Become an Informed Healthcare Consumer

Purchasing a new or used car normally involves advance research on make, model, performance history, mileage, and resale value. We examine color options and accessories, visit showrooms or car lots, review consumer reports on the vehicle type, and peruse online feedback about the dealer or vehicle we’re considering. By the time we sit down with a salesperson, we’re reasonably well informed, know what we want, have figured out how we’re going to pay for it, and are ready to make a deal and write a check.

Now compare that process to preparing for surgery. Typically, patients listen to their physician’s advice, see the specialists he or she refers them to, complete any required pre-surgical preparation such as drawing blood, fasting or stopping certain medications, and then have their surgery. The more curious among us might do some research online at a variety of websites to learn more about our procedure, options or recovery tips. But most patients still rely primarily on information their doctor gives them, verbally or in print, and get advice from neighbors, family and work associates.

Apparently, we’re a relatively trusting lot when it comes to surgery. But when you consider the potential outcomes, costs, risks and long-term consequences, don’t you wonder why we are so much better informed and prepared to buy a car then to go under the knife?

Approximately 51 million Americans have elective or emergency surgical procedures performed in hospitals, outpatient surgical centers or their physician’s offices annually. That’s everything from cataracts and colonoscopies to angioplasty, caesarean sections, hysterectomies, knee and hip replacement, tissue removal and you name it . . . if you have a part that isn’t working properly, it can likely be removed, subdued, or improved!

But the psychology of obtaining surgery differs greatly from auto purchases, and three primary factors – trust, perceived boundaries and a lack of reliable, useful information – hinder our ability to be informed and properly engaged.

First, trust. We have confidence in our physician and the specialists, hospitals or clinical settings he or she sends us to. Typically that’s been established over years of visits and care, or is limited by cost or type of insurance. If our regular doc sends us to a specialist he or she knows and trusts, that’s good enough for us. And with the labyrinth of insurance issues our provider helps manage prior to a surgical procedure, we’re happy to leave it all in their hands and be compliant.

Second, boundaries. They’re the experts with years of medical school and training, we’re the patients. Many healthcare consumers lack the medical knowledge and chutzpah to ask tough, insightful or truly probing questions. We don’t want to be perceived as troublesome, annoying patients, or risk insulting our physicians with stupid, anxious or paranoid questions. It’s bad enough when an electrician or plumber treats us as though we’re an inconvenience – why risk feeling that way with a physician when your life is going to be in his or her hands?

And finally, there’s the lack of reliable, useful information. When it comes to specifics on doctors and hospitals, there simply isn’t much available data when it comes to quality, outcomes and performance histories. Hospital and medical rating systems managed by private, State and federal agencies exist for measuring provider and hospital performance, but they keep this information close to the vest. The data is used for addressing safety and medical errors, and for determining how the government reimburses hospitals and physicians, but it isn’t public knowledge.

This conspiracy of silence is endemic to the industry, and is driven, in part, by litigation and malpractice fears. There have been efforts to try and capture and publish some related metrics – items such as infection rates, “avoidable” readmissions to hospitals within 30 days, surgical errors – but this information is tightly guarded, and difficult if not impossible to access. Some government healthcare programs, like Medicare, make certain information available on specific procedures, but it’s not easy for the layperson to find or understand. And there aren’t any simple-to-understand, straightforward websites or annual reporting mechanisms available to consumers.

So what can you do to be a better medical consumer? Ask smart, direct questions, and do some research prior to meeting with the physician. Here are some examples of questions to ask before surgery:

  • How many times and how often have you done this procedure? This is important because high-volume practitioners have more experience and may be better able to deal with unexpected problems or emergencies.
  • How experienced is the team you will work with at the hospital or clinic? Chemistry and longevity in the operating room is an important variable, and good communication among surgical team members enhances outcomes.
  • Can the facility you’re considering for surgery handle unexpected complications? For example, if you experience a heart problem during surgery, does the facility have the staff onsite necessary to address this complication? Does the facility have a trauma center for adults or infants, or more comprehensive diagnostic imaging tools?
  • What are the potential side effects or outcomes?
  • What can I do to limit or control potential side effects, or to hasten recovery?
  • What are the exact costs or co-payments for this surgery? It’s important to understand exactly what the insurance provider, if you’re covered, will pay for and what you will be expected to contribute for your care.
  • Where can I get more information on this procedure? Ask the physician for specific web addresses or other sources of information that may be helpful.
  • Can this be done through less-invasive surgery, such as laparoscopy or robotics? Physicians practicing at some smaller hospitals may lack the experience for minimally invasive procedures, or the hospital may not be able to afford certain types of surgical tools and expensive equipment. The difference in recovery time, pain and potential complications can be significant, so it’s worth inquiring about before you proceed.
  • What will I require for post-surgical care? This may include physical rehabilitation, a short-term stay in a step-down unit, a variety of follow-up visits, home care assistance, medications and a comprehensive list of foods or activities to limit or avoid.
  • What forms and releases will I be expected to complete at the hospital or surgical center? Even though your physician will have you complete pre-surgical paperwork, most facilities ask you or your guardian to sign a variety of releases immediately prior to the procedure, often when you’re at your height of pre-surgical anxiety, and distracted. Asking in advance may help you pose intelligent questions and not feel pressured.

If your provider balks at these questions or offers ambiguous or evasive answers, you might consider another physician. Remember, you don’t want to be thinking about these issues as you’re lying on the gurney being rolled into surgery, and hindsight is always 20/20! The better you’re prepared and engaged in your care in advance, the better the experience for you and your medical team. It’s not just about competence – it’s about being an informed consumer, and making sure you know what you’re buying.

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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!

Diet and Colorectal Cancer

Diet plays an integral role in keeping us healthy. But beyond strong bones, eyes and teeth, a proper diet also helps prevent or reduce the likelihood of contracting a number of serious illnesses, including many kinds of cancers. One specific example is colon (colorectal) cancer, which kills more than 50,000 men and women a year in the United States alone.

