Oh my aching head

The changing seasons bring a lot of headaches as we dodge and weave our way through the holidays, overcrowded stores, and jammed parking lots. But families, shopping and money issues aside, millions of Americans suffer from the kind of debilitating headaches that aren’t just caused by annoying relatives and obnoxious shoppers.

Headaches tend to be hereditary — four out of five headache sufferers report family histories. Other common elements that can cause or worsen headache symptoms include weather and stress, a variety of foods and medications, fatigue, lack of exercise, skipping meals, and consuming alcohol, caffeine and tobacco products.

Most headaches are tension headaches. These headaches tend to happen again and again, especially if you are under stress. They are not usually a sign of something serious. But they can be very painful and hard to live with, and can last from 30 minutes to several days.

If you have a headache on 15 or more days each month over a three-month period, you may have chronic tension headaches. This type of headache can lead to stress and depression, which in turn can lead to more headaches. It often is caused by changes in brain chemicals. About four out of every 100 people in the United States get chronic tension headaches. Symptoms can start in childhood, but they are more likely to occur during middle age.

Tension headaches are one of the most common types of headaches. They can be triggered by things such as stress, depression, hunger, and muscle strain. Tension headaches may come on suddenly or slowly. Symptoms of tension headaches include constant pain or pressure on both sides of your head, and aching pain at your temples or the back of your head and neck.

This is different from migraine headaches, which usually cause throbbing pain and start on one side of your head. Pain from a tension headache is usually not severe and does not get in the way of your work or social life. But for some people, the pain is very bad or lasts a long time, and the headaches tend to come back, especially when you are under stress.

Changing weather stimulates headaches

Experts believe that people who get frequent headaches have a greater sensitivity to changes in the environment. They also have a lower threshold to the pain response, which may be an inherited sensitivity.

In a recent survey by the National Headache Foundation, three out of every four respondents said that weather triggered their headache pain. Specific weather triggers include changes in humidity and temperature, storms, and extremely dry or dusty conditions.

Many of these conditions cause or contribute to sinus headaches, as well as migraines.  Typical sinus headache symptoms include pain and pressure around the sinuses in the forehead, especially behind and between the eyes, and above the nose. These areas may be tender to the touch.

However, if headache pain is your only symptom, you probably don’t have a sinus headache. A sinus headache is usually accompanied by nasal stuffiness or discharge, cough and sore throat, and fatigue. Sinus conditions can be treated through pain medications, and by prescription and over-the-counter antihistamines and decongestants.

Migraines — the mother of all headaches

Most people with migraines have common migraines. This type of migraine causes a throbbing pain on one side of the head. The pain is moderate to severe and gets worse with normal physical activity. You also may have nausea and vomiting and may feel worse around light and sound. The headache lasts four to 72 hours if it is not treated.

Some people with classic migraines get an aura up to 30 minutes before they have a migraine. Symptoms of the aura include seeing wavy lines, flashing lights, or objects that look distorted. Other symptoms include tingling or a “pins-and-needles” feeling. Also, many women have migraines around their menstrual cycle. These occur a few days before, during, or right after their period. The symptoms are the same as those of common or classic migraines.

A variety of foods and beverages can trigger migraines. These include foods that are aged, such as cheeses, meats and wines. Also, processed foods often contain a variety of food additives such as nitrates and nitrites which dilate blood vessels. Additionally, while consumption of alcohol actually increases blood flow to your brain, the metabolic process for breaking down alcohol releases chemicals which contribute to headaches.

