Keeping your skin in the game

If we’re lucky enough to have healthy skin, many of us may visit a dermatologist only when we’re teenagers struggling with acne. In our 20s, 30s, and 40s we probably don’t think about our skin, even though we’re likely damaging it every day through sun exposure, stress, facial movements, obesity, and even how we sleep. As we get older we have to deal with wrinkles, spots, loss of subcutaneous support (the fatty tissue between skin and muscle), moles, skin tags and, more dangerously, a variety of skin cancers.

How our skin ages depends on a variety of factors: Lifestyle, diet, heredity, and other personal habits. For instance, smoking can produce free radicals, once-healthy oxygen molecules that are now overactive and unstable. Free radicals damage cells, leading to, among other things, premature wrinkles. Exposure to the sun also is a huge factor in skin-related deterioration.

As we age, skin becomes rougher, slacker, fragile and more transparent. We bruise more easily, the way our skin “fits” on our bones and face changes, it dries out and we become more susceptible to lesions such as benign and malignant growths or tumors. 

Exposure to sunlight is the single biggest culprit in aging skin. Over time, the sun’s ultraviolet (UV) light damages certain fibers in the skin called elastin. The breakdown of elastin fibers causes the skin to sag, stretch, and lose its ability to snap back after stretching. The skin also bruises and tears more easily and takes longer to heal. So while sun damage may not show when you’re young, it will later in life.

Nothing can completely undo sun damage, although the skin can sometimes repair itself. So, it’s never too late to begin protecting yourself from sun exposure and skin cancer. You can delay changes associated with aging by staying out of the sun, covering up, wearing a hat, and making a habit of using sunscreen.

Facial movement lines become more visible after the skin starts losing its elasticity (usually as people reach their 30s and 40s). Lines may appear horizontally on the forehead, vertically on the skin above the root of the nose (glabella), or as small curved lines on the temples, upper cheeks, and around the mouth.

Sleep creases result from the way the head is positioned on the pillow and may become more visible after the skin starts losing its elasticity. Sleep creases are commonly located on the side of the forehead, starting above the eyebrows to the hairline near the temples, as well as on the middle of the cheeks. Sleeping on your back may improve these sleep creases or prevent them from becoming worse. Also of important note, smokers tend to have more wrinkles than nonsmokers of the same age, complexion, and history of sun exposure.

Dry skin and itching is common in later life. About 85 percent of older people develop “winter itch,” because overheated indoor air is dry. The loss of oil glands as we age may also worsen dry skin. Anything that further dries the skin — such as overuse of soaps or hot baths — will make the problem worse. If your skin is very dry and itchy, see a doctor because this condition can affect your sleep, cause irritability, or be a symptom of a disease. Some medicines make the itchiness worse.

The importance of visiting a dermatologist

There are several skin lesions that are very common and benign (non-cancerous). These conditions include moles, freckles, skin tags, and discoloration. It’s important to have your physician check these skin issues regularly, and to see a dermatologist if they increase in size, are painful, change color or texture or become irritated or sensitive. Here is some basic information on the most common skin maladies:

> Moles are growths on the skin that are usually brown or black. Moles can appear anywhere on the skin, alone or in groups. Moles occur when cells in the skin grow in a cluster instead of being spread throughout the skin. These cells are called melanocytes, and they make the pigment that gives skin its natural color. Moles may darken after exposure to the sun, in the teen years, and during pregnancy.

The vast majority of moles are not dangerous. The only moles that are of medical concern are those that look different than other existing moles or those that first appear after age 30. If you notice changes in a mole’s color, height, size, or shape, you should have a dermatologist evaluate it. You also should have moles checked if they bleed, ooze, itch, or become tender or painful. The same goes for freckles.

> A skin tag is a small flap of tissue that hangs off the skin by a connecting stalk. Skin tags are not dangerous. They are usually found on the neck, chest, back, armpits, under the breasts, or in the groin area. Skin tags appear most often in women, especially with weight gain, and in elderly people.

Skin tags usually don’t cause any pain. However, they can become irritated if anything, such as clothing or jewelry rubs them. Your dermatologist can remove a skin tag by cutting it off with a scalpel or scissors, with cryosurgery (freezing it off), or with electrosurgery (burning it off with an electric current).

> A lentigo is a spot on the skin that is darker (usually brown) than the surrounding skin. Lentigines (plural) are more common among whites, especially those with fair skin. Exposure to the sun seems to be the major cause of lentigines. They most often appear on parts of the body that get the most sun, including the face and hands. Some lentigines may be caused by genetics (family history) or by medical procedures such as radiation therapy.

There are several methods for treating lentigines, including cryosurgery (freezing it off), laser surgery, and creams that are applied to the skin.

> Skin cancer is a cancer that forms in the tissues of the skin. There are several types of skin cancer. Skin cancer that forms in melanocytes (skin cells that make pigment) is called melanoma. Skin cancer that forms in the lower part of the epidermis (the outer layer of the skin) is called basal cell carcinoma. Skin cancer that forms in squamous cells (flat cells that form the surface of the skin) is called squamous cell carcinoma. Skin cancer that forms in neuroendocrine cells (cells that release hormones in response to signals from the nervous system) is called neuroendocrine carcinoma of the skin.

