Feeling the Burn?

Bet you’ve been eating rich, greasy, and spicy foods the past month or so. Maybe a few cocktails to wash it all down or some cold bubbly soda, and delicious desserts followed by coffee. It all tastes so good going down. But unfortunately, for millions of Americans, it doesn’t taste as good coming back up as acid indigestion, or heartburn.

More than 60 million American adults experience heartburn at least once a month, and more than 15 million adults suffer daily from heartburn. Many pregnant women experience daily heartburn as well. For some people, it’s just too much of a good thing, and in a day or two the indigestion is gone.  But for those suffering regularly, it’s far more insidious and upsetting, and can cause long-term damage.

Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach. In most cases, GERD can be relieved through diet and lifestyle changes; however, GERD can result in serious complications. Esophagitis can occur as a result of too much stomach acid in the esophagus. Esophagitis may cause esophageal bleeding or ulcers. In addition, a narrowing or stricture of the esophagus may occur from chronic scarring. Some people develop a condition known as Barrett’s esophagus. This condition can increase the risk of esophageal cancer.

Gastroesophageal refers to the stomach and esophagus. Reflux means to flow back or return, so gastroesophageal reflux is the return of the stomach’s contents back up into the esophagus. In normal digestion, the lower esophageal sphincter (LES) opens to allow food to pass into the stomach and closes to prevent food and acidic stomach juices from flowing back into the esophagus. Gastroesophageal reflux occurs when the LES is weak or relaxes inappropriately, allowing the stomach’s contents to flow up into the esophagus.

What is hiatal hernia?

Some doctors believe a hiatal hernia may weaken the LES and increase the risk for gastroesophageal reflux. Hiatal hernia occurs when the upper part of the stomach moves up into the chest through a small opening in the diaphragm. The diaphragm is the muscle separating the abdomen from the chest. Many people with a hiatal hernia will not have problems with heartburn or reflux. But having a hiatal hernia may allow stomach contents to reflux more easily into the esophagus.

Coughing, vomiting, straining or sudden physical exertion can cause increased pressure in the abdomen resulting in hiatal hernia. Obesity and pregnancy also contribute to this condition. Many otherwise healthy people age 50 and over have a small hiatal hernia. Although considered a condition of middle age, hiatal hernias affect people of all ages.

Hiatal hernias usually do not require treatment. However, treatment may be necessary if the hernia is in danger of becoming strangulated or twisted in a way that cuts off blood supply, or is complicated by severe GERD or esophagitis. In these cases, your doctor may perform surgery to reduce the size of the hernia or to prevent strangulation.

To help your doctor diagnose GERD or hiatal hernia, an upper GI series may be performed during the early phase of testing. This test is a special X-ray that shows the esophagus, stomach, and duodenum (the upper part of the small intestine). While an upper GI series provides limited information about possible reflux, it is used to help rule out other diagnoses, such as peptic ulcers.

Endoscopy is an important procedure for individuals with chronic GERD. By placing a small lighted tube with a tiny video camera on the end (endoscope) into the esophagus, the doctor may see inflammation or irritation of the tissue lining the esophagus, and can easily and painlessly biopsy tissue samples.

What you can do to feel better

Doctors recommend lifestyle and dietary changes for most people needing treatment for GERD. Treatment aims at decreasing the amount of reflux or reducing damage to the lining of the esophagus from refluxed materials. Other tips for reducing or controlling reflux include:

  • Avoid foods and beverages that can weaken the LES. These foods include chocolate, peppermint, fatty foods, coffee, and alcoholic beverages. Foods and beverages that can irritate a damaged esophageal lining, such as citrus fruits and juices, tomato products and pepper also should be avoided.
  • Decrease the size of portions. Eating less at mealtime may also help control symptoms.
  • Eat meals at least two to three hours before Avoid eating within a few hours of going to bed or lying down. This may lessen reflux by allowing the acid in the stomach to decrease and the stomach to empty partially.
  • Lose weight. Being overweight often worsens symptoms.
  • Stop smoking cigarettes. Cigarettesmoking weakens the LES. Stopping smoking is important to reduce GERD symptoms.
  • Elevate the head of the bed. Raising your bed on six-inch blocks or sleeping on a specially designed wedge reduces heartburn by allowing gravity to minimize reflux of stomach contents into the esophagus. Do not use pillows to prop yourself up; that only increases pressure on the stomach.
  • Prescription and over-the-counter medications. Along with lifestyle and diet changes, your doctor may recommend over-the-counter or prescription treatments.

Antacids can help neutralize acid in the esophagus and stomach and stop heartburn. Many people find that nonprescription antacids provide temporary or partial relief. Long-term use of antacids, however, can result in side effects including diarrhea, altered calcium metabolism (a change in the way the body breaks down and uses calcium), and buildup of magnesium in the body. Too much magnesium can be serious for patients with kidney disease. If antacids are needed for more than two weeks, a doctor should be consulted.

For chronic reflux and heartburn, your doctor may recommend prescription medications to reduce acid in the stomach. Some of these medicines are H2 blockers, which inhibit acid secretion in the stomach. H2 blockers include cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), and ranitidine (Zantac). Additionally, doctors may prescribe proton pump inhibitors, which also decrease the amount of acid produced in the stomach. Prilosec (omeprazole) and Nexium also are commonly used to promote healing of damage to the esophagus caused by stomach acid, but these medications are not for the immediate relief of heartburn.

We can’t always prevent acid reflux or hiatal hernia, but we can choose to moderate our diets and behaviors to produce more favorable results. It’s a new year – consider adding the reduction or elimination of heartburn to your 2017 wish list!

 


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!

Glaucoma Awareness

Glaucoma is a disease that damages your eye’s optic nerve. It usually occurs when fluid builds up in the front part of your eye which increases the pressure in your eye, damaging the optic nerve. It can lead to blindness if not treated.