Solutions for dealing with a severe headache

Anyone suffering from regular or chronic headaches should see their physician. There are a variety of prescription medications available that can be taken at the first signs of onset, limiting duration and intensity. There also are steps you can take to help deal more effectively with headaches, or to prevent them from escalating. These include:

  • Seek a calm environment. At the first sign of a migraine or pressure headache, retreat from your usual activities, if possible.
  • Turn off the lights. Migraines often increase sensitivity to light and sound. Relax in a dark, quiet room. Sleep if you can.
  • Try temperature therapy. Apply hot or cold compresses to your head or neck. Ice packs have a numbing effect, which may dull the sensation of pain. Hot packs and heating pads can relax tense muscles; warm showers or baths may have a similar effect.
  • Use proper medications. Many medications contain elements that actually can make your headache worse. There are a variety of medicines that are effective for treating pain and headache symptoms, but always talk with your physician or pharmacist before self-medicating.
  • Massage painful areas. Apply gentle pressure to your scalp or temples. Alleviate muscle tension with a shoulder or neck massage.
  • Drink a caffeinated beverage. In small amounts, caffeine can relieve migraine pain in the early stages or enhance the pain-reducing effects of acetaminophen (such as Tylenol) and aspirin. Be careful, however. Drinking too much caffeine too often can lead to withdrawal headaches later on.
  • Unwind at the end of the day. Listen to soothing music, soak in a warm bath or read a favorite book. But watch what you eat and drink before bedtime. Intense exercise, heavy meals, caffeine, nicotine and alcohol can interfere with sleep.
  • Sleep well. Migraines and pressure headaches may keep you from falling asleep or wake you up at night. Likewise, many headaches are often triggered by a poor night’s sleep. Try to wake up and go to bed at the same time every day, and if you nap, take short naps (under 30 minutes) that won’t interfere with nighttime sleep.
  • Exercise regularly. During physical activity, your body releases certain chemicals that block pain signals to your brain. These chemicals also help alleviate anxiety and depression, which can make migraines worse. If your doctor agrees, choose any exercise you enjoy. Walking, swimming and cycling are often good choices. But it’s important to start slowly. Exercising too vigorously can trigger migraines.

Finally, doctors recommend keeping a headache diary, which may help you determine what triggers your headaches. Note when the pain or symptoms start, what you were doing at the time, how long they last and what, if anything, provides relief. Eventually you may be able to prevent migraines or other headaches by changing patterns in your daily life.

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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!

Stop blowing smoke — tobacco kills, in every form

For all we’ve heard, read or been told by experts, physicians and concerned friends or family, 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. More than half of these smokers have attempted to quit for at least one day in the past year. There also are approximately 13.2 million cigar smokers in the U.S., and 2.2 million who smoke tobacco in pipes.

But cigarettes, pipes and cigars are only one third of this axis of unhealthy evil — when you add smokeless tobacco products and now, e-cigarettes, the numbers increase dramatically, as do the personal and national healthcare costs.

November is Lung Cancer Awareness Month, but rather than focus on lung cancer specifically, let’s take a look at the role tobacco products play in destroying your health, and in contributing directly to lung cancer, other cancers and respiratory illnesses. Consider these facts:

  • Tobacco contributes to 5 million deaths worldwide every year. For centuries, cigarettes have remained basically the same:  Tobacco rolled in paper. What makes them so deadly are the estimated 4,000 chemicals they give off when lit. Some of those chemicals, like arsenic, formaldehyde and lead can cause cancer and a long list of other deadly diseases.
  • Chewing tobacco comes as long strands of loose leaves, plugs, or twists of tobacco. Pieces, commonly called plugs, wads, or chew, are chewed or placed between the cheek and gum or teeth. The nicotine in the piece of chewing tobacco is absorbed through the mouth tissues. The user spits out the brown saliva that has soaked through the tobacco.
  • An e-cigarette is a battery-powered tube about the size and shape of a cigarette. A heating device warms a liquid inside the cartridge, creating a vapor you breathe in. Puffing on an e-cigarette is called “vaping” instead of “smoking.” E-cigarettes also make chemicals, but in much smaller numbers and amounts than tobacco cigarettes.

The devil is in the details: Smokeless tobacco

Smokeless tobacco products are glorified through their use by many professional athletes, especially baseball players. In addition to the chewing tobacco mentioned above, snuff — which is finely ground tobacco packaged in cans or pouches — also is popular.