Excluding skin cancers, colorectal cancer is the third most commonly diagnosed cancer.  American Cancer Society estimates for the number of newly diagnosed U.S. colon cancer cases exceeds 103,000 men and women, and another 37,000 will be diagnosed with rectal cancer.

Studies suggest that diet is a key contributor to colon cancer risk. Colon cancer is most prevalent in Westernized societies, where diets are higher in animal products and processed foods and lower in unrefined plant foods.  The cells lining the intestinal tract come into direct contact with what we choose to eat, and the substances contained in our food can have profound effects on these cells and tissues. The protective value of fruits and vegetables has been established by several studies following subjects for years, keeping track of dietary patterns and colon cancer diagnoses.

Our nutritional choices can help prevent colon cancer, especially if our diet includes more vegetables and fruits and less refined and processed foods. Nutritious foods are very rich in fiber, and disease-causing foods are generally fiber-deficient. Several food components that may modulate colon cancer risk have been identified: Fiber, omega-3 and -6 fatty acids, and certain antioxidants, vitamins, and minerals all play a partial role. Red meat and processed meats are the most cancer causing, but all meats and dairy products do not contain any fiber, and are also lacking in anti-oxidants and phytochemicals. Foods made from refined grains (such as white bread, white rice, and pasta) are also not only fiber deficient but void of micronutrients and phytochemicals as well – these foods are also associated with colon and rectal cancers.

Prevention starts with awareness

March is Colorectal Cancer Awareness Month, and the perfect time to become familiar with risk factors and prevention. Risk factors include:

  • Age 50 or older
  • A family history of cancer of the colon or rectum
  • A personal history of cancer of the colon, rectum, ovary, endometrium, or breast
  • History of polyps in the colon
  • A history of ulcerative colitis (ulcers in the lining of the large intestine) or Crohn’s disease
  • Eating a diet high in fat (especially from red meat)
  • Obesity
  • Smoking
  • Alcohol use

The prognosis and chance of recovery following a colon cancer diagnosis depends on several items, including the stage of the cancer when discovered, damage it may have already caused, blood chemistry and a patient’s general health. If you experience any stomach discomfort, bleeding in your stool, or sudden weight loss, contact your physician immediately.

Beginning at age 50 (age 45 for African Americans), both men and women at average risk for developing colorectal cancer should receive a screening test. These tests are designed to find both early cancer and polyps. There are simple blood and stool tests, and surgical testing such as colonoscopies can be done virtually (using diagnostic imagery) or surgically. Talk to your doctor about which test is best for you.

People once thought that there was little that they could do to protect themselves against cancer. But we’ve learned more about how the disease develops and what biological and environmental factors increase cancer risk. We now have better weapons for fighting the disease, including more options for diagnosis and treatment, improved therapies and new technologies for early detection.

In a world where so much is beyond our control, it’s nice to know that we can still make smart choices that are likely to improve or maintain our health. Research suggests that up to 35 percent of cancers are related to poor diet. Choosing a diet rich in nutrient-dense plant foods like vegetables, fruits, beans, nuts, and seeds is a simple step we can take to protect ourselves and our loved ones against colon cancer. And by remaining active and exercising regularly, we can reduce our risk of cancer and other health problems.

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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!

Understanding thyroid health

The thyroid — a small, butterfly-shaped gland located in our lower neck below our voice box — has enormous responsibility for our body’s metabolic processes. Specifically, our thyroid releases two primary hormones — triiodothyronine (T3) and thyroxine (T4) — that control metabolism.

When working properly, the T3 and T4 hormones travel through our bloodstream and help cells get energy from the food we eat. Thyroid hormones are also responsible for helping to regulate our body temperature and blood calcium levels, helping with growth and development and, during infancy, brain development.

For an estimated 27 million Americans, however, the thyroid produces either too much or too little hormone, which causes an array of health symptoms, some severe. January is Thyroid Awareness Month. Because thyroid disease is often misdiagnosed or simply overlooked, it’s estimated that more than half of affected Americans don’t know they have a problem.

The thyroid constantly releases hormones into the blood, helping to regulate many bodily functions.  Additional hormones are produced when the body needs more energy in certain situations.

Women are much more likely to have thyroid problems than men, and may have up to a one in five chance of developing thyroid problems during their lifetime. The risk increases with age and family history, as well as having an autoimmune disease or a close relative with one; through radiation exposure; by going through menopause or perimenopause; or following childbirth.

Hypothyroidism (underactive thyroid) accounts for the majority of thyroid disease cases — up to 80 percent according to some estimates. This condition occurs when our body produces too little thyroid hormone, leading to symptoms such as fatigue and general sluggishness; unexplained weight gain or increased sensitivity to cold; pain, stiffness or swelling in joints; muscle aches and weakness; heavy menstrual periods; depression; brittle hair and nails; and elevated blood cholesterol.

If left untreated, hypothyroidism can lead to obesity, joint pain, infertility, goiter (thyroid enlargement) and heart disease, but because the symptoms can mimic other diseases, or even be attributed to aging, many people do not realize the thyroid connection. Further, the symptoms may be mild at first, becoming increasingly severe only after a number of years, making them easy to overlook.

A blood test that measures our levels of thyroid-stimulating hormone (TSH) is typically used to diagnose hypothyroidism, and treatment usually involves taking a synthetic or natural thyroid hormone daily.

In contrast, hyperthyroidism results from an overactive thyroid. Symptoms include weight loss; nervousness, anxiety and irritability; increased perspiration; racing heart, hand tremors; difficulty sleeping; increased bowel movements; and muscle weakness, especially in the upper arms or thighs.

A TSH blood test can typically diagnose hyperthyroidism, and the condition is usually treated with anti-thyroid drugs that block the gland’s ability to produce thyroid hormone. Other treatments include surgery, or radioactive iodine, which destroys overactive thyroid cells.