January is Glaucoma Awareness Month. It’s estimated that over 2.2 million Americans have glaucoma, but only half of those know they have it. Glaucoma is the second-leading cause of blindness in the world, according to the World Health Organization, and after cataracts, is the leading cause of blindness among African Americans. In the United States, more than 120,000 people are blind from glaucoma, accounting for between nine percent and 12 percent of all cases of blindness.

Everyone is at risk for glaucoma, from babies to senior citizens. Older people are at a higher risk for glaucoma but babies can be born with glaucoma (approximately one out of every 10,000 babies born in the United States). Young adults can get glaucoma, too. African Americans in particular are susceptible at a younger age.

The most common types of glaucoma — primary open-angle glaucoma and angle-closure glaucoma — have completely different symptoms.

Primary open-angle glaucoma signs and symptoms include:

  • Gradual loss of peripheral vision, usually in both eyes
  • Tunnel vision in the advanced stages

Acute angle-closure glaucoma signs and symptoms include:

  • Eye pain
  • Nausea and vomiting (accompanying the severe eye pain)
  • Sudden onset of visual disturbance, often in low light
  • Blurred vision
  • Halos around lights
  • Reddening of the eye

Both open-angle and angle-closure glaucoma can be primary or secondary conditions. They’re called primary when the cause is unknown and secondary when the condition can be traced to a known cause such as eye injury, medications, certain eye conditions, inflammation, tumor, advanced cataract or diabetes. In secondary glaucoma, the signs and symptoms can include those of the primary condition as well as typical glaucoma symptoms.

When to see your doctor

Don’t wait for noticeable eye problems before seeing a doctor. Primary open-angle glaucoma gives few warning signs until permanent damage has already occurred. Regular eye exams are the key to detecting glaucoma early enough to successfully treat the condition and prevent further progression.

The American Academy of Ophthalmology recommends a comprehensive eye exam for all adults starting at age 40, and every three to five years after that if you don’t have any glaucoma risk factors. If you have other risk factors or you’re older than age 60, you should be screened every one to two years. If you’re African-American, your doctor likely will recommend periodic eye exams starting between ages 20 and 39.

In addition, a severe headache or pain in your eye, nausea, blurred vision, or halos around lights may be the symptoms of an acute angle-closure glaucoma attack. If you experience some or several of these symptoms together, seek immediate care at an emergency room or at an eye doctor’s (ophthalmologist’s) office right away.

Glaucoma is not curable, and vision lost cannot be regained. With medication and/or surgery, it is possible to halt further loss of vision. Since open-angle glaucoma is a chronic condition, it must be monitored for life. Diagnosis is the first step to preserving your vision – regular eye exams should be part of your personal wellness regimen, especially since there are a variety of other eye ailments that can afflict us. Through a regular eye exam, doctors can detect early warning signs for other diseases ranging from cancer to stroke.

 


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!

Exercising for Financial Health

We may love money, but it doesn’t love us. Ralph Waldo Emerson famously quipped, “Money costs too much,” warning about the unhappiness associated with pursing wealth. We all need money to pay bills and to enjoy a better quality of life. But there’s an insidious nature to how we spend money, how we talk with our significant others about it, and the impact finances have on our mental and physical health.

Debt, financial stress and spending behaviors are a major cause of relationship problems and often cited as a significant contributing factor in many divorces and breakups. Worrying about money and debt also causes increased anxiety, sleeplessness, depression and stress that taxes our hearts, contributes to high blood pressure, aggravates stomach issues like acid reflux and ulcers, and can lead to strokes and heart disease. When you consider that more than three out of four American families are in debt, the weight of all that anxiety becomes more apparent.

Most of us worry about money, and this time of year, that worrying gets worse. Or, we cast caution to the wind, spend beyond our means for the holidays, and figure we’ll bear down come January . . . much like we view our diets and holiday eating.  Granted, December may not be the best time to be considering cutting back on spending, so if we allow for reality and the joys of the season – and think about what we’re going to do differently in the coming months and years — that would be a great gift to ourselves and our families.

Planning and focus pay big dividends

There’s a difference between active coping and comfort coping – some of us eat more, spend more, devise short-term solutions, and find other creative avoidance mechanisms. Instead we should be thinking about informed, collaborative planning and strategies for dealing with our money issues. Creating goals is important – if we are working toward a home purchase, a special vacation, college or retirement savings we need a clear game plan and tools to help realize our dreams. So it’s important to think long term, but live with short-term daily strategies, as well.

Here are some tips for improving our financial health:

  • Make a budget. That sounds so basic and simple, yet many people fail to truly organize their financial lives, and to understand what they bring in and what goes out . . . and what they can truly afford. Is it possible that you actually spend $25 a week buying coffee and drinks on the road? Sure it is – and that’s okay, if you can afford the extra C-note a month. If you have a detailed budget and you stick to it, buying things during the day that make you happy is okay. If you can’t pay your phone bill, purchase oil for your furnace or buy a new interview suit, it isn’t.
  • Track your expenses. Whether you write it in a notebook, record it on your computer or download one of the many spending applications available for phones and laptops, tracking what we spend is an important tool for understanding our spending habits and for charting behaviors.
  • Avoid credit, or use it wisely. All that talk about how important it is to use credit cards to build up your credit report is bologna. If you can afford something, buy it with cash or use a debit card. If you can’t afford it, and it’s really important (like fixing the car, and for travel), use a credit card, but be diligent about paying it off as quickly as possible to avoid exorbitant finance charges or the seductive allure of instant gratification.
  • Talk to others about your financial concerns. Share your worries and issues with people close to you, especially your partner. Money worries cause countless troubles for individuals, for couples, and for families. The stigma and shame that accompanies money problems – and the weight of hiding those pressures – causes stress, anxiety and depression, as well. Candor and good communication helps alleviate some of the stress that comes with feeling like you’re bearing the financial burden on your own, or the sense of hopelessness that comes with every bill or debt collector’s call.
  • Consult a financial expert. You don’t have to have a ton of investment income to seek guidance from a financial planner or consultant. He or she can help you devise a savings strategy, determine wise, affordable investments, build your budget, and plan for the future more effectively.
  • Get help for managing your debt. If you have debt and it’s wearing you and your loved ones down, there are options and strategies for addressing your bottom line. Consolidation loans with a lower monthly finance charge can help you rid yourself of credit cards. Banks love when we only pay the minimum due, and profit greatly when we miss a payment and they can charge a hefty penalty. Avoid both by paying more than the minimum monthly payment, or by paying off the card completely as soon as possible.