Moist snuff is used by placing a pinchdiplipper, or quid between the lower lip or cheek and gum. The nicotine in the snuff is absorbed through the tissues of the mouth. Moist snuff is also available in small, teabag-like pouches or sachets that can be placed between the cheek and gum. These are designed to be both “smoke-free” and “spit-free” and are marketed as a discreet way to use tobacco. Dry snuff is sold in a powdered form and is used by sniffing or inhaling the powder up the nose.

Data collected in 2012 showed that about 3.5 percent of people aged 12 and older in the United States used smokeless tobacco — that’s about 9 million people. Use of smokeless tobacco was higher in younger age groups, with more than 5.5 percent of people aged 18 to 25 saying they were current users. About 1 million people age 12 and older started using smokeless tobacco in the year before the survey. About 46 percent of the new users were younger than 18 when they first used it.

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

What you should know about e-cigarettes

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

The nicotine inside the cartridges is addictive. When you stop using it, you can get withdrawal symptoms including feeling irritable, depressed, restless and anxious. It can be dangerous for people with heart problems. It may also harm your arteries over time and contribute to respiratory ailments, heart disease and cancers.

So far, evidence suggests that e-cigarettes may be safer than regular cigarettes. The biggest danger from tobacco is the smoke, and e-cigarettes don’t burn. Tests show the levels of dangerous chemicals they give off are a fraction of what you’d get from a real cigarette. But what’s in them can vary, and while they may appear to be safer, research now being conducted requires years’ of statistical information to identify actual side effects… and by then, the damage will have occurred in regular users.

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.

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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!

Excuse me while I snooze

We’ve just changed the clocks. The days are getting darker earlier, and they’re busier than ever with school, autumn sports, and activities going at full blast. With the return to earlier mornings and a fuller schedule, chances are you and your family members are on the go constantly and you’re tired. When we’re behind in our sleep, it affects how we perform, behave, get along with others, and our overall health. And with the holidays right around the corner, the pace is going to quicken even more. So it’s important to think about how much sleep we’re getting now and how best to ensure good sleep hygiene practices.

Sleeping well is as critical to our overall health and productivity as diet and exercise, and is important for everyone, from childhood through adulthood. A good sleep hygiene routine promotes healthy sleep and daytime alertness, and can prevent the development of sleep problems and certain disorders.

What is good sleep hygiene?

Sleep disturbances and daytime sleepiness are the most telling signs of poor sleep hygiene. The most important sleep hygiene measure is to maintain a regular sleep and waking pattern seven days a week. It is also important to spend an appropriate amount of time in bed, not too little, or too much. This varies by individual; for example, if someone has a problem with daytime sleepiness, they should spend a minimum of eight hours in bed. If they have difficulty sleeping at night, they should limit themselves to seven hours in bed in order to keep the sleep pattern consolidated. Age and other issues also affect how much you should be sleeping.

Good sleep hygiene practices include a variety of elements you can influence. Here are 10 common hints for improving restfulness:

  • Avoid napping during the day; it can disturb the normal pattern of sleep and wakefulness.
  • Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime. While alcohol is known to speed the onset of sleep, it disrupts sleep in the second half of your cycle as the body begins to metabolize the alcohol.
  • Exercise can promote good sleep. Vigorous exercise should be practiced in the morning or late afternoon. A relaxing exercise, like yoga, can be done before bed to help initiate a restful night’s sleep.
  • Food can be disruptive right before sleep; stay away from large meals close to bedtime. Also dietary changes can cause sleep problems — for example, it’s not a good time to snack on spicy or greasy dishes in the evening. And, remember, chocolate contains caffeine, though it has many healthy properties, as well.
  • Ensure adequate exposure to natural light. This is particularly important for older people who may not venture outside as frequently as children and adults. Light exposure helps maintain a healthy sleep-wake cycle.
  • Establish a regular, relaxing bedtime routine. Try to avoid emotionally upsetting conversations, activities and TV shows before trying to go to sleep. Don’t dwell on, or bring your problems to bed.
  • Associate your bed with sleep. It’s not a good idea to use your bed to watch TV, listen to the radio, for playtime or for work.
  • Make sure that your sleep environment is pleasant and relaxing. The bed should be comfortable, and your room should not be too hot or cold, or too bright.
  • The kids and dog have their own beds…they should use them!
  • Be careful about sleep aids — they can be habit-forming, interfere with the restful (REM) sleep your body needs to rejuvenate itself, and can interact poorly with other medications.