Diet and thyroid health

As with virtually every bodily function, our diet plays a role in the health of our thyroid. There are some specific nutrients that the thyroid depends on and it’s important to include them in our diet:

  • Iodine: Our thyroid contains the only cells in our body that absorb iodine, which it uses to make critical hormones. Without sufficient iodine, the thyroid cannot produce adequate hormones to help our body function on an optimal level. Iodine deficiency is not that common in the United States because of the prevalent use of iodized salt. However, according to the CDC, up to 36 percent of women of childbearing age may not get enough iodine from their diets,and it’s thought that iodine deficiency is on a slow but steady rise.
  • Selenium: This mineral is critical for the proper functioning of our thyroid gland, and is used to produce and regulate an important hormone. Selenium can be found in foods such as shrimp, snapper, tuna, cod, halibut, calf’s liver, button and shitake mushrooms and Brazil nuts.
  • Zinc, Iron and Copper: These metals are needed in trace amounts for healthy thyroid function. Low levels of zinc have been linked to low levels of TSH, and iron deficiency has been linked to decreased thyroid efficiency. Copper is also necessary for the production of thyroid hormones.Foods such as calf’s liver, spinach, mushrooms, turnip greens and Swiss chard can help provide these trace metals in our diet.
  • Omega-3 Fats: These essential fats, which are found in fish or fish oil, play an important role in thyroid function, and many help our cells become sensitive to thyroid hormone.
  • Coconut Oil: Coconut oil is made up of mostly medium-chain fatty acids, which may help to increase metabolism and promote weight loss, along with providing other thyroid benefits.This is especially beneficial for those with hypothyroidism.
  • Antioxidants and B Vitamins: The antioxidant vitamins A, C and E can help our body neutralize oxidative stress that may damage the thyroid. In addition, B vitamins help to manufacture thyroid hormone and play an important role in healthy thyroid function.

Finally, there are certain foods that should be avoided to protect our thyroid function. These include:

  • Aspartame: There is concern that the artificial sweetener aspartame, sold under the brand name NutraSweet, may trigger Graves’ disease and other autoimmune disorders in some people. The chemical also may trigger an immune reaction that causes thyroid inflammation and thyroid autoantibody production.
  • Non-fermented Soy: Soy is high in isoflavones, which are goitrogens, or foods that interfere with the function of our thyroid gland. Soy, including soybean oil, soy milk, soy burgers, tofu and other processed soy foods, may lead to decreased thyroid function. Fermented soy products, including miso, natto, tempeh and traditionally brewed soy sauce are safe to eat, as the fermentation process reduces the goitrogenic activity of the isoflavones.
  • Gluten: Gluten is a potential goitrogen and can also trigger autoimmune reactions in people who are sensitive. Gluten is found in wheat, rye and barley, along with most processed foods.
  • Isothiocyanates found in cruciferous vegetables like broccoli, cauliflower, cabbage and Brussels sprouts are goitrogens as well. While large amounts of these vegetables, eaten raw, could interfere with thyroid function, they offer many other health benefits that make the benefits outweigh the risks for most people. If you know you have thyroid disease and want to be especially careful, steaming these vegetables will negate the goitrogenic effect, making them a healthy addition to your diet.

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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!

Still smoking?

Autumn and winter bring special breathing challenges for many Americans. Dry heat from central heating systems aggravates respiratory issues, and the air becomes even drier when homeowners use wood-burning stoves, space heaters, and fireplaces. When you add to this potent mix the negative effects of smoking tobacco products, breathing becomes more intense for smokers and nonsmokers alike, especially when driven indoors where windows in houses, offices and vehicles are closed up.

November is COPD Awareness Month and Lung Cancer Awareness Month. It’s not a coincidence that the two are recognized together. The primary cause of chronic obstructive pulmonary disease (COPD) is the inhalation of cigarette smoke. Up to 24 million Americans show impaired lung function, which is common among those with COPD, the third-leading cause of death in the United States. It’s a staggering number — more than 12 million Americans have been diagnosed with COPD, while an estimated 12 million more have it, but have not been diagnosed.

Tobacco use remains the single largest preventable cause of disease and premature death in the United States, yet more than 45 million Americans still smoke cigarettes. Half of all smokers who keep smoking will end up dying from a smoking-related illness. In the United States alone, smoking is responsible for nearly one in five deaths, and about 8.6 million people suffer from smoking-related lung and heart diseases.

There also are approximately 13.2 million cigar smokers in the U.S., and 2.2 million who smoke tobacco in pipes. However, more than half of these smokers have attempted to quit for at least one day in the past year.

Still smoking?

Nearly everyone knows that smoking can cause lung cancer, but few people realize it is also linked to a higher risk for many other kinds of cancer too, including cancer of the mouth, nose, sinuses, lip, voice box (larynx), throat (pharynx), esophagus, bladder, kidney, pancreas, ovary, cervix, stomach, colon, rectum, and acute myeloid leukemia.

Smokers are twice as likely to die from heart attacks as non-smokers. Smoking is a major risk factor for peripheral vascular disease, a narrowing of the blood vessels that carry blood to the leg and arm muscles. Smoking also affects the walls of the vessels that carry blood to the brain (carotid arteries), which can cause strokes. Smoking can cause abdominal aortic aneurysm, in which the layered walls of the body’s main artery (the aorta) weaken and separate, often causing sudden death. And men who smoke are more likely to develop erectile dysfunction (impotence) because of blood vessel disease.

Based on data collected in the late 1990s, the U.S. Centers for Disease Control and Prevention (CDC) estimated that adult male smokers lost an average of 13.2 years of life and female smokers lost 14.5 years of life because of smoking.

Each year, smoking causes early deaths of about 443,000 people in the United States. And given the diseases that smoking can cause, it can steal our quality of life long before we die. Smoking-related illness can limit our activities by making it harder to breathe, get around, work, or play.

Why quit now?

No matter how old you are or how long you’ve smoked, quitting can help you live longer and be healthier. People who stop smoking before age 50 cut their risk of dying in the next 15 years in half compared with those who keep smoking. Ex-smokers enjoy a higher quality of life. They have fewer illnesses like colds and the flu, lower rates of bronchitis and pneumonia, and feel healthier than people who still smoke.

If you have any habits at all, you know how hard it is to break cycles, cravings and addictions. Humiliating, shaming or punishing smokers isn’t the answer – we’re all adults here, and like it or not, it’s not illegal to smoke, just to smoke in certain places.