Most skin cancers form in older people on parts of the body exposed to the sun or in people who have weakened immune systems. Skin cancer is the most common type of cancer in the United States. Each year, more than 68,000 Americans are diagnosed with melanoma, and another 48,000 are diagnosed with an early form of the disease that involves only the top layer of skin. Also, more than 2 million people are treated for basal cell or squamous cell skin cancer each year.

Basal cell skin cancer typically occurs on the face, chest or areas exposed to the sun. It is several times more common than squamous cell skin cancer and, when caught early, easily treated and removed.

Melanoma can occur on any skin surface. In men, it’s often found on the skin on the head, on the neck, or between the shoulders and the hips. In women, it’s often found on the skin on the lower legs or between the shoulders and the hips. Melanoma is more likely than other skin cancers to spread to other parts of the body. Squamous cell skin cancer sometimes spreads to other parts of the body, but basal cell skin cancer rarely does.

Regular examinations by a dermatologist can reveal skin cancers or likely skin cancers (called pre-cancerous) in time to tend to them. As in most illnesses, the earlier skin cancer is discovered, the better the chances of removing it and limiting its spread. If you’re over 50, visit a dermatologist annually. If you’re younger and have a family history of skin cancer or any skin issues of concerns, see your doctor as well.

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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 Ovarian Cancer

September is Ovarian Cancer awareness month. Ovarian cancer ranks fifth in cancer deaths among women, accounting for more deaths than any other cancer of the female reproductive system. A woman’s risk of getting ovarian cancer during her lifetime is about 1 in 73. Her lifetime chance of dying from ovarian cancer is about 1 in 100.

About half of the women who are diagnosed with ovarian cancer are 63 years or older. It 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. The American Cancer Society estimates that approximately 22,000 women will receive a new diagnosis of ovarian cancer in 2014, and more than 14,000 will die from this disease.

What is ovarian cancer?

Ovarian cancer begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen, progesterone and testosterone.

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.

It’s not clear what causes ovarian cancer. In general, cancer begins when healthy cells acquire a genetic mutation that turns normal cells into abnormal cells. Healthy cells grow and multiply at a set rate, eventually dying at a set time. Cancer cells grow and multiply out of control, and they don’t die when they should. As abnormal cells accumulate, they form a mass (tumor). Cancer cells invade nearby tissues and can break off from an initial tumor to spread elsewhere in the body (metastasize).

The type of cell where the cancer begins determines the type of ovarian cancer you have. Ovarian cancer types include:

  • Cancer that begins in the cells on the outside of the ovaries. Called epithelial tumors, these cancers begin in the thin layer of tissue that covers the outside of the ovaries. Most ovarian cancers are epithelial tumors.
  • Cancer that begins in the egg-producing cells. Called germ cell tumors, these ovarian cancers tend to occur in younger women.
  • Cancer that begins in the hormone-producing cells. These cancers, called stromal tumors, begin in the ovarian tissue that produces the hormones estrogen, progesterone and testosterone.

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

Know 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 your 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!

Seeing clearly

There’s a lot we take for granted when it comes to our health, and much we can do to reduce the risk of illness, control aging-related issues and prevent or limit disease. Education, awareness and preventative steps typically are the best prescriptions for us and our families, yet we often fail to take precautionary measures that can prevent common and potentially dangerous health conditions from taking hold.

August is Eye Injury Protection Month, but taking good care of our eyes requires far more than simply wearing safety glasses at work and play. The first rule, naturally, is to wear approved eye protection. That can be safety glasses on a jobsite or while competing in sports, but also when mowing the lawn or using power equipment. There are so many ways to hit ourselves in the eye, or to be injured by thrown objects, splashed liquids, and even wind-blown contaminants or materials. So if you’re doing something that might result in an injury, take the safe and easy step to cover your eyes.

Being aware of the potential damage from ultraviolet light also is important. Sunglasses and clear eyeglasses with protective coatings filter out the sun’s damaging rays, so if you work or spend a lot of time outdoors, you need that extra protection.

Adults should visit with an optometrist or an ophthalmologist at least once every other year, and annually if you have bad eyesight or a family history of glaucoma, cataracts, or other congenital or age-related eye ailments. Many eye maladies develop as we get older, part of the natural aging process. Through a comprehensive eye exam, eye care professionals not only determine sight deficiencies and illnesses, but also find warning signs pointing to other dangers such as heart disease, diabetes, high blood pressure, and cancer.

Dry eye syndrome and glaucoma are two common ailments that effect people as we age. If the glands in our eyes stop making enough natural lubricants, we can buy over-the-counter remedies, but we should check for inflammation or infection. Sometimes dry eyes occur from living or working in windy, dry, or low-humidity environments, or in buildings with air-blown hot air. Doctors recommend “artificial tears,” which don’t have as many chemicals as the “get the red out” eye drops. Also, anti-inflammation medications and vitamins or foods like fish oil which are high in Omega-3 are often recommended.