There are services available to help negotiate payment plans and for consolidating debt, but many of them charge a service fee for this assistance. There also are support groups, free counseling services, and programs such as Debtors Anonymous, a confidential 12-step program available in Connecticut and across the country, where people with debt or spending issues can come together to examine solutions to their money issues, and find fellowship and support.

Money challenges us all, and there’s no reason to think that’s going to change. What can change is how we view our spending habits – if we’re not vague or frivolous about how, what and when we spend, we can take a big step toward improving our financial health, as well as our overall health and wellness.

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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!

Is Facebook Making You Sick?

Chances are you’re reading this article on your laptop or a mobile device. Hopefully you’re not reading it late at night, because if you are, it may be making you sick.  That’s because the artificial light from computer and smart phone screens is interfering with our ability to sleep properly. And when we don’t sleep well, or enough, we fail to benefit from our body’s natural restorative abilities.

But that’s only one piece of the bad news relating to electronic gadgets and our health. For all it’s given us, modern technology also is hurting our physical and emotional health, and changing behaviors in adults and children in ways that will have far-reaching, yet still undetermined consequences.

Melatonin is a hormone that regulates sleep and wakefulness in humans and animals. It is produced in darkness. Researchers have determined that the blue light from our electronic devices affects melatonin production and melanopsin stimulation, which throws off our circadian rhythms, our internal body clock. This interrupts or prevents deep, restorative sleep, causing an increase in stress and depressive symptoms.

Research shows that interactive technologies such as video games, cell phones and the Internet might affect the brain differently than those which are “passively received,” such as TV and music. That’s even more meaningful when it comes to our kids.

Children’s brains are much more sensitive to electronics use than most of us realize. In fact, contrary to popular belief, it doesn’t take much electronic stimulation to throw a sensitive and still-developing brain off track. Many parents mistakenly believe that interactive screen-time – such as the Internet or social media use, texting, emailing, and gaming — isn’t harmful, especially compared to passive screen time like watching TV. In fact, interactive screen time is more likely to cause sleep, mood, and cognitive issues, because of hyper-arousal and compulsive use.

Recent statistics show that 63 percent of American Facebook users log on to the site daily, while 40 percent of users log on multiple times a day. If you or your kids are spending a lot of time in chat rooms and on social-networking sites, a number of studies now suggest that this can be associated with depression, particularly in teens and preteens.

Internet addicts may struggle with real-life human interaction and a lack of companionship, and they may have an unrealistic view of the world. Some experts even call it “Facebook depression.” In a 2010 study, researchers found that many people ages 16 to 51 spent an inordinate amount of time online, and that they had a higher rate of moderate to severe depression. However, the researchers noted that it is not clear if Internet overuse leads to depression or if depressed people are more likely to use the Internet.

We all have our own reasons for using social media, but one of the main reasons we use it is for self-distraction and boredom relief. In essence, social media delivers reinforcement every time a person logs on. It may seem harmless to knock out a few emails before bed or unwind with a favorite movie, but by keeping our mind engaged, technology can trick our brain into thinking that it needs to stay awake. When surfing the web, seeing something exciting on Facebook, or reading a negative email, those experiences can make it hard to relax and settle into slumber. After spending an entire day surrounded by technology, our minds need time to unwind.

Why we need technology down time

Research into the use of technology produced other startling results, including sleep disorders and an increase in depressive symptoms from heavy cell phone use or the regular use of computers at night. Researchers have established that screen time:

  • Disrupts sleep and de-synchronizes the body clock. Just minutes of screen stimulation can delay melatonin release by several hours and desynchronize our body clock. Once the body clock is disrupted, all sorts of other unhealthy reactions occur, such as hormone imbalance and brain inflammation. Plus, high arousal doesn’t permit deep sleep, and deep sleep is how we heal.
  • Desensitizes the brain’s reward system. Many children are “hooked” on electronics. In fact, gaming releases so much dopamine — the “feel-good” chemical — that on a brain scan it looks the same as cocaine But when reward pathways are overused, they become less sensitive, and more and more stimulation is needed to experience pleasure. Meanwhile, dopamine is also critical for focus and motivation, so even small changes in dopamine sensitivity can wreak havoc on how well a child feels and functions.
  • Produces “light-at-night.” Light-at-night from electronics has been linked to depression and even suicide risk in numerous studies. Animal studies show that exposure to screen-based light before or during sleep causes depression, even when the animal isn’t looking at the screen. Sometimes parents are reluctant to restrict electronics use in a child’s bedroom because they worry the child will get upset — but to the contrary, removing light-at-night is protective.
  • Induces stress reactions. Both acute stress (fight-or-flight) and chronic stress produce changes in brain chemistry and hormones that can increase irritability. Cortisol, the chronic stress hormone, seems to be both a cause and an effect of depression — creating a vicious cycle. Additionally, both hyper-arousal and addiction pathways suppress the brain’s frontal lobe, the area where mood regulation actually takes place.
  • Fractures attention, and depletes mental reserves. Experts say that what’s often behind explosive and aggressive behavior is poor focus. When attention suffers, so does the ability to process one’s internal and external environment, so little demands become big ones. By depleting mental energy with high visual and cognitive input, screen time contributes to low reserves. One way to temporarily “boost” depleted reserves is to become angry, so meltdowns actually become a coping mechanism.
  • Reduces physical activity levels and exposure to “green time.” Research shows that time outdoors, especially interacting with nature, can restore attention, lower stress, and reduce aggression. So time spent with electronics reduces exposure to natural mood enhancers, as well as to chemicals which also keep us alert, and wake us up.