But there are several steps we can take to improve our health and longer-term quality of life. The most important is to quit smoking immediately and keep as physically fit as possible. Keeping active is essential for improved breathing function, and pulmonary rehabilitation can help rebuild strength and reduce shortness of breath.

November 15th is the Great American Smokeout

Mark Twain famously reported: “Quitting smoking is easy. I’ve done it a thousand times!” If you’ve tried to eliminate smoking, you know it isn’t easy. But you’re not alone. The American Cancer Society is marking the 38th Great American Smokeout on November 19th by encouraging smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day. By doing so, smokers will be taking an important step towards a healthier life — one that can lead to reducing cancer risk.

There are an abundance of programs, many free, to help smokers quit. Physicians can prescribe supportive medical aids as part of a more formal program, there are over-the-counter remedies, and support groups are available in most communities and through local hospitals.

Quitting is hard, but you can increase your chances of success with help. The American Cancer Society can tell you about the steps you can take to quit smoking and provide the resources and support that can increase your chances of quitting successfully. To learn about available tools, call the American Cancer Society at 1-800-227-2345 or visit www.cancer.org. The American Lung Association also has a wealth of information and resources. Reach them at 1-800-LUNG-USA, and find online support at www. lung.org.

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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!

Breast cancer awareness

Even with amazing medical progress, promising research and new treatment advances, thousands of American women and men are diagnosed with breast cancer annually. Early detection and treatment are keys to treating and containing this disease. When detected early before it can spread to other parts of the body, breast cancer can be treated successfully through radiation, drug therapy and surgery, and many cancer survivors live long, healthy lives.

October is National Breast Cancer Awareness Month. Knowing your family history, getting regular exams and avoiding known cancer-causing foods and activities are critical, proactive steps. By eating well, exercising regularly, not smoking tobacco products, and drinking in moderation women reduce their chances of contracting breast cancer.

But the numbers remain staggering: About one in eight American women, close to 12 percent, will develop invasive breast cancer over the course of her lifetime. Approximately 230,000 new cases of invasive breast cancer are diagnosed in U.S. women annually, along with approximately 58,000 new cases of non-invasive breast cancer. Additionally, more than 2,000 new cases of invasive breast cancer are diagnosed in men. Breast cancer results in close to 40,000 deaths in the United States alone, annually.

If you discover a persistent lump in your breast or any changes in breast tissue, it is very important that you see a physician immediately. Fortunately, eight out of 10 breast lumps are benign, or not cancerous. But women sometimes stay away from medical care because they fear what they might find. Take charge of your health by performing routine breast self-exams, establishing ongoing communication with your doctor, and scheduling regular mammograms.

Males need to remain diligent, as well. Men should speak with their doctor if they find suspicious lumps, abnormal skin growths, experience tenderness or experience other changes in their breasts.

For women, a mammogram remains one of the best tools available for the early detection of breast cancer. While women who have a family history of breast cancer are in a higher risk group, most women who have breast cancer have no family history. If you have a mother, daughter, sister or grandmother who had breast cancer, you should have a mammogram five years before the age of their diagnosis, or starting at age 35.

Here are 10 healthy lifestyle choices we can make that may reduce our risk of developing breast cancer:

  1. Maintain a healthy weight.Gaining weight after menopause increases the risk of breast cancer. In general, weight gain of 20 pounds or more after the age of 18 may increase the risk of breast cancer. Likewise, if you have gained weight, losing weight may lower your risk of breast cancer.
  2. Add exercise to your routine.Exercise pumps up the immune system and lowers estrogen levels. With as little as four hours of exercise per week, a woman can begin to lower her risk of breast cancer. Physical activity involves the energy that you release from your body. It not only burns energy (calories), but may also help lower the risk of breast cancer. This is because exercise lowers estrogen levels, fights obesity, lowers insulin levels and boosts the function of immune system cells that attack tumors. Do whatever physical activity you enjoy most and that gets you moving daily. All you need is moderate (where you break a sweat) activity like brisk walking for 30 minutes a day.
  3. Maintain a healthy diet.A nutritious, low-fat diet with plenty of fruits and vegetables can help reduce the risk of developing breast cancer. A high-fat diet increases the risk because fat triggers estrogen production that can fuel tumor growth.
  4. Limit alcohol intake.Research has shown that having one serving of alcohol (for example, a glass of wine) each day improves your health by reducing your risk of heart attack. But many studies have also shown that alcohol intake can increase the risk of breast cancer. In general, the more alcohol you drink, the higher your risk of developing breast cancer. If you drink alcohol, try to limit your intake to one drink a day.
  5. Women, limit postmenopausal hormones.For each year that combined estrogen plus progestin hormones are taken, the risk of breast cancer goes up. Once the drug is no longer taken, this risk returns to that of a woman who has never used hormones in about five to 10 years. Post-menopausal hormones also increase the risk of ovarian cancer and heart disease. Talk to your doctor about the risks and benefits.
  6. Breastfeed, if you can.Breastfeeding protects against breast cancer, especially in pre-menopausal women. There are many breastfeeding benefits for the baby, as well.
  7. If you don’t smoke, don’t start.You do your body a world of good by avoiding tobacco. If you do smoke, ask your doctor for help in quitting. Although there is no conclusive evidence that smoking causes breast cancer, smoking has been linked to many other types of cancer and diseases. There are health benefits from quitting at any age.
  8. Focus on your emotional health.Researchers continue studying the relationship between our physical and emotional health, but there is conclusive evidence that people who are stronger, emotionally, are more resistant to illness and certain diseases. It is also important to keep a healthy attitude. Do things that make you happy and that bring balance to your life. Pay attention to yourself and your needs. Read books, walk in the park, have coffee with a friend. Find what works for you – many things can help you be healthier and feel better about yourself in spite of what is going on in your life.
  9. Schedule regular mammograms. Even though many women without a family history of breast cancer are at risk, if you have a grandmother, mother, sister, or daughter who has been diagnosed with breast cancer, this does put you in a higher risk group. Have a baseline mammogram at least five years before the age of breast cancer onset in any close relatives, or starting at age 35. See your physician at any sign of unusual symptoms.
  10. Give yourself abreast self-examat least once a month. Look for any changes in breast tissue, such as changes in size, a lump, dimpling or puckering of the breast, or a discharge from the nipple. If you discover a persistent lump in your breast or any changes in breast tissue, it is very important that you see a physician immediately. However, eight out of 10 lumps are benign, or not cancerous.