Glaucoma is a group of illnesses that can lead to blindness if not treated. When fluid builds up inside the eye, pressure and tension can result in damage to the optic nerve, including blindness. Glaucoma has no early warning signs. However, symptoms can include blurriness or clouded vision, sensitivity to light, headaches, reduced peripheral or “side” vision, or “tunnel vision.” It’s more common in adults over 60, in African American adults over 40, or in adults with diabetes or a family history of glaucoma. It’s most often treated through medications and surgery.

Simple tips for keeping our eyes healthy

There are many things we can do to keep our eyes healthy and make sure we are seeing our best. Here are simple steps for maintaining healthy eyes well into our golden years:

  • Have a comprehensive dilated eye exam. You might think your vision is fine or that your eyes are healthy, but visiting an eye-care professional for a comprehensive dilated eye exam is the only way to really be sure. When it comes to common vision problems, some people don’t realize they could see better with glasses or contact lenses. In addition, many common eye diseases such as glaucoma, diabetic eye disease and age-related macular degeneration often have no warning signs. A dilated eye exam is the only way to detect these diseases in their early stages.
  • Know your family’s eye health history. Talk to family members about their eye health history. It’s important to know if anyone has been diagnosed with a disease or condition, since many are hereditary. This will help to determine if we are at higher risk for developing an eye disease or condition.
  • Eat right to protect your sight. We’ve heard carrots are good for our eyes. But eating a diet rich in fruits and vegetables, particularly dark leafy greens such as spinach, kale, or collard greens is important for keeping our eyes healthy. Research has also shown there are eye health benefits from eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut.
  • Maintain a healthy weight. Being overweight or obese increases our risk of developing systemic conditions such as diabetic eye disease or glaucoma which can lead to vision loss. If you are having trouble maintaining a healthy weight, talk to your doctor.
  • Wear protective eyewear. Wear protective eyewear when playing sports or doing activities around the home. Protective eyewear includes safety glasses and goggles, safety shields, and eye guards specially designed to provide the correct protection for a certain activity. Most protective eyewear lenses are made of polycarbonate, which is 10 times stronger than other plastics. Many eye care providers sell protective eyewear, as do some sporting goods stores.
  • Quit smoking or never start. Smoking is as bad for our eyes as it is for the rest of our body. Research has linked smoking to an increased risk of developing age-related macular degeneration, cataracts, and optic nerve damage, all of which can lead to blindness.
  • Wear shades. Sunglasses are a great fashion accessory, but their most important job is to protect our eyes from the sun’s ultraviolet rays. When purchasing sunglasses, look for ones that block out 99 to 100 percent of both UV-A and UV-B radiation.
  • Give our eyes a rest. If we spend a lot of time at the computer or focusing on any one thing, we sometimes forget to blink and our eyes can get fatigued. Try the 20-20-20 rule: Every 20 minutes, look away about 20 feet in front of you for 20 seconds. This can help reduce eyestrain.
  • Clean our hands and contact lenses properly. To avoid the risk of infection, always wash hands thoroughly before putting in or taking out contact lenses. Make sure to disinfect contact lenses as instructed and replace them as appropriate.

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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!

Immunizations are nothing to sneeze at

It’s easy to get lulled into a false sense of complacency regarding infectious diseases. Seasonal maladies such as Influenza receive a lot of publicity, and millions of Americans now get themselves and their children vaccinated annually. But diseases we thought were eradicated or totally controlled are reemerging, and pose significant and often unnecessary risks.

It’s true that vaccine-preventable disease levels in the United States are at or near record lows. But even though most infants and toddlers have received all recommended vaccines by age two, many under-immunized children remain, leaving the potential for outbreaks of disease. Many adolescents and adults are under-immunized as well, missing opportunities to protect themselves against diseases such as Hepatitis B, influenza, and pneumococcal disease.

The Centers for Disease Control (CDC) works closely with public health agencies and private partners to improve and sustain immunization coverage and to monitor the safety of vaccines. And while the “big picture” is generally positive, there are emerging gaps, primarily the result of misinformation, a lack of compliance and ignorance about the importance of ensuring that you and your children are properly immunized.

Children can’t attend public school, go to camp, compete in many sports or travel outside of the country without a proven medical history of required immunizations. But as adults, we may not have received all the necessary immunizations, some of them may no longer be working effectively, and others, such as the vaccination for tetanus, have to be repeated periodically.

But we humans are procrastinators, and either disregard our physician’s warnings, don’t have a regular physician, or figure we’re already protected.  A perfect example of where this thinking goes awry involves Whooping Cough — known medically as pertussis, which has recently reappeared in Connecticut and in other states.

Pertussis is a highly contagious respiratory tract infection caused by bacteria spread through direct contact with respiratory droplets when an infected person coughs or sneezes. The reason for its reemergence, experts believe, is because our bodies may have stopped producing antibodies in response to the vaccinations we received as children, or because some parents are not protecting their children through recommended vaccinations. Although it initially resembles an ordinary cold, whooping cough may eventually turn more serious, particularly in infants. The best way to prevent it is through vaccinations. The childhood vaccine is called DTap. The whooping cough booster vaccine for adolescents and adults is called Tdap. Both protect against whooping cough, tetanus, and diphtheria.

