat) behind the mouth. It includes the back one-third of the tongue, soft palate, side and back walls of the throat, and our tonsils. The rest are found in the lips, the minor salivary glands (which often occur in the roof of the mouth), and other sites.

These cancers are more than twice as common in men as in women. The average age of most people diagnosed with these cancers is 62, but they can occur in young people. They are rare in children, but a little more than one-quarter occur in patients younger than 55.

Smoking is a major risk factor for oral and dental disease, including oral cancer. Tobacco smoke (including the smoking of cigars and pipes) is very harmful to gum tissues and other tissues in your mouth. Toxins in smoke can cause oral cancer and also damage the bone around your teeth, a major cause of tooth loss. In fact, smoking and tobacco products that are chewed or held in the mouth are one of the biggest risk factors for gum disease and perhaps the biggest risk factor for oral cancer.

Oral tobacco products (snuff or chewing tobacco) are linked with cancers of the cheek, gums, and inner surface of the lips. Using oral tobacco products for a long time poses an especially high risk. These products also cause gum disease, destruction of the bone sockets around teeth, and tooth loss.

The most common risk factors for oropharyngeal cancer include the following:

  • Being infected with human papillomavirus (HPV) — the number of oropharyngeal cancers linked to HPV infection is increasing annually
  • A history of smoking a pack or more a day for greater than 10 years
  • The use of chewing tobacco, snuff, and other “smokeless” tobacco products
  • Heavy alcohol use
  • A diet low in fruits and vegetables
  • Drinking maté, a stimulant drink common in South America
  • Chewing betel quid, a stimulant commonly used in parts of Asia

Sometimes oropharyngeal cancer does not cause early signs or symptoms, but common signs include a lump in the neck and a sore throat. These and other signs and symptoms may be caused by oropharyngeal cancer or by other conditions. Check with your doctor if you have any of the following:

  • A sore throat that does not go away
  • Trouble swallowing
  • Trouble opening the mouth fully
  • Trouble moving the tongue
  • Weight loss for no known reason
  • Ear pain
  • A lump in the back of the mouth, throat, or neck
  • A change in voice
  • Coughing up blood.

When patients newly diagnosed with oral and oropharyngeal cancers are carefully examined, a small portion will have another cancer in a nearby area such as the larynx (voice box), the esophagus (the tube that carries food from the throat to the stomach), or the lung. Some who are cured of oral or oropharyngeal cancer will develop another cancer later in the lung, mouth, throat, or other nearby areas. For this reason, people with oral and oropharyngeal cancer will need to have follow-up exams for the rest of their lives. They also need to avoid using tobacco and alcohol, which increase the risk for these second cancers.

The good news is that the death rate for these cancers generally has been decreasing over the last 30 years. That’s primarily attributable to better health education, outreach from national organizations like the American Cancer Society, and changing patterns in the use of tobacco and alcohol. But oral cancer from human papillomavirus (HPV) is increasing significantly, and risk factors for youth who indulge in smoking or the use of smokeless tobacco also is on the rise. Another questionable practice is the use of “vapes” or electric cigarettes, but research on the long-term effects of these devices is still in its infancy.

Raise Your Glasses… Then Place Them Back Down

Think what you will about alcohol use, but a culture of drinking is part of our heritage and lifestyle. While many people abstain due to health, religious, or moral concerns, millions of Americans and people around the globe imbibe socially, use wine in religious ceremonies, binge drink, or abuse alcohol for a variety of reasons varying from habit to pain relief to genetics.

Many people enjoy the experience of being lightly intoxicated including reduced inhibitions and stimulation, and drinking is a normal part of many of our every-day rituals and customs here in the United States and around the world.

But drinking too much – on a single occasion or over time – can have serious consequences for our health. These consequences go far beyond having a headache and a hangover that make us uncomfortable but go away relatively quickly.