Most Americans admit to using electronics a few nights a week within an hour before bedtime. But to make sure technology isn’t harming your slumber, give yourself at least 30 minutes of gadget-free and TV–free transition time before hitting the hay. In fact, it’s even better if you can make your bedroom a technology-free zone. And just because you’re not using your cell phone before bed doesn’t mean that it can’t harm your sleep: Keeping a mobile within reach can still disturb slumber, thanks to the chimes of late-night texts, posts, emails, calls, or calendar reminders.

This is a growing and serious public health hazard that isn’t being adequately acknowledged and addressed by both the medical community and technology industries. About 72 percent of children ages six to 17 sleep with at least one electronic device in their bedroom, which leads to getting less sleep on school nights compared with other kids. The difference adds up to almost an hour per night, and the restful quality of their sleep is negatively affected too. To ensure a better night’s rest, parents should limit their kids’ technology use in the bedroom, and can be solid role models and improve their own health by doing the same.


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!

Stop blowing smoke – and vapor

Whether you’re an accomplished sports enthusiast or a weekend watcher, it was easy to get caught up in the excitement, drama and incredible teamwork on display in the MLB baseball Championship Series and the World Series.  And beyond the heartbreak, frustration, athleticism and celebration, there were no shortages of close-up shots of players and coaches spitting sunflower seeds, popping Bazooka gum bubbles, stuffing their cheeks with chewing tobacco, or placing pinches of smokeless tobacco in their mouths.

Paid television advertising for cigarettes might be controlled, but professional baseball is like a non-stop commercial for smokeless tobacco products . . . and kids notice and emulate their heroes. Researchers have discovered that about 3.5 percent of people aged 12 and older in the United States use smokeless tobacco — that’s about 9 million people. Use of smokeless tobacco was higher in younger age groups, with more than 5.5 percent of people aged 18 to 25 saying they were current users. About one million people age 12 and older started using smokeless tobacco in the year before the survey. About 46 percent of the new users were younger than 18 when they first used it.

The damages from smokeless tobacco products include throat, tongue, sinus, jaw, esophageal and mouth cancers, lesions, damage to teeth and gums, heart disease and stroke.

Additionally, startling numbers of young people start smoking cigarettes in their early teens and continue into adulthood. And the results are alarming – even with all we know about the perils and health risks associated with tobacco use, more than 45 million Americans still smoke cigarettes. There also are approximately 13.2 million cigar smokers in the United States, and 2.2 million who smoke tobacco in pipes.

More than half of cigarette smokers have attempted to quit for at least one day in the past year. Many of them turn to nicotine chewing gums or smoking-cessation drugs prescribed by their doctors. And over the past several years, the trend has been to vapes, or e-cigarettes, essentially nicotine-delivery systems that use a heated vapor that is inhaled by the consumer. These vapes have become hugely popular – they produce less second-hand smoke, are more discreet, and don’t contain the same high level of carcinogenic particulates found in regular tobacco. But they are still habit-forming, and their long-term use is suspect in terms of dangerous side effects.

November is Lung Cancer Awareness Month, and a good time to revisit the role tobacco products play in damaging health by contributing directly to lung cancer, other cancers and respiratory illnesses – diseases that also cost billions of dollars a year in lost-work-time and healthcare costs.

  • Tobacco contributes to 5 million deaths worldwide every year. For centuries, cigarettes have remained basically the same:  Tobacco rolled in paper. What makes them so deadly are the estimated 4,000 chemicals they give off when lit. Some of those chemicals, like arsenic, formaldehyde and lead can cause cancer and a long list of other deadly diseases.
  • Chewing tobacco comes as long strands of loose leaves, plugs, or twists of tobacco. Pieces, commonly called plugswads, or chew, are chewed or placed between the cheek and gum or teeth. The nicotine in the piece of chewing tobacco is absorbed through the mouth tissues. The user spits out the brown saliva that has soaked through the tobacco.
  • Snuff is used by placing a pinchdiplipper, or quid between the lower lip or cheek and gum. The nicotine in the snuff is absorbed through the tissues of the mouth. Moist snuff is also available in small, teabag-like pouches or sachets that can be placed between the cheek and gum. These are designed to be both “smoke-free” and “spit-free” and are marketed as a discreet way to use tobacco. Dry snuff is sold in a powdered form and is used by sniffing or inhaling the powder up the nose.
  • An e-cigarette is a battery-powered tube about the size and shape of a cigarette. A heating device warms a liquid inside the cartridge, creating a vapor you breathe in. Puffing on an e-cigarette is called “vaping” instead of “smoking.” E-cigarettes also make chemicals, but in much smaller numbers and amounts than tobacco cigarettes.
  • When you quit smoking or using products containing nicotine, risk of having a heart attack drops sharply after just one year, as does the risk of strokes and conditions such as ulcers, artery and respiratory disease, and cancers of the larynx, lung and cervix.

What you should know about e-cigarettes, or “vapes”

All e-cigarettes work basically the same way. Inside, there’s a battery, a heating element, and a cartridge that holds nicotine and other liquids and flavorings. Features and costs vary. Some are disposable. Others have a rechargeable battery and refillable cartridges.