Diphtheria, also prevented through the Tdap booster, is a very contagious bacterial disease that affects the respiratory system, including the lungs. As with pertussis and another common contagious disease, tuberculosis, diphtheria bacteria can be passed from person to person by direct contact with droplets from an infected person’s cough or sneeze. When people are infected, the diphtheria bacteria produce a toxin in the body that can cause weakness, sore throat, low-grade fever, and swollen glands in the neck. Effects from this toxin can also lead to swelling of the heart muscle and, in some cases, heart failure. In severe cases, the illness can cause coma, paralysis, and even death.

The third leg of that triad involves tetanus (lockjaw), which also can be prevented by the Tdap vaccine. Tetanus is caused by bacteria found in soil. The bacteria enter the body through a wound, such as a deep cut. When people are infected, the bacteria produce a toxin in the body that causes serious, painful spasms and stiffness of all muscles in the body. This can lead to “locking” of the jaw so a person cannot open his or her mouth, swallow, or breathe. Complete recovery from tetanus can take months. Three of 10 people who get tetanus die from the disease.

Take simple steps to protect yourself and others

A good rule of thumb is that if you can’t remember if or when you had it, talk to your doctor. Additionally, if you plan to travel outside of the United States or Canada, it’s wise to speak with your physician or an infectious disease specialist about immunizations to consider, such as protection against Hepatitis A, before traveling. In many foreign countries, especially third-world nations, diseases can still be contracted through impure water systems, through food that hasn’t been properly prepared, and by air-borne particles.

But even if you aren’t traveling abroad, it’s important to know your medical history and to obtain a copy of your personal immunization record. That’s especially valuable if you can’t remember if you ever had common diseases such as mumps, chicken pox, rubella and measles, all of which still afflict thousands of Americans. In many cases, vaccinations to prevent these diseases may not have existed when you were a child, but they do now.

If your personal record doesn’t exist or has been lost, your physician can order a simple blood test that checks for the antibodies currently active in your system. He or she can then offer you the missing vaccinations, bringing you up-to-date as required. Typically, you’ll only have to do this once, unlike the vaccination for preventing influenza, which has to be received annually since strains of “flu” mutate or change from year to year.

Protecting ourselves and our loved ones is our most important job. Today’s medical advances and access make that far easier, but only if we each take personal responsibility to ensure that our immunizations are up-to-date. For more information, call toll free 1-800-CDC-INFO (1-800-232-4636) or visit

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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!

Give yourself a break (fast!)

We have places to go, things to do, school, work, and commutes to face. So we wake up, shower, put on clean clothes, grab a hot cup of coffee, and off we go. How about a healthy breakfast? Nice idea, but who has time? We can grab a breakfast bar, sandwich, bagel or muffin on the road, or nosh on whatever’s in the break room or in our desk at work.

If this scenario sounds familiar, it’s time to rethink your morning strategy and make time for breakfast. A good breakfast gives us a sound foundation for the day, helps us stay focused and achieve optimum efficiency in school and at work. And, according to researchers, a nutritious breakfast helps us both physically and mentally. People who eat a hearty breakfast containing more than one-quarter of their daily calories consume less fat and carbohydrates during the day than people who skimp on food in the morning. Breakfast eaters have a higher intake of essential vitamins and minerals. Plus they generally have lower serum cholesterol levels, which are associated with reduced danger of heart disease.

Start your day the healthy way

By eating a nutritious breakfast — one that includes at least one serving of fruit — we improve our chances of reaching the recommended five servings of fruits and vegetables a day. Dozens of studies have shown that people who eat plenty of fruit (and vegetables) generally have a lower risk of heart disease, cancer, and other chronic diseases. What’s more, orange juice, typically a breakfast staple, is loaded with vitamin C and potassium. A glass of O.J. daily boosts “good” HDL cholesterol, which helps keep arteries from getting clogged, reducing the risk of high blood pressure and stroke.

Start your day with a bowl of breakfast cereal (preferably lightly sweetened), and you’re more likely to get all the nutrients you need. That’s because most cereals are fortified with an array of important vitamins and minerals, including folic acid, which helps prevent birth defects and has been linked to lower risk of heart disease and colon cancer.

The best breakfast cereals are rich in fiber, something most of us don’t get enough of. Experts say we need 25 to 30 grams of fiber a day to be our healthiest. The average American consumes only 13 grams, a shortfall that may put us at unnecessary risk of heart disease. Fiber is found in fresh fruit, and with foods made from grains, particularly those less processed. Also, if you’re trying to lose some weight, sitting down to a healthy, high-fiber breakfast could be the key to success. High-fiber foods fill you up on fewer calories. Fiber also slows the digestive process, which in turn wards off hunger pangs later. That’s especially important in the morning, and when followed by a healthy mid-morning snack, it makes it easier to avoid that mid-morning slump, which often drives us to pastries and fat- and sugar-rich foods which satisfy our craving but are nutritionally empty.