What you should know about Melatonin

Melatonin’s main job in the body is to regulate night and day cycles or sleep-wake cycles. Darkness causes the body to produce more Melatonin, which signals the body to prepare for sleep. Light decreases Melatonin production and signals the body to prepare for being awake. Some people who have trouble sleeping have low levels of Melatonin. It is thought that adding Melatonin from supplements might help them sleep.

Melatonin is likely safe for most adults when taken by mouth short-term or applied to the skin. But like any medicine or supplement, you should check with your physician before taking it. Melatonin can cause some side effects including headache, short-term feelings of depression, daytime sleepiness, dizziness, stomach cramps and irritability.

If you’re pregnant or breastfeeding, don’t use Melatonin. It also might interfere with ovulation, making it more difficult to become pregnant. Melatonin should not be used in most children — because of its effects on other hormones, it may interfere with development during adolescence. Additionally, Melatonin can raise blood pressure in people who are taking certain medications to control blood pressure. Melatonin also might increase blood sugar in people with diabetes, and can make symptoms of depression worse.

While found naturally in the body, Melatonin used as medicine is usually made synthetically in a laboratory. It is most commonly available in pill form, but also available in forms that can be placed in the cheek or under the tongue. This allows the Melatonin to be absorbed directly into the body.

People use Melatonin to adjust the body’s internal clock. It is used for jet lag, for adjusting sleep-wake cycles in people whose daily work schedule changes (shift-workers), and for helping blind people establish a day and night cycle. It is also used for the inability to fall asleep (insomnia); delayed sleep phase syndrome (DSPS); insomnia associated with attention deficit-hyperactivity disorder (ADHD); insomnia due to certain high-blood pressure medications called beta-blockers; and sleep problems in children with developmental disorders including autism, cerebral palsy, and intellectual disabilities. It is also used as a sleep aid after discontinuing the use of benzodiazepine drugs and to reduce the side effects of stopping smoking.

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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!

October is time to bone up on your bones!

Sure, it’s almost Halloween, and bones are everywhere…hanging from doorways, draped in trees, and propped in gardens. But October is also Bone and Joint Health Awareness Month, so unwrap a chocolate bar and pay attention to this important information — you’ll appreciate it as your own bones get older!

It’s important to take steps now so that your bones will be healthy and strong throughout your lifetime. If you’re still young or a parent, note that it’s especially critical in the childhood and teen years to avoid osteoporosis and other bone problems later in life. Osteoporosis is a condition in which bones become softer and fragile, making them fracture or break much easier.

Your body continually removes and replaces small amounts of calcium from your bones. If your body removes more calcium than it replaces, your bones will become weaker and have a greater chance of breaking. By getting lots of calcium when you’re young, you can make sure your body doesn’t have to take too much from your bones.

Calcium is a mineral that is necessary for life. In addition to building bones and keeping them healthy, calcium helps our blood clot, nerves send messages and muscles contract. About 99 percent of the calcium in our bodies is in our bones and teeth. Each day, we lose calcium through our skin, nails, hair, sweat, urine and feces. But our bodies cannot produce new calcium — that ability ends around age 18. You can only maintain what is already stored to help your bones stay healthy.