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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!

Fighting ovarian cancer

Science has made tremendous progress battling certain cancers and other potentially deadly diseases. But one of the best advances, arguably, is how much more informed we are today about chronic and life-threatening illnesses, and our willingness to learn the factors — such as family history, nutrition and life-style choices — that can help reduce or prolong our lives.

One insidious disease that continues to plague women is ovarian cancer, and September is Ovarian Cancer Awareness Month. While medical researchers still don’t know how to prevent ovarian cancer, they do know a great deal more about this disease, and now have a variety of screening methods for detecting it earlier, when there’s a better chance to stem its advance.

Most importantly, this disease must be taken seriously. Each year in the United States, about 20,000 women get ovarian cancer and about 14,500 die from it. Ovarian cancer causes more deaths than any other cancer of the female reproductive system, but it accounts for only about three percent of all cancers in women.

What women — and men — need to know

Women have two ovaries that are located in the pelvis, one on each side of the uterus. The ovaries make female hormones (estrogen, progesterone and testosterone) and produce eggs. When cancer starts in either ovary, it is called ovarian cancer.

Fallopian tube cancer (which starts in the fallopian tube) and primary peritoneal cancer (which starts in the lining that supports the abdomen) are very similar to ovarian cancer. Many of the signs and symptoms are the same, and doctors treat these cancers in the same way.

All women are at risk for ovarian cancer, but older women are more likely to get the disease than younger women. About 90 percent of women who get ovarian cancer are older than 40 years of age, with the greatest number of cases occurring in women aged 60 years or older. A woman’s risk of getting ovarian cancer during her lifetime is about one in 73. Her lifetime chance of dying from ovarian cancer is about one in 100.

Ovarian cancer is more common in white women than African-American women. Fortunately, through earlier detection and more advanced treatments, the rate at which women are diagnosed with ovarian cancer has been slowly falling over the past 20 years. However, that’s no reason to relax.

Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is difficult to treat and is often fatal. Like most illnesses, the earlier it’s detected, the better your chances for leading a normal and longer life.

Physicians diagnose ovarian cancer through pelvic examinations, the use of ultrasound scanning or by taking small tissue samples. The type of ovarian cancer someone has helps determine prognosis and treatment options.

Ovarian cancer signs and symptoms

Researchers are studying ways to improve ovarian cancer treatment and looking into ways to detect ovarian cancer at an earlier stage — when a cure is more likely. Symptoms of ovarian cancer, however, are not specific to the disease, and they often mimic those of many other more-common conditions, including digestive problems.

Signs and symptoms of ovarian cancer may include:

  • Abdominal pressure, fullness, swelling or bloating
  • Pelvic discomfort or pain
  • Persistent indigestion, gas or nausea
  • Changes in bowel habits, such as constipation
  • Changes in bladder habits, including a frequent need to urinate
  • Loss of appetite or quickly feeling full
  • Increased abdominal girth or clothes fitting tighter around your waist
  • A persistent lack of energy
  • Low back pain

Make an appointment with your doctor if you or someone you know has any signs or symptoms that worry you. If you have a family history of ovarian cancer or breast cancer, talk to your doctor about your risk of ovarian cancer. In some cases, your doctor may refer you to a genetic counselor to discuss testing for certain gene mutations that increase your risk of breast and ovarian cancers.

Certain factors may increase your risk of ovarian cancer. Having one or more of these risk factors doesn’t mean that you’re sure to develop ovarian cancer, but your risk may be higher than that of the average woman. These risk factors include:

  • Inherited gene mutations, which can often be determined through genetic testing.
  • Family history of ovarian cancer.If women in your family have been diagnosed with ovarian cancer, you have an increased risk of the disease.
  • A previous cancer diagnosis.If you’ve been diagnosed with cancer of the breast, colon, rectum or uterus, your risk of ovarian cancer is increased.
  • Increasing age.Your risk of ovarian cancer increases as you age. Ovarian cancer most often develops after menopause, though it can occur at any age.
  • Never having been pregnant.Women who have never been pregnant have an increased risk of ovarian cancer.

Overall, the best advice is to talk with your physician about risks and to determine appropriate testing. Again, early detection is critical to increased survival, so remain diligent and encourage other women at risk to do the same!

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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!

Lead the battle against seasonal flu and colds

The mornings are taking on that characteristic early autumn chill, and the sugar maples are starting to turn red. Pumpkins will soon appear in local farm markets, along with fresh apples, cider and gourds. But as much as we may welcome and savor the oncoming fall, it’s also a harbinger of cold and flu season. And while we can’t totally eliminate seasonal illnesses, there are plenty of steps we can take to ensure a healthier workforce and to limit the spread of germs and bacteria among staff and associates.

If you’re wondering if taking simple, inexpensive steps in the workplace is worthwhile, consider these flu-related costs: The Centers for Disease Control (CDC) estimates that, on average, seasonal flu outbreaks cost the nation’s economy $10.4 billion in direct costs of hospitalizations and outpatient visits. That does not include the indirect costs related to lost productivity and absenteeism.

One CDC study estimates that each flu season, 111 million workdays are lost to flu-related absenteeism, which amounts to about $7 billion annually in lost productivity. And that doesn’t include time lost to “presenteeism,” when employees come to work not feeling well. This has an impact on customer service, productivity, quality and safety, as well.

And if you think you’ll wait until the season arrives, it’ll be too late. Prevention is essential, and for the most part, this entails some simple, common sense measures, such as encouraging employees to wash their hands, offering free or low-cost flu vaccination shots, and routinely washing and disinfecting work surfaces. Most importantly, workers who suspect they are ill should stay home from work.