The nicotine inside the cartridges is addictive. When you stop using it, you can get withdrawal symptoms including feeling irritable, depressed, restless and anxious. It can be dangerous for people with heart problems. It may also harm your arteries over time and contribute to respiratory ailments, heart disease and cancers. Additionally, the wide variety of non-nicotine flavors and additives found in e-cigarettes are now being tested, and researchers are finding dubious results, including danger to unborn children and reproductive systems, cancer risks, and the buildup of arterial plaque that can lead to heart disease and strokes.

Quitting is hard, but you can increase your chances of success with help. The American Cancer Society can tell you about the steps you may take to quit smoking, and provide resources and support that can increase your chances of quitting successfully. And if you have or know children, you’ll want to learn more about the dangers of alternative nicotine products, and how to help raise awareness and promote prevention.  To learn about available tools, call the American Cancer Society at 1-800-227-2345 or visit www.cancer.org.


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!

Tips for healthy skin

It’s getting cold out there. And faster than the plunging numbers on our bank’s digital thermometer, we can probably count the emerging hangnails, itchy dry patches, flaking scalp, rashes and a worsening of skin conditions like eczema or psoriasis wrought by the cold, dry air.

During flu and cold season, we’re also washing our hands more often than ever, which saps the natural oils in our skin, leaving hands, feet and other body parts dehydrated until they crack, peel and bleed. The skin barrier is a mix of proteins, lipids and oils. It protects our skin, and how good a job it does is largely genetic, but also a measure of environmental conditions. If we have a weak barrier, we’re more prone to symptoms of sensitive skin such as itching, inflammation and eczema. Our hands are also more likely to become very dry in winter if they’re constantly exposed to cold air, water, extreme heat or other environmental factors.

November is National Healthy Skin Month. Dry skin occurs when skin doesn’t retain sufficient moisture — for example, because of frequent bathing, use of harsh soaps, aging, or certain medical conditions. Wintertime poses a special problem because humidity is low both outdoors and indoors, and the water content of the epidermis (the outermost layer of skin) tends to reflect the level of humidity around it. Fortunately, there are many simple and inexpensive things we can do to relieve winter dry skin, also known as winter itch.

For example, scented, deodorant and anti-bacterial soaps can be harsh, stripping skin of essential oils. That’s why many skin care experts suggest using non-scented, mild cleansers or soap-free products like Aveeno, Cetaphil, Dove, Dreft, or Neutrogena.

A diet rich in healthy fats can be another crucial element in our fight against dry, itchy skin. That’s because essential fatty acids like omega-3s help make up our skin’s natural, moisture-retaining oil barrier. Too few of these healthy fats can not only encourage irritated, dry skin, but leave us more prone to acne, too.

We can achieve an essential fatty acid boost with omega-3-rich foods like flax, walnuts, and safflower oil, as well as cold-water fish such as tuna, herring, halibut, salmon, sardines, and mackerel.

Another common culprit is dry indoor air, which can really irritate our skin.  Using a humidifier to pump up the moisture, or even surrounding ourselves with indoor plants helps keep the indoor air moist. Dermatologists suggest aiming for an indoor moisture level between 40 percent and 50 percent. Investing in an inexpensive hygrometer (humidity monitor) can help us keep track of our house’s humidity.

Skin moisturizers, which rehydrate the epidermis and seal in the moisture, are the first step in combating dry skin. In general, the thicker and greasier a moisturizer, the more effective it will be. Some of the most effective (and least expensive) are petroleum jelly and moisturizing oils (such as mineral oil), which prevent water loss without clogging pores. Because they contain no water, they’re best used while the skin is still damp from bathing, to seal in the moisture. Other moisturizers contain water as well as oil, in varying proportions. These are less greasy and may be more cosmetically appealing than petroleum jelly or oils.

Dry skin becomes much more common with age — at least 75 percent of people over age 64 have dry skin. Often it’s the cumulative effect of sun exposure; sun damage results in thinner skin that doesn’t retain moisture. The production of natural oils in the skin also slows with age; in women, this may be partly a result of the postmenopausal drop in hormones that stimulate oil and sweat glands. The most vulnerable areas are those that have fewer sebaceous (or oil) glands, such as the arms, legs, hands, and middle of the upper back.

Here are useful tips for combating dry skin:

  • Use a humidifierin the cold-weather months. Set it to around 60 percent, a level that should be sufficient to replenish the top layer of the epidermis.
  • Limit yourself to one 5- to 10-minute bath or shower daily. Use lukewarm water rather than hot water, which can wash away natural oils.
  • Minimize the use of soaps— replace them with super-fatted, fragrance-free soaps, whether bar or liquid, for cleansing, and moisturizing preparations such as Dove, Olay, and Basis. Also consider soap-free cleansers like Cetaphil, Oilatum-AD, and Aquanil.
  • To reduce the risk of trauma to the skin, avoid bath sponges, scrub brushes, and washcloths.
  • Apply moisturizerimmediately after bathing or after washing hands. This helps plug the spaces between our skin cells and seal in moisture while our skin is still damp.
  • Try not to scratch! Most of the time, a moisturizer can control the itch. Also use a cold pack or compress to relieve itchy spots.
  • Use sunscreenin the winter as well as in the summer to protect against dangerous ultra-violet rays and aging.
  • When shaving,use a shaving cream or gel and leave it on the skin for several minutes before starting.
  • Wear gloves and hatswhen you venture outdoors, and latex or rubber gloves when you wash dishes and clothes.
  • Stay hydrated– no matter the season, you need to drink plenty of water, and be careful about caffeine and alcohol products, which dry you out.

We can’t do much about the colder weather that doesn’t include moving south or west, but we can control what we put on our bodies and how we treat our skin!