Here are some simple tips for eating a quick and easy breakfast:

  • Choose two or three foods, including at least one from each of the following food groups:
    – Bread and grain (i.e., cereal, toast, muffin)
    – Milk and milk product (i.e., low-fat yogurt, low-fat milk)
    – Fruit or vegetable group (i.e., bananas, apples, carrots)
  • Pick up portable breakfast items when at the grocery store. You should buy foods like fruit, low-fat yogurt, whole-grain breakfast bars or granola bars for those mornings when you have to eat breakfast on the go. If you can keep a box of low-fat, low-sugar cereal at work or school, eat when you get there!
  • Replace or accompany that morning cup of coffee with a glass of orange juice or milk.
  • Make an omelet! Eggs with some kind of lean meat, cheese and veggies give your body a much-needed boost in the morning. You can shorten preparation time by chopping up your vegetables the evening before and storing them in your fridge.
  • Get up 15 minutes earlier.  You can easily fix and consume a healthy breakfast in 15 minutes or less.
  • Plan ahead to eat breakfast.  This means you should decide what you are going to eat for breakfast before the next morning.  You can save time by putting out the box of cereal or cutting up some fruit the night before.

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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!

Protecting your skin saves your life

As summer rapidly approaches, we’re back outdoors with a vengeance, working, gardening, going to athletic events, catching up on our walking, attending barbecues and hitting the beaches. While many of us crave the sun and sporting a “killer tan,” that tan actually is a killer…but you can help prevent overexposure and reduce the dangerous side effects of ultraviolet (UV) rays.

Skin cancer is the most common form of cancer in the United States. Unprotected exposure to UV radiation also is the most preventable risk factor for skin cancer. In fact, UV radiation from the sun is classified as a human carcinogen by the U.S. Department of Health and Human Services and the World Health Organization.

Each year, more new cases of skin cancer are diagnosed in the U.S. than new cases of breast, prostate, lung, and colon cancer combined. One in five Americans will develop skin cancer in their lifetime, and one American dies from skin cancer every hour.

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

How to protect yourself from excess UV exposure

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

If possible, avoid sun exposure during the peak hours of 10:00 am to 4:00 pm, when UV rays are the strongest. Clouds and haze do not protect you from the sun, so use sun protection even on cloudy days. Use sunscreens that block out both UVA and UVB radiation. Products that contain either zinc oxide or titanium oxide offer the best protection. Less expensive products that have the same ingredients work as well as expensive ones. Older children and adults (even those with darker skin) benefit from using SPFs (sun protection factor) of 15 and over. Many experts recommend that most people use SPF 30 or higher on the face and 15 or higher on the body, and people who burn easily or have risk factors for skin cancer should use SPF 50+.

Here’s when and how to use sunscreen:

  • Adults and children should wear sunscreen every day, even if they go outdoors for only a short time.
  • Apply 30 minutes before going outdoors for best results. This allows time for the sunscreen to be absorbed.
  • Remember to use sunscreen during the winter when snow and sun are both present.
  • Reapply at least every two hours while you are out in the sunlight.
  • Reapply after swimming or sweating. Waterproof formulas last for about 40 minutes in the water, and water-resistant formulas last half as long.

Here are additional safety tips and information for protecting yourself from harmful UV radiation:

  • Adults and children should wear hats with wide brims to shield from the sun’s rays.
  • Wear protective clothing. Look for loose-fitting, unbleached, tightly woven fabrics. The tighter the weave, the more protective the garment.
  • Buy clothing and swimwear that block out UV rays. This clothing is rated using SPF (as used with sunscreen) or a system called the ultraviolet protection factor (UPF) index.
  • Avoid surfaces that reflect light, such as water, sand, concrete, snow, and white-painted areas.
  • Beware that at higher altitudes you burn more quickly.

We all need the vitamins from the sun and can still enjoy the outdoors, but taking proper precautions allows us to be outdoors more safely, year round.


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!

Being sandwiched eats away at our health

Generational forces are driving socio-economic changes in lifestyles and families that are contributing to stress and negatively affecting our health and wellbeing. One prime example is the pressures faced by Baby Boomers as they come of age and, in many cases, find themselves faced with caretaker burdens that “sandwich” them between supporting their children, themselves, and aging parents.

It is estimated that American families provide 80 to 90 percent of all in-home long-term care services for their aging family members, disabled adult children, and other loved ones.  These services may include assistance with activities of daily living, medical services coordination, medical supervision, administration of medications and assistance with financial, legal, spiritual and emotional concerns. These family caregivers often go unrecognized and are typically over-utilized. Focusing on their children, parents, and jobs, their own needs often go unfulfilled, which leads to additional stress.

Typically the American “Sandwich Generation” caregiver has been a woman in her mid-forties, married, employed and caring for her family and an elderly parent, usually her mother. Today, however, there are more and more men finding themselves in a caregiving role as well, and often they are squeezed in between the generations. 