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

  • The calcium in milk and dairy products is easy for the body to absorb and in a form that gives the body easy access to the calcium
  • Milk has added vitamin D, which is important for helping your body better absorb calcium
  • In addition to calcium, milk and dairy products provide other essential nutrients that are important for optimal bone health and development.

Other good sources of calcium include dark green, leafy vegetables such as spinach, broccoli and bok choy. There also are foods with calcium added, such as calcium-fortified tofu, orange juice, soy beverages, and breakfast cereals or breads. Adults or youth who can’t process lactose also can take calcium supplements but you should check with your physician to ensure compatibility with other medicines or conditions.

There are a variety of calcium supplements available over the counter and by prescription. The amount of calcium you need from a supplement depends on the amount of calcium you get from food. If you get enough calcium from the foods you eat, then you don’t need to take a supplement. In fact, there is no added benefit to taking more calcium than you need in supplements and doing so may even have some risks.  

When choosing the best supplement to meet your needs, keep the following in mind:

  • Choose brand-name supplements with proven reliability. Look for labels that state “purified” or have the USP (United States Pharmacopeia) symbol. The “USP Verified Mark” on the supplement label means that the USP has tested and found the calcium supplement to meet certain standards for purity and quality.
  • Read the product label carefully to determine the amount of elemental calcium, which is the actual amount of calcium in the supplement, as well as how many doses or pills to take. When reading the label, pay close attention to the “amount per serving” and “serving size.”
  • Calcium is absorbed best when taken in amounts of 500-600 mg or less. This is the case when you eat calcium-rich foods or take supplements. Try to get your calcium-rich foods and/or supplements in smaller amounts throughout the day, preferably with a meal. While it’s not recommended, taking your calcium all at once is better than not taking it at all.
  • Take most calcium supplements with food. Eating food produces stomach acid that helps your body absorb most calcium supplements. The one exception to the rule is calcium citrate, which can absorb well when taken with or without food.

Exercise also builds strong bones

Even if you’re older, there are a variety of steps you can take to ensure healthier bones and joints. Bones are living tissue. Weight-bearing physical activity causes new bone tissue to form, which makes bones stronger. When muscles push and tug against bones during physical activity, bones and muscles become stronger.

There are two types of exercises that are important for building and maintaining bone density:  Weight-bearing and muscle-strengthening exercises. Weight-bearing exercises include activities that make you move against gravity while staying upright. These can be high-impact or low-impact. High-impact weight-bearing exercises help build bones and keep them strong. If you have broken a bone due to osteoporosis or are at risk of breaking a bone, you may need to avoid high-impact exercises. If you’re not sure, you should check with your healthcare provider.

Examples of high-impact weight-bearing exercises include dancing, aerobics, hiking, jogging or running, jumping rope, stair climbing and racquet sports such as tennis. Low-impact weight-bearing exercises can also help keep bones strong and are a safe alternative if you cannot do high-impact exercises. Examples of low-impact weight-bearing exercises include using elliptical training machines, doing low-impact aerobics, using stair-step machines, and fast walking on a treadmill or outside.

Muscle-strengthening exercises include activities where you move your body, a weight or some other resistance against gravity. They are also known as resistance exercises and include:

  • Lifting weights
  • Using elastic exercise bands
  • Using weight machines
  • Lifting your own body weight
  • Functional movements, such as standing and rising up on your toes.

Yoga and Pilates can also improve strength, balance and flexibility. However, certain positions may not be safe for people with osteoporosis or those at increased risk of broken bones. For example, exercises that have you bend forward may increase the chance of breaking a bone in the spine. A physical therapist or your physician should be able to help you learn which exercises are safe and appropriate for you.

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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!

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!

Wash your hands of flu, colds, and viruses

For all our technology, medical advances and sophisticated health resources, it often seems we’re no closer to taming the common cold, eliminating flu and infections, or reducing many common and costly chronic diseases and illnesses. In part, that’s the insidious nature of human health and the ability of diseases to transform and elude researcher’s best efforts. But often, it’s also the result of misinformation, and our unwillingness — purposely or through lack of accurate direction or failed compliance — to help ourselves through knowledge and prevention.