What to expect, how to react

The timing of flu is very unpredictable and can vary in different parts of the country and from season to season. Most seasonal flu activity typically occurs between October and May. Flu activity most commonly peaks in the United States between December and February.

The CDC recommends a yearly flu vaccine for everyone six months of age and older as the first and most important step in protecting against this serious disease. People should begin getting vaccinated soon after flu vaccine becomes available, if possible by October, to ensure that as many people as possible are protected before flu season begins. However, as long as flu viruses are circulating in the community, it’s not too late to get vaccinated. It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against the flu.

It’s important to get a flu vaccine every season, even if you got vaccinated the season before and the viruses in the vaccine have not changed for the current season. And while you’d think that this message has been heard, the numbers of Americans still not getting vaccinated is extremely high. According to the CDC:

  • Only 49.9 percent of children six months to 17 years received an influenza vaccination during the past 12 months.
  • The number of adults 18-49 years who received an influenza vaccination during the past 12 months was only 31.2 percent.
  • And only 45.5 percent of adults 50-64 years received an influenza vaccination during the past 12 months. The number for adults over 65 was 70 percent.

A number of different private-sector vaccine manufacturers produce flu vaccine for use in the United States. This season, both trivalent (three-component) and quadrivalent (four-component) influenza vaccines will be available. Different routes of administration are available for flu vaccines, including intramuscular, intradermal, jet injector and nasal spray vaccine.

Even if you don’t have a regular doctor or nurse, you can get a flu vaccine somewhere else, like a health department, pharmacy, urgent care clinic, and often through your school, college health center, or at work.

Information, access and accommodation

Employers also can take the lead on educating their workforce about prevention and treatment.

Antiviral drugs are prescription drugs that can be used to treat flu illness. People at high risk of serious flu complications (such as children younger than two years, adults 65 and older, pregnant women, and people with certain medical conditions) and people who are very sick with flu (such as those hospitalized because of flu) should get antiviral drugs. Some other people can be treated with antivirals at their health care professional’s discretion. Prompt treatment can mean the difference between having a milder illness versus very serious illness that could result in a hospital stay.

Treatment with antivirals works best when begun within 48 hours of getting sick, but can still be beneficial when given later in the course of illness. Antiviral drugs are effective across all age-and risk groups. Studies show that antiviral drugs are under-prescribed for people who are at high risk of complications who get flu. This season, three FDA-approved influenza antiviral drugs are recommended for use in the United States: oseltamivir, zanamivir, and peramivir.

Children younger than six months are at higher risk of serious flu complications, but are too young to get a flu vaccine. Because of this, safeguarding them from flu is especially important. If you live with or care for an infant younger than six months of age, you should get a flu vaccine to help protect them from flu.

In addition to getting vaccinated, you and your loved ones can take everyday preventive actions like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading influenza to others.

Finally, there are a few other simple steps employers can take at the office, shop floor or in work areas to help protect your workforce from colds and the flu. Here are a few additional examples:

  • Work with your staff or your health and wellness champion to send out regular messages, information and access to websites
  • Increase shifts so there are fewer people in the office at one time
  • Limit meetings and communal lunches during the height of flu and cold season
  • Expand opportunities, if possible, for telecommuting
  • Encourage workers who are sick or becoming sick to work from home or remain home to rest, without fear of compromising their jobs
  • Allow more flexibility for parents with sick children
  • Install “no-touch” garbage cans and hand sanitizers throughout the workplace
  • Encourage hand washing frequently
  • Offer onsite flu clinics for your workers, or work with a local health facility to accommodate your workers at convenient times.

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If you’re not enjoying the benefits of a wellness program at your company, join CBIA Healthy Connections at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Putting our shoulder into our work

For pitchers, quarterbacks and carpenters, it can be a career-limiting — or ending — injury. Likewise, if you do manual labor or projects involving lifting, carrying or moving objects, it can sideline you for months. Even working out in the gym, swimming or playing tennis can cause this injury, but the most common catalyst, affecting millions of Americans annually, is advancing age and the normal wear and tears of life.

The culprit is a rotator cuff injury. The rotator cuff is a group of four tendons and muscles that converge around the shoulder joint at the top of the humerus, the upper arm bone above the elbow. Together, they form a ”cuff” that both holds our arm in place and allows it to move in different directions. While our shoulder is one of our most mobile joints, it’s also somewhat weak. Too much stress — or repetitive motion — can cause partial tears and swelling in the tendons of the rotator cuff. Abrupt stress may even cause one of the tendons to pull away from the bone or tear in the middle of the tendon.

Sometimes the shoulder blade is rough or abnormally shaped and rubs or scrapes the tendon. Over time, this can cause tiny tears and bleeding. When these tears heal, the scar tissue is weaker and less flexible than normal tendon, so the whole rotator cuff gets weaker. The weaker the tendon becomes, the greater its chances of tearing.

Most rotator cuff tears develop gradually. But they also can happen suddenly — you might feel a pop, intense pain, and weakness in the arm. Falls, lifting heavy luggage, even shoveling snow or working in the garden can aggravate our shoulders, especially as we age. Aging causes tendons to wear down, which can lead to a tear. Also, previous injuries and genetics may play a role in increasing susceptibility to rotator cuff injuries.

If the shoulder is very painful and motion is limited, or if you have numbness, tingling and a “pins and needles” sensation that travels down through your elbow and into your hands, you should consult your physician, orthopedist, or sport medicine specialist. Without treatment, rotator cuff disease may lead to permanent stiffness or weakness and may result in progressive degeneration of the shoulder joint.

Typical symptoms of a rotator cuff tear include:

  • Pain in the shoulder and arm, which varies depending on how serious the tear is
  • Weakness and tenderness in the shoulder
  • Difficulty moving the shoulder, especially when trying to lift our arm above our head
  • Snapping or crackling sounds when moving the shoulder
  • Inability to sleep on the shoulder

As bad as these injuries can be, the good news is that many rotator cuff tears heal on their own. They may simply require a little time and relative inactivity involving the injured shoulder. You also should:

  • Rest the joint as much as possible, and avoid any movement or activity that hurts. Some patients may require slings early in the healing process.
  • Ice the shoulder two to three times a day to reduce pain and swelling.
  • Perform range-of-motion exercises, if your doctor recommends them.
  • Consider physical therapy to strengthen the joint and to learn safe, supportive exercises.
  • Use anti-inflammatory painkillers, or NSAIDS, like Advil, Aleve, or Motrin. However, these drugs can have side effects, like an increased risk of bleeding and ulcers. They should be used only occasionally, unless your doctor specifically says otherwise.