The demanding role of being multi-generational caregivers spreads across all racial, gender, age and ethnic boundaries.  Some of the common stressors that affect both urban and rural sandwich generation caregivers are:

  • Splitting time between children/family and elder loved ones
  • Finding time for each caregiving role
  • Finding time for marriage or a significant other
  • Finding time for yourself
  • Not falling behind in your work or bringing your home stress to the work place
  • Keeping generational peace between children and elder loved ones
  • Finding the resources needed to care for family members
  • Combating feelings of isolation
  • Dealing with all the guilt associated with not having enough time to accomplish all that “should” be done.

Related challenges include geographic barriers to resources, and isolation from other caregivers, family members or informal supports.  The lack of service or care network availability, especially burdensome outside of cities, can add to caregiver stress, burnout, and depression. Solving these issues and controlling related stress and health factors is critical, though not easy – it requires adjustments on both sides, establishing boundaries, and setting priorities that include time for yourself, empathy and outreach to others. If you’re “sandwiched,” here are a few tips to help achieve better balance:

Regular “team” communication. Consider having a weekly family meeting where you discuss upcoming events, responsibilities, issues and opportunities. This gives everyone in the family the opportunity to discuss what’s on his or her mind in an open, safe environment. Use this forum to discuss the many different caregiving tasks that need to be accomplished each day or week. 

Set a family weekly or monthly task list.  Set mutual expectations for how the many tasks of caregiving will be accomplished.  Caregiving often becomes a one-person show but it does not need to be if you have family support. 

Ask for assistance. Make a point of picking up the telephone and spending time calling resources such as your local area Agency on Aging, hospital, a social worker, a physician or a local church or temple. There are a variety of services available in most communities and cities. Many can be found on the internet or simply by talking with other caregivers, social service agencies, behavioral health centers and related professionals.

Take time to care for yourself.  Sandwich generation caregivers become run down and sick because they have not taken time to care for themselves.  You can’t care effectively for your loved ones if you don’t care for yourself, as well.  Here are some useful hints to help make sure you focus on your own needs as well as those you are caring for:

  • Take time every day to “check-in” with yourself, even if it is only for half an hour.  This should be your protected time.  Enjoy this time by reading, listening to music, exercising or whatever you like to do.
  • Remember to take time to laugh, talk with friends, and eat properly, especially nutritious food rather than prepared foods high in fat, sugar and salt.
  • Take time to be “in” your marriage or relationship.
  • Try to “be present” at work as much as possible… our jobs exercise our creativity and usefulness in different ways, and association with others outside the home is valuable, emotionally.
  • Listen to your body – if it’s telling you to slow down, or that something is not right, seek medical advice.  Also seek assistance from a therapist or professional counselor versed in caretaker stress.

Every caregiver and caregiving situation is unique, but there are always common factors bridging situations and caregivers.  Support can come from many different sources and in many different ways as long as you seek it out and remember, always, that taking care of yourself is your most important job.

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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!

Why Aren’t You Laughing?!

Humor is a universal language, and good medicine. We watch comedies on television and at the movies and read humorous articles and books. We relax at the end of the day with Letterman, Fallon, or Kimmel. We enjoy sharing a joke at the office, when we’re meeting with friends, over the phone or through social media. Think about how you feel when you laugh or make someone else laugh. And when you laugh at yourself, a situation or something you’ve observed, it relieves tension, defuses situations, and helps us bond with others. 

Laughing makes us feel good — and that good feeling can stay with us long after the laughter stops. In fact, the sound of roaring laughter is far more contagious than any cough, sniffle, or sneeze.

April is National Humor Month, but every healthy day should include humor and laughter and its many benefits:

  • People with a sense of humor typically have a stronger immune system.
  • People who laugh heartily on a regular basis have lower standing blood pressure than the average person. When people have a good laugh, initially the blood pressure increases but then decreases to levels below normal. Breathing then becomes deeper, which sends oxygen-enriched blood and nutrients throughout the body.
  • Laughter can be a great workout for your diaphragm, abdominal, respiratory, facial, leg, and back muscles. It massages abdominal organs, tones intestinal functioning, and strengthens the muscles that hold the abdominal organs in place. It is estimated that hearty laughter can burn calories equivalent to several minutes on the rowing machine or the exercise bike.
  • Laughter stimulates both sides of the brain to enhance learning. It eases muscle tension and psychological stress, which keeps the brain alert and allows people to retain more information. Laughing also elevates moods.

Striving to see humor in life and attempting to laugh at situations rather than bemoan them will help improve our disposition and the disposition of those around us. Our ability to laugh at ourselves and situations will help reduce our stress level and make life more enjoyable. Humor also helps us connect with others. People naturally respond to the smiles and good cheer of those around them.

Tips for adding more humor and laughter in our life include

  • Remember to have and seek fun and opportunities to laugh
  • Spend time with those who help us see the bright side and who make us laugh
  • Get regular doses of humor from various sources such as television, movies, plays, shows and performances, or books
  • Don’t take ourselves and others too seriously…keep life and work in perspective.