April is National Alcohol Awareness Month. Most people recognize that excessive drinking can lead to accidents and dependence, and can cause liver disease. But that’s only part of the story. Unlike other drugs, alcohol disperses in all body tissues and therefore has the potential to harm many organ systems. Alcohol abuse can damage organs, weaken the immune system, and contribute to a variety of cancers. Plus, much like smoking, alcohol affects different people differently. Genes, environment, and even diet can play a role in whether you develop an alcohol-related disease.

On the flip side, some people may actually benefit from drinking alcohol in small quantities. Alcohol’s effect on our heart is the best example of alcohol’s dual effects. Drinking a lot over a long time or too much on a single occasion can cause heart problems including high blood pressure, strokes, arrhythmia, and cardiomyopathy, a condition that causes our heart muscle to weaken and droop. But research also shows that healthy people who drink moderate amounts of alcohol (such as red wine) may have a lower risk of developing coronary artery disease than people who never drink at all.

Putting drinking in perspective

If you enjoy an alcoholic beverage once in a great while, you’re in good company: According to the 2015 National Survey on Drug Use and Health (NSDUH), seven out of 10 Americans report drinking alcohol at some point in the past year, and 56% drank in the past month. However, 26.9% of people ages 18 or over reported that they engaged in binge drinking, and 7% in heavy alcohol use regularly.

Alcohol Use Disorder (AUD) – or problem drinking – was reported in 15.1 million adults age 18 and over, with 1.3 million Americans seeking help in treatment facilities for drinking problems. What’s even more frightening is that, according to NSDUH, 623,000 adolescents ages 12 to 17 were reported suffering from AUD, resulting in 37,000 treated at medical or rehabilitation facilities.

Approximately 90,000 people die from alcohol-related causes annually, making alcohol the fourth-leading preventable cause of death in the United States. Close to 10,000 Americans die in alcohol-related car accidents annually, and alcohol misuse costs our country approximately $250 billion in health-related expenses, lost work time, and other factors such as reduced productivity and accidents.

How alcohol hurts us

While drinking in moderation may not affect the health of our liver, heavy drinking can definitely take its toll. The liver helps rid our bodies of substances that can be dangerous, including alcohol. By breaking down alcohol, the liver produces toxic byproducts that damage liver cells, promote inflammation, and weaken the body’s natural defenses. This can make conditions ripe for disorders like steatosis, fibrosis, and cirrhosis, and dangerous inflammations like hepatitis to develop.

Pancreatic inflammations can also develop in response to drinking too much. Alcohol causes the pancreas to produce toxic substances that can eventually cause inflammation and swelling in tissues in blood vessels. This inflammation, called pancreatitis, prevents the pancreas from digesting food and converting it into fuel to power our bodies.

Aside from damaging our organs, drinking too much alcohol can also increase our risk of developing certain cancers, including those of the mouth, esophagus, pharynx, larynx, liver, and breast.

Alcohol also can weaken our immune systems, making our bodies a much easier target for disease. Drinking a lot on a single occasion slows our body’s ability to ward off infections, even up to 24 hours after getting drunk. Chronic drinkers are more likely to contract diseases like pneumonia and tuberculosis than people who do not drink too much.

So while some light to moderate drinking may not hurt you, it’s important to understand the toxic, longer-term effects of alcohol and use common sense when drinking any alcoholic beverage. We may never be a nation of teetotalers, but understanding what we put in our bodies and making smart decisions about our health will always work in our favor.

It’s Spring, Pass the Tissues!

There are several sure signs spring has arrived. The daffodils and crocuses are up, trees are budding, migrating birds are flocking, ice cream trucks and motorcycles can be heard in the distance, and people all around us are starting to sneeze, wheeze, and sniffle.  For all its color, warmth, and wonder, springtime also heralds the return of seasonal allergies, and for millions of Americans, it’s not a pleasant visit.

The severity of allergy season can vary according to where you live, the weather, indoor contaminants, and many other elements. Seasonal allergic rhinitis is usually caused by mold spores in the air or by trees, grasses, and weeds releasing billions of tiny pollen grains.