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 Bones Have It

People say change is constant, and that’s certainly no exception when it comes to our bones.  New bone is made and old bone is broken down. When we’re young, our body makes new bone faster than it breaks down old bone, increasing bone mass. Most people reach their peak bone mass around age 30. After that, we lose more bone mass than we gain.

Osteoporosis is a condition that causes bones to become weak and brittle, making them easier to fracture or break. Our likelihood of developing osteoporosis depends on how much bone mass we attain by the time we reach age 30 and how rapidly we lose it after that. The higher our peak bone mass, the less likely we are to develop osteoporosis as we age.

Obviously, it’s important to take steps now so our bones will be healthy and strong throughout our lifetime.  Unless you have a time machine there’s no going back, so protecting what we have now is the smart play.

We can build strong bones by getting enough calcium and weight-bearing physical activity during the tween and teen years, when bones are growing the fastest. Young people in this age group have calcium needs that they can’t make up for later in life. In the years of peak skeletal growth, teenagers build more than 25 percent of adult bone. By the time teens finish their growth spurts around age 17, 90 percent of their adult bone mass is established.

Don’t Overdraw Your Calcium Bank

Since our bodies continually remove and replace small amounts of calcium from our bones, stemming the loss of calcium is important. After age 18, we can’t add more calcium to bones, but can try to maintain what is already stored to help our bones stay healthy.

Calcium is found in a variety of foods. Low-fat and fat-free milk and other dairy products are great sources of calcium. Tweens and teens can get most of their daily calcium from three cups of low-fat or fat-free milk, but they also need additional servings of calcium to get the 1,300 mg necessary for strong bones.

Other good sources of calcium include dark green, leafy vegetables such as spinach, broccoli and bok choy.  Other sources of calcium include almonds, broccoli, kale, canned salmon with bones, sardines and soy products such as tofu. If you find it difficult to get enough calcium from your diet, ask your doctor about supplements.

There also are foods with calcium added, such as calcium-fortified tofu, orange juice, soy beverages, and breakfast cereals or breads. Adults or kids who can’t process lactose also can take calcium supplements, but should check with their physician to ensure compatibility with other medicines or conditions.

When muscles push and tug against bones during physical activity, bones and muscles become stronger. Weight-bearing exercises, such as walking, jogging, tennis and climbing stairs can help build strong bones and slow bone loss. So exercise, as well as proper nutrition, play vital roles in helping us build and maintain healthy bones at any age.

A number of additional factors can affect bone health.

  • Tobacco and alcohol use. Research suggests that tobacco use contributes to weak bones. Similarly, having more than two alcoholic drinks a day increases the risk of osteoporosis, possibly because alcohol can interfere with the body’s ability to absorb calcium.
  • Gender, size and age. You’re at greater risk of osteoporosis if you’re a woman, because women have less bone tissue than do men. You’re also at risk if you’re extremely thin (with a body mass index of 19 or less) or have a small body frame, because you may have less bone mass to draw from as you age. Also our bones become thinner and weaker as we age.
  • Race and family history. You’re at greatest risk of osteoporosis if you’re white or of Asian descent. In addition, having a parent or sibling who has osteoporosis puts you at greater risk — especially if you also have a family history of fractures.
  • Hormone levels. Too much thyroid hormone can cause bone loss. In women, bone loss increases dramatically at menopause due to dropping estrogen levels. Prolonged absence of menstruation before menopause also increases the risk of osteoporosis. In men, low testosterone levels can cause a loss of bone mass.
  • Eating disorders and other conditions. People who have anorexia or bulimia are at risk of bone loss. In addition, stomach surgery (gastrectomy), weight-loss surgery and conditions such as Crohn’s disease, celiac disease and Cushing’s disease can affect our body’s ability to absorb calcium.
  • Certain medications. Long-term use of corticosteroid medications, such as prednisone, cortisone, prednisolone and dexamethasone, are damaging to bone. Other drugs that may increase the risk of osteoporosis include aromatase inhibitors to treat breast cancer, selective serotonin reuptake inhibitors, methotrexate, some anti-seizure medications and proton pump inhibitors.

In summation, to help prevent or slow bone loss, include plenty of calcium in your diet, pay attention to vitamin D, include physical activity in your daily routine, and avoid smoking tobacco products or drinking too much alcohol. The health of our bones, in a manner of speaking, is in our own hands!


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!

Look Into Your Phone and Say “Aaahhh”

For those of us old enough to remember The Jetsons, their flying car was only one of the many futuristic perks imagined way back in 1962 by the show’s creative producers, Hanna-Barbera. The pioneering duo also foretold holographs, robot servants, talking computers . . . and tele-medicine!

Their version of remote diagnostic care was to have a family member stick their arm in a portal in the wall, which would “read” their symptoms and offer a diagnosis. As far-fetched as that might have seen back in the day, today it’s far closer to reality. Patients with congestive heart failure, diabetes and other ailments can step on automated scales in their homes, which measure their weight and send the data electronically to monitoring services. An appreciable weight loss or gain could indicate a problem – it’s flagged by the system, and a nurse then calls the patient to check in. People also can have their blood pressure, heart rate and sugar levels checked remotely using electronic sensors, communicate online with their physician’s offices, and access a wide variety of personal medical information and history via private electronic portals.

More than 15 million Americans received some kind of medical care remotely last year, according to the American Telemedicine Association, a trade group, which expects those numbers to grow by 30 percent this year. And according to the American Academy of Family Physicians, 41 percent of family practice physicians use electronic portals for secure messaging, another 35 percent use them for patient education, and about one-third use them for prescribing medications and scheduling appointments.

For all the rapid growth, however, significant questions and challenges remain. Physicians groups are issuing different guidelines about what care they consider appropriate to deliver in what forum. Complicating matters, rules defining and regulating telemedicine differ widely from state to state and are constantly evolving. In Connecticut, for instance, physicians cannot be compensated for services provided over the telephone, via fax or electronically, and are not allowed to prescribe controlled substances through tele-health services.