Head off stress with regular bouts of laughter and by sharing humor with others. Remember, nobody’s perfect and life should be fun. Laughter can make us feel like a new person. We all can use some of that…no joke.


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!

Don’t Let Stress Break Employees’ Hearts or Their Spirits

It isn’t a coincidence that National Stress Awareness Month and National Humor Month are observed at the same time. Stress is a very common denominator for humans, regardless if at work, home, school, or wherever our daily travels carry us. And humor is a factor we can learn to embrace in our efforts to reduce the pressure and strains that are killing us, literally and figuratively.

We all experience stress, though it affects each of us differently. Sometimes we don’t recognize when we’re acting short tempered, impatient or easily distracted. When stress levels are high, we can become withdrawn, agitated, depressed or angry. We may not sleep well, can eat less or too much. We also may experience tightness in our chests, stomach discomfort, headaches, increased blood sugar, cholesterol and blood pressure, and other physical manifestations.

In the workplace, these symptoms often drive increased absenteeism and presenteeism (coming to work while sick), lower productivity, and service errors. Stress also has a negative impact on safety, quality, and teamwork.

According to the 2013 Work and Well-Being Survey conducted by the American Psychological Association’s (APA) Center for Organizational Excellence, more than one-third (35%) of American workers experience chronic work stress, with low salaries, lack of opportunities for advancement, and heavy workloads topping the list of contributing factors. The APA’s recent Stress in America survey (released last winter) also found high levels of employee stress, with 65% of working Americans citing work as a significant source of stress, and 35% reporting that they typically feel stressed during the workday.

Despite growing awareness of the importance of a healthy workplace, few employees say their organizations provide sufficient resources to help them manage stress (36%) and meet their mental health needs (44%). Just 42% of employees say that their organizations promote and support a healthy lifestyle, only 36% report regularly participating in workplace health and wellness programs, and just over half (51%) say they feel valued at work.

Employers can’t eliminate all the factors that cause their workers to feel stressed, but there are a number of items that can be addressed. Working with your staff to create wellness and feedback programs, encouraging them to take breaks, work out, walk, or nap are extremely beneficial. And providing access to stress-relief activities without having to leave work are a few solutions.

As one workplace example, Christy Graham, wellness champion at The Bushnell Center for the Performing Arts in Hartford, says they implemented yoga classes starting in fall 2013. The classes are held onsite once a week from 12:15 pm to 1:00 pm. Graham contacted several studios before choosing an instructor, and says the Bushnell staff really enjoys the classes. Half a dozen employees participate, she adds, and the fee is only half of what yoga classes held offsite normally would cost. She also sends out a reminder email about a farmer’s market held weekly near their office. Additionally, staff regularly walks together at lunchtime in nearby Bushnell Park, and they have added a water cooler to help keep hydrated.

Address the issues that are adding to your stress

Whether we’re the employer or an employee, often the best way to cope with stress is to find a way to change the circumstances that are causing it. And one common set of tools that traverse all aspects of our lives is our ability to efficiently manage time, especially if we tend to feel overwhelmed at work. Here are some useful tips for reducing time-related stress:

  • Set realistic goals. Work with colleagues and leaders to set realistic expectations and deadlines. Set regular progress reviews and adjust your goals as needed.
  • Make a priority list. Prepare a list of tasks and rank them in order of priority. Throughout the day, scan your master list and work on tasks in priority order.
  • Protect your time. For an especially important or difficult project, block time to work on it without interruption.
  • Get other points of view. Talk with trusted colleagues or friends about the issues you’re facing at work. They might be able to provide insights or offer suggestions for coping. Sometimes simply talking about a stressor can be a relief.
  • Take a break. Make the most of workday breaks. Even a few minutes of personal time during a busy workday can be refreshing. Similarly, take time off when you can — whether it’s a two-week vacation or an occasional long weekend.
  • Have an outlet. To prevent burnout, set aside time for activities you enjoy — such as reading, socializing or pursuing a hobby.
  • Take care of yourself. Be vigilant about taking care of your health. Include physical activity in your daily routine, get plenty of sleep and eat a healthy diet.
  • Seek help. If none of these steps relieves your feelings of job stress or burnout, consult a mental health provider — either on your own or through an employee assistance program offered by your employer. Through counseling, you can learn effective ways to handle job stress.

It’s also critical to keep your perspective. When your job is stressful, it can feel as if it’s taking over your life. To maintain perspective:

  • Get other points of view. Talk with trusted colleagues or friends about the issues you’re facing at work. They might be able to provide insights or offer suggestions for coping. Sometimes simply talking about a stressor can be a relief.
  • Take a break. Make the most of workday breaks. Even a few minutes of personal time during a busy workday can be refreshing. Similarly, take time off when you can — whether it’s a two-week vacation or an occasional long weekend.
  • Have an outlet. To prevent burnout, set aside time for activities you enjoy — such as reading, socializing or pursuing a hobby.
  • Take care of yourself. Be vigilant about taking care of your health. Include physical activity in your daily routine, get plenty of sleep and eat a healthy diet.
  • Seek help. If none of these steps relieves your feelings of job stress or burnout, consult a mental health provider — either on your own or through an employee assistance program offered by your employer. Through counseling, you can learn effective ways to handle job stress.