Outdoor molds are very common, especially after the spring thaw. They are found in soil, some mulches, fallen leaves, and rotting wood. Everybody is exposed to mold and pollen, but only some people develop allergies. In these people, the immune system, which protects us from invaders like viruses and bacteria, reacts to a normally harmless substance called an allergen (allergy-causing compound). Specialized immune cells called mast cells and basophils then release chemicals like histamine that lead to the symptoms of allergy: sneezing, coughing, a runny or clogged nose, postnasal drip, and itchy eyes and throat.

Asthma and allergic diseases, such as allergic rhinitis (hay fever), food allergy, and atopic dermatitis (eczema), are common for all age groups in the United States. For example, asthma affects more than 17 million adults and more than 7 million children. It’s estimated that one-fifth of all Americans are allergic to something, whether seasonal, airborne, or food related. Nasal allergy triggers can be found both indoors and outdoors, and can be year-round or seasonal. It’s important to be aware of the times of day, seasons, places, and situations where your nasal allergy symptoms begin or worsen. If you can identify your triggers, and create a plan for avoiding them when possible, you may be able to minimize symptoms.

Here are a few points to remember:

  • You may be reacting to more than one type of allergen. For example, having nasal allergies to both trees and grass can make your symptoms worse during the spring and summer, when both of these pollens are high.
  • Molds grow in dark, wet places and can disperse spores into the air if you rake or disturb the area where they’ve settled.
  • People with indoor nasal allergies can be bothered by outdoor nasal allergies as well. You may need ongoing treatment to help relieve indoor nasal allergy symptoms.

If avoidance doesn’t work, allergies can often be controlled with medications. The first choice is an antihistamine, which counters the effects of histamine. Steroid nasal sprays can reduce mucus secretion and nasal swelling. The National Institutes of Health (NIH) says that the combination of antihistamines and nasal steroids is very effective in those with moderate or severe symptoms of allergic rhinitis. However, always consult with your physician before taking even over-the-counter medicines for allergies, as they may conflict with other medications or aggravate symptoms of other illnesses or chronic conditions.

Another potential solution is cromolyn sodium, a nasal spray that inhibits the release of chemicals like histamine from mast cells. But you must start taking it several days before an allergic reaction begins, which is not always practical, and its use can be habit forming. Immunotherapy, or allergy shots, is an option if the exact cause of your allergies can be pinpointed. Immunotherapy involves a long series of injections, but it can significantly reduce symptoms and medication needs.

Your physician can help pinpoint what you are allergic to, and tell you the best way to treat your nasal allergy symptoms. Providing detailed information about your lifestyle and habits will help your physician design an appropriate treatment plan for relieving your symptoms.

The American Academy of Allergy, Asthma, and Immunology has some useful tips for those who suffer from seasonal allergies:

  • Wash bed sheets weekly in hot water.
  • Always bathe and wash hair before bedtime (pollen can collect on skin and hair throughout the day).
  • Do not hang clothes outside to dry where they can trap pollens.
  • Wear a filter mask when mowing or working outdoors. Also, if you can, avoid peak times for pollen exposure (hot, dry, windy days, usually between 10:00 a.m. and 4:00 p.m.).
  • Be aware of local pollen counts in your area (visit the National Allergy Bureau Website).
  • Keep house, office, and car windows closed; use air conditioning if possible rather than opening windows.
  • Perform a thorough spring cleaning of your home, including replacing heating and A/C filters and cleaning ducts and vents.
  • Check bathrooms and other damp areas in your home frequently for mold and mildew, and remove visible mold with nontoxic cleaners.
  • Keep pets out of the bedroom and off of furniture, since they may carry pollen if they have been outdoors, or exacerbate your allergies if, for example, you’re allergic to cat dander.

We can’t always avoid the pollens, mold, and other triggers that aggravate our allergies, but we can try to limit or control exposure and pursue medical interventions to help mitigate our suffering. Spring is a wonderful time of year – enjoy it to its fullest, and pass the tissues