More serious rotator cuff tears require surgery. One procedure is shoulder arthroscopy, usually an outpatient procedure. During arthroscopy, the patient is put to sleep with general anesthesia. A small camera is inserted into the shoulder to see the injury, and miniature tools are used to repair the rotator cuff tear. In some situations, an open tendon repair may be a better option. In these types of surgeries, your surgeon works through a larger incision to reattach the damaged tendon to the bone. Open tendon repairs typically have a longer recovery time than that seen with more minimally invasive procedures done arthroscopically.

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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!

Spread the word, not the germs

In today’s world, we’re well aware of many deadly viruses, thanks to media, anxious friends and the Internet. This past year Ebola raged in Eastern Africa and even made it to American shores. We’re bombarded almost daily by scary stories about strains of Avian, Swine and Bird flus. And closer to home, many of us are still infected by common contagious culprits such as influenza, measles, chickenpox, tuberculosis and even Whooping Cough.

Many infectious diseases can be largely prevented by vaccines. Frequent and thorough hand-washing also helps protect you from infectious diseases. The easiest way to catch most infectious diseases is by coming in contact with a person or animal that has the infection. Three ways infectious diseases can be spread through direct contact are:

  • Person to person. A common way for infectious diseases to spread is through the direct transfer of bacteria, viruses or other germs from one person to another. This can occur when an individual with the bacterium or virus touches, coughs on or kisses someone who isn’t infected. These germs can also spread through food handling, the exchange of body fluids from sexual contact or a blood transfusion. The person who passes the germ may have no symptoms of the disease, but may simply be a carrier.
  • Animal to person. Being bitten or scratched by an infected animal — even a pet — can make you sick and, in extreme circumstances, can be fatal. Handling animal waste can be hazardous, too. For example, you can acquire a toxoplasmosis infection by scooping your cat’s litter box.
  • Mother to unborn child. A pregnant woman may pass germs that cause infectious diseases to her unborn baby. Some germs can pass through the placenta. Germs in the vagina can be transmitted to the baby during birth.

Disease-causing organisms also can be passed by indirect contact. Many germs can linger on an inanimate object, such as a tabletop, doorknob or faucet handle. When you touch a doorknob handled by someone ill with the flu or a cold, for example, you can pick up the germs he or she left behind. If you then touch your eyes, mouth or nose before washing your hands, you may become infected.

Some germs rely on insect carriers — such as mosquitoes, fleas, lice or ticks — to move from host to host. These carriers are known as vectors. Mosquitoes can carry the malaria parasite or West Nile virus, and deer ticks may carry the bacterium that causes Lyme disease.

Another way disease-causing germs can infect you is through contaminated food and water. This transmission mechanism allows germs to be spread to many people through a single source. E. coli, for example, is a bacterium present in or on certain foods — such as undercooked hamburger or unpasteurized fruit juice. E. coli makes people violently stomach sick and dehydrated, and may require hospitalization.

In Connecticut, cases of Pertussis (Whooping Cough) have reemerged in the western part of the State, due largely to parents who choose to not vaccinate their children. Tuberculosis (TB) also remains stubbornly entrenched in Connecticut.

Understanding TB

Tuberculosis is a potentially serious infectious disease that mainly affects your lungs. The bacteria that cause tuberculosis are spread from one person to another through tiny droplets released into the air via coughs and sneezes.

Once rare in developed countries, tuberculosis infections began increasing in 1985, partly because of the emergence of HIV, the virus that causes AIDS. HIV weakens a person’s immune system so it can’t fight the TB germs. In the United States, because of stronger control programs, tuberculosis began to decrease again in 1993, but remains a concern and fairly active in most major cities.

Many strains of tuberculosis resist the drugs most used to treat the disease. People with active tuberculosis must take several types of medications for many months to eradicate the infection and prevent development of antibiotic resistance.

Tuberculosis is caused by bacteria that spread from person to person through microscopic droplets released into the air. This can happen when someone with the untreated, active form of tuberculosis coughs, speaks, sneezes, spits, laughs or sings.

Although tuberculosis is contagious, it’s not easy to catch. You’re much more likely to get tuberculosis from someone you live with or work with than from a stranger. Most people with active TB who’ve had appropriate drug treatment for at least two weeks are no longer contagious.

Don’t buy into the myths about vaccines

Earlier this year, hundreds of people contracted measles. “Ground zero,” it turned out, was Disneyland, in Anaheim, California. While there were only 50 reported measles infections in the United States in 2009, there had already been 288 cases in the country this year before the end of May 2015. Most of those cases have been linked to the unvaccinated; a recent study found “substandard vaccination” to have been the cause of the massive measles outbreak at Disneyland.

This month, California passed a mandatory vaccination law requiring children to be fully vaccinated before attending public school or a licensed pre-school program. Vaccinating children poses nearly no risk to their health; choosing not to vaccinate not only puts the child in harm’s way, but also endangers other immunocompromised persons — pregnant women, the elderly, and those who’ve had cancer or organ transplants — that un-vaccinated children come into contact with.

Additionally, adults should verify their own vaccination history. Disease resistance can deteriorate over many years, but your physician can easily search for active antibodies through a simple blood test, and revaccinate you as an adult. This is especially important if you work in healthcare, plan to travel internationally or will be living in communal spaces like college dormitories.

Other than a minuscule population who avoid vaccinations based on religious grounds, most non-conforming parents or individuals worry about contracting autism or other diseases from vaccinations. There are absolutely no scientific or medical grounds for that myth. However, an ingredient commonly found in some vaccinations — thimerosal — does contain trace amounts of mercury. According to the Centers for Disease Control (CDC), these extremely low doses of thimerosal pose no risk to humans, except for minor reactions like redness and swelling at the injection site.