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!

Our Kidneys Are Important; Take Care of Them

We have two kidneys. They are fist-sized and located in the middle of our back, on the left and right sides of our spine. The kidneys filter our blood, removing wastes and extra water to make urine. They also help control blood pressure and make hormones that our body needs to stay healthy.

When the kidneys are damaged, they can’t filter waste effectively, which then can build up in the body. For most people, kidney damage occurs slowly over many years, often due to diabetes or high blood pressure. This is called chronic kidney disease. When someone has a sudden change in kidney function — because of illness, or injury, or have taken certain medications — this is called acute kidney injury. This can occur in a person with normal kidneys or in someone who already has kidney problems.

Kidney disease is a growing problem. More than 20 million Americans may have kidney disease and many more are at risk. Anyone can develop kidney disease, regardless of age or race. April is National Kidney Month, and a good opportunity to think about improving your diet to prevent damage to your kidneys and a whole host of other nutrition-related health issues. The main risk factors for developing kidney disease include diabetes, high-blood pressure, cardiovascular disease, and a family history of kidney failure.

Early kidney disease has no signs or symptoms. You may not feel any different until your kidney disease is very advanced. Blood and urine tests are the only way to know if you have kidney disease. A blood test checks your glomerular filtration rate (GFR), which tells how well your kidneys are filtering. A urine test checks for protein in your urine.

The sooner you know you have kidney disease, the sooner you can get treatment to help delay or prevent kidney failure. Treatment may include taking medicines called ACE inhibitors or ARBs to manage high blood pressure and keep your kidneys healthier longer. Treating kidney disease may also help prevent heart disease.

Lose your salt shaker

What you eat and drink can help prevent or slow down chronic kidney disease. Some foods are better for your kidneys than others. Cooking and preparing your food from scratch can help you eat healthier.

The first steps to eating right involve choosing and preparing foods with less salt and sodium. To help control your blood pressure, your diet should contain less than 1,500 milligrams of sodium each day. Here are five simple steps for healthier eating:

Step 1: Buy fresh food more often. Sodium (a part of salt) is added to many packaged foods.

  • Use spices, herbs, and sodium-free seasonings in place of salt
  • Check the Nutrition Facts label on food packages for sodium — Daily Value of 20 percent or more means the food is high in sodium
  • Try lower-sodium versions of frozen dinners and other convenience foods
  • Rinse canned vegetables, beans, meats, and fish with water before eating
  • Look for food labels that say “sodium free, salt free, low sodium, reduced or less sodium, no salt added, unsalted or lightly salted.

Step 2: Eat the right amount and the right types of protein. To help protect your kidneys, eat small portions of higher-protein foods. Protein is found in foods from plants and animals. You can talk to your physician, nutritionist or dietitian about how to choose the right combination for you. Animal-protein foods include chicken, fish, meat, eggs and dairy. Plant-protein foods include beans, nuts and grains.

Step 3: Choose foods that are healthy for your heart. To help keep fat from building up in your blood vessels, heart, and kidneys, grill, broil,  bake, roast, or stir-fry foods, instead of deep frying. Cook with nonstick cooking spray or a small amount of olive oil instead of butter. And trim fat from meat and remove skin from poultry before eating. Heart-healthy foods include:

  • Lean cuts of meat, like loin or round
  • Poultry without the skin
  • Fish
  • Beans
  • Vegetables
  • Fruits
  • Low-fat milk, yogurt, cheese

Step 4: Choose foods with less phosphorus. Phosphorus helps protect your bones and blood vessels, but too much isn’t good for us. Many packaged foods have added phosphorus. Look for phosphorus — or for words with “PHOS” — on ingredient labels. Deli meats and some fresh meat and poultry can have added phosphorus. Ask your butcher to help you pick fresh meats without added phosphorus.

Foods lower in phosphorus include:

  • Fresh fruits and vegetables
  • Breads, pasta, rice
  • Rice milk (not enriched)
  • Corn and rice cereals
  • Light-colored sodas/pop

Foods higher in phosphorus include:

  • Meat, poultry, fish
  • Bran cereals and oatmeal
  • Dairy foods
  • Beans, lentils, nuts
  • Colas

Step 5: Choose foods that have the right amount of potassium. Potassium helps our nerves and muscles work the right way. Salt substitutes can be very high in potassium, so it’s important to find a balance, since too much salt isn’t good for us, either. Read the ingredient label, and check with your provider about using salt substitutes.

Foods lower in potassium include:

  • Apples, peaches
  • Carrots, green beans
  • White bread and pasta
  • White rice
  • Rice milk (not enriched)
  • Cooked rice and wheat cereals, grits

Foods higher in potassium include:

  • Oranges, bananas
  • Potatoes, tomatoes
  • Brown and wild rice
  • Bran cereals
  • Dairy foods
  • Whole wheat bread and pasta
  • Beans and nuts


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!