As the annual flu season descends, we need to protect ourselves. Flu vaccine is plentiful and often effective against specific strains of influenza, but many people still choose to not get themselves or their children vaccinated. That’s a personal decision, but it can mean that you or your kids spread illness and disease to others, including the most vulnerable — the sick, elderly and babies.

Amid heightened global concerns over Ebola, which has now reached American shores, another far more common virus has been making the rounds. This flu-like strain, called Enterovirus (EV) D68, is now afflicting people across the country, and is particularly dangerous to infants, seniors, or anyone with respiratory illnesses, asthma, or chronic, obstructive pulmonary disease (COPD). Strains of the Enterovirus (there are more than 100) are not new — they’ve been formally catalogued since the early 1960s — but this year’s outbreak has been more virulent than in recent years.

Most common in the summer and early fall, mild symptoms may include fever, runny nose, sneezing, cough and body and muscle aches. Sound familiar? Unfortunately, it presents like the common cold and many other viruses. Severe symptoms may include wheezing and difficulty breathing. Since Enterovirus causes respiratory illness, the virus can be found in an infected person’s respiratory secretions, such as saliva, nasal mucus, or sputum. EV-D68 spreads from person to person when an infected person coughs, sneezes, or contaminates common surfaces or objects through touch.

There is no specific treatment for people with respiratory illness caused by EV-D68, nor a vaccine to prevent it. For mild respiratory illness, you can help relieve symptoms by taking over-the-counter medications for pain and fever (aspirin should not be given to children). Some people with severe respiratory illness may need to be hospitalized — if symptoms worsen, you should see your physician.

We can help protect ourselves from Enterovirus, the flu, other viruses and colds by following these simple steps:

  • The easiest, safest, cheapest and most effective way to prevent the spread of disease or to limit infection is to wash your hands often. That includes when you come home from anywhere, before you eat in a dining hall or restaurant, after you use a restroom, visit the supermarket, ride a bus or train, or touch an ATM. And when it isn’t easy to wash your hands, use a hand sanitizer. Also, don’t share toothbrushes, razors or other personal grooming products, and avoid sharing food, drinks or eating off of one another’s plates.
  • Avoid touching eyes, nose and mouth with unwashed hands
  • Disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick
  • Sneeze into tissues or your arm, not your hands and not into the air — airborne pathogens spread highly contagious viral or bacterial infections
  • Get a flu shot! Flu vaccines are very safe and can’t infect you with the flu. Injected flu vaccines only contain dead virus, and a dead virus can’t infect you. There is one type of live virus flu vaccine, the nasal vaccine, FluMist. But in this case, the virus is specially engineered to remove the parts of the virus that make people sick. The standard flu vaccine can be dangerous if you’re allergic to eggs, so you should always talk with your doctor before taking the vaccine.
  • Stay home when you’re sick; incubation time — or the days it takes for germs to turn into something truly nasty in your system — allow you to spread those germs to many other people before you even realize you’re infectious.

Additionally, remember that antibiotics won’t help you fight the flu or a cold, which are not caused by bacteria, but by a virus. Taking antibiotics unnecessarily weakens your body’s ability to fight bacterial illnesses, since many bacteria become resistant to antibiotics due to overuse and bad prescribing practices.

However, there are instances of flu complications that involve bacterial infection. The flu virus can weaken your body and allow bacterial invaders to infect you. Secondary bacterial infections due to the flu include bronchitis, ear infections, sinusitis, and most often, pneumonia. The flu doesn’t peak until February or March, and it hits all across the country, so if you haven’t had your flu shot there’s still plenty of time to protect yourself and your family.

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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!

Don’t Let Your Teeth Mouth Off!