While not dangerous, thimerosal has been removed from most vaccines anyway. In fact, there is no thimerosal present in the vaccine for measles, mumps, and rubella — and there never was.

Follow these tips to decrease your risk of infecting yourself or others:

  • Wash your hands. This is especially important before and after preparing food, before eating and after using the toilet. And try not to touch your eyes, nose or mouth with your hands, as that’s a common way germs enter the body.
  • Get vaccinated. Immunization can drastically reduce your chances of contracting or spreading many diseases. Make sure to keep up to date on your recommended vaccinations, as well as your children’s.
  • Stay home. Don’t go to work if you are vomiting, have diarrhea or are running a fever. Don’t send your child to school if he or she has these signs and symptoms, either.
  • Prepare food safely. Keep counters and other kitchen surfaces clean when preparing meals. Cook foods to the proper temperature using a food thermometer to check for doneness. For ground meats, that means at least 160 F (71 C), for poultry, 165 F (74 C), and for most other meat, at least 145 F (63 C). In addition, promptly refrigerate leftovers — don’t let cooked foods remain at room temperature for extended periods of time.
  • Practice safe sex. Always use condoms if you or your partner has a history of sexually transmitted infections or high-risk behavior.
  • Don’t share personal items. Use your own toothbrush, comb and razor. Avoid sharing drinking glasses or dining utensils.
  • Travel wisely. If you’re traveling out of the country, talk to your doctor about any special vaccinations you may need or foods to avoid.

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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!

Keep moving — even when you’re not!

Unless you work in an environment that is physically challenging or potentially dangerous, the worst most of us have to fear at work is eye or ear strain, sore backs or necks, repetitive motion injuries or circulation problems. The latter issue can result from sitting too long at your desk or workstation, in a plane, bus or another vehicle. Repeated inactivity or lack of entire-body movement for extended periods inhibits circulation and can lead to clotting problems.

Two of the more common circulation-related health issues include the risk of developing Deep Vein Thrombosis or a Pulmonary Embolism.

Veins are blood vessels that return blood from the tissues of the body back to the heart. The body has two distinct systems of veins — superficial and deep. The superficial system is made up of veins that are close to the skin. These are the blood vessels we frequently can see on our hands, arms or legs that can become more prominent when we exercise. The deep system comprises veins within the muscles of the body. The two systems are connected by small communicating veins. The body regulates the amount of blood going through both systems as a way of rigidly controlling the body’s central temperature.

Deep vein thrombosis (DVT) is a condition where a blood clot forms in a vein of the deep system. DVTs can occur anywhere in the body, but are most frequently found in the deep veins of the legs, thighs, and pelvis. They may infrequently arise from the upper extremities usually because of trauma.

Thrombophlebitis is a condition in which there is both inflammation and a blood clot in a vein. Thrombophlebitis can occur in either superficial or deep veins. Superficial thrombophlebitis occurs in veins close to the skin surface, and usually causes pain, swelling and redness in the area of the vein. Superficial thrombophlebitis usually is treated with heat, elevation of the affected leg or arm, and anti-inflammatory medications.

A thrombosis in a deep vein is a much more serious problem than one in a superficial vein, because a piece of the clot can break off and travel through the deep veins back to the heart, and eventually be pumped by the heart into the arteries of the lung. When this happens, the condition is called pulmonary embolism (PE). Pulmonary embolisms occur in 30 percent of people with DVT, and cause 60,000 deaths annually, many of them unrecognized and labeled incorrectly as heart attacks. Blood clots from DVT can lodge in the legs, heart, kidneys, lungs or brain.

Symptoms of deep vein thrombosis may be difficult to identify. That’s because DVT symptoms are similar to many other health problems. People most at risk from DVT are over 60, smoke, or are overweight. Women on birth control or patches, or people who sit for long periods of time can be at risk as well.

If you or someone you know has any of the DVT symptoms below — especially if they occur suddenly — call your doctor right away:

  • Swelling in one or both legs
  • Pain or tenderness in one or both legs, which may occur only while standing or walking
  • Warmth in theskin of the affected leg
  • Red or discolored skin in the affected leg
  • Visible surface veins
  • Leg fatigue

If a blood clot breaks free and travels to your lungs, it’s called a pulmonary embolism, and it can be fatal. Pulmonary embolism may not cause symptoms, but if you ever suffer sudden coughing, which may bring up blood; sharp chest pain; rapid breathing or shortness of breath; or severe lightheadedness, call 911 or go to an emergency room immediately.

How to improve your circulation and avoid potential clots

About 350,000 Americans are diagnosed with DVT and pulmonary embolism each year, although it is estimated that some 300,000 more adults have undiagnosed DVT/PT. The condition has a 6 percent to 12 percent mortality rate.

If you’re at risk, there is much you can do to prevent DVT. Here are 10 tips to help avoid circulation-related clotting or related problems:

  • Eat a healthy diet, maintain an active lifestyle andexercise regularly — daily, if possible. Walking, swimming, and bicycling are all great activities.
  • If you smoke, quit! Nicotine therapy (in patches, gums, or sprays) and support groups can make this easier to do.
  • Getyour blood pressure checked regularly; take steps to lower it, if necessary, and report any family or personal history of blood-clotting problems to your doctor.
  • Discuss alternatives tobirth control pills or hormone-replacement therapy with your doctor.
  • If you are on an airplane for more than four hours, walk when possible and while awaiting connecting flights, or do leg stretches in your seat.
  • Stay well-hydrated and avoid alcohol and caffeine consumption – both contribute to dehydration, which cause blood to thicken and the veins to narrow.
  • In the workplace, stretch, move around regularly, and walk as often as possible, even if to the lunch room, bathrooms or outside during breaks.
  • Avoid wearing short, tight socks or crossing your legs for long periods.
  • When traveling by car, stop once every hour or two to walk around and stretch.
  • Consider purchasing compression stockings at a medical supply store and wearing them during your travels to help reduce swelling.

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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!