Another huge hurdle is physician compensation. Legislation today severely limits telemedicine. And without financial incentives to provide care electronically, physicians are reluctant to get onboard, especially since health insurance, which varies from plan to plan, covers only a narrow range of electronic services.

The future of telemedicine in the United States will depend on how regulators, providers, payers and patients can address these challenges, and the issue of quality versus convenience.  For example, there are a variety of on-line services now available where a patient can connect with a clinician for one-time phone, video or email visits on demand. These, typically, are for non-urgent-care issues such as colds, rashes and headaches. They cost far less than a trip to a physician’s office, or to an urgent care center or hospital.

Many large employers and their insurance providers are offering these services to the employees as a cost-saving alternative.  However, these services lack the bonds of trust and communication that are built over time between patient and caregiver, and can’t replace the value of a personal physician or health expert listening to your heart or lungs, peering into your throat, eyes or ears, drawing a culture sample or tapping other in-person diagnostic skills.

Over the past year, more than 200 telemedicine-related bills have been introduced in 42 states, many regarding what services Medicaid will cover and whether payers should reimburse for remote patient monitoring as well as store-and-forward technologies (where patients and doctors send records, images and notes at different times), in addition to real-time phone or video interactions. Medicare, the federal health plan for the elderly, covers a small number of telemedicine services — only for beneficiaries in rural areas, and only when the services are received in a hospital, doctor’s office or clinic.

There are many additional challenges. Everyone is looking at how to manage state’s rights against national priorities and demands, never an easy task. Malpractice issues are complicated, and many physicians simply do not feel comfortable rendering services online or via a phone. Still, every day brings new technologies, legislation and efforts to respond to changing patient and physician needs.

When you look at emerging smart phone technology and the portable monitoring devices we now wear on our wrists to monitor steps, sleep, heart rate and more, it’s easy to imagine how quickly future generations of health monitoring tools will evolve. And it’s probably a safe bet that we’ll be using them to help manage our health long before we’re flying to work in our own personal aero-cars!


 

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!

Using Steroids Safely and Appropriately

The use of steroids and other natural and synthetic substances by professional athletes often is in the news.  Used primarily for building muscle mass and expanding strength and endurance, these drugs, many obtained illegally, give users an “edge” that is considered unfair.  Many Russian athletes were not allowed to compete in this summer’s Olympic Games in Rio due to their use of banned drugs, and controversy has swirled around famous baseball players, runners and biking legend Lance Armstrong over their use of steroids and other performance-enhancing supplements.  But there are many kinds of steroids, including those used by physicians to treat allergies, asthma, arthritis and many chronic illnesses.

Steroids, known medically as corticosteroids, can reduce inflammation associated with allergies, rashes or itching. They prevent and treat nasal stuffiness, sneezing, and runny nose due to seasonal or year-round allergies. They can also decrease inflammation and swelling from other types of reactions.

Systemic steroids are available in various forms as pills or liquids for serious allergies or asthma, locally acting nasal sprays for seasonal or year-round allergies, topical creams for skin allergies, or topical eye drops for allergic conjunctivitis.

Steroids are highly effective drugs for allergies, but they must be taken regularly, often daily, to be of benefit — even when you aren’t feeling allergy symptoms. In addition, it may take one to two weeks before the full effect of the medicine can be felt.

Steroids are used for reducing joint or bone inflammation and for battling osteoporosis. They also are known to increase recovery times in individuals dramatically. Cortisol is a hormone which is produced inside our body to help it handle stress. Cortisol is responsible for causing damage to muscle tissues and slowing down the time taken for a human body to recuperate. Steroids are known to regulate the production of this hormone when an individual’s body is stressed. This helps bodies to recover from sustained injuries a lot faster than normal and allows more stamina while an individual is exercising.

Of note, potential side effects from oral steroids may include insomnia, increased appetite and weight gain, high blood pressure, lowered immune system resistance, stomach irritation and water retention.

Anabolic steroids were developed in the late 1930s primarily to treat hypogonadism, a condition in which the testes do not produce sufficient testosterone for normal growth, development, and sexual functioning. The primary medical uses of these compounds are to treat delayed puberty, some types of impotence, and wasting of the body caused by HIV infection, cancer or other diseases.

The dangers of steroid abuse

When we take small, prescribed doses of steroids for a short time in response to an inflammation or allergic reaction, our bodies eliminate or flush most of the residual compounds. However, people who abuse anabolic steroids usually take them orally or inject them into the muscles, where they remain for longer periods of time, and travel to our brains and other organs. These doses may be 10 to 100 times higher than doses prescribed to treat medical conditions. Steroids are also applied to the skin as a cream, gel, or patch.

Anabolic steroids do not have the same short-term effects on the brain as do other abused drugs. The most important difference is that steroids do not trigger rapid increases in the brain chemical dopamine, which causes the “high” that drives people to abuse other substances. However, long-term steroid abuse can act on some of the same brain pathways and chemicals — including dopamine, serotonin, and opioid systems — that are affected by other drugs. This may result in a significant effect on mood and behavior.

Abuse of anabolic steroids also may lead to mental problems, such as:

  • Paranoid (extreme, unreasonable) jealousy
  • Extreme irritability
  • Delusions (false beliefs or ideas)
  • Impaired judgment

Extreme mood swings can also occur, including “roid rage” — angry feelings and behavior that may lead to violence. Additionally, anabolic steroid abuse may lead to serious, even permanent, health problems such as:

  • Kidney problems or failure
  • Liver damage
  • Enlarged heart, high blood pressure, and changes in blood cholesterol, all of which increase the risk of stroke and heart attack, even in young people

As with most medicines, supplements or drugs, steroids should be taken under the direction of a physician or medical professional. When used properly and as prescribed, they are incredibly effective and valuable. When abused or taken improperly, they can lead to a variety of negative side effects and behaviors with potentially long-term and life-threatening consequences.