Understanding and practicing the tenets of good oral health should be an important part of our general personal wellness strategy. We should eat well, exercise regularly, protect ourselves from the sun’s damaging ultraviolet rays, sleep soundly, comply with medical direction and focus daily on maintaining a healthy mouth!

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

There are threats to oral health across the lifespan. Nearly one-third of all adults in the United States have untreated tooth decay. One in seven adults aged 35 to 44 years has gum disease; this increases to one in every four adults aged 65 years and older. Oral cancers are most common in older adults, particularly those over 55 years who smoke and are heavy drinkers.

Plaque is a sticky, colorless film of bacteria that constantly builds up, thickens and hardens on the teeth. If it is not removed by daily brushing and flossing, this plaque can harden into tartar and may contribute to infections in the gums. Left untreated, gum disease can lead to the loss of teeth and an increased risk of more serious illnesses.

The bacteria in plaque can travel from the mouth to the lungs, causing infection or aggravating existing lung conditions. It creates risks for heart patients, too, as it can travel through the bloodstream and get lodged in narrow arteries, contributing to heart attacks. There also is a link between diabetes and gum disease. People with diabetes are more susceptible to gum disease and it can put them at greater risk of diabetic complications.

With proper care, your teeth and gums can remain healthy throughout your life. There are four basic steps to caring for teeth and gums:

  • Brushing
  • Flossing
  • Eating right
  • Visiting the dentist

Brush teeth and gums at least twice a day. If you can, brush 30 minutes to one hour after every meal. Brushing removes plaque. When bacteria in plaque come into contact with food, they produce acids. These acids lead to cavities.

Flossing our teeth is a critical part of good oral hygiene. Often overlooked, it should be practiced adjunct to brushing daily. While brushing is critical, flossing does about 40 percent of the work required to remove plaque from the hard-to-reach spaces between our teeth.

Most floss is made of either nylon or Teflon, and both are equally effective. People with larger spaces between their teeth or with gum recession (loss of gum tissue, which exposes the roots of the teeth) tend to get better results with a flat, wide dental tape. If teeth are close together, try thin floss that bills itself as “shred resistant.”

Bridges and braces require more effort to get underneath the restorations or wires and between the teeth. Use a floss threader, which looks like a plastic sewing needle. Or look for a product called Super Floss that has one stiff end to fish the floss through the teeth, followed by a spongy segment and regular floss for cleaning.

The third step to good oral health is proper nutrition. Food high in processed sugars and fats are not good for body or your teeth – they contribute to weight gain, diabetes, heart disease, hypertension and even certain types of cancers. A well-rounded, vitamin-rich, balanced diet high in fiber and filled with vegetables, fruits and plenty of water will help you maintain a healthy mouth, as well as a healthier body.

Finally, make sure and visit a dentist regularly for preventative screenings, and to check for cavities, infections or other abnormalities. As we age, the prevention or removal of plaque becomes more important for heart health, and regular checkups and diagnostic images can tell your dentist what’s going on “behind the scenes” in our mouths. Don’t wait for something to hurt before you go to the dentist – remember, the rest of your body is counting on your mouth!

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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!

Navigating complementary and alternative health options

When it comes to our complicated medical and health worlds, there are many questions to ask and a confusing morass of information and suggestions. Even the terms are confusing, such as complementary, alternative and integrative medicine. While these terms are often used to mean the array of healthcare approaches with a history of use or origins outside of mainstream medicine, they are actually hard to define and may mean different things to different people.

Many Americans — nearly 40 percent — use healthcare approaches developed outside of mainstream Western, or conventional, medicine for specific conditions or overall well-being. When describing health approaches with non-mainstream-roots, people often use the words “alternative” and “complementary” interchangeably, but the two terms refer to different concepts.

“Complementary” generally refers to using a non-mainstream approach together with conventional medicine. “Alternative” refers to using a non-mainstream approach in place of conventional medicine. True alternative medicine is not common. Most people use non-mainstream approaches along with conventional treatments. And the boundaries between complementary and conventional medicine overlap and change with time. For example, guided imagery and massage, both once considered complementary or alternative, are used regularly in some hospitals to help with pain management and stress reduction.

The array of non-mainstream healthcare approaches may also be considered part of integrative medicine or integrative healthcare. For example, cancer treatment centers with integrative healthcare programs may offer services such as acupuncture and meditation to help manage symptoms and side effects for patients who are receiving conventional cancer treatments such as chemotherapy.

There are various definitions for “integrative healthcare,” but many individuals, healthcare providers, and healthcare systems are integrating various practices with origins outside of mainstream medicine into treatment and health promotion. Still, the scientific evidence on some of these practices is limited, and a lack of reliable data makes it difficult for people to make informed decisions about using integrative health care.

“Natural” products, and mind and body options

This group includes a variety of products, such as herbs (also known as botanicals), vitamins and minerals, and probiotics. They are widely marketed, readily available to consumers, and often sold as dietary supplements.

Interest in and use of natural products has grown considerably in the past few decades. The most commonly used natural product among adults is fish oil/omega 3s (reported in surveys by 37.4 percent of all adults who said they used natural products). Popular products for children include Echinacea and fish oil/omega 3s.

Some of these products have been studied in large, placebo-controlled trials, many of which have failed to show anticipated effects. Research on others to determine whether they are effective and safe is ongoing. While there are indications that some may be helpful, more needs to be learned about the effects of these products in the human body and about their safety and potential interactions with medicines and with other natural products.

Mind and body practices include a large and diverse group of procedures or techniques administered or taught by a trained practitioner or teacher. For example:

  • Acupuncture is a technique in which practitioners stimulate specific points on the body — most often by inserting thin needles through the skin.
  • Massage therapy includes many different techniques in which practitioners manually manipulate the soft tissues of the body.
  • Most meditation techniques, such as mindfulness meditation or transcendental meditation, involve ways in which a person learns to focus attention.
  • Movement therapies include a broad range of Eastern and Western movement-based approaches; examples include Feldenkrais method, Alexander technique, Pilates, Rolfing Structural Integration, and Trager psychophysical integration.
  • Relaxation techniques, such as breathing exercisesguided imagery, and progressive muscle relaxation, are designed to produce the body’s natural relaxation response.
  • Spinal manipulation is practiced by healthcare professionals such as chiropractors, osteopathic physicians, naturopathic physicians, physical therapists, and some medical doctors. Practitioners perform spinal manipulation by using their hands or a device to apply a controlled force to a joint of the spine. The amount of force applied depends on the form of manipulation used.
  • Tai chi and qi gong are practices from traditional Chinese medicine that combine specific movements or postures, coordinated breathing, and mental focus.
  • The various styles of yoga used for health purposes typically combine physical postures or movement, breathing techniques, and meditation.

There’s an abundance of information on all-things-healthy to explore, digest, practice, or disregard. If you take the time to explore carefully, keep an open mind, and talk with professionals, friends and associates, you can start to hone in on healthcare practices that are appropriate and safe.

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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!

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!

Mirror mirror on the wall, who’s the sneeziest of them all?

Sneezy, Sleepy, and Grumpy may have been three of the seven dwarves of Disney fame, but Itchy, Runny, and Miserable could be their springtime cousins. The flowering trees in New England are a colorful and welcome break from the bleak winter landscape. However breathtaking, though, they can take our breath away… literally. For all its beauty, this is a difficult time of year for millions of Americans, and the severity of allergy season can vary according to where you live, the weather, indoor contaminants and many other elements.

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

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

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

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

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

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

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

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

For allergy information from NIH’s National Institute of Allergy and Infectious Diseases, visit www.niaid.nih.gov/publications/allergies.htm. For prevention strategies from NIH’s National Institute of Environmental Health Sciences, visit www.niehs.nih.gov/airborne/prevent/intro.html.

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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!