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!

All the Dirt on Antibacterial Soaps, Colds, and the Flu

The long hot days of summer have blown by as if propelled by Hurricane Hermine’s winds. The sun sets earlier, sugar maples are starting to tinge, and the evenings already bear traces of autumn chill. September is upon us – the kids are back in school, pumpkins are showing up in the supermarkets, and the “Get your flu shot here” signs are appearing all around us. Sadly, colds, influenza, and throat, ear and sinus infections can’t be far behind.

With kids and adults in close proximity, poor hand-washing habits, and everyone sneezing around us, our natural immunities to bacterial and viral infections are taxed, leaving us more likely to contract a variety of illnesses. The late summer and early fall also bring a resurgence in seasonal allergies. Sometimes it’s hard to tell one malady from another  . . . with the aches and pains, runny noses, itchy throats and increased body temperature, we’re off to the doctor in search of an antibiotic, or searching at the drug store for magic pills to cure or, at the least, relieve us.

Many of the illnesses that wreak havoc in the autumn and winter are caused by bacteria or viruses, and it’s important to know the difference. Bacteria are single-celled organisms usually found all over the inside and outside of our bodies, except in the blood and spinal fluid. Many bacteria are not harmful. In fact, some are actually beneficial. However, disease-causing bacteria trigger illnesses such as strep throat and some ear infections. Viruses are even smaller than bacteria. A virus cannot survive outside the body’s cells. It causes illnesses by invading healthy cells and reproducing.

Antibiotics are our chosen line of offense against many types of infections, but they don’t work against all. For example, we should not treat viral infections such as colds, the flu, sore throats (unless caused by strep), most coughs, and some ear infections with antibiotics.

Antibiotics are drugs that fight infections caused by bacteria. After the first use of antibiotics in the 1940s, they transformed medical care and dramatically reduced illness and death from infectious diseases. The term “antibiotic” originally referred to a natural compound produced by a fungus or another microorganism that kills bacteria which cause disease in humans or animals. Although antibiotics have many beneficial effects, their use has contributed to the problem of antibiotic resistance, which is the ability of bacteria or other microbes to resist the effects of an antibiotic.

Antibiotic resistance occurs when bacteria change in some ways that reduce or eliminate the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply causing more harm. Almost every type of bacteria has become stronger and less responsive to antibiotic treatment. These antibiotic-resistant bacteria can quickly spread to family members, schoolmates and co-workers, threatening the community with a new strain of infectious disease that is more difficult to cure and more expensive to treat.

According to the Centers for Disease Control (CDC), the single most important thing we can do to keep from getting sick and spreading illness to others is to clean our hands. As we touch people, surfaces, and objects throughout the day, we accumulate germs on our hands. In turn, we can infect ourselves with these germs by touching our eyes, nose, or mouth and food.

Although it’s impossible to keep our hands germ-free, washing hands frequently helps limit the transfer of bacteria, viruses, and other microbes. According to CDC research, some viruses and bacteria can live from 20 minutes up to two hours or more on surfaces like cafeteria tables, doorknobs, ATM machines and desks. So wash before and after using a restroom. Wash after visiting the supermarket, ride a bus or train, or using an ATM. When it isn’t easy to wash, use a hand sanitizer. Don’t use anyone else’s toothbrush, and avoid sharing food, drinks or eating off of one another’s plates. And in late-breaking news, stop using antibacterial soaps and products – they aren’t useful in protecting you, and are causing more damage than good.

Antibacterial soaps aren’t good for us

The Food and Drug Administration (FDA) recently banned the sale of soaps containing certain antibacterial chemicals, saying industry had failed to prove they were safe to use over the long term or more effective than using ordinary soap and water.

In all the FDA took action against 19 different chemicals and has given industry a year to take them out of their products. About 40 percent of soaps – including liquid hand soap and bar soap – contain the chemicals. Triclosan, mostly used in liquid soap, and triclocarban, in bar soaps, are by far the most common.

The rule applies only to consumer hand washes and soaps. Other products may still contain the chemicals. The agency is also studying the safety and efficacy of hand sanitizers and wipes, and has asked companies for data on three active ingredients – alcohol (ethanol or ethyl alcohol), isopropyl alcohol and benzalkonium chloride – before issuing a final rule on them.

This decision comes after years of mounting concerns that the antibacterial chemicals that go into everyday products are doing more harm than good. Health experts have pushed the agency to regulate antimicrobial chemicals, warning that they risk damaging hormones in children and promote drug-resistant infections. Additionally, studies in animals have shown that triclosan and triclocarban can disrupt the normal development of the reproductive system and metabolism, and health experts warn that their effects could be the same in humans.

The chemicals were originally used by surgeons to wash their hands before operations. Their use has expanded significantly in recent years as manufacturers added them to a variety of products, including mouthwash, laundry detergent, fabrics and baby pacifiers. The CDC reports the chemicals from antibiotic soaps are found in the urine of three-quarters of Americans, one of the many factors they considered in issuing the ban.

The surest bet for a healthy fall and winter is to be vigilant about hand washing, and to take reasonable precautions such as getting flu shots (note that the CDC is questioning the effectiveness of the nasal spray version of the flu vaccine for the 2016/2017 flu season) and avoiding people who are coughing, feverish or obviously ill. When sick, try to stay home from work or school to avoid spreading the joy, and seek medical care if you feel you may require antibiotics or other medicinal remedies. You also can speak with your physician about antibiotic resistance, or take the time to learn more about this important subject by visiting reliable websites such as www.cdc.gov.


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!